Health professionals interested in how systematic feedback can be used to refine health promotion materials, with a focus on culture and inclusivity, will find this information beneficial. General audiences interested in the types of community-based health promotion classes offered within UF/IFAS Extension will also benefit from this information.
Introduction
UF/IFAS Extension offers a variety of group-based nutrition education and culinary skills training classes in communities throughout Florida to support health and wellness. Taste of Culture is a culinary-based Extension program that integrates cultural exploration, culinary skills, and evidence-based health benefits of cooking with herbs and spices. The curriculum was created by county-based Extension faculty and further refined by an Extension state specialist as well as undergraduate and graduate students. The four-lesson curriculum currently covers African, Caribbean, East Asian, and South Asian cuisines. This publication provides an overview of several key topics relevant to the curriculum review and update. We describe, in detail, the systematic review and feedback process, highlighting topics associated with high-quality health education (e.g., culturally relevant language, message framing, health literacy, engagement, visual design, program goals, learning objectives). This is the second publication in a two-part series related to the Taste of Culture curriculum.
Reviewing Educational Resources to Promote Engagement
Integrating food history and culture into educational health programs can help learners connect with the information. Engagement with educational material is shaped by various factors, such as its format, intended purpose, and the context in which it is used. All of these factors can affect a program's effectiveness and promote inclusivity (Griffith et al., 2024). We used strategies for reviewing educational resources that consider the needs of a broad range of communities. Communities may be connected by geographic location, shared interests, circumstances, cultural backgrounds, values, or preferences (Lapinski et al., 2024). We considered these concepts in our review of the Taste of Culture curriculum to ensure that the program is relevant and aligned to the program’s stated learning objectives and goals.
Methods
This collaborative review highlights the importance of integrating cultural diversity into educational programs. The collaborative approach to starting this new Extension program relied on a structured approach to curriculum development, refinement, and evaluation. We also refined to include accessible messages and language that would communicate the potential applications in managing chronic diseases and improving nutrition.
A team consisting of Active Learning Program (ALP) interns, a graduate research assistant (GRA), an undergraduate research assistant (RA), an Extension specialist, and Extension agents worked together with the UF/IFAS Extension Culinary Action Team to develop and refine the Taste of Culture curriculum. The refinement of the Taste of Culture curriculum was guided by literature on cultural adaptation. Livingstone et al. (2023) define cultural adaptation as any modification made to a service delivery or treatment regimen that considers the cultural beliefs, attitudes, language, context, and behaviors of the audience. This process involved systematic evaluations, participant feedback, and revisions to enhance cultural relevance, health literacy, and educational impact.
Reviewer Identity and Roles
The Extension specialist plays a vital role by “synthesizing research, providing leadership for their subject-matter expertise area, and contributing to the Extension body of knowledge through scholarly efforts” (Benge et al., 2024). In addition to the specialist, four Active Learning Program (ALP) interns, one undergraduate research assistant (RA), and one GRA participated in the review process. Each ALP intern was assigned one slide deck to review that corresponded to their familiarity with the represented culture. The GRA reviewed the African slide deck. The RA, with expertise in health literacy, reviewed all the lessons and provided targeted feedback. The Extension state specialist supervised the review and facilitated group discussions of each reviewer’s feedback. All reviewers provided a reflexivity statement (Appendix A).
The lessons were developed by Culinary Action Team members, who are UF/IFAS Extension agents (county faculty). The initial lesson topics were selected by this team and covered African, Caribbean, East Asian, and South Asian cuisines. When the agents updated the African slide deck, they incorporated relevant revisions to maintain alignment within cultural contexts while preserving the curriculum’s structure. Certain suggested changes, such as adding more recipes, were considered but ultimately not implemented to maintain the curriculum’s focus on a few key ingredients and skills rather than a comprehensive recipe collection. The formatting adjustments, such as bullet points on certain slides, were also evaluated in the context of slide space and visual consistency. When revising the South Asian slide deck, adjustments were made based on feedback, ensuring consistency with the overall curriculum while respecting cultural distinctions.
Rubric Development and Review Process
Two rubrics were developed by an Extension state specialist and an undergraduate research assistant (RA) to guide systematic review and feedback. The first rubric (Appendix B) allowed structured feedback on seven categories identified as important for a high-quality program: 1) cultural sensitivity, 2) health literacy, 3) graphics, 4) engagement, 5) formatting, 6) purpose, and 7) oral presentation. The second rubric allowed for more comprehensive feedback, questions, and suggestions on the program overall and was only filled out by the Extension state specialist.
