Deadly Koolinga Chef Program: A community-based cooking program for Aboriginal children and adolescents, pregnant women, breastfeeding mothers, and their families

There are four components to the DKCP: Component One The cooking and nutrition class/workshop component will be conducted from September / October 2021 to September 2023 for the first two years of the research initiative, at each of the participating sites: The Murray Districts Aboriginal Association (MDAA) Centre (Pinjarra, WA), and the Winjan Aboriginal Association (Winjan) Centre (Mandurah, WA) in partnership with the Nidgalla Waangan Mia (NWM) Aboriginal Health Service (AHS) (Mandurah, WA), and at the Kulunga Moort Mia (KMM) Aboriginal family lounge at the Perth Children’s Hospital (PCH) WA, in partnership with PCH’s Nutrition and Dietetics Department. The children (6-12 years) will attend weekly cooking and nutrition classes during the West Australian school terms (28 per year), at all partner sites, and the adolescents (13-17 years), pregnant women and breastfeeding mothers will attend 10 workshops per year (one every 5 - 6 weeks) at the MDAA and Winjan sites. The cooking classes will be 2.5 - 3 hours each, and the half day workshops will be 4 – 5 hours each. Each participant will take home a family meal for 4-6 people after each class/workshop to contribute to the family food work. Nutrition and food skills activity workbooks with age-appropriate activities will be provided to each participant at each cooking class/workshop participant at each session. The activity workbooks will focus on developing nutrition knowledge, healthy eating behaviours and kitchen and food safety skills. Thirty minutes will be allocated to completing the workbooks during the introduction to each class/workshop and workbook completion records for each participant will be recorded by the community Elder DKCP Research Associates (RAs). Any further completion of the workbooks outside the cooking sessions will be done at the participant’s discretion. The DKCP website will be developed to support the delivery of the DKCP to the participating sites (term plans for the cooking classes/workshops, class/workshop lesson plans, recipes, project updates, children’s nutrition workbooks, nutrition and dietetics information and links to other relevant websites). At each cooking class / workshop there will be 10-15 cooking stations and to ensure equity in participation a rolling family roster will be maintained allowing for all eligible children / adolescents in any one family to participate equally, and to allow for as many families as possible to be accommodated. Class / workshop attendance registers will be maintained, and this data will determine the time/length of exposure to the learning opportunities offered by attending and participating in the DKCP, compared to nutrition knowledge development data from pre- and post-testing. Component Two The research component will run concurrently alongside the cooking and nutrition component from September / October 2021 to September 2023. A Community Based Participatory Action Research (CBPAR) approach (Burns et al., 2011) underpinned by the Making Two World Work (MTWW) Aboriginal Health Promotion Framework (MAC & WHGNE, 2008), will be employed. CBPAR is a collaborative approach to research that involves all stakeholders throughout the research process, from establishing the research question, to developing data collection tools, to analysis, evaluation and dissemination of findings (Burns, et al., 2011). CBPAR recognises that community knowledge is irreplaceable and provides key insights that ‘ground-truths’ observational data, and that there is value and legitimacy in the knowledge of community individuals and families. The MTWW Aboriginal health promotion framework is underpinned by the Aboriginal ethical principles of partnerships, participation and empowerment, social justice and equity, and the determinants of Aboriginal social and emotional wellbeing, and proposes empowerment as its foundation (MAC & WHGNE, 2008). The DKCP will be evaluated using Realist Evaluation (RE) (Pawson & Tilley, 1997). RE guided by the Indigenous Evaluation Strategy (2000) will measure the impacts of the DKCP on the community members’ lives. Therefore, RE will: (a) evaluate the positive and negative, primary and secondary long-term impacts that result from the DKCP; (b) assess the direct and indirect contribution of the DKCP to such impacts, regardless of intention; and (c) explain how the DKCP contributes to policy and practice from the lessons learned The Aboriginal Advisory Group (AG), the Chief Investigator (CI) research team, Aboriginal Health Workers (AHWs), Aboriginal Health Professionals (AHPs) and community Elders from the partner sites will develop the DKCP Research and Data Management Plan and regularly review all the processes of the research and the cooking and nutrition component against the MTWW framework to ensure adherence to culturally appropriate protocols. Initial contact to provide the communities with information on the DKCP will be through community gatherings. These gatherings will be held at the sites noted above. The AHWs and RAs will be well versed in the DKCP and the research components and will ‘yarn’ informally with the community members while handing out