Nourishing the Community Through Culinary Medicine - Acres Homes
Phase: NA
Conditions: Diabetes, Elevated Body Mass Index
Sponsor: The University of Texas Health Science Center, Houston

IRB NUMBER: HSC-SPH-23-0810 
IRB APPROVAL DATE: 04/08/2024 
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Nourishing the Community Through Culinary Medicine- Acres Homes 
 
NCT06096506 
 
Version Date: 04/08/2024 
 
 

IRB NUMBER: HSC-SPH-23-0810 
IRB APPROVAL DATE: 04/08/2024 
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Protocol Title: 
Nourishing the Community Through Culinary Medicine- Acres Homes 
 
Principal Investigator: 
Natalia Heredia, PhD, MPH, Assistant Professor, Department of Health 
Promotion and Behavioral Sciences 
 
Study Coordinator: 
Sarah Bentley, MPH 
 
Population: 
132 adult patients (18-75 years) with type 2 diabetes and elevated body 
mass index receiving care from UT Physicians clinics 
 
Number of Sites: 
Various UT Physicians clinics- single system 
 
Study Duration: 
October 2023 to September 2024 
 
Subject Duration: 
12 months participation with approximately 3 months of active participation 
and the remainder of time for passive follow-up on patient outcomes via 
electronic medical records. 
 
 
General Information 
− 
Nourishing the Community Through Culinary Medicine Study is a pilot study to implement a virtual 
culinary medicine intervention to low income, ethnically diverse adults with diabetes and elevated 
body mass index. A pre-post survey design and clinical electronic medical record data (HbA1c, Body 
Mass Index, Blood Pressure, HDL, LDL and Triglycerides) will be used to evaluate patient outcomes. 
 
Background Information 
− 
Over 34 million (13%) adults in the United States (US) have diabetes mellitus (DM), with rates 
climbing over 26% among adults aged 65 years or older and disproportionately higher rates among 
many Texas residents. (CDC, 2020; Schuler & Koka, 2019). The disparity grows stark when broken 
down by age among Texas residents, with 42% and 53.9% of adults aged 45 or older suffering from 
DM in the Dallas and Houston regions respectively (BRFSS, 2018). Further, adults with DM carry a 
50% higher risk of mortality, have more health complications, and spend more than $9,500 yearly 
on medical costs than their counterparts. (Rowley, 2017). In addition, the CDC estimates more than 
34% of adults are currently afflicted with pre-diabetes and at risk of developing DM. Alarmingly, the 
prevalence of DM is forecast to increase by more than 50% over the next decade (Rowley, 2017). 
− 
Although consuming a healthy diet is a well-supported and low-cost approach for reducing the risk 
of Type 2 DM (Hu et al., 2020), less than 10% of adults in the U.S. actually follow this approach 
(USDA 2015; Wilson et al., 2016). Low levels of food literacy coupled with poor dietary consumption 
behaviors among the US population warrant the need for innovation in nutrition education and 
intervention approaches (Downer et al., 2020; Etherton et al., 2014; Van Horn et al., 2019). Culinary 
Medicine (CM) is an emerging educational and nutritional approach that adds to current nutrition 
education and interventions by incorporating both, the practical hands-on preparation skills and 
pleasure of food, and the scientific knowledge of how nutrition and dietary patterns affect health 
outcomes (Birkhead, et al., 2014; La Puma et al., 2016; Polak et al., 2016; Barkoukis et al., 2019). 

IRB NUMBER: HSC-SPH-23-0810 
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− 
There is currently a critical gap of evidence-based “how-to” nutrition information that is tailored for 
culturally diverse, low-income minority populations across Texas. Furthermore, lifestyle 
interventions are needed to mitigate chronic disease such as type 2 DM among low-income minority 
populations, who are at a disproportionately higher risk for these conditions. This can be done by 
strengthening clinic-community linkages to offer lifestyle-based prevention services for their 
patients. We will build upon existing resources at UTHealth Nourish program (McWhorter et al., 
2019) which implements interdisciplinary evidence-based CM curricula across sectors in Harris 
County. 
 
