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: 10710195
• 负责人: Uriyoan Colon-Ramos
• 金额: $ 53.1万
• 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/10710195
• 关键词: Address; African American; Area; Attention; Baltimore; Behavior; Beverages; Black race; Calibration; 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; Visualization; Work; cancer prevention; cancer risk; dashboard; dietary; dynamic system; experimental study; food environment; food preparation; 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

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.

项目概要 高品质的饮食可以预防癌症。先前通过改变食物来改善饮食质量的工作 环境强调增加零售店购买健康食品的机会，但关注相对较少 专注于干预独立经营的餐馆，这有可能有助于 在以少数族裔为主的低收入城市社区预防癌症。我们的团队已经努力了 广泛与这些类型的餐厅合作，以增加获得并推广更健康的主菜、配菜和 饮料，从而导致促销食品的总收入、销售和购买量显着增加。 基于这项工作，本研究有两个相互关联的目标，即可持续地改善获得和 在独立经营的餐厅中推广更健康的食品：1）使用系统科学方法 完善、实施和测试新颖干预措施的效果（FRESH：关注餐厅参与度 除其他成果外，加强健康）的饮食质量和常客的健康； 2）使用 用于开发、参数化和校准系统的新鲜形成数据、基线数据、实施数据和结果数据 动态模型，使利益相关者能够虚拟测试 FRESH 策略对结果的影响 他们自己的社区。 FRESH 是一种基于多层次理论和实践的干预措施，针对独立拥有的企业 具有 3 个核心组成部分的餐厅：食物准备、食物获取和采购以及消费者营养 环境。目标 1) 使用系统科学方法从我们成功的案例中提炼现有材料 餐厅干预措施，并将干预措施调整到两个城市地点（巴尔​​的摩和华盛顿都会区） 主要是低收入和少数族裔（非裔美国人和拉丁裔）。目标 2) 在 24 小时内实施 FRESH 在 16 个月内对两个地点独立拥有的餐厅进行调查并收集流程数据。目标 3) 至 使用多中心整群随机对照试验评估 FRESH 对饮食质量的影响（主要 结果）;健康指标；常客 (n=576) 的心理社会因素，并评估其对 单位销售额和每周收入。主要假设：FRESH 参与餐厅的常客 干预社区的健康饮食指数得分将至少提高 5 分，因为 与比较街区的餐厅顾客相比。目标 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 FRESH 干预策略的效果 在不同的场景下，实现目标 4) 传播规划工具，使利益相关者能够 在其他城市环境中模拟和虚拟测试 FRESH 干预策略，可视化潜在效果 通过基于网络的单位销售、收入、客户健康指标和防癌饮食行为 用户友好的交互式仪表板。这项研究将产生既新颖又重要的结果，包括 模拟模型来测试基于餐厅的癌症预防策略，从而节省大量成本 避免了反复试验的实施。