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

该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环境中随处可见，并呈现出独特的特色 为周边社区提供健康食品选择的机会。然而这些小店 通常很少或根本不携带既健康又实惠的食物。健康放养的主要障碍， 城市小食品店买得起的食品是因为缺乏足够的分销网络；小店主 通常需要自己前往商店为其商店购买健康食品和饮料。访问权限低 健康食品和大量获取低营养价值食品与饮食质量差有关， 许多研究表明肥胖和慢性病。 我们的研究团队在巴尔的摩工作了 16 年多，致力于开发、实施和评估 通过改善低收入社区的食品环境来实施慢性病预防计划。我们的 初步形成性研究评估了移动应用程序的初步可接受性，该应用程序将使小型城市 食品店老板可以从当地批发商和生产商那里获得一系列健康食品，并促进 负担得起的送货到他们的商店。我们发现利用集体的应用程序具有很高的可接受性 数字网络小型食品店的购买力，并将成本效率引入食品配送。对于 在 NHLBI 临床试验试点研究 (R34) 中，我们建议开发一个基于网络的巴尔的摩工作平台 城市食品配送 (BUD) 应用程序，试用该应用程序，并评估其可行性和对 东巴尔的摩健康食品和饮料的可用性、价格和分销，其中包括： 主要目标：1）开发和优化技术稳定且实用的数字战略，以克服小问题 低收入城市食品环境中常见的零售食品系统限制； 2) 试用 BUD 应用程序 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）； 3) 评估 BUD 应用程序对拐角的影响 健康和不健康食品和饮料的商店库存（可用性、及时性、质量）、价格和销售 在一项试点研究中，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以及参与零售商和生产商的成本效益分析。 研究结果将使我们能够 1) 制作一个功能齐全且可接受的基于网络的应用程序，2) 提供初步数据 全面试验的功率计算所需，3) 生成和完善过程评估工具以及 制定实施标准，4) 制定协议并展示我们招募和留住人才的能力 大量批发商、生产商、街角商店和消费者。我们将评估该方法的普遍性 通过与其他地区的小店主和供应商对开发的应用程序进行可行性评估来开发应用程序 城市环境。 R34 申请的结果对于支持全面的临床试验至关重要，该试验 将测试 BUD 应用程序的多城市部署，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.