Improving Cooking and Food Preparation Skills: A Profile of Promising Practices in Canada and Abroad

Health Canada
2010
Cat. No.: H164-123/2-2010E-PDF
ISBN: 978-1-100-16500-4

Acknowledgements

Improving Cooking and Food Preparation Skills: A Profile of Promising Practices in Canada and Abroad was prepared by Cathy Chenhall, M.H.Sc., P.Dt. for the Healthy Living Issue Group (HLIG) of the Pan-Canadian Public Health Network in collaboration with the Federal/Provincial/Territorial Group on Nutrition.

Strategic Collaboration Working Group

The Strategic Collaboration Working Group (SCWG) of the HLIG helped to create the broad vision of the report and provided input and feedback throughout the project. The SCWG acknowledges Anne Adair, Nutrition Advisor with the Office of Nutrition Policy and Promotion, Health Canada, for preparation of the international case studies.

The membership of the SCWG includes:

Glendora Boland
Provincial Nutrition Consultant, Department of Health and Community Services, Government of Newfoundland and Labrador

Kathy Cassels
Executive Director, The Directorate of Agencies for School Health BC (DASH BC)

Meghan Day
Manager, Healthy Eating and Food Security, Population and Public Health
British Columbia Ministry of Health Services

Elsie DeRoose
Territorial Nutritionist, Department of Health and Social Services, Northwest Territories

Caroline Dubeau
National Nutrition Month Manager, Dietitians of Canada

Ann Ellis
Nutrition Advisor, Office of Nutrition Policy and Promotion, Health Canada

Saskia Jarvis
Policy Analyst, Healthy Communities Division, Public Health Agency of Canada

Holly Kerr
Consultant / Public Health Nutritionist, Ontario Ministry of Health Promotion

Sarah Lambert
School Health Coordinator, Joint Consortium for School Health

Craig Larsen
Executive Director, Chronic Disease Prevention Alliance of Canada (CDPAC)

Amanda MacNaughton
Advisor, Scientific and Regulatory Affairs, Food and Nutrition Policy, Food & Consumer Products of Canada

Patricia Martz
Project Manager, Alberta Health and Wellness

Lisa Mawani
Policy Analyst, Healthy Communities Division, Public Health Agency of Canada

Shannon Olson
Nutritionist, Office of Nutrition Policy and Promotion, Health Canada

Victoria Smith
Acting Senior Nutritionist, First Nations and Inuit Health Branch, Health Canada

Sharon Zeiler
Chair of the SCWG
Senior Manager, Diabetes Education and Nutrition, Canadian Diabetes Association

Key Informants

The author wishes to thank the following key informants who generously shared insights during telephone interviews and reviewed earlier versions of the case studies:

Connie Abram, Mary Clifford and Susan Ross
Canadian Diabetes Association, Pacific Region
British Columbia: Food Skills for Families

Suzanne Galesloot
Alberta Health Services: Calgary Zone
Alberta: Collective Kitchens Coordinator Training

Tony Bairos
Bishop Klein School

Robin Hartl
CHEP Good Food Inc.
Saskatchewan: Kids Kitchen

Pat Burgera Krawchuk
Dairy Farmers of Ontario
Manitoba: Kids in the Kitchen

Elizabeth Smith
Nutrition Resource Centre, Ontario Public Health Association
Ontario: Community Food Advisor Program

Lucie Leduc
Les ateliers cinq epices
Quebec: Petits cuistots/Parents en réseaux

Cheryl Parrish
Mapleton Teaching Kitchen Inc.
New Brunswick: Healthy Cooking, Healthy Kids

Caroline Whitby
Annapolis Valley Health Promoting Schools Program
Nova Scotia: Strive for Five at School!

Barb Lundrigan
East Kings Community Coalition/Main Street Family Centre
Prince Edward Island: What's for Dinner?

Jill Wheaton
Central Health - Health Promotion and Wellness
Newfoundland and Labrador: Food and Fun Camp Program

Gisela Larkin
Tantalus School
Yukon: Tantalus School Food Program

Heather MacKenzie
Food First Foundation
Northwest Territories: Kids in the Kitchen

Renata Rosol, Jennifer Wakegijig, Mary Ugyuk, Lynn Kanguaq
Nunavut: Healthy Foods North

Kevin Naylor
Food Standards Agency
United Kingdom: What's Cooking?

Ange Barry
Stephanie Alexander Kitchen Garden Foundation
Australia: Stephanie Alexander Kitchen Garden

Executive Summary

Food choices, eating behaviours and resulting nutritional health are influenced by a number of complex and inter-related individual, collective and policy-related determinants.^{Footnote 1} A growing body of research is supporting the relationship between food preparation and cooking skills and food choices of children and adolescents.

This report profiles case studies of 13 Canadian and two international promising or successful programs which aim to improve cooking and food preparation skills among children and/or families. The case studies are a selection of innovative programs that provide pertinent and varied lessons, while sharing a focus on improving cooking and food preparation skills, and, in a number of cases, knowledge about healthy eating among children and families toward improved health outcomes. The case studies profiled in this report include:

British Columbia: Food Skills for Families
Alberta: Collective Kitchens Coordinator Training
Saskatchewan: Kids Kitchen
Manitoba: Kids in the Kitchen
Ontario: Community Food Advisor Program
Québec: Petits cuistots/Parents en réseaux
New Brunswick: Healthy Cooking, Healthy Kids
Nova Scotia: Strive for Five at School!
Prince Edward Island: What's for Dinner?
Newfoundland and Labrador: Food and Fun Camp Program
Yukon: Tantalus School Food Program
Northwest Territories: Kids in the Kitchen
Nunavut: Healthy Foods North
United Kingdom: What's Cooking?
Australia: Stephanie Alexander Kitchen Garden

The key informants interviewed for this report offered helpful information based on their experience developing, implementing and evaluating cooking and food preparation skills programs. The analysis of their insights was grouped under three general headings selected as a result of the relevance of this information to future program and policy development: generating and fostering ongoing buy-in, lessons learned (to date) and advice to other communities. Key insights include:

Generating Buy-In/Fostering Ongoing Commitment

Consult with individuals/representatives from stakeholder groups/populations of interest and potential partners to generate support for programs and their ongoing success;
Ensure and/or develop linkages with existing funding priorities and strategies of government, non-government and community-based organizations; and
Communicate passion for, evidence and value of the program to potential supporters.

Lessons Learned

Ensure supports to minimize participation-related barriers in both program implementation and evaluation;
Facilitate "easy" implementation and evaluation of the program through the development of readily accessible supports/resources and training, as required;
Be aware of and plan for inevitable turn over within volunteer-based program facilitation models, while at the same time, maximizing retention efforts;
Ensure adequate human resource and content-related support for those delivering programs;
Have clear expectations related to program coordination and administration, be organized and prepared to bring on new partners and additional/unanticipated funding;
Explore program adaptations which aim to strengthen community and organizational capacities;
Ensure evaluation plans are included within the overall program implementation model to ensure timely availability of data to support sustainability;
Foster partnerships to maximize program reach to identified populations of interest and ongoing sustainability;
Involve and engage parents to enhance program impacts/outcomes and the potential for long-term behaviour change;
Be open to unanticipated benefits of programs; cooking and food skills programs are great "equalizers" which have been associated with enhanced engagement and the development of positive learning environments (particularly in school settings), as well as the development of strong social support networks among populations of interest in community-based settings; and
Ensure basic, hands-on opportunities for participants to prepare and try new foods using a balance of familiar and new foods and recipes.

Advice to Other Communities

Don't "re-invent the wheel;" promising and successful programs reflect both innovative approaches and those adapted to ensure relevance to specific communities of interest;
"Just do it." Start small and build slowly, while always listening and responding to participants and stakeholders; and
Ensure program implementation is based on adherence to quality standards, while allowing some flexibility in implementation to meet community needs.

This report presents many promising or successful cooking and food preparation skills programs as a foundation for future policy and program efforts in Canada. The case studies reflect the responsiveness of programs and their leading organizations to the realities, assets and needs within the community in which they are based and the population of interest. As evidenced by the case studies, from whatever sector or organizational perspective we approach, the ultimate goal for these cooking and food skill programs is improved nutritional and overall health for Canadians.
A concerted effort to support the evaluation of the short- and long-term impacts of existing programs can only benefit the sustainability of efforts and enhance their success. There is also a need to learn from practice and strengthen the evidence base to inform future program and policy decisions.

Introduction

Food choices, eating behaviours and resulting nutritional health are influenced by a number of complex and inter-related individual, collective and policy-related determinants^{Footnote 1}. A growing body of research is supporting the relationship between food preparation and cooking skills and food choices of children and adolescents.

Several technological, food-system related and broader shifts within the social, economic, physical and cultural environments have been identified as factors influencing the culture of cooking and food preparation within the home or domestic environment, including the following:

increased availability of food commodities (basic/raw and processed);
technology for food storage, preparation and cooking, resulting in changes in the level of knowledge and skill required to cook;
time and financial demands/realities related to labour market participation,
shifting family priorities and values; and
decreased opportunities for cooking and food preparation skill acquisition both within the home and in school^{Footnote 2-Footnote 5}.

Limited quantifiable and generalizable data exists to confirm the state of, and changes to, cooking and food preparation skills within populations, children and families. Information is limited to substantiate a direct relationship between cooking and food preparation skills and health ^{Footnote 2,Footnote 6-Footnote 9}. While the results of interventions may be quite moderate, Wrieden^{Footnote 9} and others^{Footnote 6,Footnote 8} believe that some studies do indicate that food skills interventions may be a useful starting point for initiating dietary change, while recognizing that addressing any one barrier to change (i.e., in isolation of others or a broader context) is unlikely to radically alter established eating behaviours among adults, in particular. Interestingly, both of these information gaps have not limited the growing discourse and concern within public and academic sectors over the past decade.

Research and food purchasing and consumption data, nationally and internationally, confirm that food choice and consumption patterns have transitioned with increased processed, pre-prepared and convenience foods being purchased, 'assembled' and consumed across population subgroups on a daily basis. The results of several research initiatives support the normalization of processed, pre-prepared and convenience foods within the eating patterns of individuals and families, again across population subgroups^{Footnote 9} and others^{Footnote 6-Footnote 8,Footnote 10,Footnote 11}. Related to this normalization is the potential lack of transference of basic, traditional or 'from scratch' cooking and food preparation skills from parents (primarily mothers) to children and adolescents, which has traditionally been the primary mode of learning. Without the opportunity to observe and practice basic or 'from scratch' cooking and food preparation skills within the home environment, many argue that children and adolescents will not be equipped with the necessary skills to make informed choices within an increasingly complex food environment.^{Footnote 2,Footnote 6} In support of this argument, low self-efficacy and self-perceived inadequate cooking and food preparation skills have been identified as barriers to food choice within several recent research initiatives^{Footnote 10-Footnote 12}. This could result in a greater reliance on pre-prepared or convenience foods, reduced variety in food choice and consumption and the atrophy of cooking and food preparation skills^{Footnote 3-Footnote 5}.

This report profiles case studies of 13 Canadian and two international promising or successful programs which aim to improve cooking and food preparation skills among children and/or families. This environmental scan is one of two reports within the project titled, Improving Cooking and Food Preparation Skills: A Synthesis of the Evidence and Lessons Learned to Inform Program and Policy Development. The first report of the project synthesizes the state of knowledge and research gaps related to cooking and food preparation skills among children and families. Criteria used to select the case studies in this report were selected to identify different types of promising or successful programs so that their successes and lessons learned could be shared with other communities. The report profiles one case study from each province and territory to provide a pan-Canadian perspective, as well as two international examples. The case studies reflect the responsiveness of programs and their leading organizations to the realities, assets and needs within the community in which they are based and population of interest. The case studies profiled in this report include:

These case studies provide insight related to the successful development, implementation and sustainability of cooking and food skills programs for children and families such as:

how stakeholders/participants and key community partners have been involved in identifying the need for the program, and its subsequent planning and implementation;
how programs remain responsive to ongoing input from stakeholders/participants;
how buy-in from key decision-makers was fostered and achieved;
how partnerships have been developed and maintained;
how the program has been successful and how success has been determined;
what lessons have been learned and what challenges exist; and
what supports and resources are needed to sustain and/or expand programs.

This pan-Canadian and international snapshot presents promising and successful programs as a foundation for future efforts. These stories capture many similarities and differences, reflecting the diversity of communities and cultures which exist across Canada. The lessons learned and advice provided suggest how these initiatives could be replicated or adapted in other communities.

The report is not intended to be an inventory or an exhaustive sampling of relevant Canadian and international initiatives but rather a selection of innovative programs that provide pertinent and varied lessons. What they share in common is their focus on improving cooking and food preparation skills, and, in a number of cases, knowledge about healthy eating among children and families toward improved health outcomes. The intent of this report and the overall project is to facilitate information sharing and linkages among existing and new programs and to strengthen the "evidence to practice" link to inform existing and future policy and program development.

The first part of this report begins with a discussion of how the case studies were identified and selected by the Strategic Collaboration Working Group, followed by a summary of themes shared across the 15 case studies. Following the presentation of the case studies by jurisdiction, findings/common themes across the case studies are reported. The final section outlines concluding remarks and suggested next steps. In addition, the Appendix includes a brief overview of some additional programs aimed at improving cooking and food preparation skills among children and their families that are not highlighted in the report.

Methodology

This collection of case studies includes promising or successful programs from each of Canada's ten provinces and three territories, as well as Australia and the United Kingdom. Programs were identified through two main mechanisms: first, by request for nominations to the SCWG, the Healthy Living Issue Group and the Population Health Promotion Expert Group of the Public Health Network and the Federal/Provincial/Territorial Group on Nutrition; second, through research and networking by the author.

The following sources of information were used to develop the criteria for program/activity selection:

findings from the review of relevant literature obtained via the stated search strategy;
criteria used to inform the identification of case studies for the HLIG report, Bringing Health to the Planning Table: A Profile of Promising Practices in Canada and Abroad^{Footnote 13}; and
the Public Health Agency of Canada's Canadian Best Practices Initiative Background Methodology^{Footnote 14}.

Case studies were selected based on the following criteria. Programs:

articulated outcomes of interest to the project (e.g., development of cooking and food preparation skills among children and families for health; promote and support healthy eating; and contribute to improved food security);
showed evidence of effectiveness in eliciting the desired changes (i.e., stated outcomes);
showed evidence of effective strategies that are replicable and adaptable (practical);
had documented information available, sufficient to prepare a program annotation, including descriptive information of the topic the program/activity aims to address, goals/objectives, specific strategies/activities and evaluation design and outcomes;
had a stated theoretical basis, or, at a minimum, a set of defendable community-relevant assumptions upon which the program or activity is based;
had, as their core, opportunities for experiential/hands-on learning (i.e., ranging from taste testing to demonstrations to cooking and food preparation skills) to promote and build self-confidence and self-efficacy through skill development and encouraged children and youth to become involved in food preparation activities within the home environment;
involved parents, either actively or as intermediaries depending on the age of the child (i.e., emphasize the influence of parents in food choices and food preparation skills of children and youth), in program implementation and evaluation;
were community-based and tailored for specific population groups (learner-centred);
were based on measurable, specific goals set by participants (individuals and, ideally, families); and
capitalized on interest in learning and demonstrate that healthy, cost-effective foods and meals can be planned, prepared and served in limited time .

A total of thirty-seven programs were nominated and included in a decision-making matrix specifying their alignment with the criteria outlined above. Strategic Collaboration Working Group members were provided with a brief synopsis of each program, the extent of which depended on information provided by those who nominated the program and follow-up information received from key contacts. The SCWG reviewed and assessed each of the programs according to stated criteria and selected one for each province and territory.

