Promoting Healthy Dietary Intake Among Families With Obesity Via a Grocery Shopping Intervention
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 384
- 主要终点
- Nutritional quality of household grocery purchases
研究概览
简要总结
Obesity continues to be a major public health concern, and children who are overweight by age 5 are at increased risk for future obesity, highlighting the importance of early efforts to promote healthy eating and growth. The goal of this project is to test a new family-based approach to early childhood obesity prevention, specifically using pre-filled, online grocery shopping carts to make it easier for parents to select healthy foods like fruits and vegetables. This study will be the first to test whether such default shopping carts can help promote the purchasing and consumption of healthier foods, as well as healthier diets and weight outcomes, among parents with obesity and their 2-to-5-year-old children, offering the potential for a meaningful impact on the health of young children and their families.
详细描述
Obesity is a diet-related disease that continues to be a major public health concern. Children who are overweight by age 5 are at increased risk for future obesity, highlighting the importance of early efforts to promote healthy diets. Modifying home food availability can impact the diets of children and their families, and online grocery shopping offers untapped potential as a way to modify the family food environment. The objective of this grant is to test a new family-based approach to early obesity prevention, specifically using optimal defaults to promote healthier online grocery shopping. Making "optimal" choices easier by making them the default option has strong scientific support, but this strategy has not been implemented in the context of online grocery shopping on a large scale. The study team's preliminary research demonstrated the potential of pre-filling online grocery shopping carts with nutritious foods: this default grocery cart strategy had significant, positive effects on the nutritional quality of grocery purchases in two pilot studies. The proposed study will expand upon this preliminary research, recruiting 192 parents with obesity who use online grocery shopping and have a 2-to-5-year-old child. Families will be randomly assigned to a default grocery cart intervention or control group. Both groups will be provided with 4 main meal recipes and 4 lunch and/or snack recipes each week of a 6-month intervention period, with recipes corresponding to the Traffic Light Diet, an evidence-based diet for family-based obesity prevention and treatment. Corresponding nutritional guidance will be provided, with a goal to increase low energy-dense, high nutrient-dense foods and decrease the energy density of the diet. In addition, the defaults group's online grocery carts will be pre-filled with items that correspond to the provided recipes each week. Participants can alter these carts as they like. Assessments will occur via grocery receipt forms, phone interviews, remote food photography, height/weight measurements, and online surveys. Hypotheses corresponding to primary and secondary aims are: It is hypothesized that the defaults group will have household grocery purchases that are better-aligned with dietary goals (e.g., more fruits and vegetables, higher nutritional quality, fewer calories) (Aim 1), and that participating parents and 2-to-5-year-old children will have healthier dietary intake (e.g., more fruits and vegetables, higher nutritional quality, fewer calories) than controls (Aim 2) following the 6-month intervention. These aims are designed to leverage a simple but powerful behavioral principle, optimal defaults, to make purchasing of healthier foods easier among families with young children during a period of the life span in which dietary preferences and future weight trajectories are being established. In the long-term, this research offers the potential for a scalable, sustainable approach to facilitate healthier dietary intake among a broad population of individuals and families at risk for diet-related diseases.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
盲法说明
It is not possible to mask the participant or core study staff to study group given the nature of the interventions. Wherever possible, those processing outcome data (e.g., coding nutritional quality data from receipts) will be masked to study group.
入排标准
- 年龄范围
- 2 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •The participating adult must be >18 years old
- •Participating adult is English speaking
- •Participating adult has a self-reported body mass index >30
- •Participating adult has a 2-to-5-year-old child
- •The participant also must report online grocery shopping from study stores (Aldi, Tops, Wegman's, and/or Walmart) at least 2 times per month
- •Willing to purchase fresh foods online (e.g., fruits, vegetables, meat if meat is consumed), vs. using online shopping solely for shelf-stable pantry staples.
- •Participants also must be a primary caregiver of the enrolled child
- •Do greater than or equal to 75% of their grocery shopping from study stores and at least 50% of the grocery shopping for the family.
排除标准
- •Families in which the child is underweight (BMI-for-age percentile <5) will be excluded
- •There must not be family dietary restrictions that preclude being able to use at least some recipes in the study's recipe bank.
