Comparing family health before and after a family-focused nutrition program during the pandemic

Abstract Background The COVID-19 pandemic has affected child health behaviors (e.g., diet and exercise), leading to worse physical health. Studies demonstrate the importance of good family health in improved child health outcomes. This secondary cohort analysis tested the hypothesis that family health, parent and child nutrition, and food insecurity would improve from baseline to 12-week follow-up after participation in a novel home-based family nutrition program. Methods Diverse parent-child dyads participated in a randomized controlled trial where all families received a home-based Teaching Kitchen Outreach (TKO) program (11 weekly healthy, low-cost recipes, cooking videos, and associated groceries delivered), and half were randomly assigned to also receive virtual coaching. The primary outcome was the Family Healthy Lifestyle Subscale (FHLS). Secondary outcomes were parent and child nutrition, and food insecurity. Paired t-tests, Wilcoxon matched-pairs signed-rank tests, and a McNemar’s chi-squared test compared pre-post outcomes, and a multilevel mixed-effects tobit regression model assessed pre-post FHLS, after adjusting for baseline covariates. Results Of 123 enrolled dyads, 114 (93%) had sufficient data for analysis. Participants were 11% Hispanic, 54% Black, and 28% White; 31% completed high school or less; and 30% indicated food insecurity. Cohort mean pre-post FHLS scores significantly increased (25.5 vs. 27.3; p < 0.001), and there were significant improvements in parent nutrition (p < 0.001) and child nutrition (p = 0.02 to < 0.001). After adjusting for baseline covariates, the tobit regression model found statistically significant pre-post FHLS differences (2.3; 95% CI=[1.4, 3.3]; p < 0.001). Conclusions Participants in the novel home-based TKO program reported improved family health over 12 weeks.