Systems Science Approaches to Improve Access to Healthier Foods: The FRESH Trial

改善健康食品获取的系统科学方法：FRESH 试验

• 批准号: 10562311
• 负责人: Uriyoan Colon-Ramos
• 金额: $ 60.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10562311
• 关键词: Address; African American; Area; Attention; Baltimore; Behavior; Beverages; Black race; Calories; Cities; Communities; Complex; Conflict (Psychology); Cost Savings; Data; District of Columbia; Educational workshop; Environment; Environmental Risk Factor; Evidence based intervention; Exhibits; Food; Food Access; Health; Health Food; Healthy Eating; Improve Access; Intervention; Interview; Intuition; Latinx; Lead; Low income; Malignant Neoplasms; Methods; Minority; Modeling; Neighborhoods; Not Hispanic or Latino; Nutrient; Online Systems; Outcome; Output; Persons; Positioning Attribute; Prevention strategy; Preventive; Process; Psychosocial Factor; Public Health; Randomized; Randomized Controlled Trials; Restaurants; Sales; Science; Side; Site; Source; System; Testing; Visual; Work; base; cancer prevention; cancer risk; dashboard; dietary; experimental study; food environment; food preparation; implementation outcomes; improved; indexing; insight; metropolitan; minority communities; model building; models and simulation; mortality; novel; nutrition; primary outcome; protective factors; public health priorities; secondary outcome; stem; theories; tool; urban minority; user-friendly; virtual; willingness; work-study

Project Summary High dietary quality is protective against cancer. Previous work to improve dietary quality by changing the food environment has emphasized increasing access to healthy foods in retail stores, but relatively little attention has focused on intervening in independently owned restaurants, which have the potential to contribute to cancer prevention in predominantly minority, low-income urban neighborhoods. Our team has worked extensively with these types of restaurants to increase access to and promote healthier entrees, sides and beverages, leading to significant increases in total revenues, sales, and purchasing of promoted foods. Stemming from that work, this study has two interrelated objectives to sustainably improve access to and promotion of healthier foods in independently owned restaurants: 1) to use systems science approaches to refine, implement and test the effects of a novel intervention (FRESH: Focus on Restaurant Engagement to Strengthen Health) on dietary quality, and health of regular customers, among other outcomes; and 2) to use FRESH formative, baseline, implementation and outcome data to develop, parametrize, and calibrate a system dynamics model that will allow stakeholders to virtually test the effects of FRESH strategies on outcomes in their own communities. FRESH is a multilevel theory- and practice-based intervention for independently owned restaurants with 3 core components: food preparation, food access & procurement, and consumer nutrition environment. Aim 1) To use systems science approaches to refine existing materials from our successful restaurant interventions and adapt the intervention to two urban sites (Baltimore and the DC metro area) that are predominantly low-income and minority (African American and Latinx). Aim 2) To implement FRESH in 24 independently owned restaurants across both sites during 16 months and collect process data. Aim 3) To assess the impact of FRESH using a multisite cluster randomized controlled trial on dietary quality (primary outcome); health indicators; psychosocial factors of regular customers (n=576), and evaluate its impacts on unit sales and weekly revenues. Primary Hypothesis: Regular customers of participating restaurants in FRESH intervention neighborhoods will demonstrate at least a 5-point increase in Healthy Eating Index score, as compared to restaurant customers in comparison neighborhoods. Data from Aims 1- 3 will be used to develop, parameterize, and calibrate a system dynamics model to simulate the effects of FRESH intervention strategies under different scenarios, leading to Aim 4) To disseminate a planning tool that enables stakeholders to simulate and virtually test FRESH intervention strategies in other urban contexts, visualizing potential effects on unit sales, revenues, customer health indicators, and cancer-prevention dietary behaviors, via a web-based user-friendly interactive dashboard. This study will yield results that are both novel and significant, including a simulation model to test restaurant-based cancer-prevention strategies, yielding substantial cost-savings from avoided trial-and-error implementation.

项目摘要 高质量的饮食可以预防癌症。以前的工作是通过改变食物来提高饮食质量 环境保护强调增加零售店获得健康食品的机会，但相对较少关注 专注于干预独立拥有的餐厅，这些餐厅有可能为 在以少数民族为主的低收入城市社区预防癌症。我们的团队一直在努力 与这些类型的餐厅广泛合作，以增加获得和推广更健康的主菜、配菜和 饮料，导致总收入、销售额和促销食品购买量显著增加。 由于这项工作，这项研究有两个相互关联的目标，以可持续地改善获得和 在独立经营的餐厅推广更健康的食物：1)使用系统科学方法 改进、实施和测试新干预措施的效果(Fresh：Focus on Restaurant Engagement 加强健康)对饮食质量和常客健康的影响，以及其他结果；以及2)使用 最新的形成性、基线、实施和结果数据，以开发、参数化和校准系统 动态模型将允许利益相关者虚拟测试新战略对以下方面结果的影响 他们自己的社区。Fresh是一种多层次的以理论和实践为基础的独立拥有的干预 有3个核心组成部分的餐厅：食物准备、食物获取和采购以及消费者营养 环境。目标1)使用系统科学方法提炼我们成功的现有材料 餐厅干预，并将干预适应于两个城市地点(巴尔的摩和华盛顿大都会地区) 主要是低收入和少数民族(非裔美国人和拉丁裔)。目标2)在24年内实施Fresh 在16个月内在这两个地点拥有独立的餐厅，并收集流程数据。目标3) 使用多点整群随机对照试验评估Fresh对饮食质量的影响(初级 结果)；健康指标；经常顾客的心理社会因素(n=576)，并评估其对 单位销售额和每周收入。基本假设：参加Fresh餐厅的常客 干预社区将证明健康饮食指数得分至少增加了5分，因为 与比较社区的餐馆顾客相比。来自AIMS 1-3的数据将用于开发， 对系统动力学模型进行参数化和校准，以模拟新干预策略的效果 在不同的情况下，导致目标4)传播一种规划工具，使利益攸关方能够 在其他城市环境中模拟和虚拟测试新的干预策略，可视化潜在影响 关于单位销售额、收入、客户健康指标和防癌饮食行为的信息 用户友好的交互式仪表板。这项研究将产生既新颖又有意义的结果，包括 模拟模型测试基于餐厅的癌症预防策略，从以下方面节省大量成本 避免了反复尝试的实施。