By Paul Karon

A team of health information researchers has developed a smartphone app to help low-income parents cook healthful and appealing dishes for their children.

Children in low-income families face particular risks for poor nutrition and obesity, problems often associated with diets low in fresh fruits and vegetables.

The good news is that America’s networks of food banks and food-assistance agencies in recent years have begun to distribute vastly more of the fresh produce crucial to good health. The bad news is that kids and families don’t always know what to make of the sometimes unfamiliar foods they receive from these agencies, and much of it goes uneaten.

Called “Quick! Help for Meals,” the app generates recipe books customized for each family, as well as tips about food and nutrition, explained principal investigators Peter Clarke and Susan Evans, both faculty at the USC Annenberg School for Communication and Journalism.

“To some of the people who receive food assistance, even common vegetables like cauliflower and green beans can be mysterious and not particularly appetizing,” said Evans. “Our goal was to give people a tool to provide very specific information that matches the foods they have on hand with their family’s individual tastes, medical considerations, and even their kitchen appliances and utensils.”

To create the recipes in Quick! Help for Meals, Clarke and Evans went to the experts: professional chefs and fine cooking schools. They asked the chefs to create dishes that were easy to prepare, healthful and delicious. The chefs used the same types of vegetables commonly distributed by food pantries and other ingredients within the reach of low-income households.

The app starts by asking clients a series of questions: What vegetables do they want to cook? Are they using a microwave, stove-top steamer, slow cooker or oven? Do they like soup? Does the family lean toward particular cuisines and flavors, such as Asian, Hispanic or African-American? Do they need to cook for a baby or for someone with diabetes? The app also asks if users want to see practical tips, such as ideas about freezing and leftover storage.

Quick! Help then crunches the answers to create a customized color booklet full of recipes — the client’s personal VeggieBook. The recipes are illustrated with clear instructions and food-magazine quality photos, and clients can easily individualize the booklet’s cover with a photo or religious image — a seemingly small touch that can make a big difference in usage of the booklet, Evans said.

Currently, the app contains about 280 different recipes and more than 150 food-use tips, but it’s designed to be expandable. All materials are available in English and Spanish, and users can print out the booklets or refer to the electronic versions on their smartphones while they cook. 

About a third of pantry clients have smartphones now, an amount bound to increase as the technology gets less expensive and spreads further through the population, Evans said.

The researchers worked closely with several Los Angeles-area food assistance agencies during development of Quick! Help. One of these was Meet Each Need with Dignity (MEND), a multiservice poverty relief agency based in Pacoima, Calif., that is one of the LA area’s largest pantries.

“We surveyed a thousand clients to find out how we could best help them, and the majority said they wanted more fresh produce because it can be so expensive, so the USC project really complemented our needs,” said Marianne Haver Hill, president and CEO of MEND. “A lot of our work centers around helping our clients find pathways to self-reliance, and Quick! Help provides education central to that goal.”

Last year, some 40 million people in the United States received food assistance through a mix of agencies and programs, including food banks and food pantries, and on-site feeding programs serving adults and children.

For decades, food pantries — local sites that distribute groceries to families in need — mainly dispensed less perishable items, such as rice and cereal. Fresh fruits and vegetables were seldom included, and even then in small quantities, primarily because of the complications of storage, refrigeration and spoilage.

In a major victory for nutrition, however, efforts by food aid groups, commercial distributors, farmers and other members of the food industry have made fresh produce a bigger component of the food that pantries dispense to clients.
The trick is getting families to use the produce.

“The mom may be handed something like zucchini or cabbage and because of her personal experience in the kitchen, she may have no idea how to cook it,” Evans said. “Or she may not know how to cook it in ways her kids will like. So a lot just goes to waste.”
Although kids can be stubbornly resistant to vegetables, Clarke said, there are healthy ways to cook veggies, such as roasting, that have widespread appeal to youthful palates.

Clarke and Evans now are studying both short-term and sustained changes in diet. Ultimately, they want to learn whether the use of Quick! Help improves markers of obesity, such as body mass index and body fat.

“It’s not enough that our app is attractive and easy to navigate,” Clarke said. “It must also help people change their lives in measurable ways.”

For the design of field trials and data analysis, the pair depended heavily on Wendy Mack, professor of biostatistics in the Department of Preventive Medicine at the Keck School of Medicine of USC and director of biostatistics resources for the Southern California Clinical and Translational Science Institute (SC CTSI). The institute offers investigators in diverse fields access to expert advice at every stage of research.

With this support, the investigators won additional funding from the U.S. Department of Agriculture to continue the development and testing of Quick! Help.

“Wendy’s experience with randomized, controlled experiments is invaluable,” Clarke said. “She provides deep knowledge of how to gather and analyze valid evidence about the impact of health interventions.”

SC CTSI and Children’s Hospital Los Angeles is part of the 60-member Clinical and Translational Science Awards network funded through the National Center for Advancing Translational Sciences at the National Institutes of Health (grant UL1TR000130). Under the mandate of “Translating Science into Solutions for Better Health,” SC CTSI provides a wide range of services, funding and education for researchers, and promotes online collaboration tools.