For whom and under what circumstances do nutrition-education cooking interventions work: A realist synthesis

Objective: To explore for whom and under what circumstances nutrition-education cooking interventions affect nutrition outcomes in adults. 

Methods: A realist synthesis was undertaken. The CINAHL, Ovid Medline, Scopus, and Web of Science databases were searched for literature published between 1980 and 2019, using the terms "cook"and "intervention"and their synonyms; 5759 articles were identified. Grey literature was sourced for further additional program context. A total of 23 articles (n = 11 programs) met inclusion criteria for analysis. Program data were coded in duplicate for context, outcome, and mechanism configurations, and used to build a refined program theory. 

Results: Nutrition-education cooking interventions targeted at low-socioeconomic-status and marginalized populations produced a range of positive nutrition outcomes. Outcomes were observed when the program involved hands-on cooking and a skilled facilitator coupled with individual self-efficacy, knowledge gain, family support, and an expectation of positive health outcomes. 

Conclusion: These findings highlight key program components to achieve improvements in nutrition and important recommendations for nutrition-education cooking interventions.