Objectives 
− 
The purpose of this study is to implement a five-session hands-on virtual CM program (to be held 
weekly or bi-weekly) among patients with diabetes and elevated body mass index receiving care UT 
Physicians clinics serving the Acres Homes neighborhood, and comparing their outcomes to patients 
in usual care from UT Physicians clinics outside of the Acres Homes service area. 
− 
The overall goals of this project are to: 
o To implement adapted virtual CM curriculum among target population 
o To assess if program participation improves participant dietary behaviors, nutrition 
knowledge, and cooking skills and behaviors above standard of care. 
o To assess if program participation improves patient levels of HbA1c, Body Mass Index, Blood 
Pressure, HDL, LDL and Triglycerides above standard of care. 
o To assess if social determinants of health modify the association between participating in 
the program and any of the aforementioned outcomes. 
o To determine the feasibility and reproducibility of virtual synchronous CM classes. 
 
Study Design 
− 
This study is a pilot study with a quasi-experimental design using assigned intervention and control 
clinics. 
− 
Study participants will be evaluated prior to and immediately after the program via pre and post 
survey. 
− 
EMR data will be reviewed at baseline and completion of program 
− 
This one-year project will include: 
a) conducting the virtual CM program for approximately 66 intervention patients with diabetes 
receiving care at UT Physician Clinics serving the Acres Homes neighborhood in Houston 
b) conducting program evaluation (pre- and post-test surveys and EMR data) using data from 
those 66 intervention participants and 66 control participants recruited from UT Physicians 
clinics outside of the Acres Homes service area 
− 
The pre-post survey will evaluate participants’ dietary behaviors, nutrition knowledge, cooking skills 
and behaviors along with demographic information. The EMR data will evaluate improvements in 
clinical data: HbA1c, Body Mass Index, Blood Pressure, HDL, LDL and Triglycerides. The results will be 
used to determine if virtual CM education can be effective in improving certain health outcomes, 
dietary behaviors and cooking-related constructs. 
− 
There are a few minimal risks known to taking part in this study. Knives will be utilized raising the 
risk for minor cuts. Stove tops, ovens, microwaves, and other kitchen equipment will be utilized 
raising the risk for minor burns. Food items containing known allergens will be utilized raising the 
risk for allergic reaction. We anticipate participation in this study to be of minimal risk and do not 
expect our program or surveys to cause emotional distress. 

IRB NUMBER: HSC-SPH-23-0810 
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Study Population 
− 
It is anticipated that program participants will be low-resource and ethnically diverse, reflective of 
UT Physicians patients at the clinics serving the Acres Homes neighborhood of Houston. 
− 
Inclusion Criteria: 
o Receiving care at UT Physicians clinics; 
o Adult patients (18 to 75 years) diagnosed with type 2 diabetes and elevated body mass 
index (>=25); 
o HbA1c labs and clinic-assessed weight completed within the last 3 months; 
o English speaking or Spanish speaking. 
o Can obtain groceries before each class (intervention group only) 
− 
Exclusion Criteria: 
o Patients without the technological support needed to participate (e.g., reliable internet and 
device - cell phone, tablet or laptop); 
o Patients with an uncontrolled impairment that interferes with ability to participate. 
− 
Recruitment: Patients meeting the aforementioned inclusion criteria will be invited to participate. 
We will conduct separate recruitment for intervention and control participants- with the 
intervention participants recruited from the Victory and Greens UT Physicians clinics that serve 
Acres Homes, and control participants recruited from the Jensen UT Physicians clinic. Jensen has a 
similar patient population to Victory and Greens, and is relatively close geographically, while still 
sitting outside of the target neighborhood of Acres Homes. UT Physicians’ care coordinators will 
assess patient eligibility to participate in the program and share either a flyer or an interest form link 
with eligible patients. Patients will complete the interest form giving UTHealth their contact 
information. UTHealth staff will reach out to patients and explain the program (time commitment, 
class days/time). If patient is interested, UTHealth study staff will perform a technology screening 
since all classes will be held virtually. After screening, UTHealth will send an online informed consent 
and pre-survey. 
Study Procedures 
− 
Program Adaptation and Implementation: 
− 
For this project, we will use the Nourishing the Community through Culinary Medicine curriculum 
that is available on our Nourish website: 
https://sph.uth.edu/research/centers/dell/nourish/research-resources/toolkit 
− 
The table below outlines the topics and objectives for the 5 NCCM sessions: 
Session 
Cooking 
Technique 
Topics and Materials 
Learning Objectives 
SCT Change Objectives 
1 
Roasting 
vegetables and 
steaming grains. 
Handouts: Healthy Eating; Goal 
setting. 
Videos: My Plate is Your Plate; 
Small Changes for Health. 
• Use safe and effective knife skills to 
cut a variety of vegetables. 
• Discuss challenges with managing 
diabetes. 
• Identify a healthy plate as ½ fruits 
and vegetables, ¼ lean protein, and 
¼ whole grains. 
• Understand how to set realistic 
goals. 
• Learn how to prepare a balanced 
family meal. 

