A multilevel community engaged intervention to build a sustainable and equitable food economy with food is medicine offerings in the Mississippi Delta to improve minority health and reduce disparities

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PROJECT SUMMARY/ABSTRACT Administrative Supplement to NIMHD R01MD018208 Parent project title: “A multilevel community engaged intervention to build a sustainable and equitable food economy with food is medicine offerings in the Mississippi Delta to improve minority health and reduce disparities”. This Administrative Supplement is based on NOT-OD- 23-083, “Notice of Special Interest (NOSI): Administrative Supplement for Research Efforts that Elucidate Fundamental Processes Underlying Behavior Change, Maintenance, and Adherence.” It is a request to support the inclusion of new measures and methods that will complement the parent study and expand it to identify the mechanisms underlying behavior change within a food is medicine (FIM) intervention. FIM interventions offer promise to achieve behavior change; however, the pathway(s) underlying this behavior change have not been studied. Through this administrative supplement, we will use an explanatory sequential mixed-methods approach to investigate the mechanisms of behavior change through the lens of Social Cognitive Theory (SCT). SCT is one of the most widely used behavioral theories and may be particularly useful when applied to interventions conducted in rural settings given its emphasis on social determinants of health and how individuals interact and are influenced by their environment. For those allocated to the FIM intervention of the parent grant, this supplement will add a new survey measure to assess SCT constructs (e.g., knowledge, self-efficacy, etc.) at the planned baseline, three- and six-month timepoints. We also propose adding new in-depth interviews at the three- and six-month time points to further explain and interpret results from the quantitative data. This work will be led by Dr. Economos, parent study co-PI Erin Hennessy, parent study co-I, and Dr. Kia Jones, an early career investigator based in Mississippi and a post-doctoral fellow on the parent grant. Findings from this study will greatly advance ongoing efforts to apply and scale FIM interventions by studying the factors affecting the acceptance and adoption of weekly produce delivery aimed to increase fruit and vegetable consumption. Theory-driven FIM interventions that propel behavior change are needed to reverse the trends in diet related health outcomes for the rural minority population participating in the intervention.