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									Cook it! Evaluation First Progress Report

Contents
Background and Context The Programme Links with other organisations in relation to programme development Cook it! Coffee and View Sharing morning Conclusions Recommendations p3 p5

p13 p13 p20 p21

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Cook it! Evaluation – First Progress Report
1. Background and Context Cook It! is a community based nutrition education programme which was inspired by „Friends with Food‟, a successful initiative among Mother and Toddler Groups in Huddersfield, England. Cook it! was originally developed by the Health Promotion Agency (HPA) in 1995, specially for use in Northern Ireland with groups „where cost is a consideration‟. In 2000-2001, the original Cook it! programme was updated and rewritten by the HPA in conjunction with three Community Dietitians from the Eastern, Northern and Western Health and Social Services Boards. Some regional training was offered to community, voluntary and statutory organisations and carried out in 20012002. In 2004 each Health Board received funding from the Big Lottery (formerly New Opportunities Fund) to develop Cook it! programmes throughout their respective areas, with regional support from the HPA. In the Western Health and Social Services Board, a Cook it! team, comprising Dietitian, Development Officer and Admin Assistant has been established and based at the Western Health Action Zone office in Strabane. Support from a number or other organisations including the WHSSB, Westcare Business Services, Western Group Environmental Health is also received. The team recruit, train and support community Tutors who deliver Cook it! in their localities. A Cook it! programme lasts six sessions covering the principles of healthy eating using the Balance of Good Health plate model, basic food hygiene and hands on cooking, with an opportunity to sample the completed dishes. This latter component forms an important part of the appeal of Cook it! because it provides practical experience of food preparation and allows participants to enhance their cooking skills, while removing the financial risk involved in experimenting with new dishes within restricted resources. The Cook It! programme was therefore developed to ensure its relevance to those groups who have lower incomes. It is well documented that people from lower income groups die younger and experience more ill health than those in higher income groups. Research also indicates that people from lower socio-economic groups feel less informed about healthy eating. They tend to eat less of the foods recommended for health, and they experience most difficulties in making appropriate dietary changes. Children‟s food preferences have a strong influence on the foods served within the household. Eating patterns during childhood influence health in both short and long term, as can be seen in the rising incidence of childhood obesity and the increased prevalence of obesity related conditions such as Type II diabetes among young people. Mother and toddler groups were therefore considered a particularly appropriate target group for the delivery of the Cook It! programme. However, Cook it! has relevance for all those who feel ill equipped to prepare a healthy meal from basic ingredients and for whom the cost of food is a prime consideration. The Cook it! programme was originally developed as an approach to addressing inequalities against the background of Targeting Social Need (TSN) and more recently New TSN (1998) which deals with the need to redress inequalities in health, housing and education. More recently still the Government programme „Investing for Health‟

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(IfH) with specific health and wellbeing targets, aims to ensure that resources are put to best use to promote and support the health and wellbeing of people in Northern Ireland. “Poverty, low income and unemployment all have a negative impact on people‟s health and wellbeing and this is true for almost every health problem. Poorer families have less to spend on the physical determinants of health, such as good food and housing. Their children are more likely to have poor education. They live and work in more difficult conditions. They lead more stressful lives. Although they may know what affects their health, they may find it difficult to act on this and make healthy choices. The damage these factors do to health is cumulative. The end result can be a downward spiral of deprivation and poor health.” (IfH 7.1)

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2 The Programme 2.1 Aims of the programme     to work with groups to increase understanding of healthy eating to demonstrate that it is possible to eat healthily on a limited budget to enhance group members‟ cooking skills and increase their confidence in cooking to encourage appropriate changes in shopping for food and eating patterns

2.2 Contents of programme The programme is made up of six participative sessions covering healthy eating, food hygiene and hands-on cooking. Tutors are recruited from the community or from interested organisations and are trained to run Cook it! courses in their own community or organisation. Training for the tutors lasts two days and covers:  the principles of healthy eating using the Balance of Good Health plate model  food hygiene,  kitchen safety,  group skills and problem solving,  practical exercises in using the Cook it! pack and taking part in a Cook it! session. Training is organised and delivered by the Cook it! team. 2.3 The role of the Cook it! team is:      Training, updating and supporting Cook it! tutors, Updating and modifying Cook it! in conjunction with the other Cook it! teams and under the auspices of the HPA Developing and disseminating information for use with different client groups, Evaluation and development of the project, Making links with new and established food programmes.