IRB NUMBER: HSC-SPH-23-0810 
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2 
Cooking grains 
pilaf-style and 
baking. 
Handouts: Diabetes 
management; Carbohydrate 
counting; Label reading. 
• Use safe and effective knife skills to 
cut a variety of vegetables. 
• Describe what foods and beverages 
contain carbohydrates. 
• Learn how to control blood sugar 
levels using a MyPlate approach. 
• Learn how to prepare a balanced 
family meal. 
• Outcome expectations 
of the taste of healthy 
foods. 
• Knowledge of healthy 
eating. 
• Self-efficacy of 
preparing healthy 
foods. 
• Perceived social 
support for healthy 
eating. 
• Normative beliefs of 
healthy food. 
Videos: All About 
Carbohydrates; Low Blood 
Glucose; High Blood Glucose. 
3 
Soups, stews, and 
preparing 
dressings. 
Handouts: Healthy habits for 
the family 
• Use safe and effective knife skills to 
cut a variety of vegetables. 
• Practice strategies to develop 
healthy and mindful habits with 
family. 
• Learn how to prepare a balanced 
family meal. 
Videos: A Family Affair 
Why Beverages Matter. 
4 
Sautéing, stir 
frying, and 
steaming grains. 
Handouts: Planning Healthy 
Meals 
• Use safe and effective knife skills to 
cut a variety of vegetables. 
• Practice strategies meal planning 
and grocery shopping. 
• Practice reading food labels to 
encourage better food purchases. 
• Prepare a balanced family meal. 
Videos: How to Stock a Healthy 
Pantry; How to Read Nutrition 
Facts Labels. 
5 
Sautéing, stir 
frying, and 
microwave 
cooking. 
Handouts: Mindful eating. 
Videos: Beyond the Scale 
Mindful Eating Techniques. 
• Use safe and effective knife skills to 
cut a variety of vegetables. 
• Practice strategies to develop 
healthy and mindful habits to 
control blood sugar. 
• Describe plans to focus on health 
versus weight. 
• Prepare a balanced family meal. 
 
 
− 
To conduct the program virtually, we will do the following 
o First, classes will be streamed live from UTHealth Nourish Program’s Teaching Kitchen via 
Zoom or WebEx platform. Participants will cook and engage virtually (with video and sound 
on) from their home kitchens via the digital platform. 
o Second, participants will be located across Houston, limiting the ability to provide a “grocery 
bag”. Participants will be provided a $40 grocery card and shopping list per class (5 classes 
for a total of $200) to purchase ingredients for the cooking sessions. The grocery lists will 
provide tips and insight to help participants navigate shopping for ingredients. 
o Third, asynchronous virtual educational content (cooking skills videos, animated nutrition 
education videos, and additional recipes) will be provided to engage and retain participants 
beyond initial sessions (available at website link). 
o Fourth, to ensure opportunities for participants to engage, classes will be offered during 
convenient time for participants and recipes will provide enough food for a family of four. 
o Fifth, cohorts will be conducted in either English or Spanish to include a large percentage of 
clinic patients. 
− 
UTHealth staff will call participant one week prior to classes starting to confirm attendance. If 
patient confirms attendance, UTHealth staff will send email with class information and gift card e- 

