Language, communication, and cognition: A study of slum-dwelling women in a nutrition education programme in India
Whilst the research on nutrition education is consistently growing, it has typically focused on outcomes of nutritional status and nutrition knowledge. The demand for language and cognitive skills, barriers they may present, and the potential beneficial effects on these skills, specifically within individuals with low literacy skills, have been unexplored. This interdisciplinary thesis addresses these gaps by focusing on the cognitive flexibility and oral communication skills of Bengali-speaking mothers living in the Chetla slum in Kolkata, India, in collaboration with the NNEdPro Mobile Teaching Kitchen (MTK) project. This thesis presents a scoping review of the existing evidence, before outlining the development and adaptation of a task battery, comprising a demographic and language background questionnaire and tasks of literacy, narrative production, verbal fluency, and executive functions. To understand participants’ perceptions of their own learning and experience of nutrition education, a set of qualitative questions were also developed. The study was delivered at pre- and post-intervention alongside the MTK See One, Do One, Teach One (SODOTO) intervention in March 2022. Results I presents a profile of participants’ demographic and language background, as well as their anthropometric results. Comparative analysis at pre- and post-intervention reveals non- significant increases on most task measures. The consistency of task stimuli are also assessed, providing multiple discussion points for future research. Results II explores the relationships between task measures, finding a significant association between n-back and category naming performance, congruent with existing knowledge on verbal fluency and executive function components. Analysis of demographic, SES, and language context factors on task performance reveal a significant role of education on both literacy and picture sequencing performance, as well as maternal education on literacy and category naming performance. Individual level observations provide insights into patterns of performance across tasks, evidencing strengths and challenges across the group. Results III outlines findings from the nutrition measures, including significant improvements in Knowledge and Attitudes (KA). The correlational and predictive relationships with language and cognitive measures are assessed, with education, picture sequencing, and category naming performance found to be significant predictors of Do One Assessment (DOA) scores, but not of Knowledge and Attitudes (KA). This suggests that whilst education, cognitive flexibility, and verbal fluency skills appear to support performance and evidencing of skills during the intervention, they are not as important to changing KA. Finally, the results are discussed within the context of the hypotheses and existing literature, drawing together the interdisciplinary nature of the research. The limitations are outlined, alongside suggestions and recommendations for future research and continuation of this research. I propose changes to the task battery, as well as suggestions for modifying the NNEdPro KAP assessment to better capture information on learning, knowledge transfer, oral communication, planning skills, and mental flexibility. Overall, this thesis outlines an approach to exploring language and cognition in nutrition education, providing insights for health education more widely. With a previously underrepresented participant group, it presents findings that support the existing literature on cognitive skills, knowledge transfer and learning, and provokes suggestions for future research in this field. Beyond this, the research highlights both opportunities for cross-disciplinary collaboration and potential approaches to interdisciplinary research. It complements the work of NNEdPro, and by utilising linguistic and cognitive experimental methods, it instigates the exploration of nutrition education beyond nutrition and health outcomes.
communication, literacy, verbal fluency, executive functions, nutrition education, Bengali, India, knowledge transfer, learning
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