Date of Award

Fall 12-2018

Degree Name

Doctor of Public Health (DrPH)

Advisor(s)

Joya Chandra, PhD

Second Advisor

Shreela Sharma, PhD

Third Advisor

Vanessa Schick, PhD

Abstract

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body camera unit (eButton) during the cooking session. Ingredient amounts were be observed and recorded during the video sessions and final prepared foods analyzed for micronutrient and macronutrient quantities. Resulting videos were coded for healthy cooking behaviors using the Healthy Cooking Score (HCS) coding system, based on a conceptual framework previously developed by the authors. Families were assigned HCS based on the video analysis. Parents filled out a healthy cooking behavior questionnaire constructed from the conceptual framework. Height and weight was assessed from children and general family demographics and parenting practices collected from parents. Observed and self-reported healthy cooking behaviors were shown to be significantly different, with nine HCS items responsible for the majority of discrepancy between self report and observed cooking behaviors. The eButton images were examined and compared to audio/video observations of the cooking sessions. The eButton closely approximated the audio/video observations, but failed to collect usable images in 5 out of 40 cases. CCS cooking habits were compared to non CCS families and showed similar cooking habits. Qualitative analysis of the CCS family cooking videos revealed four major meal planning values in the sample including health, budget, effort and preferences. Several of these values were impacted by the cancer experience. Taken together, this study provides preliminary data for the assessment and development of healthy cooking programming in CCS and the general population

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