2.4 Funding Western HAZ has been included as a third party applicant as part of the WHSSB umbrella bid to the New Opportunities Fund programme, “Coronary Heart Disease, Stroke and Cancer”. Total for the three year programme is £200,000 2.5 In-kind Contributions of Partner Agencies In the Cook it! Business plan 2003-2006, in-kind contributions from a number of partner agencies are detailed with calculation of their values. The extent to which these contributions have been met to date are summarised below

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Contribution Management support

Contributor Western HAZ

Estimated Contribution 10% HAZ managers time

Total cost over Meeting of contribution? three years (£) 13420 Regular meetings and consultation with HAZ manager Steering group meetings not required 6 times per year – 3 to 4 times is more realistic. Not all members attend regularly Support readily available as required and Trust Dietitians meetings open to Cook it! Dietitian Health Promotion support supplied mostly through appropriate Health Promotion Officer eg Nutrition Accommodation, telephone, heat and light etc provided by HAZ Regular financial advice and monitoring of financial position provided. Assistance with monitoring of project provided. Advice and assistance with tendering and ordering received from Regional Supplies.

Professional support

Steering group members Trust Dietetics Manager

12 members meeting 21,600 6 times per year 5% Dietetic Managers time 7280

Office premises Financial support Technical support

Westcare Health 5% Health Promotion Promotion Managers time Western HAZ 20% of HAZ costs WHSSB WHSSB 5% Grade 5 Finance Support Support services (recruitment, statistical information and analysis, professional input and insurance cover) Support services (recruitment, payroll processing, payment processing and management support) Estimated purchase price Professional review and consultation

5460 5100 3400 7500

Westcare Business Services

7500

Assistance and advice on recruitment, salaries and travel processed, help with managing petty cash and small grants payments, IT support

Office equipment Equality impact

WHSSB WHSSB

2000 1000

Purchased before project commenced Have not availed of this as yet

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Contribution Graphics and design Training

Contributor Westcare Business Services Westcare Business Services Westcare Business Services

Estimated Contribution Costs of design of 5 items per year Course costs for staff and facilitators (25 places per year including training inputs to Tutor‟s network) Promotion of programme through staff and publications

Total cost over Meeting of contribution? three years (£) 6000 Assistance with design, production and utilisation of various items to date including invitations, certificates and logos 7500 Initially some input to Cook it! Tutors training – Group Skills training provided. This was withdrawn in 2005. In house training for Cook it! team Contributions to IfH newsletter and word of mouth advertising by eg HPOs

Promotional activities

1500

HSS Trusts

Promotion of programme through staff and publications

3000

Not known

Community networks SureStart projects Older people‟s networks Voluntary organisations

Advertising in publications 3000 and leaflet distribution As above 1500

Articles, flyers distributed on request

Individual projects advertise through newletters, posters etc

As above

1500

Not known

As above

1500

Not known

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Contribution Programme input

Contributor District Councils

Estimated Contribution Input of EHO‟s to community programmes

Total cost over Meeting of contribution? three years (£) 10000 EHOs provide input to training and updating of Cook it! Tutors and give support to Cook it! programmes on request

HSS Trusts/Westcare Research and Health Promotion evaluation Agency Cook it! Health Promotion materials Agency

Input of staff to community 10000 programmes Estimated cost provided by 3000 HPA Surplus materials supplied 1000 by HPA

None relevant to Cook it! at present though this may change Baseline information and evaluation of Cook it! Dietitians, tutors and participants underway. Packs, Cook it! covers, Tutor Registration forms and questionnaires supplied as required.