Criteria were grouped under five categories:

Location: provincial, territorial
Setting: school, community
Successful or Promising Practice: relevant outcomes, evidence of effectiveness, effective strategies, available program information
Evidence and Experience Specific to Cooking and Food-Preparation Skill Initiatives: basis in theory, experiential learning, parental involvement, learner-centred, goal-oriented, enjoyable and practical
Age Group: prenatal, preschool, school-aged, adolescent, parent/family

In addition, to facilitate the inclusion of a variety of programs in the environmental scan, reflecting the wide variation in settings, regional circumstances and program partners, SCWG members were encouraged to consider including programs that:

were delivered in rural/remote and more urban centres;
were delivered in school and community settings; during and after-school programs;
had as their population of interest different age-groups (preschool, school-aged, adolescent, pregnant women and families, families with young children);
aimed to improve health outcomes and/or reduce health disparities among specific population groups; and
aimed to specifically increase fruit and vegetable consumption or promote overall healthy eating patterns.

Following case study selection, key informants were invited to participate in a telephone interview. The case study profiles are largely based on information gained through these interviews, using a structured set of questions, and augmented with program documentation provided either prior to or following the interview. The key informants, all actively involved with their program, came from a variety of organizations including public health, family centres, schools/education, non-governmental organizations and government.

Case studies were written for each program following the interview process using a standard format with the following headings: background, partnerships, generating buy-in, lessons learned, advice to other communities, and evaluation and impact. All case studies have been reviewed and approved by the key informants who participated in the interview process.

The analysis across case studies focuses specifically on the lessons learned, generating and maintaining buy-in and advice to other communities. This analysis approach was chosen as a result of the specific relevance of this information to fostering linkages and information sharing across programs and influencing policy and program development.

The SCWG and the project consultant are extremely grateful to the program key informants who were interviewed for this report. Their willingness to share detailed information about their work, including the challenges and successes, provided essential information for this review.

Case Study Profiles

British Columbia: Food Skills for Families

Lead Organization:
Canadian Diabetes Association

Key Partners:
British Columbia Healthy Living Alliance,
Directorate of Agencies for School Health,
Fresh Choice Kitchens

Community:
Communities across British Columbia

Setting:
Community

Population of Interest:
Families from key groups facing increased risk of negative health outcomes and health
disparities including Aboriginal, Punjabi, low-income and new immigrant

Program Focus:
Nutrition knowledge and cooking skills, Community Capacity Building

Implementation Level:
Provincial

Stage of Development:
Completed; implementation ongoing

Background

Food Skills for Families (FSF) is a community-based skill building program with a standardized, best practice curriculum for teaching healthy cooking skills developed by expert community-based dietitians and a Train-the-Trainer Mentorship program for lay personnel. The program's goals and objectives include:

Build cooking skills and nutrition knowledge in targeted at-risk populations: Aboriginal, Punjabi, low-income families, and new immigrant.
- Increase participant's intake of fruits and vegetables, as per Canada's Food Guide.
- Increase individual knowledge, skills and confidence about what foods are healthy and in preparing and cooking healthy foods to lead to sustained changes in behaviours.
- Develop and implement cooking and nutrition resources which are useful for each target community.
Increase capacity within communities across British Columbia, by training community facilitators, to reach out to and improve food and nutrition knowledge and skills in the targeted populations.
- Recruit, train, mentor and retain facilitators in each of the target communities.
- Recruit, train, mentor and retain facilitators from across the province, who are involved with nutrition and other appropriate community support systems serving one or more of the target groups.
Enhance existing food programs in BC communities including community kitchens, school-based initiatives, food security and parent/child nutrition programs.
- Develop partnerships with organizations providing programs in these areas to deliver FSF programs and /or train FSF community facilitators.

FSF was developed by the Canadian Diabetes Association (CDA), Pacific Area, as a key initiative to contribute to the following provincial targets identified by two organizations (The BC Healthy Living Alliance (BCHLA) and ActNow BC): to increase vegetable and fruit consumption (i.e., seven out of ten British Columbians will eat at least five servings of vegetables and fruit a day) and to reduce health disparities across the population.

Consultation with community stakeholders identified the need for a standardized curriculum that reflected evidence-based practice and could be used in community-based programs. Consultations also identified the need to build community capacity by training lay individuals to teach healthy eating and cooking skills rather than relying on the availability of scarce professional resources. Program leaders from the CDA consulted and worked closely with community-based groups and organizations supporting the identified population groups of interest from the outset and involved
some directly in curriculum development to shape the program content and ensure cultural relevance and legitimacy. Examples of groups and organizations consulted and involved in the development of the program include: Community Nutritionists Council of BC, Fresh Choice Community Kitchen, and DASH BC.

In addition, program developers drew on the strengths of two existing CDA programs: Cooking Fun for Families and Cooking for your Life, as well as the experience of community kitchens. However, CDA took the development a step further to define
a specific curriculum that could be used by community kitchens and other relevant groups. All aspects of the program, including participant and training manuals, the standardized curriculum and the mentorship program, were informed by the described extensive consultation process. Phase I of program implementation began in the fall of 2008 and continued until March 2010 through funding from the BC Healthy Living Alliance. To date, implementation of the program has exceeded program targets that projected the number of programs offered and number of participants per program. Over 1600 participants completed the FSF program between September 2008 and December 2009 and it is expected that another 1500 will complete the FSF by the end of March 2011. (Within these figures, the number of children participating, or families with young children, is difficult to estimate as it varies by cultural group). Preliminary data indicate that the cost per-participant is approximately $200 for a six session program. This figure includes the cost of food, the services of the Community Facilitator, program manuals, miscellaneous program costs and coordination.

Partnerships

The FSF program has established key partnerships with DASH BC, Fresh Choice Kitchens and other provincial, regional and community organizations to optimize uptake and reach and enhance the implementation and success of the program. The program collaborated with other BCHLA healthy eating initiatives (e.g., Sip Smart) and the Community Capacity Building Strategy to enhance common healthy eating messages and goals and to address community-based food security issues. Food Skills for Families has also entered into a number of other partnerships to facilitate the training of Community Facilitators and expand the reach of the program to specific populations of interest including the following: Health Canada's Aboriginal Diabetes Initiative, First Nations Health Society, Fraser Health and organizations representing various new immigrant groups. CDA fulfilled a significant coordination role to support this collaboration through its existing infrastructure and as the administrator of the core
program funding provided by the BCHLA.

Generating Buy-in

CDA's leadership role in the development of FSF automatically generated buy-in from funders and program partners as it is a well known, respected and trusted organization, provincially and nationally. In addition, the highly consultative, transparent and "authentic" process used to develop all aspects of the program has fostered the highly successful program implementation, to date. The use and integration of current evidence-based information within the curriculum and program manuals is also seen by partners and stakeholders as a strength of the program.

Lessons Learned

A great deal has "worked" thus far in terms of the FSF program implementation. The adapted and flexible core curriculum has been welcomed and in great demand provincially. The community development and capacity building approaches within populations of interest have also been well received. Host organizations have been able to support child care and transportation needs of families, thereby increasing participation. Overall feedback from participants confirms that the program demonstrates that healthy cooking is not as difficult as perhaps it has been perceived and that healthy foods taste good!

From a lessons-learned perspective, while training and supporting community facilitators is an excellent model, dealing with the realities of turn-over and ongoing training requirements has posed challenges locally and provincially. This has reinforced the importance of a strong and supportive coordinating infrastructure for the program. Another lesson learned is that the program has been successful in fostering positive outcomes among families struggling with inadequate incomes and food insecurity as they often can't and don't take risks trying new foods as waste is not an option. The FSF program allows them to do this without implications for the family food budget. Informal and formal evaluation results also indicate, as a somewhat unanticipated program outcome, that FSF helps bridge language gaps for new settlement and immigrant groups in very practical way.

Next steps for the program include ensuring long-term program sustainability and expansion, enhancing the program's mentorship component, strengthening and streamlining CDA's communication capacity with partners and host organizations while maintaining effective coordination and enhancing the implementation related roles and responsibilities of the Health Authorities.

Advice To Other Communities

Quite simply, "do it," but don't re-invent the wheel. Use and adapt existing programs and resources to meet specific needs and requirements of communities and population groups.

Evaluation And Im Pact

A comprehensive provincial program evaluation of FSF has recently been conducted and the report released. Overall, the FSF program evaluation demonstrates that the program achieved each of its stated program goals and exceeded its stated program targets. It reached vulnerable populations through targeted program delivery to Aboriginal, new immigrant, Punjabi and low-income families throughout BC. The evaluation findings highlight that participants report they are:

eating more fruits and vegetables every day as a result of taking this course;
have a significantly higher level of knowledge about what foods are healthy;
are cooking more meals from "scratch;" and
have a significantly higher level of confidence about preparing and cooking healthy foods, trying new foods, applying food safety procedures and understanding nutrition facts on food labels.

Follow-up focus groups and participant surveys conducted three to six months after completion of the FSF program indicate that participants retained healthier eating behaviours and are cooking healthier foods.
Related to other FSF goals:

The program has built community capacity by training at least two Master Trainers in each health region and 143 Community Facilitators in communities across the province;
As of December 31, 2009, the Community Facilitators delivered the program to over 1600 participants (with 1500 children);
The program has stimulated the upgrading of many community and school-based kitchens, and in a number of communities, the program has led to advocacy for access to fresh produce and healthier food and to the development of other healthy eating initiatives;
Stakeholders frequently commented on the usefulness of the training and curriculum components of the program, the successful adaptation to meet the needs of each identified target population and the potential to adapt these to new target populations and communities province-wide and nationally; and
FSF established key partnerships with DASH BC, Fresh Choice Kitchens (the community kitchens program of the Vancouver Food Bank) and other provincial, regional and community organizations to optimize uptake and reach and to enhance the implementation and success of the program.

A six-month follow-up evaluation of the program is planned. The evaluation results have and will continue to be shared with program funders, partners and interested organizations. It will also be incorporated as part of the BCHLA's Healthy Eating Strategy
evaluation.

Further to the evaluation results, the following have been identified as factors contributing to the success of the program:

the provincial coordinating infrastructure;
the training of Community Facilitators from populations of interest;
strong and supported partnerships;
the evidence-based curriculum; and
the ability of the program to respond to community demands and needs.

Contact

Connie Abram, Executive Director
Canadian Diabetes Association, Pacific Region
360-1385 West 8th Avenue,
Vancouver, BC V6H 3V9
Telephone: 604-732-1331 Ext. 254
E-mail: connie.abram@diabetes.ca

Alberta: Collective Kitchens Coordinator Training

Lead Organization:
Alberta Health Services - Calgary Zone

Key Partners:
Community-based organizations and agencies serving the following population groups: lower income, refugees and immigrants, Aboriginals, individuals with cognitive and/or behavioural challenges and at-risk prenatal women and families

Community:
Calgary, Alberta

Setting:
Community

Population of Interest:
Staff and volunteers within the organizations and agencies noted

Program Focus:
Participatory facilitator training to initiate and support collective kitchens, healthy eating knowledge and skill development

Implementation Level:
Local - Calgary Zone

Stage of Development:
Completed; implementation ongoing

Background

Building on the successful Calgary Zone Collective Kitchens model, Coordinator Training was developed in 1995 to provide resource-effective ongoing education, training and resources for community-based organizations and agencies interested in running Collective Kitchens. Discussions with key stakeholders, an evaluation of pilot training sessions and the use of existing, similar resources from other established community and collective kitchen models informed the development of Calgary's Coordinator Training manual and overall approach.

Organizations and agencies interested in Collective Kitchens are encouraged to support representatives in completing a Collective Kitchen Coordinator Training program. The coordinators' training sessions are offered two to four times a year. The training program is free of charge and runs as three, three-hour sessions. The sessions cover the philosophy of Collective Kitchens and the basics of setting up and running a Collective Kitchen. The program is based on a participatory approach in which potential facilitators experience the planning, shopping, cooking and coordination aspects of Collective Kitchens. Limited follow-up support to organizations, agencies and trained coordinators is available through Alberta Health Services, Calgary Zone.

The goal of the training is to support skill building in facilitating the preparation of healthy meals, particularly among populations at-risk of food insecurity, using evidence-based, consistent approaches which ensure appropriate knowledge in developing and running a Collective Kitchen program. Another important goal of the program is that the organizations and agencies sponsoring participants will integrate Collective Kitchens as a core component of their regular program. In Calgary Health Zone's experience, organizations and agencies that have done so find that programs that support people in cooking and sharing food together help to build community and offer a vehicle for discussion of many issues. In addition, the program provides an opportunity for learning important nutrition and food-related knowledge and skills, and facilitates increased access to healthy foods.

Partnerships

Community-based organizations and agencies serving the identified population groups of interest are the program's key partners. Following successful completion of the Coordinator Training, these groups implement Collective Kitchens on their own, ideally integrating them into core or regular programming. In addition to providing limited follow-up support to organizations, agencies and trained facilitators, the designated Coordinator within Calgary Zone acts as a conduit to support both logistical (e.g., locations, facilities) and food and nutrition-related content aspects of Collective Kitchen implementation. Since the Coordinator Training program was initiated in 1995 a total of 385 coordinators from more than 60 community agencies in the Calgary Zone have participated in the training. Approximately 30 to 40 agencies have incorporated Collective Kitchens into their regular programming.

Generating Buy-in

Buy-in for the long-standing Collective Kitchens program and the Coordinator Training has not been difficult to maintain as organizations and agencies value the program. Within Calgary Zone, recognition of resource allocation, constraints and the desire to sustain the program with the broadest possible reach to community-based partners supported both the development and continued implementation of the Coordinator Training. An evaluation of Calgary's Collective Kitchens model in 2002 demonstrated the achievement of stated objectives and its alignment with strategies within the population health promotion model, securing support within the organization for its continuation and evolution.

Lessons Learned

Key lessons learned associated with the Coordinator Training program highlight the importance of partnerships. Specifically, community agencies are critical partners in the delivery of skill- and community-building programs. Working with community-based organizations and agencies, who serve and support vulnerable populations, provide the most efficient and effective means of reaching and supporting the food and nutrition needs of these groups.

Relationship building and rapport are critical. Facilitators require strong skills in learner-centred and asset-based educational approaches.

Collective Kitchens are effective models for population public health strategies aimed at developing personal skills and strengthening community action. The Collective Kitchens program addresses several health determinants: education, personal health practices and social support networks.

One key challenge that remains (and is not unique to Calgary) is the inability of Collective Kitchens to directly alleviate food insecurity. Collective Kitchens, however, as one outcome, do assist vulnerable populations in having greater access to healthy foods and assist participants in preparing healthy recipes.

Advice To Other Communities

Understanding and responding to the needs of the community in developing and implementing programs is key. Effective training programs focus on a few (versus many) key issues or components. As a result of its inherent nature, approach and design, the Collective Kitchen Coordinator Training program could fairly easily be adapted to different settings and to meet the needs of different populations of interest.

Evaluation And Impact

The Coordinator Training program is informally evaluated by participants after each session. Feedback received is considered and integrated into subsequent training sessions and is shared both within the Calgary Zone and with partners. While the training sessions have been received very positively, and an evaluation of the impact of the Collective Kitchens model delivered in the Calgary Zone was completed in 2002, it is hoped that a formal evaluation of the coordinator training approach will be conducted in the future. While specific changes or improvements to the program will be determined via any planned evaluation, an area of interest for program improvement involves exploring the role of new technologies in program delivery and ongoing support to Collective Kitchens.

Contact
Suzanne Galesloot, Public Health Nutritionist
Alberta Health Services, Calgary Zone
10101 Southport Road
SW Calgary, AB T2W 3N2
Telephone: 403-943-6752
E-mail: suzanne.galesloot@albertahealthservices.ca

Saskatchewan: Kids Kitchen

Lead Organization:
Bishop Klein School

Key Partners:
Child Hunger and Education Program Good Food Inc., Greater Saskatoon Catholic Schools Foundation

Community:
Saskatoon, Saskatchewan

Setting:
School

Population of Interest:
Students (grades four-five and high school) who are caregivers for younger siblings

Program Focus:
Hands-on food and nutrition-related life skills via an after-school program

Implementation Level:
Local

Stage of Development:
Completed; implementation ongoing

Background

In 2007, the principal of Bishop Klein School, an inner-city community school in Saskatoon, recognized the need to teach cooking and food handling skills to students who were caregivers for their younger siblings to enable them to provide healthy meals and snacks. She approached professional staff from the Child Hunger and Education Program (CHEP) Good Food Inc. to work with her to develop her envisioned program in consultation with the community schools coordinator and other schools within the Catholic Board who were interested in the concept.