IRB NUMBER: HSC-SPH-23-0810 
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code, grocery list, recipes, etc. UTHealth staff will call patients the day before class and send a text 
reminder 2 hours prior to the class start time. 
− 
The virtual curriculum will include five 90-minute sessions (to be held weekly or bi-weekly). 
Participants will also be expected to shop for groceries ahead of the sessions to participate in the 
program. A gift card will be provided for groceries ($40 per class = $200 total). 
− 
Partnership with UT Physicians sites will allow use of Electronic Medical Record (EMR) data: patient 
level data for HbA1c, Body Mass Index, Blood Pressure, HDL, LDL and Triglycerides collected as part 
of their regular standard of care and documented within the EMR. No additional visits, screenings or 
time will be necessary for participation in the program. Data will be abstracted and shared by clinic 
site to UTHealth at: baseline (within 90 days of starting the NCCM program) and at program 
completion (within 90 days of NCCM program completion). 
− 
Informed consent will be obtained electronically via REDcap prior to survey administration. 
Participants will review the consent documents. Participants will be allowed to contact the Study 
Coordinator with any questions prior to completing the consent form or the survey. Participants will 
be allowed to leave the project at any time. 
− 
Participants will be asked to complete an electronic 15-minute survey via REDcap at two timepoints: 
pre-test survey before the first class and a post-test after the conclusion of the program. The 
electronic pre- and post-test surveys will collect information on 1) dietary intake, 2) cooking skills, 3) 
cooking-related psychosocial constructs, 4) diabetes management, and 5) demographics (age, sex, 
race/ethnicity, education, employment status, preferred language spoken at home, and 
participation in government assistance programs will be collected at baseline at the start of the 
program). Survey items are described in detail in the measurement resource table below. 
 
Primary Outcome- measured at both pre-survey (baseline) and post-intervention (follow-up) 
HbA1c 
Measured by the clinic at baseline and follow-up 
Secondary Outcomes- measured at both pre-survey (baseline) and post-intervention (follow-up) 
Other clinical 
measures 
Body Mass Index (height and weight), Blood Pressure, HDL, LDL and Triglycerides measured by the clinic at baseline and 
follow-up 
Variable (Construct) 
Number of items and 
sample question 
Source citation 
Perceived Health 
1 item 
E.g. Overall, how would 
you rate your health in 
the past four weeks? 
Response options (1-6) 
– Excellent to Very Poor 
Bowling, A; Just one question: If one question works, why ask several? Journal of 
Epidemiology & Community Health (2005); 59:342-345. 
Fruit & Vegetable 
consumption 
2 item 
E.g. How many servings 
of VEGETABLES do you 
eat or drink each day? 
Response options (0 to 
5): None to 4+ servings 
per day 
Yaroch AL, et al. Evaluation of Three Short Dietary Instruments to Assess Fruit and Vegetable 
Intake: The National Cancer Institute's Food Attitudes and Behaviors Survey. J Acad Nutr 
Diet. 2012 Oct;112(10):1570-7.(Link: http://www.ncbi.nlm.nih.gov/pubmed/23017567) 
Whole grain 
consumption 
1 item 
E.g. How many servings 
of Whole Grains do you 
eat each day? 
Response options (0 to 
5): None to 4+ servings 
per day 
Adapted from: 
Yaroch AL, et al. Evaluation of Three Short Dietary Instruments to Assess Fruit and Vegetable 
Intake: The National Cancer Institute's Food Attitudes and Behaviors Survey. J Acad Nutr 
Diet. 2012 Oct;112(10):1570-7.(Link: http://www.ncbi.nlm.nih.gov/pubmed/23017567 

