A Multilevel Intervention in the Hunger Relief Network to Improve Diet Among Adults Experiencing Food Insecurity

Not Applicable

Terminated

Conditions: Food Selection

Interventions: Behavioral: Intervention Food Pantries
Other: Control Food Pantries

Registration Number: NCT03421106

Lead Sponsor: University of Connecticut

Brief Summary: The investigator proposes an evaluation of a randomized, sustainable intervention in 8 intervention and 8 control pantries. We will enroll a sample clients at the food pantry at baseline and follow them for 1 year to assess changes in overall diet quality (the primary outcome) and cardiovascular health. We will also enroll a sample of clients at follow-up to assess to assess the nutritional quality of food selected at the pantry.

Detailed Description: Evaluate the health impact of an intervention targeting the hunger relief network and the clients with food insecurity it serves. The long-term goal of this work is to reduce nutrition-related health disparities by intervening on a system that serves individuals at high risk for chronic disease. In 2014, an estimated 14% of U.S. households experienced food insecurity (i.e., they lacked access to enough food for an active, healthy life for all household members). Large numbers of low-income, racial/ethnic minority, and immigrant families who experience food insecurity rely on a hunger relief network that includes food banks and food pantries. Pantry clients have demonstrated poor nutritional outcomes, high chronic disease rates, and dissatisfaction with the quality and cultural-appropriateness of food offered. Unlike other food assistance programs, there are currently no standards on the nutritional quality of pantry offerings, but recent work by our study team demonstrated the need to improve the healthfulness of hunger relief network inventory. We proposed an evaluation of a randomized, sustainable intervention in 8 intervention and 8 control pantries. We will enroll clients at baseline and follow them for 1 year to assess changes in overall diet quality (the primary outcome). Working with our food bank partners, the intervention at the pantry level targets the supply of nutritious foods. At the client level, the intervention targets healthy food demand. Measured outcomes include overall diet quality (the primary outcome), as assessed by the Healthy Eating Index-2015 (HEI), the nutritional quality of foods selected at the food shelf visit, and cardiovascular disease health (assessed by the American Heart Association's Life's Simple 7 scores). The study will also evaluate the impact of a multilevel intervention on the nutritional quality of pantry offerings. The study also aims to improve implementation of practices that promote a nutrition-focused hunger relief network.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 504

Inclusion Criteria

-≥18 years old

Mentally capable of consent and participation
Speak English, Spanish, or Somali
Have access to a phone

Exclusion Criteria

Not capable of consent or participation
Speak only languages other than English, Spanish or Somali
Not a food pantry user

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention Food Pantries	Intervention Food Pantries	Food pantries will transform to offer healthier and more appealing food ; the effect on clients will be measured.
Control Food Pantries	Control Food Pantries	Food pantries will make no changes during the evaluation period; the effect on clients will be measured.

Primary Outcome Measures

Name	Time	Method
Overall Diet Quality of Clients	Baseline, 1 year	Assessed by Healthy Eating Index-2015 scores (scale 0-100), with 100 representing the best possible score (i.e., nutritional quality best aligned with Dietary Guidelines for Americans)

Secondary Outcome Measures

Name	Time	Method
Cardiovascular Health	Baseline, 1 year	American Heart Association's Life's Simple 7 (LS7) scores (scale 0 -7), with 7 representing the best possible score for cardiovascular health
Nutritional Quality of Food Selected by Clients at the Food Pantry	1 year post-sample comparison	Assessed by Healthy Eating Index-2015 scores (scale 0-100), with 100 representing the best possible score (i.e., nutritional quality best aligned with Dietary Guidelines for Americans)