The resulting Kids Kitchen program was informed by an existing CHEP cooking skills development program (Kids Can), Manitoba's Kids and the Kitchen and another similar program which originated in Saskatchewan. The Kids Kitchen program curriculum aims to support students in learning life skills dealing with proper food handling, meal preparation and healthy eating and the students are able to take home samples of the foods made or parts of a meal for their family after each session.

The program objectives/outcomes are:

students learn how to cook safely in the kitchen;
students learn about the benefits of healthy eating;
students learn safe food handling techniques;
students learn to read recipes and simple meal preparation skills; and
students are supported in caring for their siblings.

The program was successfully implemented in four schools (grades four and five) during the 2007-2008 school year, and was expanded to involve seven schools in 2008-2009, resulting in a total of 270 program participants. In 2008-2009, the program was also adapted for high school sessions which involved increasing the number of sessions per program and adding age and 'depth' appropriate sessions such as menu planning, label reading and grocery shopping. Each group has between eight and ten students depending on the size of each school's kitchen facilities. The program runs in elementary schools with five sessions for five weeks in each school. At the high school level this program ran after school for ten sessions. Intended to run for six months of the school year, this year (2009-2010) the program has only been operational since February as a result of a challenge finding an appropriately qualified facilitator, however a drop in participants is not anticipated as a result of this delayed start.

Partnerships

CHEP Good Food Inc. has been a Kids Kitchen program partner since its inception, providing experience, professional knowledge, expertise, Kids Kitchen staff management and support and funding to the table, as well as its program partners (e.g., Co-Op who provides Kids Kitchen with grocery discounts). The Greater Saskatoon Catholic Schools Foundation has also been a Kids Kitchen funding partner since the program's beginnings in 2007-2008.

Generating Buy-in

Generating buy-in for Kids Kitchen wasn't difficult as the need presented by the principal at Bishop Klein School at the time was recognized by many and her vision was compelling and easily supported. Having an existing relationship (school-based and also via their Board of Directors) with CHEP certainly facilitated the organization's support combined with the fact that it fit with CHEP's mission and experience. Support and commitment to the program has been fostered through ongoing communication and information sharing with students and parents, CHEP's Board of Directors, the Greater Catholic School Boards Foundation, the School Board itself and the School Community Council.

Lessons Learned

The most significant implementation challenge and lesson learned relates to finding and retaining facilitators who are appropriately trained, knowledgeable and supported for this type of work with students in a school environment. In addition, volunteers/helpers are required depending on the group size and finding these individuals has also proven to be a challenge.
While the after-school format of the program seems to be working quite well, students who want to participate, but do not have transportation, are not able to. Finding solutions to this challenge would enable the program to expand its reach. Access to affordable nutritious food and lack of food-related skills are two additional challenges facing families that the program tries to support.As well, adequate kitchen facilities are required, which can be a challenge for some schools. However, most have been able to make it work.

Next steps for Kids Kitchen include:

developing a manual to assist program implementation and support facilitators;
expanding the program to involve new schools, pending the availability of facilities and adequate facilities; and
enhancing the evaluation of the program to ensure that session evaluations are completed (a time-constraint issue) and integrating a three month follow-up component.

Advice To Other Communities

Confirming the need for a similar program is the first step in advising other communities interested in initiating a program similar to Kids Kitchen. Secondly, key informants suggested that existing programs and resources be identified and adapted versus "re-inventing the wheel".

Evaluation And Impact

Evaluation of the program to date has been largely informal. Students are 'formally' asked to complete evaluation forms at the end of the first and fifth sessions, as time permits. The tool used assesses basic food preparation and nutrition related knowledge. During the 2008-2009 year, following week-one of the program, very few elementary school students participating in the program were able to correctly answer any evaluation questions. Following the fifth session, the percentage of correct responses provided by participants ranged from 47% (who knew it was important to clean a countertop with bleach/bleach water solution after cutting raw chicken) to 62% (who could name at least one food from the meat & alternatives group that did not come from an animal) to 98% (who could identify a liquid measure cup to use for measuring liquids).

As well, informal feedback from students and parents (comments, questions, feedback related to food and recipe choices) is taken into account on a session-by-session basis. Generally, feedback from students, parents, community school coordinators, facilitators and school administration has been positive, providing the lead and partnering organizations with the assurance that the program is contributing to the achievement of its goals and objectives. As noted earlier, a key next step for the program will involve enhancing the program evaluation to confirm the program's effectiveness and impact in the short-and longer-term.

Contact

Tony Bairos, Principal
Bishop Klein School
1121 Northumberland Avenue
Saskatoon, SK S7L 3X2
Telephone: 306-659-7151
E-mail: TBairos@gscs.sk.ca

RESOURCES

CHEP Good Food Inc.

Manitoba: Kids in the Kitchen

Lead Organization:
Dairy Farmers of Manitoba

Key Partners:
Heart & Stroke Foundation of Manitoba, Dairy Farmers of Manitoba, Winnipeg Regional Health Authority, First Nations and Inuit Health of Health Canada, Manitoba Healthy Living, Youth and Seniors

Community:
Initially piloted in Winnipeg, Manitoba

Setting:
Rural and urban; community and school

Population of Interest:
Children six-11 years of age and their families

Program Focus:
Healthy eating knowledge and skill development through hands-on learning; a cooking club

Implementation Level:
Provincial

Stage of Development:
Completed; updated program manual slated for re-release Spring 2010

Background

Observed gaps in the nutrition-related programming for younger children by the dietitian working at the Youville Centre in Winnipeg, followed by informal conversations among colleagues in the health and education fields about food choices being made by children and their families, led to the development of the first Kids in the Kitchen program in 2002. This initial after-school 'pilot' program which aimed to develop or enhance food and nutrition knowledge, skills and confidence, was conducted several times with great success, at which time the decision was made to adapt, formalize and expand the program. The original program materials included information and resources from a variety of credible sources. Adaptations were made as necessary based on direct feedback from participating children and community nutritionists who facilitated the program. To support program expansion with limited funds and human resource capacity, the decision was made to develop a 'how to' manual to set up a kids cooking club that would allow for flexibility in implementation.

In 2002, program partners produced 300 kits which included the Kids in the Kitchen manual and basic food preparation supplies, anticipating that this supply would last one year. At a cost of $30 to cover shipping and handling, and without any significant promotion, the kits were sold out within eight months! As well, the manual was made available on the Youville Centre website.

Following revision/adaptation of the manual with support from Health Canada's First Nations and Inuit Health Branch, an additional 150 kits for First Nations communities were distributed during training programs. In 2005, the Winnipeg Regional Health Authority supported a small reprint of the manuals to respond to continued demand.

The manual and program has been implemented by many community-based organizations across Manitoba and beyond, adapting its delivery, as required, to meet community needs and those of participating children and families.

Kids in the Kitchen inspires children to learn to cook easy, inexpensive, tasty foods through participation in a kids' cooking club. Kids in the Kitchen provides the foundation for lifelong healthy eating by:

providing opportunities for children to learn about food and where it comes from;
teaching children healthy nutrition practices in a fun manner;
providing children an opportunity to socialize by sharing food with friends and family;
encouraging children to talk to their families about the importance of family cooking and family eating;
improving children's food preparation skills;
teaching kitchen safety and safe food handling practices;
enhancing community partnerships around the issue of child health; and
encouraging food security through promotion of affordable meal and snack ideas.

Partnerships

With the exception of the provincial government (Manitoba Healthy Living, Youth and Seniors), all other partners (Heart & Stroke Foundation of Manitoba, Dairy Farmers of Manitoba, Winnipeg Regional Health Authority, Health Canada's First Nations and Inuit Health Branch) have been with Kids in the Kitchen since the program's inception. To support the initial program development and manual/kit production, these initial partners all provided funding and in-kind support which included contributing to content development and guiding implementation of the manual and program. Funding for the program is now provided by the provincial and federal governments, with other partners contributing content and implementation expertise. Coordination for the revision and re-release of the program manual in spring 2010 is being led and coordinated by Dairy Farmers of Manitoba.

Generating Buy-in

Generating support for the program has fortunately not been a challenge for partners. The need for a Kids in the Kitchen-type program has been readily acknowledged locally, provincially and nationally. In addition to the adaptation for First Nations communities in Manitoba and the north, program partners are aware that 4H has adapted the program into one of its components, based on input from children participating in the program.

Lessons Learned

One of the most important lessons learned by program partners was that while the initial development and sale of the program kits was very well intentioned, it created more of a problem than a solution in that demand quickly exceeded supply! While some may have required assistance, most communities and community groups are very resourceful and could have quite easily pulled together their own kits. What communities and community groups needed most was the manual.

On a more positive note, program partners quickly learned that the development of the 'how to' manual was a great success with community groups and organizations expressing appreciation for the flexibility in the very comprehensive and evidence-based program. A total of 21 lesson plans were included in the 2002 version of the program allowing host organizations and participants to select those of greatest interest and to offer the program multiple times without repeating content.

To address the often widespread perceptions that healthy cooking and food preparation is difficult and time consuming and that the resulting foods produced won't live up to the taste expectations of children and other family members, the program is based on relatively basic recipes which balance the use of familiar ingredients and new food experiences. This approach has received positive feedback from facilitators and participants. Within the soon-to-be released program revision, a new "take home" component within each lesson plan encourages recipe-related problem solving and food preparation experiences at home, a program enhancement consistent with the above-stated philosophy.

Advice To Other Communities

Ensure that programs being developed support flexibility in implementation which has been a huge success factor for Kids in the Kitchen. A flexible approach to program implementation increases the reach and use of the program, while maintaining accurate, credible and age-appropriate content. Also, do not "re-invent the wheel"; many programs and resources are available that can easily be adapted to meet the needs of specific communities and situations.

Evaluation And Impact

Kids in the Kitchen has not been formally evaluated, however, recent revisions have been made based on feedback sought from community-based facilitators and program organizers from within communities across the province. General program knowledge and feedback have enabled support from provincial and federal governments for its recent revision and continuation. Next steps related to evaluation include the development of a database/monitoring mechanism to enable a more rigorous evaluation of the newly revised program in the not too distant future.

Contact

Pat Bugera Krawchuk, Nutrition Programs Manager
Dairy Farmers of Manitoba
36 Scurfield Boulevard
P.O. Box 724, Station Main
Winnipeg, MB R3C 2K3
Telephone: 204 488 6455
E-mail: patbk@milk.mb.ca

Ontario: Community Food Advisor Program

Lead Organization:
Nutrition Resource Centre, Ontario Public Health Association

Key Partners:
Health Units

Community:
Communities across Ontario

Setting:
Community

Population of Interest:
General Population

Program Focus:
Volunteer Peer Education Program focused on improving food and nutrition-related knowledge and skills
Implementation Level:
Provincial

Stage of Development:
Completed; implementation ongoing

Background

Concerns related to general healthy eating capacity within Ontario communities, knowledge of programs which aimed to address similar concerns in the U.S. using leadership development approaches and the passion of a manager working within the Leadership and Organizational Development Division of the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) led to the development of the Community Food Advisor (CFA) Program in 1992. Organizations involved in the development of the program included OMAFRA, the Ontario Ministry of Health, the Ontario Home Economics Association, the Ontario Dietetic Association, Canadian Institute of Public Health Inspectors (Ontario Branch) and Health Units in Guelph, London and Kingston.

The goal of the CFA program is to improve and promote safe and nutritious food selection, preparation and storage practices in Ontario by increasing individual and group access to reliable information and education through the use of trained volunteers.

The program is designed to:

increase confidence, knowledge and skills in food selection and food handling;
increase community awareness and access to effective resources and education in healthy eating;
develop partnerships between individuals, organizations and the Ontario government based on community needs and resources; and
increase leadership skills of individuals and organizations within communities.

Through this volunteer peer education program, people in communities who have a love of food and some knowledge and skills in food handling, are provided with technical and leadership training to provide the knowledge and skills needed to work in the community. The training program is made up of 12 core sessions, plus two sessions for the Food Handler Training/Certification Course and several optional modules. Upon successful completion, volunteer peer educators become certified as Community Food Advisors and work in their community to improve and promote safe and healthy food selection, preparation and storage practices. Volunteer CFAs are re-certified annually upon completion of provincially specified continuing education and service requirements.

To support program implementation, the CFA program has presentation kits, called "Reach and Teach" kits which are available for use by CFA groups and are adaptable to a variety of audiences and settings. Each kit is designed to support a 30 to 60 minute presentation with additional optional activities outlined. Ten kits exist, including one titled Cooking Basics for Kids which was designed to assist CFAs to teach basic cooking skills, kitchen safety and food safety to school-aged children.

Developed and pilot-tested in 1992-1993, the original program has undergone significant program expansion since this time, from both a content and 'reach' perspective. In 2009, there were over 350 trained Community Food Advisors in 16 areas of Ontario completing over 1000 health promotion activities/placements, reaching over 45,000 people.

CFA Summary of Reach to Children and Families, 2006, 2007, 2008
Placements completed	895	1398	2043*
	2006	2007	2008
Active CFAs	303	353	285
% community groups	40%	40%	40%
% schools	18%	20%	20%
% camps, daycares	7%	5%	4%
Total Reach	40,900	52,606	47,841
0-12	7,491	6,491	6,011
Mixed groups	20,141	25,235	19,624

* Number may signify over-reporting; 2009 data will clarify

In addition, the entire CFA program has been adapted for use in First Nations Communities. It is called the Community Food Educator Program and continues to be used in Ontario, administered by dietitians at Health Canada, Ontario Region.

Partnerships

At present, the key partners of the CFA program are the Health Units/host organizations across the province. Local Program Coordinators and CFA representatives from all sites contribute to the ongoing implementation of the program via several key mechanisms including the Provincial Advisory Committee, the CFA Coordinators Group and the CFA Council.
Following the transfer of the CFA program from OMAFRA to the Nutrition Resource Centre (NRC), Ontario Public Health Association in 2001, the Ontario Ministry of Health Promotion became the sole provincial funder of the program (i.e., for provincial coordination and partial CFA training).

Generating Buy-in

Support from key decision-makers has been achieved through long-term, strategic program promotion efforts. The fact that the goals and objectives of the program contribute to the achievement of targets outlined within provincial healthy eating and active living strategies certainly assists as well. Broad recognition of the importance of volunteer community capacity building within the current context of professional human resource constraints has also generated support for the program. In addition, Health Units and others at the community level understand the value of the program which keeps momentum going. Finally, and perhaps, most importantly, the program couldn't be what or where it is today without the commitment of trained volunteer CFAs who play a huge role in its success and sustainability. Many volunteers remain active in the program for five or more years including a few who have been involved since the 1992 pilots.

Lessons Learned

One of the key lessons learned for the CFA program is the need for sponsoring agencies to provide combined professional (i.e., dietetics) and volunteer management support/expertise to ensure the long-term success of the program. As well, for the program to achieve its intended impact and for the CFAs to be satisfied in their role, sponsor agencies need to recognize the importance of improved healthy eating and cooking knowledge and skill while honouring the principles associated with working with volunteers. Sponsoring agencies and those requesting the services of trained CFAs also need to be prepared to address barriers such as child care and cultural issues to facilitate participation.

Challenges or learnings associated with program delivery specifically for children and families included finding clean and adequate facilities for program delivery and recruiting and training facilitators who have an interest and experience working with children and in delivering multi-session programs. Next steps for the program include increasing uptake across the province, pending available and enhanced funding and expanding the program content.

