Systems Science Approaches to Improve Access to Healthier Foods: The FRESH Trial

改善健康食品获取的系统科学方法：FRESH 试验

• 批准号: 10562311
• 负责人: Uriyoan Colon-Ramos
• 金额: $ 60.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10562311
• 关键词: Address; African American; Area; Attention; Baltimore; Behavior; Beverages; Black race; Calories; Cities; Communities; Complex; Conflict (Psychology); Cost Savings; Data; District of Columbia; Educational workshop; Environment; Environmental Risk Factor; Evidence based intervention; Exhibits; Food; Food Access; Health; Health Food; Healthy Eating; Improve Access; Intervention; Interview; Intuition; Latinx; Lead; Low income; Malignant Neoplasms; Methods; Minority; Modeling; Neighborhoods; Not Hispanic or Latino; Nutrient; Online Systems; Outcome; Output; Persons; Positioning Attribute; Prevention strategy; Preventive; Process; Psychosocial Factor; Public Health; Randomized; Randomized Controlled Trials; Restaurants; Sales; Science; Side; Site; Source; System; Testing; Visual; Work; base; cancer prevention; cancer risk; dashboard; dietary; experimental study; food environment; food preparation; implementation outcomes; improved; indexing; insight; metropolitan; minority communities; model building; models and simulation; mortality; novel; nutrition; primary outcome; protective factors; public health priorities; secondary outcome; stem; theories; tool; urban minority; user-friendly; virtual; willingness; work-study

Project Summary High dietary quality is protective against cancer. Previous work to improve dietary quality by changing the food environment has emphasized increasing access to healthy foods in retail stores, but relatively little attention has focused on intervening in independently owned restaurants, which have the potential to contribute to cancer prevention in predominantly minority, low-income urban neighborhoods. Our team has worked extensively with these types of restaurants to increase access to and promote healthier entrees, sides and beverages, leading to significant increases in total revenues, sales, and purchasing of promoted foods. Stemming from that work, this study has two interrelated objectives to sustainably improve access to and promotion of healthier foods in independently owned restaurants: 1) to use systems science approaches to refine, implement and test the effects of a novel intervention (FRESH: Focus on Restaurant Engagement to Strengthen Health) on dietary quality, and health of regular customers, among other outcomes; and 2) to use FRESH formative, baseline, implementation and outcome data to develop, parametrize, and calibrate a system dynamics model that will allow stakeholders to virtually test the effects of FRESH strategies on outcomes in their own communities. FRESH is a multilevel theory- and practice-based intervention for independently owned restaurants with 3 core components: food preparation, food access & procurement, and consumer nutrition environment. Aim 1) To use systems science approaches to refine existing materials from our successful restaurant interventions and adapt the intervention to two urban sites (Baltimore and the DC metro area) that are predominantly low-income and minority (African American and Latinx). Aim 2) To implement FRESH in 24 independently owned restaurants across both sites during 16 months and collect process data. Aim 3) To assess the impact of FRESH using a multisite cluster randomized controlled trial on dietary quality (primary outcome); health indicators; psychosocial factors of regular customers (n=576), and evaluate its impacts on unit sales and weekly revenues. Primary Hypothesis: Regular customers of participating restaurants in FRESH intervention neighborhoods will demonstrate at least a 5-point increase in Healthy Eating Index score, as compared to restaurant customers in comparison neighborhoods. Data from Aims 1- 3 will be used to develop, parameterize, and calibrate a system dynamics model to simulate the effects of FRESH intervention strategies under different scenarios, leading to Aim 4) To disseminate a planning tool that enables stakeholders to simulate and virtually test FRESH intervention strategies in other urban contexts, visualizing potential effects on unit sales, revenues, customer health indicators, and cancer-prevention dietary behaviors, via a web-based user-friendly interactive dashboard. This study will yield results that are both novel and significant, including a simulation model to test restaurant-based cancer-prevention strategies, yielding substantial cost-savings from avoided trial-and-error implementation.

项目摘要 高饮食质量可防止癌症。以前通过更改食物来提高饮食质量的工作 环境已经强调增加零售商店获得健康食品的机会，但关注相对较少 专注于干预独立餐厅，这有可能为 主要是少数群体的低收入城市社区的预防癌症。我们的团队工作了 广泛使用这些类型的餐馆，以增加获得和促进更健康的主菜，方面和 饮料，导致总收入，销售和促销食品的购买大幅增加。 源于这项工作，这项研究具有两个相互关联的目标，可持续提高进入和 在独立餐厅促进更健康的食品：1）使用系统科学方法 精炼，实施和测试新颖的干预效果（新鲜：专注于餐厅参与到 增强健康质量的健康状况，以及普通客户的健康以及其他结果； 2）使用 新的形成性，基线，实施和结果数据，以开发，参数化和校准系统 动态模型将允许利益相关者虚拟测试新鲜策略对结果的影响 他们自己的社区。 Fresh是独立拥有的多级理论和基于实践的干预措施 拥有3个核心组成部分的餐厅：食物准备，食品获取和采购以及消费者营养 环境。目的1）使用系统科学方法从我们的成功中完善现有材料 餐厅干预措施，并将干预措施调整到两个城市地点（巴尔​​的摩和DC都会区） 主要是低收入和少数民族（非裔美国人和拉丁裔）。目标2）在24中实施新鲜 在16个月期间，这两个站点都独立餐馆并收集流程数据。目标3） 使用多站点群集随机对照试验对饮食质量进行评估新鲜的影响（主要 结果）;健康指标；常规客户的心理因素（n = 576），并评估其对 单位销售和每周收入。主要假设：新鲜参与餐厅的常规客户 干预社区将至少显示健康饮食指数评分的5分提高，因为 与餐馆客户相比相比。 AIMS 1-3的数据将用于开发， 参数化并校准系统动力学模型，以模拟新鲜干预策略的影响 在不同的情况下，导致目标4）传播一种计划工具，使利益相关者能够 在其他城市环境中模拟和实际测试新的干预策略，可视化潜在影响 通过基于网络的单位销售，收入，客户健康指标和预防癌症的饮食行为 用户友好的交互式仪表板。这项研究将产生既新颖又显着的结果，包括 模拟模型，以测试基于餐厅的癌症预防策略，从 避免了反复实施。