Objective: To examine changes in health-related quality of life (HRQoL) among youth who participated in Flint Kids Cook, a six-week healthy cooking program for children, and assess whether changes in HRQoL were associated with changes in cooking self-efficacy, attitude towards cooking (ATC), and diet. Design: Pre-post survey (Pediatric Quality of Life Inventory, Block Kids Food Screener, 8-item cooking self-efficacy, 6-item ATC) using child self-report at baseline and program exit. Analysis involved paired sample t-tests and Pearson correlations. Setting: Farmers’ market in Flint, Michigan, USA. Participants: Children (n=186; 55.9% female, 72.6% African American) participated in Flint Kids Cook October 2017–February 2020 (mean age 10.55 ± 1.83 years; range 8-15). Results: Mean HRQoL summary score improved (p<0.001) from baseline (77.22 ± 14.27) to program exit (81.62 ± 14.43), as did mean psychosocial health summary score (74.68 ± 15.68 vs 79.04 ± 16.46, p=0.001). Similarly, physical (p=0.016), emotional (p=0.002), social (p=0.037), and school functioning (p=0.002) improved. There was a correlation between change in HRQoL summary score and change in ATC (r= -0.194, p=0.025) as well as change in cooking self-efficacy (r= -0.234, p=0.008). Changes in HRQoL and psychosocial health summary scores were not correlated with dietary changes, which included decreased added sugar (p=0.019) and fruit juice (p=0.004) intake. Conclusions: This study is the first to report modest yet significant improvements in HRQoL among children and adolescents who participated in a healthy cooking program. Results suggest that cooking programs for youth may provide important psychosocial health benefits that are unrelated to dietary changes.

A large pediatric clinic in Flint, Michigan, implemented a produce prescription program for youth to address enduring challenges with food access and food insecurity. Approximately 18 months later, on March 23, 2020, the State of Michigan issued a "stay home, stay safe" executive order in response to the COVID-19 pandemic. This study sought to (1) explore caregiver experiences with access to and utilization of the prescription program during COVID-19; and (2) understand perceived changes in the food environment during the "stay home, stay safe" executive order. MethodsResearchers collected data through recorded, semi-structured telephone interviews with caregivers of children who received at least one produce prescription and had previously enrolled in a preliminary effectiveness study on the prescription program. We transcribed the recordings verbatim for textual analysis. Examining the qualitative data using thematic analysis, we identified patterns across transcripts and formulated illustrative themes. ResultsFifty-six caregivers (mean age, 41.3 ± 10.3 years) participated in interviews. The majority were female (91%), African American (70%), and Flint residents (75%). Recurrent themes, each centered around changes in the food environment resulting from COVID-19, emerged: (1) produce prescription access and utilization; (2) food access constraints; (3) food shopping adjustments; and (4) food insecurity stress. Perceived consequences of COVID-19 included increased anxiety related to food shopping and food insecurity alongside challenges accessing and utilizing the produce prescription program. ConclusionsThis study highlights the many ramifications of the COVID-19 pandemic on vulnerable families. More comprehensive efforts are necessary to address substantial barriers to healthy food access and affordability caused by the recent pandemic.

No abstract