Evaluation And Impact

The CFA program was formally evaluated in 1994, 1997, and 2002. Provincial summary reports are prepared annually. Annual summary reports include information on the number of active sites, the number of new and existing volunteer CFAs and associated volunteer hours, the number and type of CFA placements and program activities/services provided, topics covered (detailed account), the CFA program reach by age groupings, and a summary of other activities such as efforts to ensure and integrate feedback from CFAs in program planning, implementation and evaluation, educational updates, volunteer recognition and site budgets The 2002 evaluation focused on identifying critical program elements to be preserved during program transition to the NRC to ensure sustainability. These elements included: program support, training, recruitment and retention of volunteers and program evaluation and feedback. Data was collected from trained CFAs and representatives from sponsoring organizations using developed survey tools.

As a result of the 2002 evaluation the following recommendations / changes were made:

local sponsor organizations were encouraged to hire or designate a full-time or part-time paid CFA coordinator;
provincial funding was needed to support volunteer recognition and education as well as the development of provincial resource materials;
provincial training materials were revised into 12 core sessions with specific enhancements;
the Safe Food Handlers Course was added to the CFA training program;
a CFA Scope of Activity was developed that delineates what services and what topics CFAs may address; local sites are encouraged to review and discuss this regularly with CFAs;
additional presentation kits were developed; and
a Program and Volunteer Management Manual was developed to support local sponsors in developing volunteer and program management plans, policies and procedures.

In 2010 the CFA Program Training Materials are being audited to determine the extent to which they contribute to enhanced food skills among participants. As well, the NRC is undertaking an assessment of the level of food skills possessed by active CFAs. Results will inform changes to the training program. A second phase is planned to assess the ability of CFAs to transfer Food Skills (knowledge) to program participants.

Contact

Elizabeth Smith, Program Coordinator
Nutrition Resource Centre, Ontario Public Health Association
700 Lawrence Avenue, W., Suite 310
Toronto, ON M6A 3B4
Telephone: 1-800-267-6817
416-367-3313 ext. 245
E-mail: esmith@opha.on.ca

Resources

Quebec: Petits cuistots/Parents en réseaux

Lead Organization:
Les ateliers cinq épices (The Five Spices Workshops)

Key Partners:
Montreal Public School Board

Community:
Initially piloted in Montreal, Quebec

Setting:
Elementary schools (Kindergarten to sixth grade)

Target Group:
Elementary school children

Program Focus:
Cooking skills, nutrition, healthy living habits

Type of Program:
School integrated program: knowledge and hands-on skills development

Implementation Level:
Provincial

Stage of Development:
Completed; implementation Ongoing/undergoing expansion

Background

In 1996, a community group preparing lunches for school students in a low-income area of Montreal hired a nutritionist to develop an educational component to the service. The nutritionist, in collaboration with the community group and the school director, initiated cooking workshops to assist parents and children in developing knowledge and skills to improve their food choices and health. She realized that she had to start by teaching cooking and food preparation skills to promote healthier eating among children and families. The program that evolved aimed to overcome nutrition-related health disparities among low-income families by improving their nutrition knowledge and cooking skills.

Petits cuistots/Parents en réseaux is an innovative project, developed 'from scratch' with input from school directors and teachers in the initial pilot school. The program is based on the experience and expertise of those involved in its development, the needs observed within schools and the philosophy that in order to change healthy eating behaviours, program participants need to "touch, taste and prepare food" in an enjoyable environment.

The mission of the community-based lead organization, Les ateliers cinq épices ("The five spices workshops") is to promote culinary skills and nutrition knowledge to children and their parents, giving priority to low-income populations.

The program objectives for students are to:

develop culinary skills and the pleasure of preparing and tasting food in a health intended outcome;
acquire knowledge of nutrition, agriculture and ecological issues;
develop a critical mind and assume more responsibility toward their diet and eating habits; and
develop self-esteem and competence for working as a team.

For parents, the objectives are to:

have and promote positive culinary experiences with their child;
learn about a healthy diet;
get involved in their child's school life; and
meet other parents for networking.

The in-class workshops involve a preparation activity lead by the teacher to introduce students to the theme, preparation of a recipe by students themselves, an educational game which allows the students to learn about an aspect of food and nutrition, agriculture, ecology and local and international food, tasting of the recipe, followed by distribution of the written recipe to bring home.

The classroom teacher is present and collaborates in the workshop with the class but program employees (mostly nutritionists) lead the animation and the implementation of the workshop.

Partnerships

For six years (2003-2009), the Chagnon Foundation funded the project for eight schools (eight workshops a year to each class of the eight schools) plus part-time implementation in three to four other schools. During this time period, approximately 2700 students were reached each year, via 1150 workshops for students and approximately 75 other activities for parents and students. Ten professional employees delivered the program with an annual budget of $450, 000.

In 2009-2010, with a budget of $366, 000, including eight employees, the organization had to charge schools $210 for each workshop. Six hundred and thirty-seven (637) workshops have been delivered, to date, with a goal of 880 for the school year. The Montreal Public School Board has provided $145, 000 in financial support and in some exceptional cases the Board pays the entire cost of the program to some schools. Parents are strongly encouraged to collaborate in the workshops with their children and they do! Last year, 1992 parents participated in the program, which made it the program with the greatest parent involvement within the Montreal Public School Board. In many schools, a network of parents develops around the program. Subsequently, many of these parents become involved in other projects within the school. Three parents are members of the Board of Directors for Les ateliers cinq épices.

In addition to the Foundation, the Montreal Public School Board and parents, the program has benefited from the partnership of school directors and teachers, the academic research group and other community groups. All partnerships have been truly collaborative with all involved giving time and energy to support the achievement of shared goals.

The research and evaluation group helped the nutritionists involved in Petits cuistots / Parents en reseaux to document and expand the program to kindergarten to grade six students, and to include it in the Quebec Government Educational Program curriculum (Programme de formation de l'école québécoise ).

In terms of new partnerships, the Quebec government, in partnership with the Chagnon Foundation, launched a government action plan (PAG) called Investir pour l'avenir (Invest for the future) to improve the adoption and maintenance of healthy living habits, an active way of living and a healthy diet for young people from zero to 18 years old, in 2006. This public and private partnership involves a ten- year initial commitment, managed by an organization called Québec en forme. The implementation of the plan started with physical activity promotion, with the promotion of healthy eating just beginning. In early 2010, Québec en forme and the Fund Management Society (SGF) announced funding and human resource support for Les ateliers cinq épices and two other community-based organizations, Jeunes pousses and La Tablée des Chefs to plan and execute the integrated implementation of the three organizations' programs across the province of Quebec. Jeunes pousses focuses on food production through gardening and agriculture and La Tablée des Chefs organizes sessions of after-school culinary workshops for secondary students.

Generating Buy-in

Initial support for the program was not difficult to obtain from the public school board, school communities and the Chagnon Foundation as its need was acknowledged. The program has been promoted to government and public health organizations, resulting most recently in its inclusion and expansion within the Investir pour l'avenir strategy. Les ateliers cinq épices has also made it a priority to be involved in health and food security-related community cooperation groups as a means of garnering support for the program from other community leaders.

Lessons Learned

For Les ateliers cinq epices , one of the key lessons learned resulted from the experience of having an excellent group of researchers interested in the Petits cuistots/Parents en réseaux project who sought out funding for the evaluation. In fact, having completed the first phase, the group is in the process of securing additional funding from Instituts de Recherche en Santé (Canadian Institutes of Health Research) to continue the evaluation. As mentioned earlier, not only has the evaluation contributed to the increased exposure and sustainability of Petits cuistots/Parents en réseaux , project staff have benefited from training in the areas of education techniques and evaluation.
The opportunity given by the Chagnon Foundation subsidy to have been a pilot project for six years was a very positive experience for the program and the lead organization. From the evaluation results, the organization learned about the successes, challenges and barriers and provided them with the opportunity to find creative ways to make improvements.

Another key to success for Petits cuistots/Parents en réseaux has been its commitment to quality. To achieve optimum quality in terms of program implementation and evaluation, strategic program design and implementation (e.g., the logistics) is essential. Simply stated, "when you prepare food and have many people involved in the workshops, you need to be well organized and to have done planning before."

The fact that the program begins with students in kindergarten and involves experimentation with healthy food in a fun and familiar environment addresses two known challenges associated with the improvement of cooking and food preparation skills among children and families. While not the case in all schools, securing the program's placement within the educational plan to achieve curriculum-related goals has been identified as another success factor.

Advice To Other Communities

Les ateliers cinq épices is committed to transferring its knowledge and experience about the mature and evaluated project, Petits cuistots/Parents en réseaux to other communities within Quebec and beyond. Take advantage of it and don't "re-invent the wheel"!

Evaluation And Impact

The full evaluation reports can be found at: www.crie.ca by clicking on Recherches (Research), Diffusion des resultants (Results) and the name is: Étude PC-PR 2008. As well, the research results have been published in several journals¹⁵ and research centre publications and have been disseminated via numerous conferences.

purchasing certain foods introduced and tasted during the workshops;
reading the nutrition facts label on food packaging;
preparing and cooking recipes at home;
adding healthy foods into daily intake; and
a sense of pride, self-esteem and autonomy related to food preparation.

The researchers conclude that Petits cuistots/Parents en réseaux supports:

hands-on learning permitting the transfer of knowledge and techniques at home;
acquisition of knowledge and development of skills for students in grades three to six;
development of team work skills by the students;
a non-threatening space for parents, which fosters participation in their child's class and overall school life;
greater connection and collaboration between school and family life; and
the creation of a group of actors around the workshops that have a common social vision of it.

Next steps for the program include provincial program expansion, which involves both enormous opportunities and challenges. Les ateliers cinq épices is currently enhancing and documenting the required program infrastructure (e.g., human resource requirements and supports, program criteria, animator training), which can be responsive to specific community needs without sacrificing its established quality.

Contact

Lucie Leduc, Director
Les ateliers cinq epices
1945 Mullins-RC12,
Montreal, QC H3K 1N9
Telephone: 514-931-5031
E-mail: lleduc@cinqepices.org

Resources

Les ateliers cinq épices - available in French only

New Brunswick: Healthy Cooking, Healthy Kids

Lead Organization:
Mapleton Teaching Kitchen/Moncton Headstart

Key Partners:
District 2 (School Board, Moncton): Community Schools and Alternative Education Centre

Community:
Selected schools, Moncton, New Brunswick

Setting:
School and community

Population of Interest:
Initially, students in Grades five to eight attending Moncton's District 2 Alternative Education Site

Program Focus:
Nutrition knowledge, cooking and food preparation skills development

Implementation Level:
Local

Stage of Development:
In progress

Background

During the summer of 2009, the new coordinator for the established Mapleton Teaching Kitchen (MTK) in Moncton researched and updated the kitchen's nutrition, food skills and food safety program materials. The Kitchen operates several programs which aim to alleviate the effects of food insecurity among families by teaching basic cooking skills and encouraging healthy eating. In the early fall, the local community school coordinator contacted the kitchen with an idea for a new program involving students in grades five to eight from the Alternative Education Site/School.

The resulting program, which is currently in its fifth month of operation, was developed through consultation with the community school coordinator and the principal of the alternative school, using evidence-based information and resources from known government, non-government and community-based organizations. The goal of the program is to teach nutrition and healthy eating through cooking. The objectives are to build awareness of the importance of nutrition and healthy eating and to develop confidence in practical cooking skills.

Students meet at MTK weekly for two hours of hands-on, interactive teaching sessions. The curriculum was created to maximize comprehension of concepts and allow student participation to reinforce that learning. Each session ends with students working as a group to prepare and enjoy healthy meal choices together.

While not yet in operation for a full school year, the program is "known" within the community and has received very positive and enthusiastic feedback from students, teachers, the community school coordinator and principal. A local high school's culinary technical program initiated a partnership with the Healthy Cooking, Healthy Kids program. Project plans range from writing a cook book of healthy kid-friendly recipes to planning and executing a "gala" dinner event where parents of the Alternative School's students will be the guests. The experience of working with high school students has helped to reinforce the value of healthy eating and healthy food skills concepts taught to both groups of students.

Partnerships

Healthy Cooking, Healthy Kids is the result of a partnership between MTK and District 2. The school district has been involved with the program since its early inception when the community schools coordinator approached MTK with the idea. Program partners communicate openly and as required to address any matters arising related to the program. To date, the MTK, a United-Way funded agency, provides funding and staff to support the program.

Generating Buy-in

The MTK Coordinator and the District 2 Community Schools Coordinator received support from key decision-makers within their respective organizations. The opportunity introduced by the experiential-learning program was widely known, as were the issues and concerns that led to its development. In the case of the MTK, organizational support has led to funding support for the program.

Lessons Learned

The MTK Coordinator attributes the success of the program to its focus on starting small and keeping the experience "real" for the students. The program is very interactive and relevant and students are highly involved in all aspects of each session. As a facilitator, she is experienced in working and connecting with kids and is very comfortable with and passionate about the program content and approach, both of which contribute to the student's enthusiastic participation in the program.

Changing long-held food and nutrition perceptions of parents and adults can be a challenge; however, the opportunity to introduce new foods and new skills and influence family food practices through enthusiastic and engaged students is a huge motivator!

While not yet an issue, the MTK Coordinator anticipates that securing funding to expand the program to respond to requests may be a concern in the not too distant future; however, she is encouraged by interest in the program by potential partners in the local and surrounding communities.

Evaluation And Impact

As a result of its 'new-ness' the Healthy Cooking, Healthy Kids program has not yet been formally evaluated. Students do, however, complete a pre-questionnaire and are asked to evaluate each session to assess interest in topics covered and their own learning. As well, the MTK coordinator has begun a process of self-evaluation at the conclusion of each session in keeping with a philosophy of continuous quality improvement.

Positive feedback communicated via word of mouth from students and program partners has contributed to the program's success thus far, opening doors for program expansion and adaptation for different population groups.

Contacts

Cheryl Parrish, Coordinator
Mapleton Teaching Kitchen Inc.
111 Mountain Road
Moncton, NB E1C 2S9
Telephone: (506) 858-8252
E-mail: cheryl.parrish@monctonheadstart.com

Nova Scotia: Strive for Five at School!

Lead Organization:
Annapolis Valley Health Promoting Schools Program

Key Partners:
Armstrong Foodservice, Annapolis Valley Regional School Board, Annapolis Valley Public Health staff, Annapolis Valley Health Community Health Boards, Nova Scotia Department of Agriculture, Nova Scotia Department of Health Promotion and Protection, Acadia University, Kings County Federation of Agriculture, Nova Scotia Fruit Growers Association, local producers and suppliers

Community:
Annapolis Valley Regional School Board; Provincial

Setting:
School

Population of Interest:
School communities (i.e., students (P-12), parents, education assistants and teachers, school food preparation workers and volunteers)

Program Focus:
Healthy eating knowledge and skill development; increased local fruit and vegetable consumption

Implementation Level:
Provincial

Stage of Development:
Completed; provincial implementation in progress

Background

A component of the successful Annapolis Valley Health Promoting Schools Program, Strive for Five at School! was developed in response to challenges voiced by schools following the release of the provincial Food and Nutrition Policy for Nova Scotia Public Schools. The policy clearly outlines the healthy food choices that should be available within public schools; however, many schools were challenged in making the required changes, specifically related to availability of fruit and vegetables as a result of preparation skill and time, cost and procurement implementations. In addition, despite being the agricultural centre for the province, schools within the Annapolis Valley had difficulty procuring local fruit and vegetables in season, a distribution challenge long-recognized by the Producer Supplier Committee of the Annapolis Valley Health Promoting Schools Program. Further to concerns cited by schools, the Committee generated the specific idea for the initiative and supported and guided its development and evolution.

The Annapolis Valley Health Promoting Schools Program has an almost ten-year legacy of grassroots program development built on a foundation of open communication with school communities. The development of Strive for Five at School! responded to needs expressed directly by schools, and began with the identification and adaptation of recipes which focused on fruit and vegetables that would be appropriate for the school environment. The program evolved to include nutrition education and food preparation workshops for various groups within the school community, followed by the development of guidelines to encourage taste-testing of new foods and recipes within the school environment, all with the goal of supporting changes to school food menus that support the provincial policy and the greater availability and consumption of local and seasonal fruit and vegetables.

