Obesity, unhealthy dietary habits, and food insecurity are major public health concerns, especially affecting individuals living in poverty. Food pantries, which provide free food to those in need, are increasingly interested in promoting healthy choices, but few rigorous studies have tested healthy eating interventions in food pantry settings. The overall objective of this proposal is to conduct a randomized-controlled trial among 500 regular food pantry clients to compare the influence of a behavioral economic intervention to promote healthier food choices delivered via a web-based ordering platform to usual care (control group).
The primary objective of this proposal is to evaluate the influence of a web-based behavioral economic intervention compared to a control group on the following outcomes among food pantry clients: 1) Nutritional quality of food chosen at the pantry using food transaction data; 2) Fruit and vegetable intake measured by biomarkers and food frequency questionnaires; 3) Objectively measured biomarkers of health. The web-based behavioral economic intervention will include the following modifications to the online shopping platform: 1) Healthy food shopping cart defaults, 2) healthy placement choice architecture, 3) traffic light nutrition labels, 4) social norms messaging, and 5) healthy swaps. Food transaction data will be collected from the online system at baseline and then continuously for the remaining 3 months of the study (participants typically shop monthly). Surveys and objective biomarkers will be collected at baseline and three-months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
286
This intervention includes multiple behavioral economic interventions, healthy food shopping cart defaults, healthy placement choice architecture, traffic light nutrition labels, social norms messaging, and healthy swaps.
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Mean Monthly Change in Number of Units of Healthier Foods
Average monthly change from baseline across 3 months of participation, in number of units of healthier foods (labeled with a green traffic light) purchased per shopping trip using the food pantry's definition of a unit.
Time frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
Mean Monthly Change in Number of Units of Less Healthy Foods
Average monthly change from baseline across 3 months of participation, in number of units of less healthy foods (labeled with a red or yellow traffic light) purchased per shopping trip using the food pantry's definition of a unit.
Time frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
Mean Monthly Change in Calories From Healthier Foods Per Shopping Trip
Average monthly change from baseline across 3 months of participation, in number of calories from healthier foods per shopping trip.
Time frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
Mean Monthly Change in Calories From Less Healthy Foods Per Shopping Trip
Average monthly change from baseline across 3 months of participation, in number of calories from less healthy foods per shopping trip.
Time frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
Self-reported Change in Fruit and Vegetable Intake
Change from baseline in fruit and vegetable intake as measured by the National Cancer Institute (NCI)'s fruit and vegetable module of the Dietary Screener Questionnaire in the National Health and Nutrition Examination Survey (NHANES). Scores estimate average daily cup equivalents of total fruit and vegetable servings.
Time frame: Assessed at baseline and 3 months.
Biomarker Change in Fruit and Vegetable Intake
Change from baseline in carotenoid levels (scores range 0-800) as measured by the VeggieMeter®. The VeggieMeter® is a spectroscopy-based skin carotenoid measurement device, created by Longevity Link Corporation in 2015. It uses pressure-mediated reflection spectroscopy (RS) to detect and quantify skin carotenoids as a proxy for fruit and vegetable intake in humans. Validation studies show VeggieMeter scores to be highly correlated with blood serum measures of carotenoids (R=.81). Higher units represent a higher concentration of carotenoids in the skin.
Time frame: Assessed at baseline and 3 months.
Change in Body Mass Index (BMI)
Change from baseline in BMI (weight in kg / height in meters\^2)
Time frame: Assessed at baseline and 3 months.
Change in Systolic Blood Pressure
Change from baseline in systolic blood pressure (indicator of heart health)
Time frame: Assessed at baseline and 3 months.
Change in Diastolic Blood Pressure
Change from baseline in diastolic blood pressure (indicator of heart health)
Time frame: Assessed at baseline and 3 months.
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