# Comparing Family Health Before and After a Family-Focused Nutrition Program during the Pandemic

## TL;DR

A home-based virtual nutrition program improved family health and nutrition during the pandemic, especially for underserved families.

## Contribution

This is the first study to examine changes in family health over time through a home-based virtual nutrition program.

## Key findings

- Family health scores significantly improved after 12 weeks in the program.
- Both parent and child nutrition improved significantly, though food insecurity did not.
- The program was effective across diverse racial and socioeconomic groups.

## Abstract

The COVID-19 pandemic affected child health behaviors, leading to worse physical health. Given the importance of good family health in improved child health outcomes, this secondary cohort analysis tested the hypothesis that family health would improve from baseline to 12-week follow-up after participation in a novel family nutrition program.

Diverse parent-child dyads participated in a home-based virtual Teaching Kitchen Outreach (vTKO) program (11 weekly healthy, low-cost recipes, cooking videos, and associated groceries delivered). The primary outcome was the Family Healthy Lifestyle Subscale (FHLS). Secondary outcomes were parent and child nutrition, and food insecurity. Statistical testing and modeling were used to evaluate pre-post outcomes.

Of 123 enrolled dyads, 114 (93%) had sufficient data for analysis. Participants were 11% Hispanic, 54% Black, and 28% White; 31% completed high school or less; and 30% indicated food insecurity. Cohort mean pre-post FHLS scores significantly increased (25.5 vs. 27.3; p < 0.001). There were significant improvements in parent nutrition (p < 0.001) and child nutrition (p = 0.02 to < 0.001), but not in food security. After adjusting for baseline covariates, tobit regression found statistically significant pre-post FHLS differences (2.3; 95% CI=[1.4, 3.3]; p < 0.001).

Participants in the novel home-based vTKO program reported improved family health over 12 weeks.

While nutrition programs can improve individuals’ behavior, it is not known how they impact the health of the family unit. This home-based virtual nutrition program provided groceries and taught food management skills to underserved families, examining family health differences over time. Family health is a proximal social determinant of health that predicts risk or resilience during times of stress. This is the first study to examine a change in family health over time.