The goal of the program is to increase local fruit and vegetable consumption and enjoyment among school communities. The objectives are to:

increase local fruit and vegetable nutrition and food preparation knowledge and skill among school food preparation workers and volunteers;
increase local fruit and vegetable nutrition and food preparation knowledge among members of school communities; and
increase exposure (e.g., promotion, taste-test) to local fruit and vegetables among school communities, to make "Healthy Choice the Easy Choice."

Support initiated by the provincial government through the Departments of Agriculture and Health Promotion and Protection facilitated the provincial launch of the Strive for Five at School! resources and the development of a facilitator's guide to support expansion of workshops across the province.

Partnerships

Key partners in the Strive for Five at School! program include Armstrong Foodservice, local producers and suppliers, Annapolis Valley Regional School Board Food Service, Annapolis Valley Health Public Health staff, Annapolis Valley Health Community Health Boards, Nova Scotia Department of Agriculture, Nova Scotia Department of Health Promotion and Protection, Acadia University, Kings Federation of Agriculture and Nova Scotia Fruit Growers. The Annapolis Valley Health Promoting Schools Program Manager has, and will continue to, play a key role in supporting the partnerships which have been developed.

The contributions of the numerous partners are varied and necessary for the success of the program, including:

the Community Health Boards who provide funding to support training workshops for school communities;
the Armstrong Foodservice who facilitates food delivery to schools and provides professional expertise to support program material development;
Acadia University who provides the facilities to carry out the workshops;
the Department of Agriculture who provides product development, expertise and support to facilitate uptake of recipes and the program within participating schools;
the local growers, producers and representatives of the Kings County Federation of Agriculture and the Nova Scotia Fruit Growers Association who assist in identifying seasonal, local produce that may be available for schools to purchase; and

the provincial Departments of Agriculture and Health Promotion and Protection whose financial support made the recent provincial launch of resource materials possible.

Generating Buy-in

Support for this further evolution within the successful Annapolis Health Promoting Schools Program of Strive for Five at School! was fairly straight-forward as the program was developed in response to widely communicated and acknowledged needs as expressed by school communities. Funding support from Community Health Boards and the Department of Agriculture, while facilitating implementation of the program, also contributes to achieving the goals of each organization.

As noted earlier, open communication with, and responsiveness to, all partners, including school communities will ensure continued program and partner participation and support.

Lessons Learned

Thus far, the implementation of Strive for Five at School! has demonstrated that people and organizations listening to one another, working together and drawing on available expertise and resources can make amazing things happen! Patience is required given that the change process can be slow at times.

The value of the nutrition education and food preparation workshops cannot be underestimated as part of the change process, not only for food preparation staff and volunteers in schools but also for family cooking nights. These cooking nights are seen as an important next step involving Annapolis Valley Health dietitians, Public Health nutritionists and local Family Resource Centres. Families come together and cook at the school and then share a communal supper. Efforts to involve more teachers and educational assistants, particularly in family studies, will help facilitate linkages with curriculum outcomes to further increase uptake and success of the program.

Challenges that the program continues to address include changing attitudes and perceptions related to fruit and vegetable consumption within school communities and time and cost associated concerns. As well, income-related challenges experienced by some families, limits the extent to which new foods and recipes are tried within the home environment. Encouraging strong involvement of students in school-based activities (within and outside class) such as workshops, taste-testing and demonstrations is hoped to influence and support increased fruit and vegetable availability and consumption at home. Providing further support for schools, especially cafeterias, to use and integrate Strive for Five at School! recipes was identified as a priority for the 2009-2010 school year. Based on the Strive for Five at School! seasonal calendar, one fruit or vegetable per month is provided by local farmers and delivered to each school so they are able to prepare and serve the items to the students as part of the daily special or for a taste test. This initiative is titled "Farm to School - Fruit and Vegetable Promotion." This significant donation from local farmers is not sustainable and an alternate funding model is being sought.

Particularly in light of the provincial program launch, dedicated human resources and funding are required to support the delivery of workshops for various groups, both within and external to the school community. As well, continued support for school food workers and volunteers could only enhance the success of the program.

Advice To Other Communities

In keeping with the legacy and success of the Annapolis Valley Health Promoting Schools Program, individuals and communities interested in Strive for Five at School! are encouraged to start small when building an initiative or program; become involved and do something, while always listening to feedback; make connections; and ensure ongoing support and follow-through.

The program could definitely be adapted to a variety of settings and populations of interests. As each school community makes adaptations to meet its own needs. Some work has already been done with daycare centres and the local farm market. Both are using the recipes to do demonstrations and share the recipes with families. In addition the district health authority has expressed an interest in the recipes. Commitment and enthusiasm can make anything possible!

Evaluation And Impact

Observations made and feedback received via implementation of the program and several informal evaluation strategies have provided the assurance that the program is having an impact, to date, while acknowledging that progress and change take time. Those providing leadership for Strive for Five at School! prefer to coordinate program evaluation with upcoming broader evaluation efforts (e.g., Health Promoting Schools) versus seeking and securing additional evaluation resources (human and fiscal). With the involvement of Public Health staff, it may be possible to do more specific evaluation of the workshop component of the program.

Contact

Caroline Whitby, Program Manager
Annapolis Valley Health Promoting Schools Program
c/o AVRSB PO Box 340, 121 Orchard St, Berwick NS B0P 1E0
Telephone: (902) 670 0607
E-mail: Caroline.Whitby@avrsb.ca

Resources

Strive for Five School! program resources are available on the Nova Scotia Department of Health Promotion and Protection website

Prince Edward Island: What's for Dinner?

Lead Organization:
Eastern Kings Community Coalition Inc., Main Street Family Resource Centre

Key Partners:
IWK Health Centre Foundation, local dietitians and chefs

Community:
Souris/Eastern Kings, Prince Edward Island

Setting:
Community

Population of Interest:
Parents with young children (zero-five years)

Program Focus:
Healthy eating and food preparation knowledge and skill development; food insecurity

Implementation Level:
Local

Stage of Development:
Completed; implementation complete

Background

Cooking programs have been successfully developed and delivered by the Eastern Kings Community Coalition Inc., Main Street Family Resource Centre for some time. These programs are always very popular as they provide opportunities for skill development and enhanced social support among mothers and families within the community. Building on past experiences, in the fall of 2008 Centre staff developed the eight session What's for Dinner? food and nutrition education and skill development program. This program aimed to improve eating habits among participants while providing strengthened social support for mothers through hands-on meal planning and preparation and the provision of one healthy meal each week for participating families. The program reinforced the value of family meals, the positive impact of family meals on family relationships and the importance of parental role-modelling on the food choices and eating habits of children. The program was available to families free of charge and child care was provided to facilitate participation.

Specific program objectives were as follows:

participants will attend weekly sessions;
participants will cook, eat and take home a healthy meal;
participants will learn healthier ideas for home meal preparation;
participants will have a chance to eat a healthy meal at least once a week; and
participants will improve eating habits.

The content and approach for the What's for Dinner? program sessions was based on information and experience from past successful cooking programs that the Centre had offered. Specific education topics and recipes for foods/meals prepared were chosen based on the interest and input of participants and knowledge of current issues within the field of nutrition and healthy eating.

The first eight weeks of the program were so successful that when the Centre was able to unexpectedly stretch their budget for an additional six weeks, all nine participants (and their 20 children) continued, further strengthening the strong social and parenting support network that had been developed.
Funding for the program was provided by the IWK Health Centre Foundation and through the Centre itself.

Partnerships

Informal partnerships within the small community of Souris/East Kings supported the successful implementation of What's for Dinner? Sessions were often co-facilitated by local chefs and community dietitians/ nutritionists and Family Centre staff.

Generating Buy-in

As a result of past cooking and healthy eating program successes at the Centre, and widespread appreciation for the issues facing families that the program was developed to address, support for What's for Dinner? was strong from both the Centre's Director and the Board of Directors, which largely consists of past participants in the Centre's programs.

Lessons Learned

One of the biggest lessons learned - or reinforced - through the What's for Dinner?" program was that cooking is a great equalizer and food brings people together. Participants listened, learned from and supported one another all while strengthening their nutrition knowledge and food skills in a very hands-on way. As a result of funding received from the IWK Foundation and support from the Centre, the program was offered at no cost to participants, making it possible for mothers from lower-income groups to be part of the group and share the positive experience.

Another lesson learned relates to the importance of providing child care for similar community-based programs as it removes a participation barrier for mothers/parents and also promotes socialization and exposure to different education and play environments for children. As well, having the children within the Centre meant that they also had the opportunity to try new foods that they may not have had the opportunity to had they been cared for elsewhere.

The benefit of having community-based partners as guest speakers/co-facilitators at the weekly sessions was another lesson learned as it provided participants with the opportunity to connect with local resources, something they may not have done in the past.

Advice To Other Communities

This type of program could easily be adapted to different settings and populations of interest provided that they share the same primary goals or motivations: planning and preparation of a weekly meal, opportunity to learn about nutrition, healthy eating and food skills and interest in being exposed to a greater variety of healthy foods. Seek out support from partners (i.e., chefs, farmers, dietitians) within your community to make it happen.

Evaluation And Impact

A pre-and post-test survey was completed by participants to determine changes in food and nutrition knowledge that could be attributed to the program. Participants were asked to rate items ranging from their ability to provide healthy foods for their families to their knowledge of food handling, and assess the level of enjoyment they find in meal preparation. Post program, participants indicated improvement in all areas. Participants also provided very positive responses to general questions related to the program (e.g., what did you like, want to change, other program requests) and generally wanted the program to continue with very few changes. The results of the informal program evaluation were shared with the IWK Foundation.

The Centre would definitely like to re-offer What's for Dinner? in the future based on its demonstrated success and popularity, should funding become available. As an indication of the popularity of cooking programs, not long after What's for Dinner? had concluded a group of mothers, who participated in Centre programs, successfully received funding from the PEI Healthy Living Collaboration to develop a crockpot cooking program.

Contacts

Barb Lundrigan, Director
Lori MacGregor, CPNP Coordinator
Eastern Kings Community Coalition Inc./Main Street Family Resource Centre
P.O. Box 682
Souris, PEI C0A 2B0
Telephone: 902-687-3928
E-mail: mainfrc@pei.aibn.com

Newfoundland and Labrador: Fun and Food Camp Program

Lead Organization:
Central Health

Key Partners:
Twillingate/New World Island Primary Health Care Community Advisory Committee, local school boards, schools and town councils, health care professionals, summer student programs, regional and provincial Wellness Coalitions and children and families of rural Newfoundland and Labrador communities.

Community:
Twillingate/New World Island area of central Newfoundland and Labrador

Setting:
Rural; community-based

Population of Interest:
Children aged eight to ten and their families

Program Focus:
Healthy eating knowledge and skill development, physical activity

Implementation Level:
Local and Regional

Stage of Development:
Completed; implementation ongoing

Background

In 1999, the concept of a nutrition program for preteen children was introduced in the Twillingate/New World Island (NWI) area of central Newfoundland and Labrador (NL) by a nutrition focus group formed through the Primary Health Care (PHC) Enhancement Project. This focus group was made up of individuals representing stakeholders from a number of sectors concerned with the health of children in the region, including health care providers, a school principal and a community breakfast program volunteer.

Rates of childhood overweight, obesity and inactivity have been concerns for many years in NL, supported by national, provincial and local data. Studies have shown for some time that children in the province, especially the central region, are at a high risk of being overweight and inactive. The link between nutrition, weight, chronic diseases and other health-related issues, including positive self-image, and self-rated health, are well known. The Food and Fun Camp Program (FFCP) was designed to address these issues and to support children in developing basic, life-long healthy eating and food preparation knowledge and skills in a fun environment that also promotes physical activity.

The nutrition focus group used information from a variety of sources to form the basis for the initial program; however, it was the effort and commitment of the "right people" - a lead dietitian and regional nutritionist, several dietetics students, a Primary Health Care Facilitator and an administrative Primary Health Care support person - that facilitated the full development of the program, the program manual and the further expansion of the program in 2005-2006. This work was supported by Central Health, as the lead organization and a provincial wellness grant. Program trained Public Health Nurses and Community Development Nurses serve as ambassadors for the program, connecting with community-based organizations throughout the region.

The overall goal of the program is to improve the health of children aged eight to ten years and their families in the Twillingate/NWI area. The purpose of the Food and Fun Camp Program is to help participating children learn more about the importance of, and enjoyment in, healthy eating, being active and staying smoke-free. The specific objectives of the program are to work with children to:

develop basic skills for preparing and cooking food;
handle food safely to help prevent food poisoning;
take what they know about healthy eating and apply it to making a meal; and
be more confident about cooking, so they'll be ready to prepare nutritious foods for themselves and their family.

Various teaching methods are used during the camp including personal instruction, demonstration, hands-on learning, video, activity work sheets and interactive activities such as games, grocery store tours and outdoor hikes. The FFCP is designed to be interactive and fun while teaching and reinforcing healthy living messages in a way that children get hands-on experience and knowledge they can build on and share with others.

Adaptations to the FFCP electronically formatted guide/program have already been made to meet the needs of different population groups (e.g., age) and different settings, including provincial Community Youth Networks and Boys and Girls Clubs. It has also been adapted and applied in the local school system as a part of the grade three Exploratories curriculum.

Since its inception in 1999, a minimum of 500 children and their families have participated in the program. The camp runs for five days, five to six hours per day for six-eight weeks during the summer, with different community-based organizations (e.g., service clubs, child and youth focused clubs and networks, recreation organizations and family resource centres) throughout the region serving as hosts and implementers.

The Central Region Wellness Coalition has supported implementation of the FFCP program over the past few years by building and securing grants for program operations into its budget (approximately $1,000-$1,200 per requesting organization). In-kind donations of supplies and facilities enable full implementation within communities, as well as summer student grants, two of which are required to support each program. In addition, efforts have been taken to address transportation challenges within this largely rural area of the province to facilitate participation in the program. All of this support enables children/families to participate in the program free of charge.

Next steps for the FFCP include the development of a formal train-the-trainer program to support program implementation, expanding the healthy recipe selection within the program manual and developing and implementing a formal evaluation framework for the program.

Partnerships

A wide variety of partners have been engaged in the FFCP including the following: the Twillingate/New World Island PHC Community Advisory Committee (CAC), local school boards, local schools and town councils, health care professionals, summer student programs, regional and provincial Wellness Coalitions, the Central Tobacco Advisory Committee, service clubs, boys and girls clubs, faith-based organizations, family resource centres and children and families of rural NL communities. Central Health facilitates the overall program implementation, including program coordination, training and consultation through a designated portion of the role of a regional nutritionist.

The FFCP is provided with direction from the local PHC CAC which consists of membership from town councils, health, education, justice, employment, youth, seniors, ministerial and other key members of the community. The CAC acts as a leader and supports the FFCP by ensuring the program meets the needs of the population. The FFCP engages children and their parents in leadership roles of advocacy for healthy food choices, physical activity and living smoke-free. Parents and children are asked to provide feedback and suggestions for change whenever possible. The "consumers" (being the child campers themselves) have been noted to "educate" their parents and other adults in making healthier lifestyle choices. In planning for and implementing the FFCP itself, collaboration with local schools or other hosts, for use of kitchen facilities and further support in promotion of the program is essential. In recent years, due to rural geography, transportation was identified as a barrier to attendance and running some aspects of the program. This has been overcome through the development of partnerships with parents and other volunteers to provide transportation and support to the program where necessary.

Generating Buy-in

Generating essential support from key health-related and other organizations has fortunately not been a challenge for the FFCP since its inception over ten years ago. Support (financial and in-kind) from Central Health, regional Primary Health Care committees and Wellness Coalitions has been, and continues to be, strong. The leadership of Public Health Nurses and Community Development Nurses has been identified as essential in fostering strong and growing interest from community-based organizations wanting to bring the program to children and families in their area. Securing 'timely' funding for summer students has been the greatest challenge for the program.