IRB NUMBER: HSC-SPH-23-0810 
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Typical food 
consumption 
behaviors 
7 items: 
E.g. How often do you 
typically eat a green 
salad? 
Response options (0-4): 
Not at all to More than 
once a day 
Pinard, Courtney A., et al. "Development and testing of a revised cooking matters for adults 
survey." American journal of health behavior 39.6 (2015): 866-873. 
Perceived Barriers of 
Eating Fruits and 
Vegetables 
13 items 
E.g. I don’t eat fruits 
and vegetables as much 
as I like to because they 
cost too much 
Response options (0-4): 
Strongly agree to 
strongly disagree 
Pinard, Courtney A., et al. "Development and testing of a revised cooking matters for adults 
survey." American journal of health behavior 39.6 (2015): 866-873. 
Eating/cooking/using 
nutrition labels 
10 items 
E.g. How often do you 
compare prices before 
you buy food? 
Response options (1-5): 
Never to Always 
Pinard, Courtney A., et al. "Development and testing of a revised cooking matters for adults 
survey." American journal of health behavior 39.6 (2015): 866-873. 
Barriers to Healthy 
Eating 
4 items 
E.g. Cooking healthy 
food is difficult 
Response options (1-5): 
Strongly agree to 
strongly disagree 
Not Previously validated, pilot tested in APHL 
Self-efficacy in 
cooking food and 
meal planning 
5 items 
E.g. How sure are you 
that you could use basic 
cooking techniques (e.g. 
microwaving, sautéing, 
roasting). 
Response options (0-4): 
Not at all sure to 
Extremely Sure 
Condrasky, M.D., Williams, J.E., Catalano, P.M., & Griffin, S.F. (2011). 
Development of psychosocial scales for evaluating the impact of a culinary nutrition 
education program on cooking and healthful eating. Journal of Nutrition Education and 
Behavior, 43, 511-516. 
Diabetes 
management 
16 items 
E.g. The following 
statements describe 
self-care activities 
related to your 
diabetes. Thinking 
about your self-care 
over the last 8 weeks, 
please specify the 
extent to which each 
statement applies to 
you. 
Schmitt, A., Gahr, A., Hermanns, N., Kulzer, B., Huber, J., & Haak, T. (2013). The Diabetes 
Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to 
assess diabetes self-care activities associated with glycaemic control. Health and quality of 
life outcomes, 11(1), 1-14. 
Tertiary - measured at both pre-survey (baseline) and post-intervention (follow-up) 
Nutrition knowledge 
1 item 
E.g. When thinking 
about preparing a plate 
of food, how much of 
your plate should be 
filled with fruits and 
vegetables? 
Not previously validated, pilot tested in APHL 

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Covariates- baseline only 
Food Insecurity 
2 items 
e.g., “Within the past 12 
months we worried 
whether our food 
would run out before 
we got money to buy 
more? 
Hager, E.R., Quigg, A.M., Black, M.M., Coleman, S.M., Heeren, T., Rose-Jacobs, R., Cook, J.T., 
De Cuba, S.A.E., Casey, P.H., Chilton, M. and Cutts, D.B., 2010. Development and validity of a 
2-item screen to identify families at risk for food insecurity. Pediatrics, 126(1), pp.e26-e32. 
Internet Access 
4 items 
e.g., Do you ever go on- 
line to access the 
Internet or World Wide 
Web, or to send and 
receive e-mail? 
From: HINTS 5, Cycle 4 – Section B: Using the Internet to Find Information, in HINTS 5, Cycle 
4 (2020) Methodology Report. 
https://hints.cancer.gov/docs/methodologyreports/HINTS5_Cycle4_MethodologyReport.pdf 
Health Literacy 
3 items 
e.g., How often do you 
have problems learning 
about your medical 
condition because of 
difficulty understanding 
written information? 
Chew, L.D., Bradley, K.A., & Boyko, E.J. (2004). Brief questions to identify patients with 
inadequate health literacy. Family Medicine, 36(8): 588-594. 
Housing insecurity 
2 items 
e.g., What is your living 
situation today? 
From The Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) 
Screening Tool. Billioux, A., Verlander, K., Anthony, S., & Alley, D. (2017). Standardized 
screening for health-related social needs in clinical settings: the accountable health 
communities screening tool. [Discussion paper]. NAM Perspectives. National Academy of 
Medicine. https://doi.org/10.31478/201705b 
 