the DKCP information sheet. The RAs will also guide the participants through the consent form, highlighting the participants’ rights to withdrawal from the cooking and nutrition classes / workshops and or the research and evaluation component at any time without penalty. The RAs will also discuss the processes of confidentiality, the methods of data collection and the collaborative and consultative approaches that will be used in analysing the data and the dissemination of the findings. The AHWs, AHPs and RAs supported by the CIs will attend the cooking classes and manage the attendance rosters, and oversee the completion of the workbooks, and participate in the collection of the qualitative and quantitative data. Data collection will be in the form of: Qualitative data: Individual and group yarning (Bessarab & Ng'andu, 2010) will be undertaken to obtain a holistic understanding of the communities’ experiences of participating in the DKCP Narrative art project: The use of art narrative enables cultural expression and symbolic representation of the emotional and physical experiences related to the child /adolescent’s individual participation in the DKCP through the use of traditional art. Statistical data: • Demographic Data: Address, age, sex, position in the family, family relationships, year level at school; • Attendance registers of participants and helpers at the classes and workshops; • The child nutrition knowledge survey; 14-item questionnaire (Wilson et al., 2008); • Australian Child and Adolescent Eating Survey Food Frequency Questionnaire (ACAES-FFQ) (Watson et al., 2009); • The Structure and Control in Parent Feeding (SCPF) questionnaire (Savage et al., 2017); • 24-hour recall food intake diary; • The Growth and Empowerment Measure (GEM) (Haswell et al., 2010); and • Nutrition Activity Workbook completion records for each participant will be recorded. Component Three The training and up-skilling component will also commence in September / October 2021 and will extend to December 2023. Accredited Certification training facilitated by registered training organisations either by on-line or face-to face enrolment will be offered in the areas of nutrition and dietetics, community development / project management, and research processes. Depending on the topic area selected the courses will take between 12 – 18 months to complete. The courses will be offered to workforce members from the participating sites initially, and then to other Aboriginal Health Services and community organisations who are interested in implementing the DKCP into their services after the research time frame. The workforce members and identified community members facilitating the cooking classes/workshops at the participating sites will undertake on-the-job skills training during the delivery of the cooking classes / workshops. For those facilitators enrolled in a nutrition and dietetics course, the skills training will be further supported by the learned theoretical knowledge. The cooking classes will be delivered by a CI research member with cooking class facilitation qualifications overseen by the CI dietitians. To support the roll out of the initiative and to train as many members as possible a train-the-trainer model will be employed at the sites for the duration of the cooking class/ workshop component. Component Four The dissemination of the DKCP will commence in July / August 2023. Outcomes and findings will be via co-authorship of articles and reports, co-presentation at workshops and conferences, and recommendations will be available publicly for policy makers and service providers to learn from, apply, and build on. All findings will be disseminated to the WA Aboriginal Health Services through individual distribution and through the CEO Forum of the Community Controlled Aboriginal Health Services, the WA Health Department Child and Adolescent Health Department, the West Australian Country Health Service and the WA Primary Health Alliance. Study findings will also be available through the DKCP website. The art produced by the children and adolescents will be a process in the dissemination of the findings to the wider community by means of a public exhibition. Monitoring - Adherence / Fidelity to the Intervention • The Aboriginal AG, CI research team, AHWs, AHPs and RAs will collaboratively develop the: • DKCP Delivery Plan and will review it against the MTWW Framework at 6 monthly intervals. This will also include: o Registers of attendance; o Workbook completions; o Kitchen safety monitoring; and o Food safety monitoring; o Current Working with Children Checks • DKCP Research and Data Management Plan and will review it at 6 monthly intervals against the AIATSIS (2020) Code of Ethics for Aboriginal and Torres Strait Islander Research; NHMRC (2019) Management of Data and Information in Research: A guide supporting the Australian Code for the Responsible Conduct of Research; and the Australian Research Data Commons Research Data Rights Management Guide. • The DKCP Budget and Expenditure will be reviewed regularly by the CI research team timely adjustment made as necessary; and • An upskilling and training register will be maintained and regularly reviewed by the CI research team for status on current enrolments, intermissions, completions and withdrawals.