Lessons Learned

Most of the lessons related to the FFCP have been learned by local camp organizers. Some of the key and broadly applicable lessons include ensuring buy-in, seamless coordination and workload sharing. More specifically, local camp organizers highlighted the following lessons:

have an intersectoral working committee to coordinate the camps from year to year;
write proposals and apply for funding for camps early;
apply for summer students early and through a variety of programs;
ensure that the students are highly motivated and work independently, and that the work fits well with the students' future profession/training;
dedicate at least two people to run each camp in order to maintain the one teacher to four student ratio; and
ensure that all games and active living activities are interactive and inclusive.

Advice To Other Communities

The FFCP has been fortunate to have the strong support of provincial, regional and local groups and organizations from a variety of sectors since its inception. Developing and communicating a concrete proposal including required resources for full implementation and evaluation to secure this level and type of support is essential for communities wanting to do something similar.

Evaluation And Impact

While a formal program evaluation has not been conducted, campers' food and nutrition-related knowledge and skill are assessed before and after attending the FFCP camps using questionnaires. A review of responses provided via these evaluation tools has indicated that knowledge transfer and skill development has taken place. Children in their pre-and post-tests, and through informal conversations with camp facilitators and coordinators, exhibit an enhanced understanding of healthy living messages following the program. As well, during the last day of each program, parents are invited to participate, providing program coordinators and facilitators with a great deal of valuable information related to knowledge and behaviour changes that have occurred as a result of the program. Many youth leaders, who were once campers themselves, are continuing to make healthy lifestyle choices, as demonstrated through their leadership role with the program. Program users - camp coordinators and student facilitators - are also asked to provide feedback about their personal experiences running the program and to share lessons learned to help ensure the camps' future success.

Contact

Jill Wheaton, Regional Nutritionist
Central Health - Health Promotion and Wellness
3 Bell Place, Level 1
Gander, NL A1V 2T4
Telephone: 709-651-6335
E-mail: jill.wheaton@centralhealth.nl.ca

Resources

Food and Fun Camp Program Manual soon to be available on the Go Healthy website

Yukon: Tantalus School Food Program

Lead Organization:
Tantalus School

Key Partners:
Yukon Food for Learning, Skills Canada, Tantalus School Council, Little Salmon Carmacks First Nation, First Nations Greenhouse, Bushmaster Mining Company

Community:
Carmacks, Yukon

Setting:
School

Population of Interest:
Kindergarten to grade 12 school population; entire school community

Program Focus:
Healthy eating and cooking knowledge and skill development

Implementation Level:
Local

Stage of Development:
In progress; implementation ongoing

Background

The food program at the Tantalus School in Carmacks, Yukon began as a result of concerns related to family food insecurity and food choices being made by children and families, as noted by an educational assistant (EA) and a teacher. Students either weren't bringing any food to school for snacks or lunch, or the food that they did bring wasn't as healthy as it could be to support overall health and learning. The EA and teacher began buying and preparing food with the students and the program has grown from there.
Having several different components, and now involving all grade levels within the school, the goals of the program are to:

improve healthy eating and food preparation knowledge and skills;
increase awareness of food security issues; and
improve knowledge of and exposure to healthy food choices.

Drawing on existing information sources, when relevant, the program was developed under the leadership of the EA, whose time is now almost exclusively devoted to the evolving program, to meet the specific needs and context of the school environment and community. This includes the delivery of the high school home economics curriculum. All foods and meals are prepared 'from scratch', including those prepared at home as part of homework assignments.

Currently, students in grades 10 to 12 prepare lunch. All other students and school staff can receive free of charge or purchase prepared food items. Students in grades seven to nine have led meal preparation in the past. A range of 30-50 lunches per day (total school population of 100) are prepared by students. In addition to preparing the lunch meal for students, school staff and often others in the community, these older students are directly involved in meal and menu planning, have special projects and are expected to identify personal learning outcomes. Although not directly involved in food preparation, younger students participate in food and nutrition education classes throughout the school year, which has resulted from the recognition that the curriculum component developed by the EA meets broader learning outcomes and expectations. Demand for the program has definitely exceeded expectations!

A recent and unexpected highlight for the program occurred when the Yukon Teacher's Association contacted the school requesting that students prepare dinner for a group on their way to Dawson City for meetings. Students in grades eight and nine made a lasagna dinner from scratch which received rave reviews.

Partnerships

Relationships among individuals and organizations within this small community (approximate total population of 450), and a general willingness to support school-and community-based initiatives, are credited with securing the support of diverse partners who have enabled the program to grow over the past six years. Yukon Food for Learning and Skills Canada provide funding for the program, and the remaining partners - Tantalus School Council, Little Salmon Carmacks First Nation, the First Nations Greenhouse, the Bushmaster Mining Company and forestry camps - provide significant food donations throughout the school year. In addition, the School Council and the Little Salmon Carmacks First Nation provide a means by which the program connects with the broader community, sharing feedback received on an ongoing basis. As a means of fostering these partnerships specifically with the mining companies and forestry camps, students in grades ten to 12 write thank you notes after donations have been received.

Generating Buy-in

Given that the program was originally based on an observable need within the school environment and has evolved into a program with benefits (enjoyment and health-related) for students, the school and broader community, generating and maintaining support from key decision-makers and funders has not been a challenge. Specifically, school administration and staff, parents, the school council and the Yukon Food for Learning Board have been extremely supportive from the program's outset. The commitment to a responsive program - soliciting, listening to and incorporating feedback from all school community partners - has certainly contributed to the programs support and success.

Lessons Learned

Key lessons learned thus far in the program's implementation include the need to let students "do it" on their own for maximum engagement and learning and managing the number and involvement of children in the kitchen at once, to ensure safety and full participation.

Overcoming long-standing food-related perceptions and attitudes held by families continues to be a challenge (specifically related to vegetables); however, the program has been quite creative in integrating less familiar foods into familiar meals and using persuasive strategies and techniques to facilitate behaviour change.

In terms of next steps for the program, efforts are going to be directed toward integrating more fresh vegetables into the program, as it now predominantly relies on frozen vegetables primarily as a result of limited availability and cost.

Advice To Other Communities

"If you have passion, you can do it!" In addition, for other communities wishing to begin a similar program, the EA recommends seeking out and using existing resources and being open-minded to new and innovative partnerships.

Evaluation And Impact

While the program has not been formally evaluated, those involved with the program are quite confident that it is achieving its goals as a result of observations made and feedback from students, parents and other community members. The impact of the program is largely a result of the healthy food that the children prepare and eat and how they share these experiences with their families. A parent of a program participant, who also happens to be the school secretary, recently shared that the 'best test' of all is when students prepare meals at home for their parents so they can see what they have learned. It amazed her when her daughter, who is in grade six, made chili, home-made buns and caesar salad (all from scratch) for her family for dinner. This mom also shared that while she has taken cooking classes she still can't cook and she was amazed with what her daughter had learned. In addition, the program couldn't be what it is today without the support of school administration.

Contact

Gisela Larkin, Educational Assistant

Tantalus School
P.O. Box 134
Carmacks, YK Y0B 1C0
Telephone: 863-5371
E-mail: gisela.larkin@yesnet.yk.ca

Northwest Territories: Kids in the Kitchen

Lead Organization:
Food First Foundation

Key Partners:
Health Canada's First Nations and Inuit Health Branch, schools in Northwest Territories

Community:
Communities across the Northwest Territories

Setting:
School

Population of Interest:
Children aged six to 11

Program Focus:
Healthy eating, nutrition education and safe food handling and cooking skills

Implementation Level:
Territorial

Stage of Development:
Completed; implementation ongoing

Background

The implementation of Kids in the Kitchen is supported by Northwest Territories (NWT)'s Food First Foundation, whose Board of Directors is comprised of professionals working in the areas of health, nutrition and education. The Food First Foundation also promotes school nutrition policy development, further supporting the intent and goal of Kids in the Kitchen, which is to provide school-aged children with the opportunity to develop and improve their skills in healthy, safe and cost-conscious food and meal preparation.

Kids in the Kitchen is one strategy that aims to address gaps in nutrition education, thereby contributing to sustainable behaviour changes within the NWT, specifically related to health issues including Type 2 Diabetes, childhood obesity and poor nutrition among school-aged children.

Through the suggested Kids in the Kitchen program activities, students are provided with information about nutritious food choices and opportunities to practice food preparation techniques. Students are also exposed to new, healthy foods, which helps to address food security in communities where healthy food can be priced beyond the reach of many families. The philosophy underlying the program is that by working with young students, there is an opportunity to instill healthy habits early, which may result in long-term changes into adulthood. Sustainable skill development is the long-term objective of the Kids in the Kitchen program.

Specifically, through their participation in the program, students will:

prepare inexpensive, nutritious foods;
learn basic cooking skills;
learn proper food safety and handling skills;
build their confidence in cooking;
recognize the nutritional benefit of foods prepared from scratch; and
gain experience working as a team.

The development of Kids in the Kitchen was based on information about other programs known to the Food First Foundation directors through their work in the areas of health promotion, education, public health and regional nutrition education programs. Staff and directors of Food First work with school teachers (and other members of the school community) to ensure that they have the required knowledge to accurately transfer healthy eating and food preparation information, skills and knowledge to students.

Kids in the Kitchen was designed to be an eight week program, delivered once per week either during or after school. Program materials provided by the Food First Foundation include general program guidelines, a leader manual and session work plans, which include objectives, lesson plans and evaluation suggestions for each themed session. Approximately six to eight students participate in the eight classes, depending on the size of the school's kitchen and the limitations that the classroom area might pose.

The program's budget for the 2009-2010 year has allowed funding support to ten schools (seven returning and three new). Funding supports food purchases and the cost of an instructor if a volunteer can't be secured. Funding amounts may differ from year to year but this stipulation remains. The actual cost to deliver the program depends on how the school and/or community delivers the program and the amount of support received outside of the Food First Foundation funding. Transportation/food mail costs to purchase healthy food choices, which may not be available within very small communities, have been considerable for some program sites.

To date, the implementation of Kids in the Kitchen has been very smooth. According to the Coordinator and Board Chair of the Food First Foundation, every school that has implemented the program has been extremely positive in their evaluation of the information that is provided to students, its ability to address food security issues for student participants and the positive impact it has on student learning both in the hands-on learning activities and in the overall learning of well-nourished children.

Partnerships

Schools in the NWT, and specifically school administrators and those who deliver the program within the school environment, are key program partners. These partners have been extremely positive and enthusiastic about the program's implementation to date. In addition, local grocery outlets in some communities have been extremely supportive, partnering with schools to offer food cost discounts - a partnership which is greatly appreciated in light of very expensive food costs in NWT. To enhance program implementation and support, Canadian North Airlines has donated flight passes to the Food First Foundation to enable staff and board members to visit programs in their service area.

The program is currently funded by Health Canada, the Canadian Diabetes Strategy with additional grant funding being provided this year by the NWT government via their Drop the Pop campaign.

Generating Buy-in

Generating support for the implementation of Kids in the Kitchen has not been difficult as school partners see the need for, and benefits of, the program. According to the Chair of the Food First Foundation, "We are very fortunate to have such eager supporters of our programs. It is their "on the ground" support that makes the Kids in the Kitchen program the success that it is."

Lessons Learned

Program instructors are very busy people often assuming the delivery of Kids in the Kitchen in addition to other school-based responsibilities. Food First has learned over the past few years that while not fool-proof, if a small amount of funding is withheld, evaluation survey results can be submitted on a more 'ready' and timely basis, thereby contributing to the future sustainability of the program. According to the Board Chair, "It is hard to get the final paperwork done without the help of a carrot sometimes!!" Securing multi-year funding and developing solid program timelines from the beginning to end of the school year for all schools, including contract expectations and deliverables, is a noted next step to support the successful implementation of the program.

Related to program implementation, the current program coordinator has learned that regular telephone (versus e-mail) communication has been beneficial in terms of developing and maintaining program relationships and results. While face-to-face program support would be ideal, the geographic realities of NWT and limited program funding do not currently support this. Food First Foundation, NWT is very fortunate to have Canadian North Airlines as a corporate sponsor to provide travel passes within their service area. Program visits are very important to show support for the work that is being done at the school level and to share best practices and tips between programs.
While intended to be a relatively flexible program to facilitate school-and community-based responsiveness, Food First has learned that greater guidance and program requirements to define what foods are "approved" and which are "discouraged" has been necessary. For example, juice crystals are not approved, milk is encouraged and 100% juice is approved but in limited quantities.

Again, while intended to be a flexible program, Food First would like to dedicate more time and funding to the collection and development of resources to support quality program implementation and longer term impact across the territory. Resource ideas include the development of a program manual for instructors, and a recipe bank and "take aways" for participating students such as laminated recipe cards and grocery lists that they can take home. The use of traditional and country foods has been an emphasis within some school-based programs, involving great community partnerships to facilitate food procurement and preparation.

As the Kids in the Kitchen program is offered, improvements are made based on feedback from schools and experiences of the program Coordinator. Next year, the Coordinator would like to include parents in the program to try to improve the reach and nutrition education beyond the students and into the families. The Coordinator recognizes that there is a need to be more proactive in trying to bring the families on board to adopt healthy nutrition choices to address medical conditions such as Type 2 Diabetes, colon cancer and other diseases.

Advice To Other Communities

Advice to other communities includes:

attract enthusiastic partners and participants (i.e., schools, instructors and students) for programs and watch it grow;
from an administration perspective, be organized and always prepared to bring on new partners and additional funding; and
don't "re-invent the wheel"! Contact Food First Foundation for Kids in the Kitchen information and resources.

Evaluation And Impact

Participating schools collect general program monitoring and satisfaction-related data annually from student participants, instructors and the school principal or designate. Through anecdotal comments and formal evaluations, schools continue to praise the benefits of the program in terms of providing valuable nutrition and food-handling information and skills to students in a very "learner friendly" format. They appreciate the fact that the program provides hands-on access to nutritious food which helps to address the food security issues that many program participants have. As well, several principals have shared that students take great pride in what they have prepared and have voiced that they feel the connection between the healthier foods that they are eating and how they are feeling. Students have also reported making the meals they learned to prepare in the program for their families at home. This is the kind of skills transfer that demonstrates the effectiveness of the program.

To date, the success of the program is largely attributable to ongoing support from Health Canada and the commitment and enthusiasm of participating principals and schools. The new Food First Foundation Coordinator expressed that she is "in awe of how some schools have made the program their own - tailoring it to meet the needs of their students."

Contact

Heather MacKenzie, Coordinator
Food First Foundation
P.O. Box 973
Yellowknife, NT X1A 2N7
Telephone: 867-446-3785
E-mail: foodfirst.coordinator@gmail.com

Nunavut: Healthy Foods North

Lead Organization:
Government of Nunavut in partnership with Sangita Sharma (University of North Carolina) and Joel Gittelsohn (Johns Hopkins University)

Key Partners:
Hamlet Councils, schools, community-based organizations, Health Canada's Diabetes Initiative, Arctic Co-operatives Limited and the North West Company

Communities:
Cambridge Bay and Taloyoak, Nunavut
Gjoa Haven as the control community is expected to receive the intervention in 2010/2011

Settings:
Retail grocery stores, schools, community facilities

Population of Interest:
All citizens within the two currently participating communities

Implementation Level:
Community

Stage of Development:
Pilot project currently concluding; Government of Nunavut awaiting results/evaluation

Background

In 2004, the Government of Nunavut released a territorial Diabetes Strategy, having a five-year funding commitment from Health Canada's Aboriginal Diabetes Initiative. One component of the strategy involved exploring promising practices to promote and support healthy eating within the retail setting, as one strategy to reduce high rates of risk factors for chronic diseases such as heart disease and diabetes. High rates of chronic diseases in the North are largely attributed to a rapid transition in the Arctic diet and lifestyle, including decreasing physical activity levels with less hunting activity and increased dependence on cars, snowmobiles and all terrain vehicles for transportation. As well, traditional foods have been increasingly replaced with a limited variety of processed and pre-prepared foods of low nutritional value requiring little cooking skill to prepare.
Working with primary investigators Sangita Sharma and Joel Gittelsohn, the Healthy Foods North (HFN) program was established by the Government of Nunavut to promote traditional foods and activities, improve people's diet, increase physical activity and reduce the risk of obesity and chronic disease. Consultations, public meetings and community workshops were used to inform the development of the program with particular focus on hamlet councils (local governments), community health representatives and health committees.
Working with local community groups, the specific objectives of the pilot program were to:

improve diets by maintaining or increasing traditional food consumption;
increase fruit and vegetable intake;
decrease consumption of high fat and high sugar foods;
increase physical activity through traditional activities and community-based programs; and
provide nutrition education accessible to all community members.

