iCook 4-H is a lifestyle intervention to improve diet, physical activity and mealtime behavior. Control and treatment dyads (adult primary meal preparer and a 9⁻10-year-old youth) completed surveys at baseline and 4, 12, and 24 months. A Health Disparity (HD) score composite was developed utilizing a series of 12 questions (maximum score = 12 with a higher score indicating a more severe health disparity). Questions came from the USDA short form U.S. Household Food Security Survey (5), participation in food assistance programs (1), food behavior (2), level of adult education completed (1), marital status (1), and race (1 adult and 1 child). There were 228 dyads (control n = 77; treatment n = 151) enrolled in the iCook 4-H study. Baseline HD scores were 3.00 ± 2.56 among control dyads and 2.97 ± 2.91 among treatment dyads, p = 0.6632. There was a significant decline in the HD score of the treatment group from baseline to 12 months (p = 0.0047) and baseline to 24 months (p = 0.0354). A treatment by 12-month time interaction was found (baseline mean 2.97 ± 2.91 vs. 12-month mean 1.78 ± 2.31; p = 0.0406). This study shows that behavioral change interventions for youth and adults can help improve factors that impact health equity; although, further research is needed to validate this HD score as a measure of health disparities across time.
Keywords: behavior; family mealtime; health disparities; nutrition; physical activity.