Background

The diets of many of the UK population are failing to meet recommendations aimed at avoiding ill health. While the influences on peoples’ diets are multiple and complex, people who are socio-economically disadvantaged tend to have diets that are less healthy than the average. In response to a concern that opportunities to learn how to plan and prepare meals have been lost over the past few decades, there has been recent interest in community-based courses aimed at adults who want to learn to cook. This review aimed to identify the kinds of home cooking course that have been evaluated in the UK and to summarise findings from reliable evaluations.

Methods

Eighteen bibliographic databases were searched using a highly sensitive set of indexed and free-text terms. Authors and experts in the field were contacted with requests for reports. Web-based search engines were used and 39 websites were scanned. Relevant studies were scanned for other possibly relevant studies and were used to run citation searches. Relevant studies were those that reported an evaluation of a course aimed at providing adults in the UK (aged 16+) with skills and knowledge about home cooking. They also needed to report findings about outcomes for adults, or about the way the training was delivered or received. Outcome evaluations needed to have used a comparison group design so as to compare outcomes for people who had received cooking training with outcomes for a similar group of people who had not received this training. Evaluations of processes needed to have described either their methods for data collection or their methods for data analysis. Evaluations of courses focused on academic or professional qualifications were excluded. The initial searches identified approximately 11,700 potentially relevant reports. Most were from outside the UK, or were not about adult cooking courses. On closer inspection of over 200 paper reports, 13 studies were found to meet all the above criteria. (Five of these studies evaluated home cooking courses using a comparison group design and four of these had also evaluated intervention processes. A further eight studies had evaluated processes, but had no comparison group on which to compare outcomes.) All 13 studies were examined using a framework to describe key aspects, such as content of the training, population, outcomes targeted and the research design used. The characteristics of the process evaluations were tabulated and then described narratively. Reviewers examined the outcome evaluations in greater depth. They worked independently, then compared decisions, with differences in opinion resolved by discussion with a third reviewer where necessary. The quality of each evaluation was assessed using criteria that addressed selection, attrition and reporting bias. Only one of the five outcome evaluations met all three sets of criteria and so was judged to be able to provide reliable findings about the effects of its intervention.

Findings

What kinds of home cooking courses have been evaluated in the UK?

The courses that have been looked at in evaluation studies appear broadly similar to one another. They all introduce participants to practical cooking skills, with some courses emphasising food safety and hygiene, and others shopping on a budget. They tend to be offered to existing community groups, rather than to individuals, and are usually run in community settings, which range from all-purpose centres to purpose-built community kitchens. The courses vary in three main ways: (i) whether or not the content of the training sessions is tailored to the needs of people with specific illnesses, ethnic backgrounds or life stages; (ii) whether or not the initiative recruits people from the community who then teach others; and (iii) whether courses are initiated by research teams in order that they be evaluated, or whether the courses exist prior to evaluation. In the three studies that provided a breakdown of costs per person of a full course, these ranged from £84 to £260 (for courses totalling 12 and 40 hours respectively). Costs were affected mainly by the length of the course and the extent to which the course tutors themselves were trained as part of the programme, as well as how much programmes paid for kitchen and, in some cases, crèche facilities.

The UK evaluation literature on home cooking courses is not well developed. Study reports often contained little information about the courses themselves; key details about evaluation methods were often missing.

There is interest in developing and providing such courses among a range of different organisations and agencies across the UK, offering the potential for further research in this area.

What is the evidence that courses make a difference?

The current evidence on the effects of home cooking courses for adults in the UK is inconclusive because of a lack of high-quality evaluations of these schemes.

The evidence on effects comes from one well-conducted evaluation of peer-led cooking clubs for people aged 65 or older in sheltered housing in socially deprived areas. This study suggests that cooking courses in this population might have beneficial impacts, but might also have less desirable effects.

The evaluation shows that a year after the course, participants had increased, beneficially, the percentage of energy they obtained from carbohydrate (2.4% more than people who had not attended a club). Less desirably, a year after the programme was completed, cooking club members were more likely to describe their diet as healthier than it actually was, compared to people who had not taken part in the clubs. There was no evidence that the cooking club had an effect on other aspects of diet, or on knowledge, attitudes or physical health, though it is possible that the study was too small to be able to detect such changes.

An evaluation of associated processes found that participants enjoyed these cooking sessions for largely social reasons. They thought it might be difficult to access some of the cooking ingredients under usual conditions. Participants appreciated learning from people of a similar age and authority. Not all clubs managed to start but attendance during courses was good. Some felt that 20 weeks of sessions was too long. Tutors needed to adapt the course to the physical abilities of participants and when kitchens had limited facilities.

In addition to this evaluation of a cooking course for people in sheltered housing schemes, four other studies were found that had compared people who took part in a course with people who did not (comparison group design). All four had constraints: in all four it is unclear whether or not initial differences between participants in the comparison groups affected measurements later on; in three of the four, participants also then withdrew from the studies in ways that, again, could have affected estimates of the home cooking courses’ effects. Study authors described difficulties with recruiting participants and allocating them to study groups, as well as difficulties with participants dropping out before the study was completed.

Recommendations for policy and research

For policy

• Build rigorous evaluation into the provision of home-cooking courses, where possible, before roll-out.

For research

• Conduct evaluations of a sufficient size, with robust designs that can provide reliable evidence about impact.
• Consider allocating already existing clusters of participants to evaluation comparison arms (e.g. whole community clubs), rather than individuals. Courses and evaluation can then build on existing relationships and social supports.
• Ensure that sufficient resources and feasibility testing are built into the recruitment stages of evaluations.

This summary was prepared by the EPPI Centre. The report should be cited as:

Rees R, Hinds K, Dickson K, O’Mara-Eves A, Thomas J (2012) Communities that cook: a systematic review of the effectiveness and appropriateness of interventions to introduce adults to home cooking. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.