Developing a food literacy assessment tool for the Aotearoa New Zealand context

Food literacy is a distinct and complementary concept to nutrition literacy, and both are predictors for health outcomes, including for chronic disease. The food literacy status of people living in Aotearoa New Zealand is unknown. Current food literacy assessments do not encompass concepts of a te ao Māori (Māori) worldview of health such as collective wellbeing, engagement with whānau (family), the environment, spiritual and cultural aspects. Staff from He Toa Taua (Harbour Sport), delivering Green Prescription and Active Families programmes, indicated providing nutrition education is constrained by not knowing what clients need or want. Identifying the skills, knowledge, and confidence people have about food would support better provision of nutrition education. The aim of this work was to develop a food literacy assessment tool that included concepts aligned with a Māori worldview for use in the Aotearoa NZ context. The conceptual model of food literacy by Vidgen and Gallegos (1) outlines four domains pertaining to skills, knowledge and attitudes, and was used as a foundation for this tool. Co-designed with four Māori staff from He Toa Taua, and with contributions from seven Māori dietitians/nutritionists, concepts from Te Whāre Tapa Whā (2) were also considered. The tool was styled after the Hua Oranga (3,4) wellbeing checklist. Twenty whānau engaged with He Toa Taua also had input to the tool development. The completed tool included 20 items under the four domains of Plan and manage, Select, Prepare, and Eat. Following completion, 38 clients and staff from six community services trialled the tool. A five-point Likert scale identified the level of agreement for statements describing the tool use. Twenty-three clients provided feedback and there were high levels of agreement that the tool was dignifying, mana-enhancing, highlighted topics of importance, was easy to understand and helped to identify support. Suggestions for improvement were to include items more relevant to people living alone and capture more detailed information. Nine staff completed feedback and indicated the checklist was quick to complete, increased staff confidence to support a person with food/nutrition needs, invited kōrero (conversation) and was strengths focused. Involvement of whānau and practitioners in the development of this tool was a critical factor to ensure it was relevant to the needs of both people seeking and providing nutrition information and guidance. The contributions of co-designers, whānau, and Māori nutrition practitioners resulted in a checklist that can be used to help clients and staff identify the areas where support is needed and appropriate. Further refinement of the tool and testing in more community settings is warranted, but the evaluation completed thus far indicated the tool was acceptable in the Aotearoa NZ context, facilitates opportunity to explore what is important and meaningful for people, and enables activating appropriate support.