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2.6 Organisation and management of the programme The Cook it! team is based in the Western Health Action Zone (HAZ) offices in Strabane. The team includes a Dietitian, Development officer and Admin Assistant, with input from other parties – Environmental Health, Westcare Business Services, other Cook it! tutors etc. The HAZ is a partnership including the statutory, voluntary, community and private sectors, led by the Western Health and Social Services Board (WHSSB) in order to address the links between high levels of poor health and disadvantage. Tackling the two current priorities of the HAZ - „Older people in need‟ and „families living in poverty‟ – involves co-operation between the different agencies. “Poverty is the greatest risk factor for health” (IfH 4.3). 2.7 Management and Personnel - Partnership approach The key to the Western Health Action Zone is partnership working. The Cook it! project benefits from being based within the HAZ because of its already well established networks with community and voluntary groups. This partnership approach is conducive to both management and delivery of Cook it! Western HAZ is accountable to the Western Area Investing for Health Partnership. This body, set up in response to the government‟s Investing for Health strategy, is an intersectoral body comprising the public sector (including the health sector and district councils), community and voluntary sector (including representatives from Healthy Living Centres and Healthy Cities), user interests (i.e. Western Health & Social Services Council), private sector, and local strategy partnerships. The Cook it! Working Group acts on behalf of the IFH Partnership and reports to the Partnership regularly on progress. The following organisations participate in the Steering Group:  Western Health Action Zone  Westcare Health Promotion  Western Health & Social Services Board  Health & Social Services Trusts (dietetics)  Group Environmental Health The Working Group also includes a representative from the following:  Community networks  Healthy living centres  Surestart  Older people‟s organisations  Playboard NI  A Cook it Tutor To date it has not been feasible to include user representatives who have participated in Cook it! As delivery of Cook it! is increasing, this situation will shortly be reviewed.

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2.8 Recruitment of Cook it! Tutors Crucial to the appropriate recruitment of Cook it! tutors is the role of the Development Officer. At the commencement of the programme in April 2004, this post had not been filled and indeed a post holder was not appointed until January 2005. Initially therefore, recruitment was carried out by the Cook it! Dietitian assisted by the Admin Assistant. Part of the recruitment process involves meeting the potential tutor to assess the suitability of Cook it! for their needs. Unfortunately, it was impossible, in the absence of the Cook it! Development Officer to carry out this assessment adequately. As a result some of the tutors initially trained, especially those from statutory organisations, have not to date delivered the programme. Following the appointment of a Development Officer to the project, the situation has changed substantially with a greater proportion of recruited tutors delivering Cook it! within a few months of completing their training. To date 63 Cook It! tutors have been trained in the Western Board area. These have come mainly from a variety of community organisations although there have been a few members of statutory organisations and some private individuals who have availed of the training, generally on behalf of a community organisation. To date, not all of the tutors trained have been able to commence delivery. However, those tutors who have commenced, have delivered Cook it! to a range of groups such as mothers groups, women‟s groups, people with mental health problems, community members, groups with a disability, over 50‟s groups, domestic violence survivors, alcoholics, active elderly groups and those not in paid employment.

2.9 Tutor Motivation Each individual had their own reasons for wanting to become a Cook It! tutor. Here are a few of these:  To encourage others to eat healthily to realise the importance of eating healthily.  To make others aware of the link between diet and illness  To share with others the enjoyment of cooking.  To encourage others to cook  To use the information for improving family nutrition but to also pass it on to the groups that they work with.  To complement other programmes already running within their centres  To enable them to pass on skills to members of their community  To assist service users to gain knowledge on nutrition which they can incorporate into their family lives  To show others that it is easy to cook healthy food for their family  To encourage groups to become more health conscience.

2.10 Tutor-facilitators Network The programme is in the process of establishing a Cook it! Tutors‟ network, which will enhance the support already available to Cook it! Tutors. The network will meet throughout the year at updates which will provide opportunities for tutors to enhance their knowledge and skills, ask questions and share experiences. To date three update meetings - which proved popular - have been held:

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DATE 04/04/05 11/04/05 25/04/05

VENUE RAPID, 2 Foreglen Road, Killaloo , L‟Derry Strabane Family Centre, Melmount Road, Strabane, Residential Centre, Ulster American Folk Park, Omagh

TIME 13.30 – 15.30 10.00 – 12.30 13.30 – 15.30

The programme for each was the same and covered:      Staying safe in the kitchen Insurance matters Why evaluate? Latest news Cook it! certificate presentations

