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other·nutrition, preventive_medicine, behavioral_medicine, endocrinology, obesity_medicine, culinary_medicine·PMC10181073

Expectations from a Home Cooking Program: Qualitative Analyses of Perceptions from Participants in “Action” and “Contemplation” Stages of Change, before Entering a Bi-Center Randomized Controlled Trial

Nutrients · 8 authors, 9 centres

AI SUMMARY

FIDELITY 100%

POPULATION75 adults (BMI 27.5–35 kg/m², ages 25–70) who are primary food providers consuming fewer than 5 home-cooked lunches/dinners per week, recruited from Boston, MA and Tel Aviv, Israel

INTERVENTIONQualitative analysis of expectations from a home cooking intervention (Culinary Coaching Telemedicine Program) before randomization in a bi-center RCT

COMPARISONParticipants in 'contemplation' stage (URICA < 11, n=59) vs. 'action' stage (URICA > 11, n=16) of change regarding home cooking

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

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TL;DR

This qualitative study analyzed expectations of 75 participants in a home cooking intervention, finding that those in the 'contemplation' stage of change focused on acquiring basic culinary knowledge and self-regulatory skills, while those in the 'action' stage sought to expand existing skills and achieve sustainable change. Both groups shared goals of healthy eating and lifestyle improvement, but differed in their foundational needs and concerns. These findings suggest that tailoring home cooking programs to participants' readiness to change may improve intervention effectiveness and personalization.

Full summary

3,935 CHARS

**Background:** Adherence to a healthy diet reduces risk of non-communicable diseases, yet barriers include cost, time, stress, and lack of cooking skills. Home cooking is emerging as a strategy to improve dietary adherence, but there is no consensus on learning objectives for culinary medicine programs. The transtheoretical model describes stages of change (precontemplation, contemplation, preparation, action, maintenance) that may inform personalized interventions. This study aimed to explore participant goals when enrolling in a home cooking intervention and examine whether those in different stages of change (contemplation vs. action) have different needs and expectations.

**Methods:** This was a bi-center randomized controlled trial (NCT03823469) conducted at Spaulding Rehabilitation Hospital (Boston, MA) and Sheba Medical Center (Tel Aviv, Israel). Inclusion criteria: BMI 27.5–35 kg/m², primary food provider consuming fewer than 5 home-cooked lunches/dinners per week, age 25–70. At baseline, participants completed the validated URICA (University of Rhode Island Change Assessment Scale) to assess stage of change regarding home cooking, and an open-ended questionnaire about goals, expectations, concerns, and challenges. Participants were categorized as contemplation (URICA < 11) or action (URICA > 11). Conventional content analysis was performed manually on each group separately, using triangulation (multiple researchers: AF, RP, MF, MB) to enhance trustworthiness. Demographics were analyzed using t-tests and chi-squared tests.

**Key Results:** All 75 participants completed questionnaires (39 from Sheba, 36 from Spaulding). Sixteen (21%) were in the action stage and 59 (79%) in the contemplation stage. Both groups were similar in gender, age, ethnic background, employment, income, and education. Contemplation stage participants expressed expectations to: (1) acquire culinary knowledge and skills (e.g., 'learn how to cook healthier and more nutritious food'), (2) improve self-regulatory skills (prioritizing, planning, time management), (3) adopt sustainable change, (4) achieve healthy eating and lifestyle goals (weight loss, health improvement), and (5) get guidance and support from experts. Their concerns included pre-existing culinary challenges, insufficient self-regulation abilities, implementation in daily routine (cost, time, lack of family support), and overcoming obstacles for sustainability (fear of failure, past negative experiences). Action stage participants expressed expectations to: (1) expand existing culinary knowledge and techniques (e.g., 'learn how to cook for just 1–2 people'), (2) adopt sustainable change with emphasis on fun and enjoyment, (3) achieve healthy eating and lifestyle goals, and (4) change habits and lifestyle overall. Their main concerns were continuity and sustainability of healthy changes (e.g., 'being consistent', 'not get sabotaged by friends and family').

