Effectiveness and Implementation of a Research Tested Mobile Produce Market Designed to Improve Diet in Underserved Communities

旨在改善服务不足社区饮食的经过研究测试的移动农产品市场的有效性和实施

• 批准号: 10842494
• 负责人: Lucia A Leone
• 金额: $ 8.22万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10842494
• 关键词: Behavior Therapy; Body mass index; Businesses; Carotenoids; Chronic; Cluster randomized trial; Communities; Community Outreach; Computer software; Consumption; Control Groups; Country; Data; Dermal; Diet; Dose; Eating; Education; Effectiveness; Evaluation; Face; Fatty acid glycerol esters; Feedback; Fingers; Food; Food Access; Food Preferences; Funding; Future; Health; Health Food; Healthy Eating; Heart Diseases; Height; Hour; Housing; Improve Access; Income; Individual; Intake; Intervention; Interview; Knowledge; Low Income Population; Low income; Malignant Neoplasms; Marketing; Measurement; Measures; Minority; Minority Groups; Modeling; Neighborhood Health Center; Neighborhoods; Nonprofit Organizations; North Carolina; Obesity; Outcome; Participant; Patient Self-Report; Periodicals; Persons; Population; Preparation; Price; Process; Process Measure; Program Effectiveness; Qualifying; Randomized; Randomized, Controlled Trials; Reporting; Request for Proposals; Research; Running; Sales; Scanning; Selection Criteria; Self Efficacy; Site; Socioeconomic Status; Sodium; Surveys; Techniques; Telephone; Testing; Time; Unhealthy Diet; Update; Vulnerable Populations; Weight; cluster randomized design; community college; community engagement; community organizations; cooking; cost; design; dietary; effectiveness measure; effectiveness testing; effectiveness/implementation hybrid; environmental intervention; farmers markets; flexibility; follow-up; food environment; fruits and vegetables; health disparity; hybrid type 1 design; implementation framework; implementation process; improved; informant; intervention participants; member; nutrition education; process evaluation; programs; recruit; research study; saturated fat; skills; social cognitive theory; success; sugar; theories; underserved community

Abstract Lower-income and minority groups face significant health disparities with respect to obesity, cancer, heart disease and other diet-related chronic conditions. Poor diets, low in fruits and vegetables (F&V) and high in saturated fat, sodium and sugar, contribute to many of the health problems faced by vulnerable groups. While socioeconomic status and other individual level factors (i.e., food preferences, time and skills to prepare healthy food, etc.) can lead to reduced F&V consumption, these must be viewed in an environmental context. Compared with higher-income neighborhoods, lower-income and minority neighborhoods are less likely to have stores that sell a variety of F&V and other healthy foods. And when stores are available, produce may not be affordable, high quality or culturally appropriate. Farmers' markets and mobile produce markets (MM) have become increasingly popular strategies to alleviate food access concerns in underserved communities. However, it is unclear if these programs have the necessary components to have an appreciable impact on diet. Our research team recently completed one of the first randomized controlled trials of a MM program called the Veggie Van. Veggie Van was run in partnership with our team and a small non-profit organization in North Carolina; it delivered boxes of fresh, locally grown produce and food-focused education to communities with significant barriers to F&V consumption including availability, affordability, quality and knowledge. In this small cluster-randomized trial in 12 communities (N=201), we saw impressive changes in F&V intake with intervention participants eating almost 1 more cups per day of F&Vs than the control group. Intervention participants also reported increases in perceived access to healthy foods and Veggie Van customers attributed many dietary changes to the MM program. While these results are very promising, we believe it is important to test the effectiveness of the Veggie Van program when implemented by different organizations in multiple communities. If shown to be effective, we can create a research-tested intervention toolkit which can be disseminated to communities across the country. For this research, we will use a request for proposals process to identify 8 organizations nationwide that are well-qualified to implement the Veggie Van model. Organizations will identify appropriate sites for MM deliveries (32 total) and we will randomize them to either an implementation or planning condition. With the help of our team's technical assistance and provided funding, partner organizations will engage community members in the process and initiate a MM program. We will use a Type 1 Hybrid Effectiveness-Implementation to measure effectiveness (diet, BMI, dermal carotenoids) and implementation (customer reach and sales, process measures, qualitative interviews with MM staff). We will also examine sustainability of MM financial models and determine implementation standards (i.e., dose needed to maintain impact) for inclusion in our MM toolkit for future dissemination.

抽象的 低收入和少数群体在肥胖，癌症，心脏方面面临重大健康差异 疾病和其他与饮食有关的慢性病。饮食不佳，水果和蔬菜（F＆V）低，并且很高 饱和脂肪，钠和糖会导致弱势群体面临的许多健康问题。尽管 社会经济地位和其他个人级别因素（即食物偏好，时间和技能 健康食品等）可以导致餐饮消耗减少，必须在环境环境中查看这些食物。 与高收入社区相比，低收入和少数民族社区不太可能 拥有出售各种F＆V和其他健康食品的商店。当商店可用时，农产品可能 不负担得起，高质量或在文化上不合适。农民市场和移动农产品市场（MM） 已经成为减轻服务不足社区的食品获取问题的越来越受欢迎的策略。 但是，目前尚不清楚这些程序是否具有对 饮食。我们的研究团队最近完成了MM计划的第一个随机对照试验之一 素食面包车。 Veggie Van与我们的团队和北部的一个非营利组织合作运营 卡罗来纳州；它向社区交付了一盒新鲜的，本地种植的农产品和以食品为中心的教育 F＆V消费的重大障碍，包括可用性，负担能力，质量和知识。在这个小 在12个社区中的集群随机试验（n = 201），我们看到了F＆V摄入量的令人印象深刻的变化 与对照组相比，干预参与者每天吃近1杯F＆V。干涉 参与者还报告说，可感知到的健康食品的获取和素食货车客户归因于 MM计划的许多饮食变化。尽管这些结果非常有前途，但我们认为重要的是 在多个组织中实施素食货车计划的有效性 社区。如果证明是有效的，我们可以创建一个研究测试的干预工具包 传播到全国各地的社区。对于这项研究，我们将使用提案请求 识别全国8个组织的过程，这些组织经过合格的实施素食货车模型。 组织将确定合适的MM交付站点（总计32个），我们将将其随机地随机 实施或计划条件。在我们团队的技术帮助的帮助下，提供了资金， 合作伙伴组织将与社区成员参与此过程，并启动MM计划。我们将使用 1型混合有效性 - 实现以衡量有效性（饮食，BMI，真皮类胡萝卜素）和 实施（客户覆盖率和销售，过程措施，与MM员工的定性访谈）。我们将 还要检查MM财务模型的可持续性并确定实施标准（即需要剂量 维持影响）将我们的MM工具包纳入以后的传播。