Because of the large geographical area covered by the Western HAZ, venues were chosen across the Western area in order to make the updates as accessible to Tutors as possible. (see also 4.3.3 for comment from the evaluation workshop on this). In addition, a Cook it newsletter for the western area has been produced and it is intended that this will also contribute to the support network. 2.11 Summary of training carried out 2004/2005 Autumn 2004 19 & 20 October L.A.S.T Surestart Family Centre, Omagh 9 & 12 St. Columb‟s Park House, L‟Derry November and Limavady College of Further Education 23 & 24 Aisling Centre, Enniskillen November and Fermanagh College of Further Education TOTAL Spring 2005 19 & 22 April Locations St. Columb‟s Park House, L‟Derry and Limavady College of Further Education Ulster American Folk Park, Omagh and Owenkillew Hostel, Gortin Castle Park Centre, Lisnaskea and Belle Isle School of Cookery, Lisbellaw Number of tutors trained 7 16

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30 Number of tutors trained 9

27 & 28 April

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11 & 13 May

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TOTAL

33

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2.12 Organisations Trained Autumn 2004 Organisation Active 8 Beacon Centre, NIAMH Crevagh Sure Start Dry Arch Centre (Dungiven) Dry Arch Centre (Limavady) The Edge Project Greater Shantallow Area Partnership L.A.S.T. Sure Start Oakleaf Rural Community Network Playboard NI Private Chef Private Chef Private Chef Quest Centre Roe Valley Women's Network Roslea Healthy Living Centre Shantallow Sure Start Strabane Day Centre Strabane Sure Start Waterside Health Centre WELB 2.13 Organisations Trained Spring 2005 Organisation Armagh Dungannon HAZ Ballymagoarty & Hazelbank Consummerism Programme Bogside and Brandywell Health Initiative Blind centre, Omagh Breast Cancer Support Group Churchtown Community Assocation Creggan Health living Derg Valley Care Drumquin Women's Group Faughanvale Community Associaton Fermanagh New Horizons First Steps, Killen Foyle Women's Aid Homestart Killyfoyle and District Development Assoc. Newbuildings Com. & Environmental Assoc. NIAMH Omagh Women's Aid Omagh Women's Area Network Sawel Women's Group Strathfoyle

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The Edge project WHAZ

3. Links with other organisations in relation to Cook it! programme development Playboard NI The Cook it! Dietitian was one of several Community Dietitians who worked with Playboard NI and the Health Promotion Agency to develop a “Food for Play” pack. The Western PlayBoard facilitator sits on the Cook it! Working Group. This person` has completed the Cook it! training and is hoping to deliver Cook it! to a local community group in the autumn. Lay Health Worker training Last year, a training programme for Lay Health Workers was developed by the Rural Health Co-ordinator with RAPID. This included a module on nutrition which was developed and delivered by the Cook it! Dietitian. The module was very successful and as a consequence, there has been considerable interest in Cook it! on the part of the Lay Health Workers and some have since undertaken the Cook it! training. Children’s Cookery Programme Following a request from The Bogside and Brandywell Health Initiative for a Cook it! style programme aimed at children, the Cook it! Dietitian developed a children‟s cooking programme which has been used successfully piloted with primary school children in the Bogside and Brandywell areas of Londonderry and with young adolescents at the Arc Healthy Living Centre in Irvinestown. 4. Cook It! Coffee and View Sharing morning Organised as part of the external evaluation of the project, this was a half-day workshop with two sessions involving both those who have been trained as Cook It! tutors and participants from their subsequent programmes. Six tutors and six participants attended the event. Those taking part in the workshop were divided into two groups – a tutors‟ group and a participants‟ group. The majority of questions were the same for each group and consequently a sample of the responses from both groups are included together under each of the questions. However some extra questions were included at the end for the tutors‟ group in relation to their specific responsibilities and roles. The questions were designed to cover the content of the course, the different learning experiences and to assess what changes it had effected. The overall impression from all the discussions was of a great enthusiasm for the Cook it! experience. Both groups needed little prompting to share their experiences of the course and the changes it has brought to themselves and their families.

