Evaluating Diet, Food Insecurity, and Food Purchasing Outcomes of a Full-Service Mobile Food Market with a Cluster Randomized Trial

项目摘要/摘要 这项试验的总体目标是测试提供全方位服务的移动食品市场(杂货店)的影响 在轮子上“)关于饮食质量、粮食不安全(即不确定或没有足够的机会获得健康生活的食物)和 在服务不足的社区购买食物。我们还将探讨个人、社会、行为和 可能影响采用移动市场购物的环境因素。我们工作的长期目标是 通过改善健康食品的获取和摄入量，增加与饮食/体重相关的健康结果的公平性。 目前，具有种族/少数民族背景的个人和低收入者为 不成比例地受到营养不良和与饮食/体重相关的健康后果的影响，如2型糖尿病 还有高血压。据信，缺乏负担得起的、健康的食物获取途径和粮食不安全 造成这些差距的重要因素。移动食品市场已被提议作为一种战略 缓解这些健康差距，因为它们将低成本、健康的食物直接带到供应不足的地方 人口。流动食品市场在全国范围内越来越普遍，并得到了国家的支持 立法，但人们对其有效性知之甚少。全服务移动市场可能会提高多个 通过提供方便的一站式商店，提供满足所有饮食需求的食物，从而改善饮食方面。完整的- 本提案将测试的服务移动市场(双城移动市场)从公交车上销售主食 定期访问低收入社区。食品的售价比杂货店低10%。 接受Snap/EBT，并提供国家资助的水果/蔬菜激励计划(Market Bucks) 购物者。与我们的社区团队成员合作，我们将注册6个社区站点 分两波(共12个站点/群组)，每个站点招募20名参与者(N=240)。我们会收集 基准数据和随机站点，以接受全服务移动市场干预或作为 等待列表控件。然后，我们将在干预地点实施全面服务的移动市场，跟踪参与者 为期一年，并收集随访数据。后续数据收集完成后，轮候名单控制点将收到全额- 服务移动市场干预。对于目标1，饮食质量的变化(我们的主要结果是通过 健康饮食指数-2015)和食品不安全(由18项美国成人食品安全调查衡量 模块)将进行评估。对于目标2，食品购买的变化将通过收集一项来客观衡量 基准月食品采购收据和后续数据收集。我们还将评估移动市场 在实施期间使用客户忠诚卡购买食品。对于目标3，我们将探索 影响采用移动市场购物的因素。调查结果将提供有效性的证据 建立一个提供全方位服务的移动市场，以解决饮食、食品安全和食品购买结果方面的差距。 这一创新研究将提供及时的证据，为移动市场的可持续性、政策和 立法决定。

PROJECT SUMMARY/ABSTRACT The overarching objective of this trial is to test the impact of a full-service mobile food market (“a grocery store on wheels”) on diet quality, food insecurity (i.e., uncertain or not enough access to food for a healthy life) and food purchases in underserved communities. We will also explore personal, social, behavioral, and environmental factors that may influence adoption of mobile market shopping. The long-term goal of our work is to increase equity in diet/weight-related health outcomes by improving access to and intake of healthy foods. Currently, individuals from racial/ethnic minority backgrounds and those who experience low incomes are disproportionately impacted by poor nutrition and diet/weight-related health outcomes such as type 2 diabetes and high blood pressure. Lack of affordable, healthy food access and food insecurity are believed to be important contributing factors to these disparities. Mobile food markets have been proposed as a strategy for mitigating these health disparities because they bring low-cost, healthy food directly to underserved populations. Mobile food markets are increasingly available nationally and have been supported by state legislation, but little is known about their effectiveness. Full-service mobile markets may improve multiple aspects of the diet by providing foods to meet all dietary needs through a convenient one-stop shop. The full- service mobile market to be tested in this proposal (Twin Cities Mobile Market) sells staple foods from a bus that regularly visits low-income neighborhoods. Foods are sold at prices 10% below those of grocery stores. SNAP/EBT is accepted, and a state-funded fruit/vegetable incentive program (Market Bucks) is available to shoppers. Working in partnership with our community team members, we will enroll 6 community sites (clusters) in two waves (12 total sites/clusters) and recruit 20 participants per site (N=240). We will collect baseline data and randomize sites to either receive the full-service mobile market intervention or serve as the waitlist control. We will then implement the full-service mobile market at intervention sites, follow participants for one year, and collect follow-up data. After follow-up data collection, waitlist control sites will receive the full- service mobile market intervention. For Aim 1, changes in diet quality (our primary outcome measured with the Health Eating Index-2015) and food insecurity (measured with the 18-item U.S. Adult Food Security Survey Module) will be assessed. For Aim 2, changes in food purchases will be objectively measured by collecting one month of food purchase receipts at baseline and follow-up data collection. We will also assess mobile market food purchases during the implementation period with customer loyalty cards. For Aim 3, we will explore the factors that influence adoption of mobile market shopping. Findings will provide evidence on the effectiveness of a full-service mobile market to address disparities around diet, food security, and food purchasing outcomes. This innovative research will provide timely evidence to inform mobile market sustainability, policy, and legislative decisions.