A Mobile Application to Improve Procurement and Distribution of Healthful Foods & Beverages in Low Income Urban Communities

此应用程序的总体目标是开发和试点测试基于Web的应用程序(APP)，该应用程序将 增加美国低收入城市社区获得更健康食品和饮料的机会。 小型零售食品店在美国低收入城市中无处不在，呈现出一种独特的 为周边社区提供健康食品选择的机会。然而，这些小商店 通常很少或根本不携带既健康又实惠的食物。这是健康袜子的主要障碍， 城市小食品店的负担得起的食品是缺乏足够的分销网络；小店老板 一般需要自己旅行，为他们的商店获得健康的食品和饮料。低访问权限 健康的食物和容易获得的低营养价值的食物与糟糕的饮食质量有关， 肥胖症和慢性病在许多研究中。 我们的研究团队已经在巴尔的摩工作了16年以上，以开发、实施和评估 通过改善低收入社区的食物环境来预防慢性病。我们的 初步形成性研究评估了移动应用程序的初始可接受性，该应用程序将使小城市 食品店东主可从本地批发商和生产商取得一系列健康食品，并促进 实惠的送货上门服务。我们发现，一款能够利用集体利益的应用程序具有很高的接受度 提高数字联网小型食品店的购买力，并将成本效益引入食品配送。为 这项NHLBI临床试验试点研究(R34)，我们建议开发一个基于网络的巴尔的摩工作 城市食品配送(Bud)应用程序，试运行该应用程序，并评估其可行性和对 巴尔的摩东部健康食品和饮料的可获得性、价格和分销情况如下 主要目标：1)开发和优化技术稳定和功能强大的数字战略，以克服 零售食品系统限制在低收入城市食品环境中很常见；2)通过以下方式试行Bud应用程序 总部位于巴尔的摩的生产商/批发商和街角商店，并评估其可行性(即，可接受性， 可操作性、感知可持续性、用户满意度)；以及3)评估Bud应用程序对Corner的影响 商店库存(可获得性、及时性、质量)、价格以及健康和不健康食品和饮料的销售 在一项先导性研究中，采用了38家街角商店的随机对照试验设计。次要目标将 检查对消费者的影响，并对参与的零售商和生产商进行成本效益分析。 调查结果将使我们能够1)开发出功能正常且可接受的基于Web的应用程序，2)提供初步数据 用于全规模试验的功率计算，3)生成和改进过程评估仪器，以及 制定实施标准，以及4)制定协议并展示我们招聘和留住员工的能力 大量的批发商、生产商、街角商店和消费者。我们将评估可概括性 通过与其他地区的小商店所有者和供应商一起对开发的应用程序进行可行性评估 城市环境。此R34应用程序的发现对于支持全面临床试验至关重要，该临床试验 将测试Bud应用程序在多个城市的部署，并评估其对肥胖和饮食的影响。

The overarching goal of this application is to develop and pilot test a web-based application (app) that will increase access to healthier foods and beverages in low-income urban communities in the United States. Small retail food stores are ubiquitous in low-income urban settings throughout the US and present a unique opportunity to supply surrounding neighborhoods with healthful food options. However, these small stores usually carry few or no foods that are both healthy and affordable. A primary barrier to stocking healthy, affordable foods in small urban food stores is the lack of an adequate distribution network; small store owners generally need to travel on their own to obtain healthy foods and beverages for their stores. Low access to healthy food and high access to food with low nutritional value have been associated with poor diet quality, obesity and chronic disease in many studies. Our research team has worked for more than 16 years in Baltimore to develop, implement, and evaluate chronic disease prevention programs by improving the food environment in low-income communities. Our preliminary formative research assessed the initial acceptability of a mobile app that will enable small urban food store owners to access a range of healthy foods from local wholesalers and producers, and facilitate affordable delivery to their stores. We found high acceptability for an app that would leverage the collective purchasing power of digitally-networked small food stores and introduce cost efficiencies into food delivery. For this NHLBI Clinical Trial Pilot Study (R34), we propose to develop a working web-based Baltimore Urban food Distribution (BUD) app, pilot the app, and evaluate its feasibility and impact on the availability, prices and distribution of healthful foods and beverages in East Baltimore, with the following primary aims: 1) To develop and optimize a technically stable and functional digital strategy to overcome small retail food system constraints common in low-income urban food settings; 2) To pilot the BUD app with Baltimore-based producers/wholesalers and corner stores, and assess its feasibility (i.e., acceptability, operability, perceived sustainability, user satisfaction); and 3) To evaluate the impact of the BUD app on corner store stocking (availability, timeliness, quality), prices, and sales of healthy and unhealthy foods and beverages in a pilot study employing a randomized controlled trial design of 38 corner stores. Secondary aims will examine impact on consumers and a cost-benefit analysis for participating retailers and producers. Findings will permit us to 1) produce a functional and acceptable web-based app, 2) provide preliminary data needed for power calculations for the full-scale trial, 3) generate and refine process evaluation instruments and set standards for implementation, and 4) establish protocols and demonstrate our ability to recruit and retain large numbers of wholesalers, producers, corner stores and consumers. We will assess generalizability of the app by conducting feasibility assessments of the developed app with small store owners and suppliers in other urban settings. The findings from this R34 application are essential to support a full-scale clinical trial, which will test a multi-city deployment of the BUD app and assess its impact on obesity and diet.