Feasibility, acceptability and preliminary effectiveness of a manualized lay-led food literacy intervention for women in a community setting

Abstract

Food literacy (FL) is the capability to make healthy food choices in different settings, contexts, and situations. Addressing factors such as competencies, self-efficacy and social norms enables sustainable positive change in nutrition behaviour. This study assesses the feasibility, acceptability, and preliminary effectiveness of a lay-led FL intervention for Arabic and Hebrew-speaking women in community settings, utilizing a train-the-trainer model. Feasibility was assessed through recruitment, attrition, and attendance rate, while acceptability and satisfaction were evaluated using participant feedback-forms. Preliminary effectiveness was evaluated using pre-post surveys measuring changes in FL level and Mediterranean diet adherence using validated scales (the adapted Short Perceived Food Literacy Scale (adapted SPFL, scale range 22–62) and the Israeli Mediterranean diet adherence screener (I-MEDAS, scale range 1–17)), utilizing the generalized estimating equations model. Outcomes of Hebrew and Arabic-speaking participants were compared using chi-square tests. Twenty-six lay-leaders were trained and subsequently conducted FL workshops for over 260 participants within 6 months. The 8-session workshop curriculum addressed multiple FL domains and was culturally adapted for Hebrew and Arabic-speaking populations. The intervention demonstrated feasibility with 77% attendance rate and 15% attrition rate. High acceptability was indicated by participant satisfaction with workshop content, length, structure, and lay-facilitators. The intervention demonstrated preliminary effectiveness with a three-point increase in FL level, as measured by the SPFL, from 48.66(±6.45) to 51.70(±6.13) (p < 0.001) post intervention. This change was seen in both Arab and Hebrew-speaking participants. Although overall I-MEDAS did not change significantly, Arabic-speaking groups showed a significant 0.75-point increase, and 50% of participants reported making dietary changes. The study demonstrates that lay-led FL interventions in the community utilizing a train-the-trainer model were feasible, well-accepted, and potentially effective in improving FL levels among diverse communities of women.