− 
A sub-set of participants from the intervention group (n=15) will be invited to take part in interviews 
about their experience in the program, including the cooking classes, recipes, recruitment and 
engagement. We will also try to understand if and what structural barriers they experienced to 
participating in the study. This will help provide us data as to how the program may need to be 
tailored. 
o Participants will be offered the opportunity to participate in the interviews while they are 
still enrolled in the program or immediately after completing the post-survey. 
o They will give consent by texting or emailing us their interest in participating and then 
scheduling an interview. 
o Participants will receive a $25 gift card for their time. 
o The approximately 30-45-minute interviews will be conducted by trained UTHealth staff and 
will take place via WebEx. 
o All interviews will be recorded for transcription and subsequent analysis. Spanish interviews 
will be translated to English by native Spanish speakers. Transcriptions will be coded using 
standard methods through Dedoose software and deductive thematic analysis will be 
conducted. 
− 
All patient data will be stored in REDCap and interviews will be saved on the secured share drive. 
− 
Participants will be allowed to contact the principal investigator with any questions. Participants will 
be allowed to leave the project at any time. 
 
Data and Safety Monitoring 
− 
There are few adverse events expected. Since the classes involve cooking in a participant’s home 
kitchen, there might be injuries with use of knives, other cooking utensils, stoves, and ovens. 
Participants assume all risk associated with participating in the culinary medicine classes. 

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− 
If adverse events occur, an adverse events form will be completed and submitted to the IRB. 
 
Compensation 
− 
Participants will receive a $25 gift card for enrolling in the study and completing the pre-survey. 
− 
Participants will receive a second $25 gift card for the post-survey. 
− 
Participants will not be compensated for completing the surveys if they received $25 gift cards for 
completing the surveys in a prior study cohort. 
− 
Participants will receive a $40 grocery card per class (5 classes for a total of $200) to purchase 
ingredients for the cooking sessions. 
− 
Participants who are repeating a class will not receive a $40 grocery card if they received one for the 
same class in a prior study cohort. 
− 
Participants who take part in the interviews will receive an additional $25 gift card. 
− 
Participants who are absent for a session will not receive a $40 grocery card for the following 
session until they confirm with a staff member that they plan to attend the following session. 
− 
Participants who are absent for 2 or more consecutive sessions will not receive a $40 grocery card 
until they attend another session. 
Statistics 
− 
132 participants are planned to be enrolled, 66 from intervention clinics and 66 from control clinics. 
− 
All participants that enroll in the program will be included in the analysis. Saturation point is 
considered attendance of 4 out of 5 sessions (80%). 
− 
Statistical analysis will include descriptive and frequency analysis of responses, a pre-post analysis 
using paired t-test, chi-square test, and Analysis of Covariance to determine changes in biometric 
and behavioral measures pre to post NCCM program participation. 
− 
Level of significance will be set at p < 0.05. 
− Qualitative data will be analyzed for themes using standard methods and NVivo software. 
Responses will be summarized, and a report will be created to provide information to our 
research investigators and the public health community. 
 
Ethics 
− 
We will obtain informed consent from all interested participants during the technology screening 
before the first session. The participants will be given a digital consent via REDcap to review and 
acknowledge, a copy of the consent will be sent to the email provided by the patient. Patients will 
have the opportunity to pause signing of the consent in order to ask any questions they may have. 
 
Data handling and record keeping 
− 
Electronic Medical Record (EMR) data: Clinic, demographic and healthcare utilization data will be 
stored in the UT Physicians database. UT Physicians’ team members will create custom extract 
report from the EMR for the participating patients. The report will be sent to UTHealth CMS 
Certified Data Center as a HL7 using existing UT Physicians protocols. Patient level data for HbA1c, 
Body Mass Index, Blood Pressure, HDL, LDL and Triglycerides collected as part of their regular 
standard of care and documented within the EMR will be abstracted by and provided by UT 
Physicians to the study team at baseline (within 90 days of starting the NCCM program) and at 
program completion (within 6 months of NCCM program completion). 

