Healthy Kitchens, Healthy Children: the impact of linking community kitchens to a school food program on women's economics, food security and mental health

ISRCTN ISRCTN34880574
DOI https://doi.org/10.1186/ISRCTN34880574
Secondary identifying numbers A 102829 -P 22047
Submission date
24/09/2018
Registration date
22/10/2018
Last edited
25/04/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Food insecurity threatens dietary diversity, nutritional status and physical, mental and social health of vulnerable populations. Palestinian refugees in Lebanon are protracted refugees with fragile livelihoods, high rates of poverty and food insecurity. The aim of this study is to investigate the effect of participating in the Healthy Kitchens program on women’s economic, social and food security outcomes.

Who can participate?
Adult women living in two Palestinian camps in Beirut

What does the study involve?
Two Healthy Kitchens will be established in existing community-based organisations in Palestinian camps. These are set up as small business enterprises, using participatory approaches to develop recipes and train women in food preparation, food safety and entrepreneurship. The kitchens will employ 32 women on a rotating basis to provide daily healthy meals to children attending local primary schools. The research project studies the effect of participating in the healthy kitchens program on women’s economic, social and food security outcomes.

What are the possible benefits and risks of participating?
Women who participate in the community kitchens will likely benefit from increased income generated through the sale of food at schools. Minimal risk is anticipated in this study. There is a minimal risk of injury to women during work in the community kitchens; however, this risk is not above the normal risks that women are exposed to by working in their homes, and kitchen safety is be covered in training sessions.

Where is the study run from?
Center for Research on Population and Health at the American University of Beirut (Lebanon)

When is the study starting and how long is it expected to run for?
September 2013 to December 2017

Who is funding the study?
The Nestle Foundation for the Study of Problems of Nutrition in the World (Switzerland)

Who is the main contact?
Dr Hala Ghattas
hg15@aub.edu.lb

Contact information

Dr Hala Ghattas
Scientific

American University of Beirut
POBox 11-0236/EPHD, Riad El Solh
Beirut
1107 2020
Lebanon

Study information

Study designInterventional non-randomised study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Community
Study typeOther
Participant information sheet Not available in web format, please contact Hala Ghattas (hg15@aub.edu.lb) to request a participant information sheet
Scientific titleHealthy Kitchens, Healthy Children: a community-based intervention linking community kitchens to a school food program - the Healthy Kitchens component
Study acronymHealthy Kitchens, Healthy Children - Women's study (HKHC-W)
Study objectivesThis study aimed to investigate the effect of a two-pronged intervention that employed women through social enterprises (Healthy Kitchens) to deliver a subsidised healthy daily school meal to elementary schoolchildren in Palestinian camps (Healthy Children).
We hypothesised that women who participated in the Healthy Kitchens component of the intervention would have improved economic status, food security and mental health.
Ethics approval(s)1. American University of Beirut Social and Behavioral Sciences Institutional Review Board (AUB SBS IRB), 20/12/2013, ref: FHS.HG.01 / FHS.HG.02
2. University of Maryland Institutional Review Board (UMD IRB), 02/12/2013, ref:535188-1
Health condition(s) or problem(s) studiedWomen's livelihoods, empowerment and mental health
InterventionThis study, Healthy Kitchens, is a component of a wider study called Healthy Kitchens, Healthy Children.
The Healthy Kitchens component is designed as a pre-/post-intervention, where women were recruited to work in a community kitchen by community based organisations. Women were asked to cook daily school meals in two community kitchens. These meals form the snack provided to the intervention group in the Healthy Schools component. Data were collected at the baseline and the end of the study (month 9).
Intervention typeBehavioural
Primary outcome measureWomen's livelihoods and economic empowerment at the baseline and after 9 months using:
1. A household expenditure questionnaire, adapted from the Demographic and Health Surveys (DHS)
2. A women's empowerment questionnaire, adapted from the Women's Empowerment in Agriculture Index (WEAI)
Secondary outcome measuresThe following are assessed at the baseline and after 9 months (unless otherwise stated):
1. Household food security, assessed using the Arab Family Food Security Scale
2. Mental health, assessed using the Mental Health Inventory - 5 (MHI-5)
3. Women's experience of participating in the intervention, assessed using open-ended questions at the end of the study (9 months)
Overall study start date01/09/2013
Completion date01/12/2017

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants40
Total final enrolment32
Key inclusion criteria1. Female
2. Aged over 18 years
3. Living in one of two Palestinian camps in Lebanon (Bourj el Barajneh and Shatila)
4. Willing and physically able to work from 7.30am - 12.30pm
Key exclusion criteriaDoes not meet inclusion criteria
Date of first enrolment04/06/2014
Date of final enrolment31/05/2016

Locations

Countries of recruitment

  • Lebanon

Study participating centre

Center for Research on Population and Health
Faculty of Health Sciences
American University of Beirut
Bliss Street
Hamra
Beirut
1107 2020
Lebanon

Sponsor information

The Nestle Foundation for the Study of Problems of Nutrition in the World
Research organisation

Place de la Gare 4 - PO Box 581
Lausanne
CH-1001
Switzerland

Website http://www.nestlefoundation.org/e/about.html
ROR logo "ROR" https://ror.org/021k07d19

Funders

Funder type

Research organisation

The Nestle Foundation for the Study of Problems of Nutrition in the World

No information available

Results and Publications

Intention to publish date01/01/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planData and results of the study have been presented at four conferences; some resulting in published abstracts.

Conference proceedings:
Ghattas H, Jamaluddine Z, Choufani J, Reese-Masterson A, Sahyoun NR. A Community-Based Intervention Improves Economic, Social and Food Security Outcomes of Palestinian Refugee Women and Diet Diversity of Palestinian Schoolchildren in Lebanon - The Healthy Kitchens, Healthy Children Experience. Abstract from the Lancet Palestinian Health Alliance Conference on “The Health of Palestinians Inside and Outside the Occupied Palestinian Territory”, Beirut, March 2018 (oral presentation).

Ghattas H. Assessing and engaging deprived communities; Food security and empowerment. Presentation at CRPH conference “No one left behind; A feasible goal for the health-related Sustainable Development Goals in the Arab region?”, Beirut, June 2017 (oral presentation).

Ghattas H, Jamaluddine Z, Choufani J, Btaiche R, Reese-Masterson A, Sahyoun NR. A Community-Based Intervention Improves Economic, Social and Food Security Outcomes of Refugee Women-The Healthy Kitchens Experience. The FASEB Journal. 2017;31(1 Supplement):313-6. Abstract from Experimental Biology, Chicago, April 2017 (oral presentation).

We intend to publish two papers:
1. Presenting the protocol and process evaluation of the intervention
2. Presenting the outcomes of the Healthy Kitchens (women's component) of the study
IPD sharing planThe datasets generated during and/or analysed during the current study are not expected to be made available due to the fact that studies were conducted with vulnerable refugee populations, and data transfer agreements with the collaborating organisations restrict our ability to share these data with third parties.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Abstract results results presented at Experimental Biology, Chicago, 03/10/2018 No No
Results article 29/11/2019 25/04/2022 Yes No

Editorial Notes

25/04/2022: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
02/11/2018: Internal review.