Abstract

<h3>Background</h3> The Georgia Food for Health program (GF4H) is a clinic-based nutrition education and food security intervention program that has demonstrated the ability to improve dietary behaviors. However, little is known about changes in behaviors during COVID-related lockdowns. <h3>Objective</h3> To characterize diet behavior changes experienced by former participants of a food security intervention during COVID-related lockdowns. <h3>Study Design & Setting</h3> We conducted semi-structured interviews by phone with 17 patient participants in May - June 2020 with program participants who had completed the program within the past 6 months. Participants were asked questions about the program, diet and stress-related behaviors, and changes in these behaviors within the COVID lockdown period. <h3>Participants</h3> Participants were mainly middle-aged (mean age 59 years), African American (100%), women (59%). Approximately half screened positive for food insecurity (47.1%). All participants were healthy at the time of the interview. <h3>Analysis</h3> Transcripts of interviews were analyzed for both apriori and emergent themes using thematic analysis. <h3>Results</h3> We identified 3 central themes. First, participants discussed changes in shopping behaviors to minimize time spent in stores using approaches like shopping lists to plan routes within the store or sending younger relatives to shop for them. Due to supply issues at stores, participants discussed adapting recipes to include available options. Second, participants discussed disinterest in cooking, a lack of motivation to engage in healthy eating strategies they had previously adopted, and anticipation of regretting these behaviors post-COVID. Third, participants were largely uncomfortable at the prospect of resuming in-person programming and preferred virtual options due to safety concerns. <h3>Conclusion</h3> Among former participants of the GF4H program, shopping and cooking behaviors shifted during the COVID-19 lockdown period to adapt to safety guidelines and to overcome supply issues. Motivation to engage in healthy cooking and eating behaviors was diminished. Ongoing program efforts should focus on virtual options to engage and re-engage participants.

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