研究组 & 干预措施
Recipes only
Families in this group will receive a packet of healthy recipes during each week of a 6-month intervention. Recipe packets will also include nutrition education.
干预措施: Recipes (Behavioral)
Pre-filled carts
Families in this group will receive a packet of healthy recipes during each week of a 6-month intervention. Recipe packets will also include nutrition education. In addition, each week of the intervention, their online grocery carts will be pre-filled with the ingredients to make the main meal recipes featured in the recipe packets that week. Participants can alter their carts as they like and determine which groceries they will purchase.
干预措施: Recipes (Behavioral)
Pre-filled carts
Families in this group will receive a packet of healthy recipes during each week of a 6-month intervention. Recipe packets will also include nutrition education. In addition, each week of the intervention, their online grocery carts will be pre-filled with the ingredients to make the main meal recipes featured in the recipe packets that week. Participants can alter their carts as they like and determine which groceries they will purchase.
干预措施: Pre-filled carts (Behavioral)
结局指标
主要结局
Nutritional quality of household grocery purchases
时间窗: 6 months
Nutritional quality of household grocery purchases will be coded in accordance with the Healthy Eating Index and will include all groceries purchased that time point (online or in-person, etc.). Grocery purchases are scored in 13 categories from the Healthy Eating Index, with quintiles used to operationalize lower versus higher purchasing of these categories (ex. fruits, vegetables, whole grains), with a resulting possible nutritional quality range of 13-65. Two weeks of data collection occur per time point, and values are averaged to represent the average weekly nutritional quality of grocery purchases at that time point. Analyses will compare the nutritional quality of grocery purchases between groups at the primary outcome time point of 6 months, immediately after the conclusion of the intervention, in the context of marginal models adjusting for baseline nutritional quality, stratification factors, and household size.
Energy content of household grocery purchases
时间窗: 6 months
Energy content will be operationalized across all household grocery purchases in kcal. Two weeks of data collection occur per time point, and values are averaged to represent the average weekly energy content of grocery purchases at that time point. Analyses will compare the energy content of grocery purchases between groups at the primary outcome time point of 6 months, immediately after the conclusion of the intervention, in the context of marginal models adjusting for baseline energy content, stratification factors, and household size.
Fruits purchased
时间窗: 6 months
The number of different types of fruits purchased will be operationalized across all household grocery purchases. Two weeks of data collection occur per time point, and values are averaged to represent average number of fruits purchased. Analyses will compare fruits purchased between groups at the primary outcome time point of 6 months, immediately after the conclusion of the intervention, adjusting for baseline fruit purchasing, stratification factors, and household size.
Vegetables purchased
时间窗: 6 months
The number of different types of vegetables purchased will be operationalized across all household grocery purchases. Two weeks of data collection occur per time point, and values are averaged to represent average number of vegetables purchased. Analyses will compare vegetables purchased between groups at the primary outcome time point of 6 months, immediately after the conclusion of the intervention, adjusting for baseline vegetable purchasing, stratification factors, and household size.
High energy dense foods purchased
时间窗: 6 months
The number of different types of high energy dense foods purchased will be operationalized across all household grocery purchases. Two weeks of data collection occur per time point, and values are averaged to represent average number of high energy dense foods purchased. Analyses will compare high energy dense foods purchased between groups at the primary outcome time point of 6 months, immediately after the conclusion of the intervention, adjusting for baseline high energy dense food purchasing, stratification factors, and household size. High energy dense foods are coded based on cut-offs from the Traffic Light Diet (e.g., sugar \>25% of calories/serving).
次要结局
- Nutritional quality of child intake(6 months)
- Nutritional quality of parent intake(6 months)
- Energy content of child intake(6 months)
- Energy content of parent intake(6 months)
- Child fruit intake(6 months)
- Parent fruit intake(6 months)
- Child vegetable intake(6 months)
- Parent vegetable intake(6 months)
- Child energy density of intake(6 months)
- Parent energy density of intake(6 months)
研究者
Stephanie Anzman-Frasca
Associate Professor
State University of New York at Buffalo