Nutrition Education, Hands-on Cooking and Financial Incentives to Change Purchasing Behaviors in a Low Socioeconomic Status Population: A Community-Based Study Protocol

Abstract Objectives Socioeconomically disadvantaged populations are more likely to have both low nutrition literacy and low cooking efficacy. This combination often results in a high consumption of convenience foods that are typically energy-dense, nutrient poor, and promote the development or exacerbation of chronic disease. The objective of this study is to examine the effect of nutrition education, hands-on cooking practices, and financial incentives on grocery purchasing behaviors and diet quality in a low-income community. Methods Forty participants will receive nutrition education and hands-on cooking experiences through a 10-week nutrition education program via Zoom. An instructor will teach participants a nutrition topic and then prepare and cook a related meal with them. Participants will be notified of the recipe prior to class, and required foods will be provided for those participants who are unable to afford them. Participants will also receive discounts on food items labeled as “Live HealthSmart Foods” (LHS) at the Village Market grocery store in the East Lake neighborhood of Birmingham, Alabama. LHS foods include fresh, frozen or canned fruits and vegetables, whole grains, lean proteins, and low-fat or fat-free dairy products. Participants will use a unique pin code to receive the discount and their account will be examined for trends in their shopping behaviors. Main outcomes of interest include proportion of LHS foods purchased, dietary intake measured by a food frequency questionnaire and changes in nutrition literacy and cooking efficacy. Results Study results will indicate 1) if there is a synergistic effect of nutrition education, hands-on cooking practices, and financial incentives on grocery purchasing behaviors and 2) how the intervention influences diet quality. Conclusions Results will also inform our endeavor of expanding the territory of the Live HealthSmart food model in a randomized community-based trial investigating the intervention's potential for translation and implementation in a wider and more diverse community setting. Funding Sources This work was supported by the Live HealthSmart Alabama initiative, the Cooking Well nutrition program, Village Market, Albert Schweitzer Fellowship and the University of Alabama at Birmingham.