A Randomized Trial of Web-based Behavioral Economic Interventions to Promote Healthy Food Choices Among Food Pantry Clients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 286
- Locations
- 1
- Primary Endpoint
- Mean Monthly Change in Number of Units of Healthier Foods
Study Overview
Brief Summary
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).
Detailed Description
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 Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Investigator)
Masking Description
The research team will create the randomization list and a research assistant will assign the participant to the correct online platform condition, but the investigators and data analysts will remain blind to group assignment. This study will contain two parallel groups. Although participants will not initially be aware of the other study condition, they will not be blinded to study condition because those in the intervention condition will be viewing the altered ordering platform as they shop.
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •≥18 years old
- •primary grocery shopper for the family
- •a regular in-person client at the food pantry (i.e., shops at pantry ≥ 1 per month)
- •able to use the web-based touchscreen ordering system
- •able to use a blood pressure cuff and scale provided to them for taking blood pressure and weight
- •able to come outside their home for 5 minutes for the Veggie Meter measurement
Exclusion Criteria
- •<18 years old
- •not the primary grocery shopper for the family
- •not a regular client at the food pantry (i.e., shops at pantry < 1 per month)
- •not able to use the web-based touchscreen ordering system
- •not able to use a blood pressure cuff and scale provided to them for taking blood pressure and weight
- •not able to come outside their home for 5 minutes for the Veggie Meter measurement
Arms & Interventions
Control Group
Participants in this arm will view the typical web-based ordering system platform (usual care group).
Behavioral Economic Intervention Group
Participants in this arm will be exposed to the web-based ordering system with multiple behavioral economic interventions applied, including healthy food shopping cart defaults, healthy placement choice architecture, traffic light nutrition labels, social norms messaging, and healthy swaps.
Intervention: Behavioral economic intervention of online purchasing at a food pantry (Behavioral)
Outcomes
Primary Outcomes
Mean Monthly Change in Number of Units of Healthier Foods
Time Frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
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.
Mean Monthly Change in Number of Units of Less Healthy Foods
Time Frame: Collected from the online system at baseline and then each month for the remaining 3 months of participation.
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.
Secondary Outcomes
- Mean Monthly Change in Calories From Healthier Foods Per Shopping Trip(Collected from the online system at baseline and then each month for the remaining 3 months of participation.)
- Biomarker Change in Fruit and Vegetable Intake(Assessed at baseline and 3 months.)
- Change in Body Mass Index (BMI)(Assessed at baseline and 3 months.)
- Change in Systolic Blood Pressure(Assessed at baseline and 3 months.)
- Change in Diastolic Blood Pressure(Assessed at baseline and 3 months.)
- Mean Monthly Change in Calories From Less Healthy Foods Per Shopping Trip(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(Assessed at baseline and 3 months.)
Investigators
Christina Roberto
Assistant Professor of Medical Ethics & Health Policy
Abramson Cancer Center at Penn Medicine