Multilevel Communications and access strategies to improve the food environment

改善食品环境的多层次沟通和获取策略

• 批准号: 8115552
• 负责人: Joel Gittelsohn
• 金额: $ 20.5万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8115552
• 关键词: Address; African American; Baltimore; Behavior; Chronic; Chronic Disease; Communication; Communities; Development; Diet; Dietary Intervention; Dietary intake; Ecology; Effectiveness; Energy Intake; Environment; Epidemic; Evaluation; Food; Future; Health Care Costs; Health Communication; Health education; Improve Access; Incidence; Individual; Intervention; Intervention Trial; Lead; Life; Low income; Marketing; Maryland; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Performance; Policies; Policy Maker; Population; Prevalence; Price; Process; Psychosocial Factor; Randomized Controlled Trials; Reducing diet; Research; Research Design; Restaurants; Risk; Sales; Sampling; Self Efficacy; Source; Structure; Supermarket; Target Populations; Testing; Work; base; cost; design; disorder prevention; ethnic minority population; experience; fast food; high risk; improved; innovation; meetings; novel strategies; obesogenic; population based; programs; social; social cognitive theory; tool; willingness

DESCRIPTION (provided by applicant): Innovative and culturally appropriate multilevel health communications interventions are desperately needed to address the chronic disease epidemic in high-risk populations, such as low-income urban African Americans (AA). However, the vast majority of communications strategies have focused on educating individual consumers about healthy food choices, while in poor urban settings the lower availability of affordable healthy food choices greatly limits the impact of these messages. We will work with 3 wholesalers and 24 small retail food stores to develop and test novel strategies in Baltimore, Maryland, including: 1) multilevel health communications alone directed at wholesalers, retailers and low-income AA consumers intended to enhance willingness to stock and/or purchase healthy foods; 2) pricing strategies (performance based allowances) directed at wholesalers and retailers to increase their stocking of healthy foods at reduced prices; and 3) combined health communications and pricing strategies. Intervention strategies will be tailored to meet the needs of the target populations based on formative research and stakeholder input. Our proposed work is based on significant field experience in this setting, including the development of evaluation tools to assess change in stocking and pricing of key foods (at the store level), and psychosocial factors, dietary intake, and food purchasing behaviors (at the consumer level). Our study has the following aims: 1) Conduct formative research with representatives of multiple levels of the Baltimore food environment (i.e., local wholesalers and retail food store owners) in order to select key foods for promotion, determine appropriate communication strategies (e.g., messages, channels, materials) for each level, and select the most appropriate pricing approach (i.e., performance based allowance structure and stipulations). 2) Pilot the multi-level program with three wholesalers and 24 food stores (6 control, 6 health communications only, 6 pricing only, 6 combined), and assess program implementation through detailed process evaluation. 3) Assess impact of the pilot program on a) the stocking, pricing, marketing, and sales volume of promoted foods at wholesale and retail levels, and b) food purchasing behaviors and associated psychosocial variables (i.e., self-efficacy, intentions, perceived cost) at the consumer level (final sample n=12 consumers/store, 288 total). The proposed research directly addresses the objectives of the PA by seeking to develop effective, multilevel communication strategies to improve diet and reduce risk for diet-related chronic diseases. We anticipate this design will demonstrate the value of a multipronged and multilevel health communications approach to obesity and chronic disease prevention, and will lead to a large-scale trial and informed policies designed to improve food availability and affordability in low-income urban settings. PUBLIC HEALTH RELEVANCE: The proposed study will develop and pilot an innovative multilevel communications intervention to improve the food environment at the wholesaler, retailer and consumer levels. Our interventions will combine both communications strategies and activities to improve access (i.e., prices and availability) to healthy foods in low- income urban settings. The interventions are aimed at ultimately reducing the prevalence of obesity among urban African Americans, which will greatly decrease rates of obesity-related chronic diseases and health care costs nationally.

描述（由申请人提供）：迫切需要创新且适合文化的多层次健康传播干预措施，以解决高风险人群（例如低收入城市非裔美国人（AA））中的慢性病流行问题。然而，绝大多数传播策略都侧重于对个人消费者进行健康食品选择教育，而在贫困的城市环境中，负担得起的健康食品选择的供应量较低，极大地限制了这些信息的影响。我们将与 3 家批发商和 24 家小型零售食品店合作，在马里兰州巴尔的摩制定和测试新策略，包括：1）仅针对批发商、零售商和低收入 AA 消费者的多层次健康沟通，旨在提高库存和/或购买健康食品的意愿； 2) 针对批发商和零售商的定价策略（基于绩效的补贴），以降低价格增加健康食品的库存； 3) 结合健康传播和定价策略。将根据形成性研究和利益相关者的意见定制干预策略，以满足目标人群的需求。我们提出的工作基于在此背景下的重要现场经验，包括开发评估工具来评估主要食品的库存和定价（在商店层面）以及心理社会因素、饮食摄入量和食品购买行为（在消费者层面）的变化。我们的研究有以下目的：1）与巴尔的摩食品环境的多个层面的代表（即当地批发商和零售食品店老板）进行形成性研究，以便选择促销的关键食品，确定每个层面适当的沟通策略（例如信息、渠道、材料），并选择最合适的定价方法（即基于绩效的补贴结构和规定）。 2) 在 3 家批发商和 24 家食品店（6 家控制店、6 家仅健康沟通店、6 家仅定价店、6 家合并店）试点多层次计划，并通过详细的过程评估来评估计划实施情况。 3) 评估试点计划对 a) 批发和零售层面促销食品的库存、定价、营销和销量，以及 b) 消费者层面的食品购买行为和相关社会心理变量（即自我效能、意图、感知成本）的影响（最终样本 n=12 名消费者/商店，总共 288 名）。拟议的研究通过寻求制定有效的多层次沟通策略来改善饮食并降低与饮食相关的慢性疾病的风险，从而直接解决 PA 的目标。我们预计这一设计将展示多管齐下、多层次的健康传播方法对肥胖和慢性病预防的价值，并将导致大规模试验和明智的政策，旨在改善低收入城市环境中的粮食供应和负担能力。 公共卫生相关性：拟议的研究将开发和试点创新的多层次沟通干预措施，以改善批发商、零售商和消费者层面的食品环境。我们的干预措施将结合沟通策略和活动，以改善低收入城市环境中健康食品的获取（即价格和可用性）。这些干预措施旨在最终降低城市非裔美国人的肥胖患病率，这将大大降低全国范围内与肥胖相关的慢性病的发病率和医疗保健费用。