The project involves two main interventions:

Store interventions: includes taste tests of specific healthy foods, cooking demonstrations, posters, flyers and the display of shelf labels with the Healthy Foods North logo identifying healthier alternatives.
Community interventions: involves the integration of project activities into workplaces and community events including school programs, the use of local media, cooking classes and walking programs.

The evidence-based interventions are largely based on the "Healthy Stores" experience of the two primary investigators, tailored for each community based on input from community members. Local residents are employed as much as possible to carry out the program with training being a significant component of the pilot program over the first year.

Partnerships

Key partners for Healthy Foods North include Hamlet Councils and community-based organizations and health committees. Support from hamlet councils is essential as they administer local program funds and ideally will take ownership of the program. As well, the head offices of, and the local grocery stores, are important partners as a result of their role in making selected healthy food choices available. These selected foods are in turn used for taste testing and cooking demonstrations with the goal of the stores continuing to carry these foods to promote consumption. In addition, community facilitators have developed relationships with recreation coordinators to implement the community-based physical activity component of the pilot program. Through ongoing program outreach, program staff link with existing programs and organizations within the two pilot communities to enhance implementation of the program components, with the goal of ensuring accessibility by all.

Generating Buy-in

Generating support for the program in the two current pilot communities was not a challenge. Both enthusiastically signed-on following meetings with Hamlet Councils, health committees, schools and other community-based groups as well as extensive participatory community workshops. Healthy Foods North was accepted because the organizers continually sought out community input throughout the planning and implementation of Healthy Foods North.

While post-intervention data collection continues to be analyzed, anecdotal evidence points to the program being successful within the two pilot communities, and the local program facilitators are often contacted by community groups and organizations requesting program information.

Lessons Learned

The two local program coordinators and interventionists have learned several important lessons since the implementation of the pilot program in 2008. Specifically, they have learned how to interact and communicate better with the public through both the implementation of program activities and attendance at conferences (e.g., presenting a poster at the International Conference on Circumpolar Health in Yellowknife and at the National Aboriginal Health Conference in Ottawa). Word of mouth and attendance at some of the national conferences has been a strong contributor to the success of the program.

The second lesson learned is the fact that there is always a way to make things work - even if it involves a new way of working or doing things. Being flexible and open maximized opportunities for skill development, both among program coordinators and community participants.

Taste testing, recipe demonstrations and cooking classes aim to overcome one key challenge associated with cooking and food preparation skills - the lack of these within this culture, particularly among younger people, for both store bought and traditional foods. Even among adults and elders within the community, the reduced availability and consumption of traditional or country foods (most of which were eaten raw), and the introduction of largely unfamiliar store bought foods has resulted in the need for food skills knowledge and development. The food skills component of the pilot is based on the philosophy that if people have the opportunity to try a new food or recipe, they are much more likely to prepare and eat it at home.

Key factors that have contributed to the success of the pilot program in its first year include having locally trained community interventionists delivering the program within their own community, strong community support and acceptance of the program and its components and the cooperation of local stores, which is essential to the success of the healthy eating component of the program.

Next steps for the program include enhancing nutrition-related and leadership training for those working at the community level to implement the program, expanding the program to new communities within Nunavut and developing new materials.

Advice To Other Communities

From the perspective of the Nunavut Territory Coordinator and the two community-based program coordinators/interventionists, Healthy Foods North is a well-researched and evidence-based program that can be adapted to many communities. The program approach and content has been very well received by the two pilot communities. Community members feel empowered by the knowledge and skills that they have gained over the past year. While opportunities for program expansion within current and new communities exist, it is important not to stretch program resources too thinly to avoid negatively impacting the program.

Evaluation And Impact

Healthy Foods North is currently being evaluated. Data was collected in the two intervention communities and one control community during the fall of 2009, at the conclusion of the first year of the program's implementation. Data collection related to food intake (using a food frequency questionnaire), physical activity levels, awareness of and participation in program activities and knowledge and self-efficacy related to certain health behaviours was collected using various validated tools. Once analyzed, evaluation results will be disseminated to local communities, governments and beyond to ensure program sustainability and expansion and to effect policy and strategy development.

Contacts

Jennifer Wakegijig, Territorial Public Health Nutritionist
Box 1000, Stn 1000
Iqaluit, NU
Telephone: 867-975-5726
E-mail: JWakegijig@gov.nu.ca

Renata Rosol
Hamlet of Taloyoak
P.O. Box 8
Taloyoak, NU X0B 1B0
Telephone: 867-561-6341
E-mail: renata.rosol@gmail.com

Resources

Healthy Stores

United Kingdom: What's Cooking?

Lead Organization:
Food Standards Agency

Key Partners:
ContinYou (education charity), local/regional government and schools, restaurants, catering colleges, local supermarkets and grocers

Settings:
School and community settings in the North East and East Midlands regions of England and Scotland

Population of Interest:
Children and young people (11 to 14 years of age)

Program Focus:
To enable children and young people to learn how to choose, cook and eat safe, healthy food through practical, hands-on cooking sessions

Implementation Level:
National

Stage of Development:
Completed; implementation ongoing

United Kingdom: What's Cooking?

Background

What's Cooking? school and community cooking clubs were piloted by the United Kingdom (UK)'s Food Standards Agency (FSA). The cooking program aimed to equip children aged 11 to 14 with the skills and knowledge required to enable them to cook, choose and eat safe, healthy food.

The purpose was to help 11 to 14 year olds acquire food competences (life skills), which the FSA had published for 14 to 16 year olds in 2003. These Getting to Grips with Grub competencies were the precursor to the Agency's current Food Competency Framework, which established a consensus view on the essential food skills and knowledge that young people should possess, understand and be able to apply by the ages of seven to nine, 11-12, 14 and 16+. This framework sets out the essential building blocks so that schools and community-based organizations can provide young people with a consistent set of food skills and knowledge.

The What's Cooking? program was designed to deliver the food competencies. The core activities required addressed the four competency areas of diet and health, food safety, cooking (food preparation and handling) and consumer awareness. What's Cooking? club coordinators provide local delivery of the program and work with local partners and children to determine the activities they want to do. A What's Cooking? guide provides clubs with the information needed to implement the program, while FSA and ContinYou support clubs with training and other resources.

The clubs' goals were to provide practical food opportunities and to help young people to:

be aware of the importance of following a healthy diet;
have the necessary skills to prepare and cook healthy food;
make more informed choices about the type of food and drink they consume; and
follow correct food hygiene and safety procedures.

Partnerships

The FSA provided funding for the What's Cooking? program. The Agency commissioned an education charity, ContinYou, to develop and implement What's Cooking?, and to develop a guide to delivering cooking clubs. Local/regional governments and schools, who agreed to deliver What's Cooking? clubs, generated their own local partners such as restaurants, catering colleges, local supermarkets and grocers.

Generating Buy-in

FSA and ContinYou worked at a local/regional level in the North East and East Midlands regions of England to communicate, engage and motivate government and non-government organization stakeholders. What's Cooking? clubs were established in approximately 150 school and community settings within two regions of England, as well as Scotland. Where support was received from local authorities, they helped to support the clubs and arranged meetings and events so that several clubs could share their experiences and ideas.

The FSA utilized its cross-government contacts to ensure learning from What's Cooking? was utilized by government partners in development of sister programs.

Lessons Learned

Key to the success of What's Cooking? was its flexibility, which allowed coordinators to choose their own themes and adapt the program to the participants and settings. Also instrumental in the sustainability of the clubs were enthusiastic volunteers and keen support from school management and local authorities, suitable venues and equipment to run the sessions and acquisition of ongoing funding. Popularity among participants was maintained through hands-on, interactive activities and opportunities to taste lots of different foods.

Some of the challenges encountered included transportation for participants (some children were unable to attend as they did not have a way of getting home after the club), engaging parents/families (parents couldn't always get the time off work, while others did not want to take part) and keeping it fun and interesting.

A number of next-steps have been identified:

the FSA has worked across government to feed learning from What's Cooking? into the development of other government cooking initiatives such as the School Food Trust's Let's Get Cooking program;
ContinYou has worked in the North East of England to further the legacy of What's Cooking? by creating What's Cooking Kids? for children aged eight to 11 years; and
FSA has worked with Tottenham Hotspur Foundation to develop a cooking program called What's Cooking? Kick and Cook which is being delivered inside football stadiums.

Advice To Other Communities

Keep the cooking clubs flexible. Program flexibility meaning that:

coordinators could tailor the clubs to meet their own specific aims and objectives;
different themes could be adopted;
different audiences could be targeted; and
a range of delivery methods could be used.

It is also helpful to set up support networks and cluster groups so coordinators can meet regularly to discuss issues, successes, ideas and community support.

Evaluation And Impact

A formal evaluation of What's Cooking? was completed in 2008 and indicated a number of positive outcomes. The majority of participants found the clubs very enjoyable, and at least 85% of participants reported that they had learned something (e.g., how to cook; how to prepare food safely) as a result of taking part. Participants also noted a greater understanding of the benefits of healthy eating, intentions to eat more healthily, willingness to try different foods and greater involvement in cooking at home. In addition, a number of personal and social benefits were brought about by participation in the clubs, such as the development of communication and teamwork skills.
The evaluation also found evidence of new food-related clubs/activities taking place following participation in the program and, most notably, in nearly one in five cases the What's Cooking? clubs had kick-started a permanent cooking club.

For more detail on the evaluation results, see the full report at the web link below.

Contact

Jamie Blackshaw, Senior Scientific Officer
Food Standards Agency (UK)
Aviation House, 125 Kingsway
London, England
WC2B 6NH
Telephone: +44 207 276 8935
E-mail: Jamie.Blackshaw@foodstandards.gsi.gov.uk

Resources

Australia: Stephanie Alexander Kitchen Garden

Lead Organization:
Stephanie Alexander Kitchen Garden Foundation

Key Partners:
Department of Health and Ageing (Australian Government), Go For Your Life (Victorian Government), school community, and numerous other partners

Settings:
Primary schools throughout Australia

Populations of Interest:
Students in Years three to six (eight to 12 years of age)

Program Focus:
Pleasurable food education for young children through growing, harvesting, preparing and sharing fresh, seasonal produce.

Implementation Level:
National

Stage of Development:
Completed; implementation ongoing

Background

The Stephanie Alexander Kitchen Garden (SAKG) Program started in 2001 at an inner-city school in Melbourne, Australia. It was developed by Stephanie Alexander, an Australian chef, restaurateur and food writer who was "preoccupied with the way children do, or do not, learn about food". Stephanie believed that "the earlier children learn about food through example and positive experiences, the better their food choices will be through life". Today the Kitchen Garden program operates in 138 schools throughout Australia, with 13,800 children participating each week. By 2012 over 250 schools will have joined the program.

The aim of the Kitchen Garden Program is pleasurable food education for young children. With a Kitchen Garden experience children gain an appreciation for how easy it is to bring joy and well-being to one's life through growing, harvesting, preparing and sharing fresh, seasonal produce.

In the SAKG Program, children in grades three to six (ages eight to 12) spend a minimum of 40 minutes per week in an extensive vegetable garden which they maintain on the school grounds, according to organic gardening principles. They also spend one and a half hours each week in a kitchen classroom preparing and sharing a variety of meals created from their produce. The project employs two part-time specialist staff, a garden specialist and a kitchen specialist, to run these sessions, along with support from teachers and volunteers.

There are two unique factors about the Kitchen Garden Program. The first is the intrinsic link between the garden, the kitchen and the table. The emphasis is on learning about food and about eating it. No part of the program can exist without the other. The second factor is that the program is embedded in the school curriculum. It is a compulsory part of the school's program for four years of a child's life.

Partnerships

The willingness and commitment of a school is an essential first step towards establishing a Kitchen Garden. The Stephanie Alexander Kitchen Garden Foundation provides the vision, tools, resources and ongoing support for the program. The Victorian Government provided start-up funds for 40 new school projects within the state of Victoria in 2005. The Australian Government has committed infrastructure grants for an additional 190 primary schools by 2012. Numerous other partners have also provided financial support.

Once a school has established the garden and kitchen, ongoing community support is required. With the garden producing most of the food for the kitchen, the recurrent costs are for the part-time specialist staff, supplementary produce for the kitchen, dry goods, kitchen maintenance, cleaning, utilities, garden supplies such as seeds, seedlings and replacement equipment and garden maintenance. The SAKG Program relies on generous in-kind donations from the community. The average Kitchen Garden Program, with 100 students participating per week (40 weeks per year) costs $11 per child per week.

Generating Buy-in

The Kitchen Garden program was launched by using Stephanie Alexander's iconic status to attract media coverage and support and enable contact with government decision makers. Program support was achieved by lobbying government, which included bringing politicians and policy makers to the school to witness the program success first hand.

The SAKG Foundation continues to generate buy-in through the promotion of independent evaluation findings. Positive results will be used to engage policy makers and seek permanent policy change that would allow sustained program funding.

Lessons Learned

Essential to the success of the SAKG Program is engagement with the whole school community (parents, pupils and community members). Opportunities for involvement include assisting with the initial grant application, project management, planning, construction, working bees and volunteering in the kitchen and garden. The key to success often lies with the school principal's capacity to stimulate community interest and support in the implementation of this program.

The initial challenge for this program was finding an open-minded principal and school community willing to try something new. Other challenges were funding staffing costs and creating kitchen and garden spaces within schools. The most critical challenge is sustaining the SAKG Program in participating schools once their funding comes to an end.

As the SAKG Program continues its outstanding growth and more schools come on board, the next step is to seek changes to government funding for schools, allowing for the staffing of health prevention programs such as this one.

Advice To Other Communities

According to the SAKG Foundation's CEO, Ange Barry, "Leadership, engagement, hard work, funding, passion and drive and inspiration are your key tools. Give it a go and bring like-minded people around you to make it happen."

Evaluation And Impact

A formal evaluation of the Stephanie Alexander Kitchen Garden Program was completed in 2010. See below for link to final evaluation report.

Key findings of the evaluation clearly indicate the benefits of the Kitchen Garden Program; including:

increased child willingness to try new foods;
improved child knowledge, confidence and skills in cooking and gardening; and
transferred program benefits to the home environment.

Contact

Ange Barry, CEO
Stephanie Alexander Kitchen Garden Foundation
Level 1, 165 Victoria Parade
Collingwood, Victoria
3066
Australia
Telephone: 61-3-8415 1993
E-mail: ange@kitchengardenfoundation.org.au

Resources

Stephanie Alexander Kitchen Garden Foundation
Books and other resources for the Kitchen Garden Program
Stephanie Alexander Kitchen Garden Program evaluation report (2010)

Conclusion

The case studies included within this report demonstrate a shared understanding and commitment to the importance of developing and/or supporting enhanced nutrition knowledge and cooking and food preparation skills among numerous populations across Canada. In many cases, programs were initiated based on observations that the food choices being made by or for school-aged-children were not supportive of optimal nutritional and overall health. Further to this observation, programs were developed based on the belief that opportunities to develop and enhance cooking and food preparation skills are necessary to improve food choices and the enjoyment of eating healthy food. Programs profiled in this report build on existing experience and knowledge of the lead organizations and partners. The programs aim to provide opportunities for hands-on learning and skill development within an enjoyable and comfortable environment.