4.1 Workshop I 4.1.1 How have your shopping habits for food changed because of Cook it? Give examples.
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From the comments below it is obvious the participation in Cook it! has resulted in much more discerning shoppers. Participants now have greater knowledge and motivation to scrutinise products they buy and to ensure that their shopping basket contains the right balance of foods to promote their own and their families‟ health. One participant commented that they now purchase alternatives to potatoes such as pasta and rice as this provides a greater variety to their meals. They are also critical of the lack of clarity of some of the labelling on food and make a plea for more simplicity. The impact of product brands upon price was also highlighted.            Cook it! helps you see past marketing and [you are] more informed when you go shopping. I now look at labels and can understand them, but they need to be made more simple for shoppers. I try not to buy so much sweet stuff – less fizzy drinks – and I send a cooler with food to the crèche. I buy less potatoes and more pasta and rice I buy better quality meats than I used to. Fish are too expensive and so I still do not eat any more of it than I used to. I did not know about the value of pure fruit juice. I now buy it when I shop. I buy nuts and low fat foods. I get the fat cut off the meat before I buy it and do not buy pre-packaged meat any more. I buy more fibre such as whole grain bread, Readybrek, Weetabix, porridge oats. I buy less fizzy drinks and more diluting juice. I now know that packaging and branding is often the only difference in food. It is often the same content with the same nutritional value. There is a certain amount of snobbery in buying food and choosing which store to shop at.

4.1.2 Are there any areas of your shopping that you have found difficult to change? What are they? Why have they been difficult to change? Changing family eating habits has been a challenge to all participants, as indicated by the comments below, but in spite of admitting to this the comments made in response to other questions demonstrate that they have found ways to do this successfully.     I find changing habits takes a lot of effort. It costs more money to introduce new tastes. It takes more time to cook healthy food and follow the Cook it! way. My husband does not like it when no biscuits are bought.

4.1.3 Do you spend more or less on food? About how much? We are often told that it costs more to buy healthy food, but this is not entirely borne out by the comments that follow. The workshop participants have found ways of buying and eating healthy food in an economical way. Examples given are buying and cooking large quantities and freezing family sized portions, identifying stores where they can buy fresh food cheaply especially fruit and vegetables. On the other hand some do not mind if it costs extra so long as there is a benefit to their families‟ health.
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      

I spend a bit less because I cook food in larger quantities and freeze portions. I probably spend about the same over all, but I spend more on fruit and vegetables. A main course and dessert costs me about £1.50 now – this is less than I used to spend. I do spend more money on food but I buy more fruit and vegetables, more variety and high fibre foods. It is well worth spending a little extra money for the kids. Buying more fruit is more expensive and I find I now need to shop twice weekly if I want to have fresh produce. There was great support for one particular supermarket, which was regarded as a source of cheap, healthy food - especially fruit and vegetables.

4.1.4 How has the way you prepare meals changed as a result of Cook it? Give examples. Responses to this question demonstrate creativity in preparing food, a keen awareness of food hygiene, and a sense of pride in being able to prepare a tasty attractive meal from scratch. Some have found a new confidence in the kitchen, “I would attempt to make anything now” and some have found clever ways of ensuring that their children eat healthily such as disguising vegetables in dishes and giving fruit to children in smoothies. There was a request by the Tutors group for more Vegetarian recipes in the Cook it! manual.            I grill more and steam vegetables I use a much wider range of foods and more raw ingredients. Much more aware of the importance of proper hygiene e.g. proper storage of food in the fridge, have separate chopping boards for meat and vegetables. I cook more from scratch rather than make do with processed food. I make more at home e.g. baking biscuits, crumbles etc and I find it is cheaper than the ready made stuff. The cook it! recipes are simple and easy to follow. I disguise things that the family would not otherwise eat e.g. pumpkin soup and I have introduced new things like serving salad rather than chips with tuna and sweetcorn pasta. Serving soup with a meal ensures that family members have more than one portion of vegetable at a meal. Have introduced salad to most meals. Use garlic now, prepare my own dips I put a greater variety of foods on a plate now rather than piling on lots of one kind of food. I would attempt to make anything now. I give my family carrots and celery now with home made dip rather than crisps

4.1.5 What has been the reaction of your family? Give examples. Surprise and delight best summarises the reaction of families to the new menu. Cook it! participants who are also mothers have not just begun to shop and cook differently for their families but have ensured that their families understand about healthy eating. In one case a daughter of one participant who is at university has introduced Cook it! recipes to her flat mates week by week.

