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: 10710195
• 负责人: Uriyoan Colon-Ramos
• 金额: $ 53.1万
• 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/10710195
• 关键词: Address; African American; Area; Attention; Baltimore; Behavior; Beverages; Black race; Calibration; 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; Visualization; Work; cancer prevention; cancer risk; dashboard; dietary; dynamic system; experimental study; food environment; food preparation; 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

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.

项目总结