The Totara House Healthy Eating Study: A qualitative investigation into the feasibility of adapting the Senior Chef programme for patients in a mental health setting.

Abstract

Background: People experiencing early or first episode psychosis (FEP) are at increased risk of metabolic complications resulting from an interaction of illness symptoms, medication side-effects and lifestyle choices. Few studies have explored practical lifestyle interventions utilising nutrition education strategies to improve health outcomes in this population. This study aimed to assess the feasibility of implementing a healthy eating intervention programme in Totara House (a CDHB outpatient service for young adults with first episode psychosis by analysing stakeholder feedback, to determine whether a programme could be developed from a pre-existing learn to cook programme Senior Chef.

Methods: Participants involved key stakeholders of Totara House: staff, patients and family members/carers, who were recruited by advertisement or through recommendation from Totara House staff. A combination of individual interviews amongst patients and caregivers and a single focus group amongst staff members was used to explore participant thoughts, opinions, values and experiences, about the importance of nutrition (in this population), and suggestions for programme component ideas. Participants completed a questionnaire to assess their current level of nutrition knowledge.

Results: The data were analysed using thematic analysis. Three main themes emerged: “Personal Values” which explored patient worldviews, motivators and barriers; “Knowledge and Experiences of Health and Nutrition” which covered factors that can influence patients’ thoughts and attitudes towards achieving health goals; and “Programme Specific Details” included recommendations from participants for what they wanted to see in a healthy eating intervention programme. These themes and values support implementing a programme with a relaxed social atmosphere, including relevant practical information, and simple, affordable, healthy recipes they can try out at home. The questionnaire scores showed an average level of nutrition knowledge amongst all groups with a mean score of 53% (n=24). A one-way ANOVA revealed no between group differences (p= 0.46): patients 49% (n=8), staff 55% (n=10), family/carers 56% (n=6)), range 32%-73%.

Conclusion: A healthy eating intervention programme would be highly valued by Totara House staff, patients and family members/carers. The feedback for the desired programme content aligned with the pre-existing Senior Chef model indicating its potential adaptability into this population. To ensure that the content adheres to current evidence-based nutrition advice, a registered dietitian should be involved in developing, running or overseeing the programme.