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One mother uses reverse psychology. She cooked a new meal for herself and when one of the children wanted to taste it, she refused. Next time she cooked it, she asked him would he like to try a little of it. He did so and liked it. The enthusiasm for Cook It! by both participants and tutors can be encapsulated by one mother whose family regarded their new health eating regime as “trendy”.  They are eating more healthy food now and they think this is trendy.  The first time I cooked a Cook it! recipe one of my kids said amazed, “You made that!”  They were surprised when I started to cook.  My family are more aware now of what goes through the conveyer belt (of their bodies)  The Cook it! way was a big change for my family and had to be introduced gradually.  I get my children to eat more fruit by making fruit smoothies.  I have had problems getting my children to eat new things.  I teach my daughter to eat and cook the Cook it! way, and she in turn is passing the recipes on to her house mates. She has been quite surprised about how cheap it is to cook meals.  I leave the bowl of fruit out on the table all the time now and the kids eat more of it.  Green is not a popular colour with kids! (when speaking about vegetables)  When the children are watching TV, instead of handing them a chocolate biscuit like I used to, I now cut up some fruit and they are happy to munch away at it.  It is harder to convince younger children because they do not understand nutritional values. 4.1.6 What changes have you noticed in you/your family’s health due to what you have learned from Cook it? Give examples. Parents have noticed several positive signs of health improvement in their children. They have more energy, better skin, are not gaining too much weight and are having more regular bowel movements as indicated by the comments below. One of the consequences has been, that in at least one family, they now sit around the table together for the main meal each day, which may lead to more structured eating habits and contribute to improved family relationships..        They are not eating rubbish any more because I am not buying it. After a few weeks I noticed that they had more energy from eating fruit and vegetables instead of chocolate. My children have better skin – not greasy or oily. They are not gaining too much weight any more and some are losing weight. We all go to the loo more often and regularly. We are all more aware of the importance of eating a healthy breakfast. We now always eat the main meal around the table

4.1.7 Other comments about the course:   It would be useful to have a breakdown of fat content in Cook it! recipes. There should be more linkages made for participants with other forms of healthy living such as fitness, walking etc.

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4.2 Workshop II 4.2.1 Did the Cook it! course live up to your expectations? Workshop participants were enthusiastic about the course, and commented on the new friendships made, how enjoyable it was and that it was a great social occasion. It sparked a new interest in understanding food and in developing cooking skills and this learning curve continues after the course. 4.2.2 What suggestions do you have for changing any aspect of the Cook it! course to make it better?  One tutor found it was necessary to be flexible with the time of the sessions to accommodate participants. Tutors agreed that they needed professional assistance (such as the dietetic support they currently receive) available for consultation to check that their explanation of the theory is right. The layout of the Cook it! pack needs to be improved. One tutor used dividers to mark different weeks. It would also help if all the material for each session was together in one place i.e. the background, session outline and the resources. All tutors seem to have organised it in this way for themselves. The pages should be numbered. Some of the resources used for children are attractive and colourful and could improve the adult course. (see reference to children programme p.7) Most participants agreed that the course is not long enough to cover the content adequately.

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  

4.2.3 What suggestions do you have for getting more people from the target groups (i.e. Older people and families) to participate in the Cook it! course? Suggestions were provided for recruiting participants for both the tutor training provided by the Cook It! team and the participant training which the tutors would then deliver. It was suggested that continuing to work through voluntary and statutory agencies would identify perspective tutors. It was highlighted that it may be beneficial not to mix the tutor groups as some of those previously trained perceived others to be more advanced because of their education and work status e.g. professional people such as chefs, nurses, teachers etc.   Continue to work through existing voluntary and statutory and encourage them to recruit their own staff. Don’t mix the groups (referring to training).

4.2.4 Suggestions for recruiting for the participant groups included:    Be flexible about when the course is run to accommodate different groups of people. Crèche provision where possible would help. There was recognition that men are difficult to recruit for this course but there were no practical suggestions for how this could be improved.

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  

It was pointed out by one Sure Start group that they currently have a waiting list of 25 people for Cook it! Target young people in secondary schools during their last two years as a way of preparing them for their future including cooking as a university student. Get access to colleges of Further and Higher Education to prepare students here for their future shopping and eating habits

4.2.5 What would help you to continue to practice what you learned in Cook it? Give practical suggestions. Refresher courses that would also be a get-together for course participants would help. The social element of the course was very important and this could be built on as a way of bringing past participants together again and thus encourage them to continue the practices they learned on Cook it!

