Personalized Culinary Medicine: Qualitative Analyses of Perceptions from Participants in Action and Contemplation Stages of Change Through a One-Year Bi-Center Randomized Controlled Trial

Background: A high-quality diet is linked to cardiometabolic risk reduction. Culinary medicine interventions are effective in improving nutrition and health outcomes. While personalized nutrition is usually related to improving patient outcomes through knowledge about gene-nutrient interactions, tailoring interventions based on participant motivation and biopsychosocial environment may improve outcomes. The stage of change framework categorized participants based on current behaviors and intentions for future behaviors. Our goal was to assess participant perceptions regarding accomplishments, challenges, and needs up to one year following a culinary medicine program according to their stage of change at entry. Methods: Participant perceptions were collected at (1) the intervention end (open-ended questionnaire), (2) six months (semi-structured interview), and (3) twelve months (open-ended questionnaire). Analysis was performed inductively following a thematic analysis approach. Results: Twenty-four participants completed 70 perspectives (58/12 from participants who entered at a contemplation/action stage of change). Perceptions were related to (1) acquire culinary and nutritional knowledge: improve knowledge about healthy nutrition, use new recipes, and ask for hands-on cooking classes; (2) improve culinary and self-regulatory skills: improve confidence in the kitchen, expand cooking skills, organizing and planning, and creativity and pleasure; (3) adopt home cooking and healthy nutrition: adopt home-cooking habits, spreading home cooking to other family members, improve nutrition habits throughout the day, and decrease consumption of ultra-processed food; and (4) address the sustainability of health changes: achievements in maintaining long-term health changes, challenges in maintaining long-term health changes, and facilitators for a long-term change. Conclusions: These results provide one-year-long information about participant facilitators, barriers, and needs for making home-cooking changes categorized to the participant stage of change at program entry. This information can help reform effective personalized culinary medicine programs.