**Clinical Implications:** Current home cooking education focuses primarily on culinary skills. This study suggests that a patient-centered, personalized approach should consider participants' stage of change. For contemplation-stage participants, interventions should include foundational culinary and self-regulatory skills, guidance, support, and addressing concerns about failure. For action-stage participants, interventions should focus on enhancing existing confidence and skills, honing techniques, and strengthening internal motivations for sustainability. Matching cognitive processes of change (e.g., consciousness-raising for contemplation; stimulus control and contingency management for action) may improve outcomes. Limitations include a small number of action-stage participants (n=16) and lack of social diversity. Further research is needed to determine whether stage-based personalized home cooking interventions yield sustainable improvements in dietary habits.

PICO

PPOPULATION

75 adults (BMI 27.5–35 kg/m², ages 25–70) who are primary food providers consuming fewer than 5 home-cooked lunches/dinners per week, recruited from Boston, MA and Tel Aviv, Israel

IINTERVENTION

Qualitative analysis of expectations from a home cooking intervention (Culinary Coaching Telemedicine Program) before randomization in a bi-center RCT

OOUTCOME

Themes from open-ended questionnaires about goals, expectations, concerns, and challenges related to home cooking

STUDY TYPE

other

SPECIALTY

nutrition

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10181073

Expectations from a Home Cooking Program: Qualitative Analyses of Perceptions from Participants in “Action” and “Contemplation” Stages of Change, before Entering a Bi-Center Randomized Controlled Trial

Nutrients

READ THE FULL PAPER

ABSTRACT

Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person’s genes; yet, behavioral factors, such as participant “readiness” to make a change, may also impact treatment preferences and outcomes. The purpose is to explore the expectations of participants in different stages of change from a home cooking intervention. Participants were recruited to a randomized controlled trial evaluating the impact of a home cooking intervention on weight. Stage of change assessed by a validated University of Rhode Island Change Assessment scale and expectations through an open-ended questionnaire. Sixteen (21%) participants were in the action stage of change, and 59 (79%) were in the contemplation stage. Participants from both groups shared similar expectations to achieve healthy eating and lifestyle goals and to adopt sustainable change. However, action group expectations also included expanding existing culinary knowledge and change of habits; the contemplation group expectations also included acquiring culinary knowledge, improving self-regulatory skills, and obtaining guidance and support. While action group participants were looking to expand existing knowledge and techniques, contemplation group participants were focusing on acquiring culinary knowledge and skills. This can potentially contribute to developing effective, personalized nutrition interventions.

CITATION EXPORT

Rani Polak, Adi Finkelstein, Maggi A. Budd et al.. Expectations from a Home Cooking Program: Qualitative Analyses of Perceptions from Participants in “Action” and “Contemplation” Stages of Change, before Entering a Bi-Center Randomized Controlled Trial. Nutrients. (2023). https://doi.org/10.3390/nu15092082

AUTHORS

8 · 9 CENTRES

Rani Polak, Adi Finkelstein, Maggi A. Budd, Brianna E. Gray, Hanni Robinson, Julie K. Silver, Mark D. Faries, Amir Tirosh

1Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02129, USA
2Center of Lifestyle Medicine, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer 52621, Israel
3Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem 95483, Israel; [email protected]
4Department of Spinal Cord Medicine, VA Boston Healthcare System, Department of Psychiatry, Harvard Medical School, Boston, MA 02130, USA; [email protected]
5Translational and Clinical Research Centers, Massachusetts General Hospital, Boston, MA 02114, USA; [email protected]
6Medical School, University of Nicosia, Nicosia 2408, Cyprus; [email protected]
7Massachusetts General Hospital, Brigham & Weman’s Hospital, Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02129, USA; [email protected]
8Texas A&M School of Public Health and College of Medicine, Bryan, TX 77807, USA; [email protected]
9Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer 5262161, Israel; [email protected]

EDITOR / REVIEWER

Amanda N. Szabo-Reed