Good Bowls: Empowering Communities to Achieve Good Food Access and Health Equity

好碗：赋权社区实现良好的食品获取和健康公平

• 批准号: 10490977
• 负责人: ALICE S AMMERMAN
• 金额: $ 39.34万
• 依托单位: EQUITI FOODS, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-17 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10490977
• 关键词: Address; Adoption; Adult; American; Area; Attitude; Behavior Therapy; Belief; Black American; Black race; Bluetooth; Businesses; Cardiovascular Diseases; Carotenoids; Cellular Phone; Chronic Disease; Communities; Conscious; Consumption; Cosmetics; Cost Savings; Diet; Dietary intake; Discrimination; Economics; Education; Employee; Enhancement Technology; Essential worker; Ethnic group; Face; Family; Farm; Food; Food Access; Freezing; Health; Health Care Costs; Health Food; Healthcare; Heart; Home; Household; Individual; Infrastructure; Intervention; Job loss; Life; Low Income Population; Low income; Measurable; Measures; Mediterranean Diet; Minority; Minority Groups; Mission; Modeling; Morale; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Personal Satisfaction; Phase; Price; Production; Productivity; Randomized; Randomized Controlled Trials; Reduce health disparities; Reporting; Research; Restaurants; Risk; Rural; Rural Community; Sales; Site; Social support; Structural Racism; Supermarket; Taste Perception; Taste preferences; Telephone; Testing; Transportation; Wages; Wellness Program; Work; Workplace; agricultural community; base; coronavirus disease; cost; density; design; digital; economic disparity; empowered; ethnic minority; evidence base; farmer; farmers markets; fast food; food desert; food insecurity; fruits and vegetables; health disparity; health equity; implementation facilitation; implementation strategy; improved; lower income families; nutrition; pandemic disease; phase 2 study; poor communities; primary outcome; programs; racial and ethnic; racial minority; rural poverty; rural residence; secondary outcome; virtual coach

Abstract - Low-income and ethnic minority status as well as rural residence are strong predictors of poor health. Contributors to high chronic disease rates include food insecurity (lack of access to affordable, nutritious food) and lack of economic opportunity. Rural poverty in the Southeast is exacerbated by historical discrimination against Black farmers, and ongoing structural racism. At the intersection of diet and wellbeing, the blue-collar workforce is particularly vulnerable to the conditions and impacts of poor nutrition on health and productivity, as these typically low-wage workers face heightened challenges surrounding accessibility (affordability and convenience) of healthy food, yet rely on good health to support often physically demanding labor. Few approaches to mitigating health disparities have addressed both healthy food access and economic opportunity. Equiti Foods developed Good Bowls as healthy, affordable, good-tasting frozen meals that are convenient, locally-produced, and culturally-conscious. Our mission is to decrease health disparities by increasing the availability and consumption of nutritious food in high-need communities while providing economic opportunities for local farms and small businesses. We propose rigorously testing Good Bowls’ health impact and potential health care costs savings in rural blue-collar worksites. Our solution leverages the team’s nutrition expertise to create culturally appealing meals by adapting the evidence- based Mediterranean diet to southeastern seasonal availability and taste preferences (“Med-South”). We partner with local farms and businesses to produce the bowls, making use of normally wasted seasonal excess or “cosmetically challenged” produce to curb costs and expand markets for farmers. To create a sustainable business model, Good Bowls are sold using a cost-offset subsidy approach, allowing for needs-based pricing. In our worksite RCT, subsidized Good Bowls will be paired with smart phone digital infrastructure enabling Bluetooth nudges at the worksite and educational programing for home and family. The Specific Aims of this Phase II project are: 1) Establish Employee Wellness Committees to refine implementation strategies and facilitate engagement with blue-collar workers and families; 2) Test the impact of subsidized Good Bowls availability and promotion alone (Good Bowls) relative to Good Bowls + the phone App nudge and home- based education program (Nudge/Education) using a delayed intervention randomized controlled trial; and 3) Further develop and test our cost-offset model using both direct-to-consumer and retail sales to assess the volume and pricing of high end sales needed to support the social mission. We will also assess health care- related cost savings for worksites and economic benefits to partner businesses (farms, caterers, non-profits) involved with Good Bowls production. Working in partnership with rural blue-collar worksites and with local farms and businesses, Equiti Foods seeks to reduce health disparities by improving the dietary intake of those at greatest risk for chronic disease while creating economic opportunity in rural communities.

摘要- 低收入和少数民族地位以及农村居住地是健康状况不佳的有力预测因素。 造成高慢性病发病率的因素包括粮食不安全(无法获得负担得起的营养食品) 以及缺乏经济机会。历史歧视加剧了东南部的农村贫困 反对黑人农民，以及持续的结构性种族主义。在饮食和幸福的交汇点上，蓝领 劳动力特别容易受到营养不良对健康和生产力的状况和影响的影响，因为 这些典型的低薪工人面临着围绕可获得性(可负担性和 方便)健康的食物，但依靠良好的健康来支持经常需要体力的劳动。一些 缓解健康差距的方法既涉及健康食品的获取，也涉及经济 机会。Equiti Foods开发了良好的碗，作为健康、负担得起、味道好的冷冻餐 方便，当地生产，并具有文化意识。我们的使命是减少健康 在高需求社区增加营养食品的可获得性和消费量造成的差距 同时为当地农场和小企业提供经济机会。我们严谨地建议 在农村蓝领工作场所测试Good Bowls对健康的影响和潜在的医疗成本节约。我们的 Solution利用团队的营养专业知识，通过调整证据来创造具有文化吸引力的食物- 以地中海饮食为基础，以东南部的季节性供应和口味偏好为基础(“地中海南部”)。我们 与当地农场和企业合作生产碗，利用通常被浪费的季节性剩余 或者对农产品进行“整容挑战”，以控制成本，为农民扩大市场。要创造一个可持续的 在商业模式下，优质碗的销售采用成本抵销补贴的方式，允许根据需要定价。 在我们的工作站点RCT中，补贴的Good Bowls将与启用智能手机数字基础设施 蓝牙在工作场所和为家庭和家庭提供教育程序方面起到了推动作用。这样做的具体目的是 第二阶段项目是：1)建立员工健康委员会，以完善实施战略和 促进与蓝领工人和家庭的接触；2)测试受补贴的Good Bowls的影响 可用性和促销本身(Good Bowls)相对于Good Bowls+手机应用程序轻推和回家- 使用延迟干预随机对照试验的基于教育项目(轻推/教育)；以及3) 进一步开发和测试我们的成本抵消模型，使用直接面向消费者和零售销售来评估 支持社会使命所需的高端销售量和定价。我们还将评估医疗保健- 工作场所的相关成本节约和合作企业(农场、餐饮公司、非营利组织)的经济效益 参与制作精良的碗。与农村蓝领工地和当地工人合作 农场和企业，Equiti Foods寻求通过改善这些人的饮食摄入量来减少健康差距 在农村社区创造经济机会的同时，面临患慢性病的最大风险。