4.3 Specific questions for Cook it! facilitators group: 4.3.1 What would have made your responsibilities as course leader easier?       Resource leaflets to take away would be useful. Have a core set of information available i.e. do up a pack At the end of the course we need to celebrate participants achievement. Suggestions for doing this were press coverage, presenting certificates, give a practical award at the end of the course – like a casserole dish. It was commented that “We would need more money to cover expenses.” Tutors who were in a position to work with another tutor found this to be a more beneficial way of working.

4.3.2 Would you be willing to continue to facilitate one or two Cook it! courses per year? If so please tell Cook it! Dietician or Development Officer to-day. One tutor responded that she would be willing to lead a course every quarter. However the tutors group were all enthusiastic about their experience of leading the course and seemed open to continue leading further Cook It! programmes. 4.3.3 How useful was the update event for those who attended? Updates were regarded as useful by the tutors who also commented that:     They needed updates twice a year One topic suggested for an update session was freezer use – how long different kinds of food can be safely kept in the freezer and the time needed between cooking food and taking it out of the freezer. The team should write to potential participants before the update session to ask them for topics/questions they would like to be addressed. All tutors agreed that these sessions should be held in the morning.

4.3.4 Some other points added by the tutors group were:  Training new tutors is time consuming.

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Some agencies might not be willing to give volunteer tutors time off for delivery of the course. The tutor’s time is not just two hours once a week. It takes a lot of extra time for preparation of individual sessions, photocopying, buying ingredients, washing up etc. The course suffers if it is not well organised.

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5 Summary Conclusions 5.1 The Cook it! approach to food health has been welcomed by all participants and tutors at the workshop. This is demonstrated by their willingness to come to the workshop, to the lively discussions they engaged in and by the many positive comments about their experiences of Cook It!. 5.2 Cook it has been effective in all its aims. There is clear evidence from the workshop inputs that they are more discerning as shoppers in relation to  Scrutinising and understanding labelling on food items,  The balance of the contents of their weekly shopping baskets,  Their appreciation of the role that fresh products play in health, 5.3 There is evidence that participants have developed new skills in the kitchen in cooking and presenting a healthy balance of food for themselves and their families. 5.4 There is evidence of some of the improvements in family health that implementation of the Cook it! programme has brought; children have more energy, clearer skin and improved digestion. 5.5 Some participants have found a new confidence and pride in their ability to understand and cook a balanced attractive healthy diet for their families. This may well have a positive influence over other aspects of their lives. 5.6 As a result of the new emphasis on healthy, attractive food, some families now sit around the table for the main meal. This may contribute to a more structured lifestyle and family bonding. 5.7 There was a suggestion that two facilitators per group works better but it is not clear how the work would be shared. 5.8 There was also a plea to have people with similar levels of achievement in the same tutor group. It would seem that some found it difficult to be in the same groups with people who seemed more “advanced” in the sense that some had a professional background others had not. 5.9 In addition, there have also been some important developments arising from Cook it! The Dietitian has developed a cooking programme for children which has been piloted by the Bogside and Brandywell Health Initiative among primary schools in the Triax area of L‟Derry and among young adolescents through The Edge Programme, Irvinestown, Other areas of partnership working include:   Contributing to the development of Playboard‟s “Food 4 Play” programme pack and delivery of training for Play Workers Development and delivery of Lay Health Workers Training for RAPID.