There were five main activities involved in the process of systematically reviewing and refining the program. First, the ALP interns selected a slide deck to review based on familiarity or personal experience with the culture and entered feedback into an Excel sheet containing Rubric 1 (Appendix B). Second, group discussions among ALP interns and the state specialist were held to review feedback and refine suggestions for edits focusing on clarity, cultural appropriateness, and health literacy issues. Next, Culinary Action Team members (Extension agents) received feedback, which was shared via the Microsoft Teams channel. Agents used this information to update/refine the slide decks and materials. While all this was occurring, the state specialist provided feedback via Rubric 2, including recommendations and resources to finalize program objectives and individual learning objectives. The specialist’s review also included up-to-date evidence-based literature citations, webinars, and feedback on general program/implementation considerations. Finally, an evaluation plan, which included a pre-post evaluation, was developed to assess outcomes (e.g., fruit/vegetable intake, herb and spice usage, culinary confidence, knowledge of the therapeutic role of food, and health biomarkers, including Veggie Meter® readings and blood pressure). Brief post-lesson assessments were also created to measure class enjoyment and recipe liking, among other questions.
Results
The review process produced a variety of feedback and corresponding curriculum changes, as summarized in Table 1. Some of the categories of feedback included cultural sensitivity, graphics, engagement, health literacy, and formatting.
Table 1. Overview of feedback and recommendations by lesson.
Graphics feedback revealed that images lacked cultural depth or relevance. For example, in the African lesson, an image of fried chicken on slide 12 conflicted with the health-focused messages promoting baked or grilled dishes. Reviewers suggested replacing the fried chicken image from the meal composition slide because baking and grilling are discussed as recommended cooking methods later in the lesson. Reviewers also suggested using an image of a plate of food to better align with the topic of meal composition. Changes included substituting images to better align with health promotion messages and content while prioritizing visually appealing and culturally appropriate graphics.
Engagement suggestions focused on making slides more interactive and appealing. Health literacy feedback highlighted opportunities to simplify language and improve clarity. For example, terms like “consumed” were replaced with “eaten,” and subheadings were revised for consistency. Changes also included adding culture-specific, evidence-based information, such as the health benefits of fermentation.
Next Steps
Taste of Culture was developed as a culinary-based Extension program, designed to integrate cultural exploration, culinary skills, and the evidence-based health benefits of cooking with spices and herbs. The systematic refinement of the curriculum helps reinforce the importance of integrating cultural sensitivity, health literacy, and engagement in community-based culinary education. Additionally, the creation of a spice deck (information about the health benefits of herbs and spices) will help facilitate agent access to relevant information. The development of program/learning objectives and evaluation plans will also ensure that the pilot test of the curriculum and the professional development training to support class instructors will be successful.
The next steps are to pilot test the lessons in community settings and obtain data via pre-post questionnaires and health biomarkers (e.g., blood pressure and Veggie Meter® scores) to evaluate the program’s impact on knowledge, behavior, and health outcomes.
References
Benge, M., Leitheiser, K., Mukhtar, S., Shelnutt, K. P., O'Neal, L., McGuire, M., Horrillo, S. J., & Beattie, P. N. (2024). Roles and responsibilities of the Florida Extension specialist: AEC809/WC471, 9/2024. EDIS, 2024(5). https://doi.org/10.32473/edis-wc471-2024
Griffith, D. M., Efird, C. R., Baskin, M. L., Webb Hooper, M., Davis, R. E., & Resnicow, K. (2024). Cultural sensitivity and cultural tailoring: Lessons learned and refinements after two decades of incorporating culture in health communication research. Annual Review of Public Health, 45(1), 195–212. https://doi.org/10.1146/annurev-publhealth-060722-031158
Lapinski, M. K., Oetzel, J. G., Park, S., & Williamson, A. J. (2024). Cultural tailoring and targeting of messages: A systematic literature review. Health Communication, 1–14. https://doi.org/10.1080/10410236.2024.2369340
Livingstone, K. M., Love, P., Mathers, J. C., Kirkpatrick, S. I., & Olstad, D. L. (2023). Cultural adaptations and tailoring of public health nutrition interventions in Indigenous peoples and ethnic minority groups: Opportunities for personalized and precision nutrition. Proceedings of the Nutrition Society, 82(4), 478–486. https://doi.org/10.1017/S002966512300304X
Appendix A. Reflexivity statements from all reviewers.
Appendix B. Taste of Culture rubric.
Appendix C. Preliminary feedback on Taste of Culture curriculum review.