Date Presented 04/02/2022

This study evaluated the effectiveness of the Veggies for Life (VFL) curriculum and the implementation of healthier lifestyles through the increased consumption of fruits and vegetables and the use of adaptive tools, facilitating independence in meal preparation. Through the use of adaptive tools, healthy eating, and nutritional guides, participants demonstrated an increased maintenance of healthy lifestyle routines.

Primary Author and Speaker: Reagan Collins

Additional Authors and Speakers: Mary Isaacson, Jessica Dawn Tsotsoros

Contributing Authors: Hartley Bowman, Marianna Wetherill

BACKGROUND: Adults with disabilities experience multiple dietary intake disparities, which contribute to higher risks for obesity, diabetes, and cardiovascular disease in this population (An, et al., 2014). There is little published guidance on adapting nutrition and food skills education for people with physical disabilities who may face unique barriers, including difficulty grocery shopping, limited food budgets, apprehension to using certain appliances for meal preparation, and inadequate support/resources to prepare food. This study evaluates an original healthy cooking workshop called Veggies for Life (VFL) for participants of a community day center for individuals with physical disabilities. VFL was delivered using a 4-week, small-group, learning format to address the nutritional disparities in this population. Each weekly session consists of a 90-minute curriculum including group discussion, skill-building activities, nutrition education, and goal setting.

PURPOSE: The purpose of this study was to promote healthy eating knowledge, confidence, and adaptive cooking strategies for individuals with physical disabilities. This study assessed participant knowledge, retention, and nutritional application of the information from the VFL curriculum.

METHOD: In partnership with a community-based organization an interprofessional team of OT, PT, dietetics, and culinary arts professionals developed and implemented the VFL curriculum. To inform our approach, we conducted a series of participant observations and interviews to better understand healthy eating interests, motivations, and barriers in this population as well as a comprehensive systematic review of nutrition disparities affecting people with mobility disabilities The 4-week small group curriculum emphasized adaptive cooking skills for fruits, vegetables, plant proteins, and whole grains using demonstration videos, experiential activities, group problem solving, and goal-setting. This study used a pre-post study design to evaluate the effectiveness of the VFL curriculum and the implementation of healthier lifestyles through the increased consumption of fruits and vegetables and the use of adaptive tools, facilitating independence in the kitchen. A total of 32 individuals took part in the VFL classes across four cohorts, diagnoses included CVA, TBI, CP, amputations, and other autoimmune disorders. All were invited to participate in the survey. Survey items included demographics, type of disability, kitchen equipment use, food access, and food behavior items, including a modified Block Fruit/Vegetable/Fiber screener (Block, 2019).

RESULTS: Thirty-eight percent of participants reported eating more nuts/seeds, 43% reported decreased consumption of animal foods, 50% reported reduced sugary beverage consumption, 20% reported reduced intake of sugary snacks, and 67% reported reduced consumption of frozen, canned, and boxed dinners. Additionally, 50% of participants reported increased breakfast consumption and 32% reported cooking from scratch more often upon class completion. Finally, Forty one percent of participants said changing recipes to make them healthier at home “always” or “most of the time” compared to 11% of participants at baseline.

CONCLUSION: Small group nutrition education using the VFL curriculum may be an effective tool for improving nutrition well-being of individuals with physical disabilities. Conclusion of this project will result in a group facilitator’s manual and participant teaching materials for sustained use by staff promoting broader dissemination.

IMPACT: OT practitioners may consider using this curriculum as an intervention to promote health management and maintenance as well as maintaining routines for health and wellness promotion, such as nutrition.

References

An, R., Chiu, C.Y., Zhang, Z., & Burd, N.A. “Nutrient Intake among US Adults with Disabilities.” Journal of Human Nutrition and Dietetics, vol. 28, no. 5, 2014, pp. 465– 475., https://doi.org/10.1111/jhn.12274

Block, G., Gillespie, C., Rosenbaum, E. H., & Jenson, C. (2000). A rapid food screener to assess fat and fruit and vegetable intake. American Journal of Preventive Medicine, 18(4), 284- 288. https://doi.org/10.1016/s0749-3797(00)00119-7