Behavioral Economics to Implement a Traffic Light Nutrition Ranking System in a Network of Food Pantries: Study 2
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 3,750
- Locations
- 1
- Primary Endpoint
- Pantry SWAP implementation
Study Overview
Brief Summary
This is a cluster randomized controlled trial of 30 food pantries affiliated with the Greater Boston Food Bank to test the use of behavioral economics (BE) tools to encourage food pantries to implement the Supporting Wellness at Pantries (SWAP) program, with the goal of fostering accurate use of SWAP traffic light labels on pantry shelves and increasing the healthfulness of foods chosen by pantry clients. Primary outcomes will be assessed at 6 and 12 months to compare the implementation and effectiveness of the SWAP program in the intervention vs. control pantries.
Detailed Description
This study will test the use of behavioral economics (BE) tools to encourage food pantries to implement the Supporting Wellness at Pantries (SWAP) program, with the goal of encouraging pantries to use SWAP traffic light labels on pantry shelves and increase the healthfulness of foods chosen by pantry clients. The study design is a 12-month cluster RCT of 30 Greater Boston Food Bank partner pantries comparing a basic SWAP implementation strategy (control, n=15) with a BE-enhanced SWAP implementation strategy (intervention, n=15). Primary outcomes assessed at 6 and 12 months will be implementation of the SWAP program within pantries and improvement of client food choices and dietary quality. At the end of 12 months, the BE-enhanced SWAP implementation strategy will be adapted, updated, and offered to the 15 pantries assigned to control (waitlist) at baseline. The 15 intervention pantries will be followed without further intervention.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Food pantries enrolled in the study will be partner agencies of the Greater Boston Food Bank that are maximum client choice, are located within approximately 1 hour driving time of Boston (for logistical feasibility), and are not actively using traffic-light nutrition ranking.
- •Food pantry clients that complete assessments must be 18 years or older and speak English or Spanish.
Exclusion Criteria
- •Food pantries that are not affiliated with the Greater Boston Food Bank and are not maximum client choice.
- •Food pantry clients that do not speak English or Spanish.
Arms & Interventions
Behavioral economics-enhanced SWAP implementation strategy
Pantries assigned to the intervention group will receive behavioral nudges for implementing the SWAP nutrition program. These include: 1) invoice labeling with the food labeled as red, yellow, or green; 2) receipt of the SWAP toolkit at no cost; 3) pantry learning communities; 4)incentives to purchase SWAP implementation materials (e.g., shelves); 5) food bank recognition for SWAP implementation.
Intervention: Behavioral economics-enhanced SWAP implementation (Behavioral)
Basic SWAP implementation strategy
Pantries assigned to the control arm will receive email communication from the food bank dietitian providing them with information about SWAP, online links to SWAP implementation guides, and encouragement to purchase SWAP Toolkits on their own.
Intervention: Basic SWAP implementation (Behavioral)
Outcomes
Primary Outcomes
Pantry SWAP implementation
Time Frame: 6 months and 12 months
Proportion of pantries in the intervention vs. control group that implement SWAP (e.g., traffic-light labels on shelves)
Percent items (by weight) ordered by pantry that are labeled green or red
Time Frame: 6 months and 12 months
Using data collected from the food bank ordering platform, this outcome will be the proportions (by weight) of the overall orders from GBFB that are green-labeled and red-labeled according to SWAP ranking categories
Percent of pantry clients' selected food that is green or red
Time Frame: 6 months and 12 months
Using pantry client basket assessments, the total proportion (by weight) of food selected by the client that is labeled green (or red) will be calculated for each participant
Client dietary quality score
Time Frame: 6 months and 12 months
Rapid Prime Dietary Quality Score (range 0 to 52, higher is healthier) collected at the time clients are leaving the pantry
Secondary Outcomes
- Skin carotenoid level(6 months and 12 months)
Investigators
Anne N. Thorndike, MD, MPH
Associate Professor of Medicine
Massachusetts General Hospital