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 低收入群体和少数群体在肥胖、癌症、心脏病等方面面临着巨大的健康差距 疾病和其他与饮食相关的慢性病。饮食不良、水果和蔬菜 (F&V) 含量低、维生素 D 含量高 饱和脂肪、钠和糖导致弱势群体面临许多健康问题。尽管 社会经济地位和其他个人层面因素（即食物偏好、准备时间和技能） 健康食品等）可能会导致食品和饮料消费的减少，因此必须在环境背景下看待这些问题。 与高收入社区相比，低收入社区和少数族裔社区不太可能 有出售各种 F&V 和其他健康食品的商店。当商店可用时，产品可能会 价格不菲、质量不高或不适合文化。农贸市场和移动农产品市场 (MM) 已成为越来越受欢迎的战略，以缓解服务欠缺社区的粮食获取问题。 然而，尚不清楚这些计划是否具有必要的组成部分来对 饮食。我们的研究团队最近完成了 MM 项目的首批随机对照试验之一，该项目名为 素食货车。 Veggie Van 是与我们的团队和北部的一个小型非营利组织合作运营的 卡罗莱纳州；它向有困难的社区提供了一箱箱新鲜的当地种植的农产品和以食品为重点的教育 食品和饮料消费的重大障碍包括可用性、可负担性、质量和知识。在这个小 在 12 个社区 (N=201) 进行的整群随机试验中，我们看到食品和饮料摄入量发生了令人印象深刻的变化 干预参与者每天比对照组多吃近 1 杯 F&V。干涉 参与者还报告说，人们对健康食品的认知度有所增加，而 Veggie Van 的顾客归因于 MM计划中的许多饮食改变。虽然这些结果非常有希望，但我们认为重要的是 测试 Veggie Van 计划由不同组织在多个国家实施时的有效性 社区。如果被证明是有效的，我们可以创建一个经过研究测试的干预工具包，该工具包可以 分发到全国各地的社区。对于这项研究，我们将使用征求建议书 确定全国范围内 8 个有资格实施 Veggie Van 模式的组织。 组织将确定 MM 交付的适当地点（总共 32 个），我们会将它们随机分配到 实施或规划情况。在我们团队的技术援助和提供的资金帮助下， 合作伙伴组织将让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-测量有效性的实施（饮食、BMI、真皮类胡萝卜素）和 实施（客户覆盖范围和销售、流程衡量、与 MM 员工的定性访谈）。我们将 还检查 MM 财务模型的可持续性并确定实施标准（即所需剂量 以保持影响力）以包含在我们的 MM 工具包中以供将来传播。