5.10 Through the Cook It! sessions relationships and friendships have been formed. These continue to give informal support to participants after the programme has finished thus helping them maintain their healthier changes adopted.
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5.11 The programme will fall short of the target number of Cook it! participants in the first year for two main reasons. First, the amount of time required to recruit and employ the Cook it! team members, set up the project, standardise the training across the province, recruit and then train the initial Cook it tutors had not been adequately considered in the initial business plan. Consequently the projected figures for participants in the first year were unrealistic. Second, recruitment for the Development Officer‟s post was particularly difficult and the post was not filled until January 2005. This meant that initial assessment of each person applying to become a tutor in the early part of the programme (autumn 2004) was not adequate. It was not possible to ensure either, commitment to deliver the programme on the part of the applicant and the employing agency, or availability of adequate cooking facilities to do so. As result some of the tutors trained at the beginning of the programme failed to deliver the course. With the appointment of a Development Officer, the effectiveness of the recruitment process has been greatly improved. Numbers of programmes delivered and participants are rising. 5.12 The Tutors trained are almost entirely from the voluntary and community sector, though some from statutory services – Health Trusts and the Western Education and Library Board – have also been trained as well as some private cooks and demonstrators who work with Community Groups. 5.13 The Cook it! Dietitian has worked with other organisations to develop Cook it! and food programmes geared to their particular constituencies. Two of these have been programmes for children. These developments have given added value to the programme. 6 Recommendations 6.1 The success of the programme indicates that it should continue to operate as it has done so far, while at the same time look for ways that it can improve. 6.2 One of the main ways of doing this will be through regular user feedback. Up-date sessions will partly meet this need. The programme should implement the suggestions from the workshop on how to improve these events such as organising them twice each year, by writing to potential participants well in advance of each session to give them a chance to suggest topics for discussion, problems they are meeting and questions they would like answered. 6.3 These sessions should include networking opportunities where participants are encouraged to share their experiences with others. This can be both a formal and an informal part of the session. 6.4 The Cook it! newsletter being planned by the programme and to begin soon could act as a platform for tutors and previous participants to ask questions, to share hints on what has worked well for them and to suggest changes that would improve the programme 6.4 Evidence from the evaluation workshop shows that the social aspects of Cook it! are an important part of the programme. These need to be promoted and supported through the up-date sessions.

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6.5 The Tutors group made some suggestions about organising the Cook it! manual in ways that would be more user friendly for tutors. These include marking the beginning of the different lessons with coloured tabs so that they can be found more quickly and putting all the resources needed for one lesson in one place. 6.6 Tutors who had experience of the Children‟s Programme suggested that some of the resources used for children are attractive and colourful and could improve the adult course. 6.7 Some thought that there should be a breakdown of the fat content of Cook it! recipes in the manual. 6.8 There was also a suggestion that the course should put more emphasis on linking healthy eating with other healthy living activities such as walking and other forms of exercise. 6.9 There was a suggestion that Cook it! should include more vegetarian recipes. The programme needs to consider whether this fits in with the Healthy Food message being promoted. 6.10 These last five points should be fed back to the Health Promotion Agency (HPANI) for future consideration when the pack is to be revised. 6.11 There was a suggestion that the Cook it! programme should target schools in order to influence young people in their final years at school. Staff should consider whether they are able to do this with current staff levels and in their present remit, bearing in mind that Cook it! is not aimed at children and is not written for use in school. Undoubtedly the ability to cook a nutritious and economic meal is of great value to school leavers but Cook it! may not be the format in which to do this. 6.12 Cook it! should explore the possibility of recruiting tutors among Day Centre staff to deliver the programme to their Day Centre users. 6.13 The programme needs to explore in more detail the pros, cons and practicality of having co-facilitators working in groups where this is the preferred way to lead groups. 6.14 The tutors group emphasised that it takes much more than two hours to prepare and deliver a Cook it! session. It takes extra time to do photocopying, buying ingredients, washing up afterwards and revising the teaching materials. The Programme staff need to clarify this with employers who agree that some of their staff can be Cook it! tutors so that they are allowed sufficient time for all the tasks involved. Volunteers also need to know in advance what their time commitment will be. 6.15 Cook it staff need to explore how best to get commitment from statutory agencies to allow staff members to train as Cook it! facilitators and to deliver the programme to their staff. This may need to addressed simultaneously at regional and local levels. Relevant Trade Unions should be consulted as potential allies in this. 6.16 Future programmes should recognise the importance of having sufficient staff resources in place from the beginning of programmes to enable them to make best use of potential Tutor recruits.
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6.17 Cook it staff should explore, (within the limits of current resources) the possibilities for wider use of the programmes it has helped develop for children. The obvious targets for these programmes are organisations such as Education and Library Boards, schools, uniformed groups, youth clubs, After Schools clubs etc. John Conlon – Community Development Consultant

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