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− 
All data will be kept confidential and stored on UTHealth Houston SPH computers on password 
protected share drives. All survey information will be securely collected and stored in REDCap data 
management software at UTHealth. Study codes in the form of a unique number will be assigned to 
each participant to label their response. A separate electronic password protected document that 
links the study code to subjects’ identifying information (name, phone number, email, zip code of 
residence) will be stored on UTHealth Houston SPH computers on password protected share drives. 
Only aggregate data will be reported and published. 
− 
Data on EMR outcomes will be linked to survey data based on a series of variables collected (name, 
DOB, zip code). Once the data is linked, the individual’s record will be assigned a dummy ID and all 
direct identifiers removed for safety issues. A crosswalk that would allow for re-identification will be 
kept on a separate file stored in an encrypted external drive securely saved under key UTHealth 
Houston SPH office. 
− 
All interviews will be recorded and transcribed. Transcriptions will be edited to exclude names and 
other identifying information. All audio files will be destroyed after they are transcribed and 
analyzed. Audio and transcription files will be stored on UTHealth’s secure server, on password 
protected drives. Data handling procedures will be overseen by Dr. Heredia. 
 
Quality control and assurance 
− 
Respondents’ email will be kept on a password-protected computer and can be used to correct ID’s 
if needed. 
− 
The surveys will be administered electronically and all participants will complete the survey prior to 
and after the intervention program. Any participants that do not attend the last class will be 
contacted by phone and email to complete the electronic post survey. 
Before analyses are conducted, the raw data will be reviewed for completeness. 
 
Publication Plan 
− 
Investigators at UTHealth will submit manuscripts based on the results of the project to academic 
journals for publication. All manuscripts will include de-identified data. 
− 
This culinary medicine program will be conducted in partnership with UT Physicians and have the 
potential to be integrated into existing programs. 
− 
In addition, this program will provide preliminary data that can be used for a full-scale trial. 
 
ATTACHMENTS 
1. Study Consent Form 
2. Pre/ Post Survey 
 
References: 
1. Barkoukis, H., Swain, J., Rogers, C., & Harris, S. R. (2019). Culinary medicine and the registered 
dietitian nutritionist: Time for a leadership role. Journal of the Academy of Nutrition and 
Dietetics, 119(10), 1607-1611. 

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2. Centers for Disease Control and Prevention. (2020). National diabetes statistics report, 
2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and 
Human Services, 
3. Darmon, N., & Drewnowski, A. (2015). Contribution of food prices and diet cost to 
socioeconomic disparities in diet quality and health: A systematic review and analysis. Nutrition 
Reviews, 73(10), 643-660. 
4. Hartline-Grafton, H., & Dean, O. (2017). The impact of poverty, food insecurity, and poor 
nutrition on health and well-being. Washington, DC: Food Research & Action Center, 
5. Hu, E. A., Steffen, L. M., Coresh, J., Appel, L. J., & Rebholz, C. M. (2020). Adherence to the 
healthy eating Index–2015 and other dietary patterns may reduce risk of cardiovascular disease, 
cardiovascular mortality, and all-cause mortality. The Journal of Nutrition, 150(2), 312-321. 
6. McWhorter, J. W., Raber, M., Sharma, S. V., Moore, L. S., & Hoelscher, D. M. (2019). The nourish 
program: An innovative model for cooking, gardening, and clinical care skill enhancement for 
dietetics students. Journal of the Academy of Nutrition and Dietetics, 119(2), 199-201. 
7. Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E., & Krohe, S. (2017). Diabetes 2030: Insights from 
yesterday, today, and future trends. Population Health Management, 20(1), 6-12. 
8. Schuler, D. A., & Koka, B. R. (2019). Challenges of social sector systemic collaborations: What’s 
cookin in houston’s food insecurity space? 
9. Sicker, K., Habash, D., Hamilton, L., Nelson, N. G., Robertson-Boyd, L., & Shaikhkhalil, A. K. 
(2020). Implementing culinary medicine training: Collaboratively learning the way 
forward. Journal of Nutrition Education and Behavior, 
10. Van Horn, L., Lenders, C. M., Pratt, C. A., Beech, B., Carney, P. A., Dietz, W., . . . Kohlmeier, M. 
(2019). Advancing nutrition education, training, and research for medical students, residents, 
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