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Improving Adherence to Mediterranean-Style Diet With a Community Culinary Coaching Program: Methodology Development and Process Evaluation

Polak, Rani, MD, MBA; Pober, David, PhD; Morris, Avigail, PhD; Arieli, Rakefet, RD, MSc; Moore, Margaret, MBA; Berry, Elliot, MD; Ziv, Mati, MD

Journal of Ambulatory Care Management: July/September 2018 - Volume 41 - Issue 3 - p 181–193
doi: 10.1097/JAC.0000000000000240
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The Community Culinary Coaching Program is a community-based participatory program aimed at improving communal settlement residents' nutrition. The residents, central kitchens, preschools, and communal dining rooms were identified as areas for intervention. Evaluation included goals accomplishment assessed by food purchases by the central kitchens, and residents' feedback through focus groups. Purchasing included more vegetables (mean (standard error) percent change), (+7% (4); P = .32), fish (+115% (11); P < .001), whole grains, and legumes (+77% (9); P < .001); and less soup powders (−40% (9); P < .05), processed beef (−55% (8); P < .001), and margarine (−100% (4); P < .001). Residents recommended continuing the program beyond the project duration. This model might be useful in organizations with communal dining facilities.

Department of Physical Medicine and Rehabilitation, Institute of Lifestyle Medicine, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, Massachusetts, and Department of Family Medicine, Healthy Cooking and Lifestyle Center, Hebrew University Hadassah Medical School, Jerusalem, Israel (Dr Polak); Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts (Dr Pober); Dead Sea and Arava Science Research Center, and Arava Institute for Environmental Studies, Kibbutz Ketura, Israel (Dr Morris); Department of Orthopedic Surgery, Sport Medicine Center, The Hadassah-Hebrew University Medical Center, Jerusalem, Israel (Ms Arieli); Wellcoaches Corporation, Wellesley, and Institute of Coaching, McLean Hospital, Harvard Medical School-Affiliated, Belmont, Massachusetts (Ms Moore); Department of Human Nutrition and Metabolism, Braun School of Public Health, Hebrew University Hadassah Medical School, Jerusalem, Israel (Dr Berry); and Department of Family Medicine, Rabin Medical Center and Tel Aviv, Dan & Eilat districts, Clalit (Dr Ziv).

Correspondence: Rani Polak, MD, MBA, Department of Physical Medicine and Rehabilitation, Institute of Lifestyle Medicine, Harvard Medical School, Spaulding Rehabilitation Hospital, 300, 1st Ave, Boston, MA 02129 (Rpolak@partners.org).

The authors thank Tehila Mazal, Hadassah Hebrew University School of Medicine, for her help in developing the evaluation methodology.

This work was sponsored by research grants from Yotvata Community Settlement and the Israeli Association of Family Medicine. Rani Polak was supported through his fellowship with educational grants from Maccabi Healthcare Service, Harvard Medical School-PM&R Department, and the Israeli Cancer Association.

R.P. participated in the design and delivery of the program, collection and analysis of data, and drafting the article. D.P. led the analyzing of the quantitative data and significantly contributed to the drafting of the article. A.M. led the qualitative evaluation including the delivery of the focus group and analyzing the data, and significantly contributed to the drafting of the article. R.A. participated in the design and delivery of the program collection and analysis of data. M.M. participated in the interpretation of the data and the article drafting. E.B. participated in the design and delivery of the program, analysis of data, and drafting the article. M.Z. participated in the design and delivery of the program, and collection of data.

This project was approved by the Clalit Health Service Institutional Review Board on Human Subjects Research (committee's reference number 0030-12-COM) and the need for participant consent was waived.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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