Plain English Summary
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
Trial website
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
A 102829 -P 22047
Study information
Scientific title
Healthy Kitchens, Healthy Children: a community-based intervention linking community kitchens to a school food program - the Healthy Kitchens component
Acronym
Healthy Kitchens, Healthy Children - Women's study (HKHC-W)
Study hypothesis
This 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
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
Study design
Interventional non-randomised study
Primary study design
Interventional
Secondary study design
Non randomised study
Trial setting
Community
Trial type
Other
Patient information sheet
Not available in web format, please contact Hala Ghattas (hg15@aub.edu.lb) to request a participant information sheet
Condition
Women's livelihoods, empowerment and mental health
Intervention
This 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 type
Behavioural
Phase
Drug names
Primary outcome measure
Women'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 measures
The 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 trial start date
01/09/2013
Overall trial end date
01/12/2017
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. 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
Participant type
Healthy volunteer
Age group
Adult
Gender
Female
Target number of participants
40
Participant exclusion criteria
Does not meet inclusion criteria
Recruitment start date
04/06/2014
Recruitment end date
31/05/2016
Locations
Countries of recruitment
Lebanon
Trial 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
Organisation
The Nestle Foundation for the Study of Problems of Nutrition in the World
Sponsor details
Place de la Gare 4 - PO Box 581
Lausanne
CH-1001
Switzerland
Sponsor type
Research organisation
Website
Funders
Funder type
Research organisation
Funder name
The Nestle Foundation for the Study of Problems of Nutrition in the World
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Data 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 statement:
The 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.
Intention to publish date
01/01/2019
Participant level data
Not expected to be available
Basic results (scientific)
Publication list
2017 results presented at Experimental Biology, Chicago, 2017 https://www.fasebj.org/doi/abs/10.1096/fasebj.31.1_supplement.313.6