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NCHPAD - Building Healthy Inclusive Communities

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The Story Behind the ''''Overcoming Obstacles to Nutrition'''' Cooking System


by Mary F. Rondon
Registered Dietitian

For more than 30 years, Lakemary Center, a non-profit organization in Paola, Kansas, has been a leader in providing opportunities for individuals with developmental disabilities. The 'Overcoming Obstacles to Nutrition' cooking system is an important teaching tool to enable adults to actively engage in the preparation of healthier meals.

As the wellness coordinator, I found that the clients faced nutritional challenges that I had encountered in other settings. I often had the opportunity to teach small cooking classes to these clients. The classes were well-received and well-attended. However, I noticed that no matter how simple or basic the recipes were, the clients would watch me cook, rather than participate, and rarely would they take the recipes home. That was not the purpose of the cooking classes. The question that I kept asking myself was, 'How could I improve my cooking classes so that I would watch the clients cook and they would want to take the recipes home?'

The solution that I envisioned was a picture cookbook using convenience foods. Now, my definition of convenience is NOT FROM SCRATCH! The challenge was to create recipes that met the following criteria

  • Recipes that were relatively healthy. I strived to make the recipes low in fat, but as tasty as possible. In some recipes, I used a lower-fat item instead of a nonfat version of that same item. The deciding factor was taste. No matter how low-fat I could make a recipe, if it didn't taste good, clients wouldn't eat it.
  • Recipes which used convenience foods as much as possible. I realized that the clients needed to use 'short cuts' as much as possible. Even though my personal preference is to use fresh ingredients, my clients were not going to have the time and/or the motivation to cook from scratch. Many of my clients were afraid of getting cut when using a knife to chop and dice vegetables. So, it wasn't reasonable to assume they would use a knife to prepare fresh vegetables.
  • Recipes needed to be followed with or without words. Lakemary Center serves clients with different reading levels. I did not want to take away from their ability to read a recipe. However, I did not want someone to be hindered from being able to successfully prepare a recipe because of his or her inability to read at a certain level.
  • The recipes needed to be prepared quickly

Over the course of a year, I tested and modified more than 100 recipes before deciding on the 15 recipes that are in the 'Obstacles to Nutrition' cooking system. I quickly discovered that all recipes are not easily converted into 'convenience' recipes. In fact, many of the recipes were a complete disaster!

My husband and my 10-year-old son were my first guinea pigs. I remember countless nights when they would come home to pizza for dinner, knowing that another recipe didn't turn out. Both of them were very open in voicing their opinions. My son had come to know many of my clients and his reasoning was clear: If he didn't like a recipe, he didn't want my friends at Lakemary to have to eat it.'

After making my selections, I began converting written recipes into picture recipes. At this point, I realized that I needed to be able to visually reinforce the 'technical' aspects of cooking and decided to use color-coded measuring cups and spoons. The dials on the stove and oven are also color-coded. In fact, the color markers are included with the 'Overcoming Obstacles to Nutrition' cookbook system so that you can color-code your stove and oven dials. The color-coded measuring cups and spoons are also included with the 'Overcoming Obstacles to Nutrition' cooking system.

This cooking system comes in a handy three-ring binder so individual recipes can be removed while being used. The recipes are also laminated for easy wipe-off of any spills.

The recipes use picture icons of the ingredients. Our clients associate the picture icons with the ingredients that are used in the recipes. In order to maintain consistency throughout the entire cooking system, the same picture icons are used throughout. For example, a picture icon of a chicken in one recipe is the same chicken icon that is used in all the recipes. The picture icons are only representations. You can use any brand that you want or choose different assortments of vegetables. A nutritional analysis is also included with each recipe.

After the initial prototype was complete, it was important that the recipes be tested before being introduced to the clients. I decided to see if my son could cook all the recipes by himself. This was a very important step. I know how to cook, but could a 10-year old boy with limited cooking experience prepare the recipes successfully? I am happy to say that he was able to prepare all the recipes without my intervention. Interestingly, he came up with some modifications that have been worked into the recipes.

The final - but most important - step loomed in front of me. Could the clients use these picture recipes successfully? For testing purposes, I had 16 residents from four group apartments prepare all 15 recipes. The residents who participated in this pilot program were adults with profound developmental delays and were living in a continuous support environment. Residents had little, or no reading ability, as well as speech and hearing impairments. Many exhibited behavior problems, especially during mealtimes.

The results were amazing, and the staff was thrilled. Our research showed that a majority of the residents were able to follow the recipes with minimal or no assistance. Of this majority, 26% could follow the recipes with very little or no assistance; 37% needed some instruction, but could prepare the recipes with verbal guidance from the staff. Sixteen percent needed some physical assistance and verbal guidance in the preparation of the recipes, and the remaining 21% were more dependent on the staff, needing to be helped step by step.

In addition, staff members reported a decrease in some food-related behavior problems with certain residents. Mealtime can be a time of chaos in any household. Having residents choose what menus to prepare, and then taking an active role in the preparation, has increased their self-esteem and has reduced some behavior problems. Another benefit was the staff no longer cooked the meals by themselves.

Last but not least, another benefit of the 'Overcoming Obstacles to Nutrition' cooking system is that clients of the Lakemary Day Service Center have the opportunity to earn money assembling, packaging, and shipping the cookbook.

There are 15 main entrees in the initial 'Overcoming Obstacles to Nutrition' cooking system. Additional recipe bundles such as crockpot meals, salads, or desserts may be purchased separately and easily added to the cookbook.

Bon Appetit!


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