While few of the programs included within the scan have been formally evaluated, all report success, largely based on informal and ad hoc feedback received from program participants, parents/families, the broader community and program partners. These successes include enhanced nutrition and food safety knowledge; integration of healthier food choices into eating patterns; preparation of recipes provided within programs at home; greater self-confidence and pride in cooking and food skills; and increased and sustained uptake of programs by community-based organizations and agencies.
The goals and objectives of the programs included reflect an understanding of what is possible to achieve in terms of outcomes and behaviour change via their programs. These primarily include knowledge and skill development and changes in food choice and healthy eating patterns. Key informants, however, readily acknowledge broader societal challenges influencing nutritional and overall health which remain. The 13 Canadian and two international case studies presented here illustrate the many innovative cooking and food skills programs already taking place supported by all sectors - private, voluntary and non-profit, government at all levels and beyond.

The key informants interviewed for this report offered invaluable insights from their front-line experience. Their insights can be used to shape and influence future program and policy planning, implementation and evaluation. Common themes across the following areas were identified as a means of highlighting shared experiences and fostering linkages and connections among existing and new programs currently and in the future: generating buy-in/fostering ongoing commitment, lessons learned and advice for other communities.

This report is intended to be a guide for individuals and organizations interested in developing, adapting and implementing cooking and food skills programs in their own jurisdiction. A concerted effort to support the evaluation of the short-and long-term impacts of existing programs can only benefit the sustainability of efforts and their enhanced success. There is also a need to learn from practice and strengthen the evidence-base to inform future program and policy decisions.

Appendix A: Additional Case Studies

This report profiles 13 Canadian and two international case studies of promising or successful programs aimed at improving cooking and food preparation skills among children and their families. Case studies were selected based on criteria detailed in the main body of this report. While only one case study per province/territory could be profiled within the body of the report, many more meeting selection criteria were considered. This appendix provides a brief overview of some of these additional initiatives.

Adventures in Cooking for Kids Eight to Twelve (Thunder Bay, Ontario)
Adventures in Cooking is a program manual for leaders who work with kids aged eight to 12. It is a comprehensive five-lesson program designed to pass on the basic skills of preparing food, providing healthy meals and reinforcing the importance of healthy eating. This program aims to improve kids' health and to give them a fun and safe opportunity to learn the basics of cooking skills that will last a lifetime. Having kids who are confident cooks in the kitchen, and who can make nutritious meals and snacks, will ultimately decrease their risk of diabetes and heart disease down the road.

Bookmates Alphabet Soup (Winnipeg, Manitoba)
Alphabet Soup is a six-week nutrition and literacy program. The program is offered in parent-child centres (in cities, rural communities and on First Nations Reserves in regions across Canada) and in community settings where parents and children are together. It teaches preschoolers (aged two to five) and their parents the basics of healthy eating through the love of reading, rhyme and song. Each week, parents and children participate in interactive sessions based on different food-related themes. Parents and children read food-themed books and then prepare snacks to learn new snack ideas and enjoy eating together. After snack-time, the parents come together to discuss new methods of enriching both nutrition and literary skills in their children's lives. At the same time, children participate in activities and continue to learn about food and literacy through games, crafts and play. The program's overall appeal is that it puts the focus on food and fun to motivate children to start life with a positive attitude toward food. The success of this program has led to the creation of Alphabet Soup in Motion which focuses on active play, literacy and family eating principles.

Come Cook with Us (Peterborough, Ontario)
Come Cook With Us is a six-week cooking class series, promoted to people living on low-incomes. Participants learn basic cooking skills, discuss nutrition and food safety tips and receive supports such as child care, transportation and a grocery store gift card. Come Cook With Us is an initiative of the Food Security Community Partnership Project (FSCPP), which helps people access healthier foods through innovative programming and partnerships. The goal of the FSCPP is to partner with community members and organizations to develop a coordinated and innovative system of food security programs that ensures all community members have access to affordable, nutritious and personally acceptable foods.

Cook It Up! A Community-Based Cooking Program for At-Risk Youth (London, Ontario)
Cook It Up! is an education and skill-building health promotion program for groups of at-risk youth (aged 13 to 18) focusing on nutrition, food safety, food preparation and cooking skills and agriculture fieldtrips to a variety of local farms. Based on knowledge and evidence related to health risks and status of at-risk youth and food choice determinants of adolescents, Cook It Up! was designed to provide participants with life skills necessary for leading a responsible, independent life (e.g., food selection, shopping, preparation and food preservation skills as well as decision-making, communication and social skills) which will serve to enhance their self-confidence, self-esteem and self-efficacy. A formative evaluation of the program has been undertaken and results can be shared. Cook It Up! is generously funded by Ontario Agri Food Education Inc. in collaboration with other community partners.

Cooking Fun for Families (Vancouver, British Columbia)
Cooking Fun for Families (CFFF) is a well-established hands-on cooking program bridging the community and school environments. CFFF targets at-risk school children and their families and assists them with daily issues surrounding food, including dietary quality, accessibility and affordability. The program complements school breakfast and lunch programs by involving parents in activities and discussion about the link between nutrition and health. Since 1999, CFFF has been endorsed and recommended as a core program for at-risk families by the Inner City School Advisory Committee of the Vancouver School Board.

Guelph Community Health Centre Little Chefs Program (Guelph, Ontario)
Little Chefs is a cooking and physical activity program for children aged three to six, and their parents and caregivers. The program is designed for families who face barriers to health and well-being, that is, those who are least likely to have access to resources supporting healthy eating and physical activity. Little Chefs is a hands-on program where parents and children learn healthy new recipes that are low-cost and kid-friendly, and enjoy fun, active physical activities and games. The goals of Little Chefs are to promote the benefits of healthy eating and fun physical play, to encourage families to adopt healthy lifestyle behaviours and practice them together as a family and to offer a safe place to meet other families and to try new skills.

Kids in the Community Kitchen (Simcoe, Ontario)
Kids in the Community Kitchen (KICK), a free, fun and informal program, teaches kids about food preparation, cooking skills, meal planning, Canada's Food Guide and physical activity. Each session includes tasty food, fun games and activities about food, nutrition and being active. The program is delivered by a Registered Dietitian with the help of local youth volunteers, and is made possible by a grant from The Baxter International Foundation.

Kids in the Kitchen (Souris, Prince Edward Island)
The Eastern Kings Community Coalition, Main Street Family Resource Centre in Souris, PEI, has offered the Kids in the Kitchen program once a year for ten weeks. This is a hands-on cooking program targeting children. The program uses recipes included in the program manual, but also adapts recipes as required for the ages of children involved. The children do the majority of the cooking, cracking eggs, measuring, mixing, cutting soft foods and pouring. Feedback from the participants has been positive. Child size aprons and cookbooks, with the children's names on them, were made. For more information, contact mainfrc@pei.aibn.com

Little Chefs (Fort Qu'Appelle Elementary Community School, Saskatchewan)
Little Chefs was implemented due to an identified need for a more comprehensive nutrition program for the students of Fort Qu'Appelle Community Elementary School. The school at that time provided snacks and lunches for students, and soon realized that it wanted to be more than a feeding program. The goal was to create a way for students to be educated, not only the simple health aspect of nutrition, but on preparation, budgeting and realistic menu choices for students and their families. Little Chefs is run during regular class time of the school day with a classroom teacher, nutrition coordinator and resource people such as a diabetes educator, community nutritionist and public health professional. Each session has an education, food preparation, menu planning and shopping component. For more information, contact Tami Janz-Sargees at (306) 332 -4343 or Cheryl Lowe at (306)332-5566.

Ontario Pork Early Years Initiative (Ontario)
Since 2008, Ontario Pork has partnered with Early Years Centres in southern Ontario to provide cooking and food preparation skills to parents and caregivers of children up to age six. Ontario Pork's dietitian and home economist deliver a demonstration-based program that offers tips and advice on food safety and how to prepare meals that are quick, kid-approved, inexpensive and nutritious. For recipes and nutrition information visit www.putporkonyourfork.com. For more information on Ontario Pork's Early Years Centre program contact Mary Jane Quinn, maryjane.quinn@ontariopork.on.ca

Pot, Pan and Wooden Spoon (Placentia, Newfoundland)
Pot, Pan and Wooden Spoon is a six-week parent-care giver/child cooking program. The program is offered in the Stepping Stone Family Resource Center in Placentia, Newfoundland and Labrador for children (aged zero to 6), parents and caregivers. The program uses cooking together parent/child experiences to develop independence. As well, the program strives to promote interaction and cooperation to foster discovery and exploration while providing opportunities to cook/bake nutritious snacks. Participants are introduced to Canada's Food Guide and the concept of "healthy eating means eating a variety of foods to promote healthy growth and development for children." For more information contact serenapomeroy@nf.aibn.com or 709-227-1010.

Project CHEF: Cook Healthy Edible Food (Vancouver, British Columbia)
Project CHEF is an experiential, curriculum-based school program, aimed at children in grades four and five that teaches students about healthy food: where it comes from, what it tastes like, how to prepare it and how to enjoy sharing it around a table. Designed to immerse children in the process of cooking from preparation to clean-up, children gain knowledge about food, discover the pleasure and satisfaction in creating meals for themselves and develop skills so that they can apply their new-found knowledge and abilities in making healthy food choices at home.

Slow Cooker Program (Souris, Prince Edward Island)
The Slow Cooker Program, offered by the Main Street Family Resource Centre in Souris, PEI, was originally developed as a project of the Healthy Living Collaborative Group. The project was conceived and is led by parents involved with the Centre. The Resource Centre purchased a number of slow cookers with funds supplied by the project and also have received assistance from the Chicken Growers of PEI. The families (usually a mother or grandmother) meet once a week to prepare food for the slow cookers and then take them home. The focus is on a healthier way to prepare food. To date, eight sessions of the program have been delivered. For more information, contact mainfrc@pei.aibn.com

Summer Fun Food Camp (Saskatoon, Saskatchewan)
The Summer Fun Food Camp was developed by the Division of Nutrition and Dietetics of the College of Pharmacy and Nutrition, University of Saskatchewan, to enhance children's knowledge and understanding of food and nutrition through creative, fun and challenging experiences and activities. The focus of the week-long full day camp is fun with food, cooking and nutrition. Children are taught basic food preparation and cooking skills, food and kitchen safety and basic nutrition in an interactive, hands-on environment. Food preparation and cooking, games, crafts, outside activities, food experiments and field trips are incorporated into the daily activities. At the end of each session, the participants are provided with a cookbook in addition to other information.

You're the Chef (Niagara Region, Ontario)
You're the Chef was launched to help develop the skills and confidence necessary for youth, aged ten to 14, to prepare healthy and tasty recipes emphasizing vegetables and fruit. It was developed by Registered Dietitians from the Niagara Region Public Health Department in response to school requests for programs targeting this age group. Since "tweens" (pre-teens and young adolescents) prepare many of their own meals and snacks, hands on cooking sessions provide an opportunity to influence their skills in the kitchen, improve the quality of what "tweens" prepare and help to shape their eating habits positively, which can last a lifetime. During the program, youth are taught basic cooking skills, healthy eating principles and safe food handling.

Footnotes

Footnote 1

Raine KD. Determinants of healthy eating in Canada: An Overview and Synthesis. Canadian Journal of Public Health 2005; 96(3):S8-S14.

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Footnote 2

Lang T, Caraher M. Is there a culinary skills transition? Data and debate from the UK about changes in cooking culture. Journal of the Australian Institute of Home Economics 2001; 8(2):2-14.

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Footnote 3

Lyon P, Colquhoun A, Alexander E. Deskilling the domestic kitchen: national tragedy or the making of a modern myth? Food Service Technology 2003; 3:167-175.

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Footnote 4

Jaffe J, Gertler M. Victual vicissitudes: Consumer deskilling and the (gendered) transformation of food systems. Agriculture and Human Values, 2006; 23(2):143-162.

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Footnote 5

Kornelson, S. Is that the way the cookie crumbles? Consumer deskilling in food systems and the journey toward food sovereignty. 2009. Wilfred Laurier University.

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Footnote 6

Caraher M, Dixon P, Lang T, Carr-Hill R. The state of cooking in England: the relationship of cooking skills to food choice. British Food Journal 1999; 101(8):590-609.

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Footnote 7

Larson NI, Story M, Eisenberg ME, Neumark-Sztainer D. Food preparation and purchasing roles among adolescents: associations with sociodemographic characteristics and diet quality. Journal of the American Dietetic Association 2006; 106(2):211-8.

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Footnote 8

Larson NI, Perry CL, Story M, Neumark-Sztainer D. Food preparation by young adults is associated with better diet quality. Journal of the American Dietetic Association 2006; 106(12):2001-2007.

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Footnote 9

Wrieden WL, Anderson AS, Longbottom PJ, Valentine K, Stead M, Caraher M, Lang T, Gray B, Dowler E. The impact of a community-based food skills intervention on cooking confidence, food preparation methods and dietary choices - an exploratory trial. Public Health Nutrition 2007; 10(2):203-211.

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Footnote 10

Engler-Stringer R. The Domestic foodscapes of young low-income women in Montreal: Cooking practices in the context of an increasingly processed food supply. Health Education and Behaviour 2009.

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Footnote 11

Geishirt Cantrell B. Access and barriers to food items and food preparation among Plains Indians. Wicazo SA Review, 2001; 65-74.

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Footnote 12

Broughton MA, Janssen PS, Hertzman C, Innis SM, Frankish CJ. Predictors and outcomes of household food insecurity among inner city families with preschool children in Vancouver. Canadian Journal of Public Health 2006; 97(3):214-216.

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Footnote 13

Lees, EL, Redman, H, Berland, A. Bringing Health to the Planning Table: A Profile of Promising Practices in Canada and Abroad: Built Environment. 2009. Ottawa, Healthy Living Issue Group of the Pan-Canadian Public Health Network. 6-21-2010. Online:http://www.phac-aspc.gc.ca/publicat/2009/be-eb/index-eng.php

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Footnote 14

Dubois, N, Jetha, N, Robinson, K, Szuto, I, Wan, G, Wilkerson, T. Canadian Best Practices Initiative Methodology Background Paper. 2008. Ottawa, Public Health Agency of Canada. Online: http://cbpp-pcpe.phac-aspc.gc.ca/pubs/CBPI-methodology.pdf

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Footnote 15

Bisset SL, Potvin L, Daniel M, Paquette M. Assessing the impact of the primary school-based nutrition intervention Petits cuistots - parents en réseaux. Canadian Journal of Public Health 2008; 99(2):107-113.

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Additional Resources

Improving Cooking and Food Preparation Skills: A Synthesis of the Evidence to Inform Program and Policy Development

Page details

Date modified:: 2011-01-13

Improving Cooking and Food Preparation Skills: A Profile of Promising Practices in Canada and Abroad

Table of Contents

Acknowledgements

Strategic Collaboration Working Group

Key Informants

Executive Summary

Introduction

Methodology

Case Study Profiles

British Columbia: Food Skills for Families

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Im Pact

Contact

Alberta: Collective Kitchens Coordinator Training

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Impact

Saskatchewan: Kids Kitchen

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Impact

Contact

RESOURCES

Manitoba: Kids in the Kitchen

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Impact

Contact

Ontario: Community Food Advisor Program

Background

Partnerships

Generating Buy-in

Lessons Learned

Evaluation And Impact

Contact

Resources

Quebec: Petits cuistots/Parents en réseaux

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Impact

Contact

Resources

New Brunswick: Healthy Cooking, Healthy Kids

Background

Partnerships

Generating Buy-in

Lessons Learned

Evaluation And Impact

Contacts

Nova Scotia: Strive for Five at School!

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities

Evaluation And Impact

Contact

Resources

Prince Edward Island: What's for Dinner?

Background

Partnerships

Generating Buy-in

Lessons Learned

Advice To Other Communities