Behavioral economics to implement a traffic light nutrition ranking system in a network of food pantries

行为经济学在食品储藏室网络中实施红绿灯营养排名系统

• 批准号: 10733657
• 负责人: Douglas Levy
• 金额: $ 74.01万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10733657
• 关键词: Adopted; Adoption; American; Architecture; Boston; Cardiometabolic Disease; Cardiovascular Diseases; Carotenoids; Client; Cluster randomized trial; Collaborations; Consumption; Diabetes Mellitus; Diet; Dietary Intervention; Dietary intake; Dissemination and Implementation; Effectiveness; Eligibility Determination; Equipment and supply inventories; Evidence based intervention; Evidence based practice; Family; Food; Food Assistance Programs; Food Labeling; Food Selections; Health; Health Food; Household; Hunger; Hybrids; Incentives; Intervention; Knowledge; Label; Light; Maintenance; Measures; Nutrition Labeling; Online Systems; Persons; Practical Robust Implementation and Sustainability Model; Privatization; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Skin; Source; System; Testing; Time; Waiting Lists; Workplace; behavior test; behavioral economics; budget impact; cost effectiveness; dietary; dietary guidelines; disorder risk; effectiveness/implementation study; evidence base; experience; feeding; food consumption; food insecurity; food quality; high risk; implementation barriers; implementation research; improved; marginalization; nutrition; obesity risk; programs; social norm; tool

Approximately one in 10 US households experience food insecurity, which is associated with cardiometabolic disease risk. Federal food assistance programs are often insufficient, and therefore the charitable food system, largely comprised of food banks that distribute food to partner agencies (e.g., pantries), is a regular food source for 53 million people a year. The quality of food offered in pantries and consumed by clients often does not align with US dietary guidelines. Pantry interventions to promote healthier food choices can improve clients’ health but have not been widely adopted due to implementation barriers. The project’s overall objective is to use multi-level behavioral economics (BE) interventions to implement evidence-based strategies to improve the dietary quality of food offered by pantries and selected and consumed by clients. Traffic light nutrition ranking is an evidence-based BE strategy for increasing healthy food choices in multiple settings. Feeding America, the largest U.S. private hunger relief organization, released recommendations in 2021 for food banks to implement traffic light nutrition ranking on their ordering platforms. Supporting Wellness at Pantries (SWAP) is a program to guide both traffic light labeling for use on ordering platforms and pantry shelves, as well as food pantry layout to inform clients and encourage healthy food choice. Nevertheless, widespread implementation of SWAP is challenging due to barriers such as time constraints and competing priorities. The proposed project is a collaboration with the Greater Boston Food Bank (GBFB) to test BE strategies (choice architecture, framing, social norms, and incentives) for implementation of an evidence-based intervention (traffic light nutrition ranking, SWAP) at two levels of the charitable food system: a food bank and food pantries. We will conduct a Hybrid Type II effectiveness-implementation study, guided by the Practical, Robust, Implementation, and Sustainability Model (PRISM) to examine Reach Effectiveness Adoption Implementation Maintenance (RE- AIM) domains. Aim 1 is a randomized controlled trial of 600 GBFB partner agencies to determine if using BE strategies on the GBFB ordering platform will increase agencies’ utilization of the platform’s traffic light nutrition labels (Reach) and their orders of healthy food over 12 months (Effectiveness and Maintenance). Aim 2 is a waitlist-control randomized trial of 30 GBFB pantries to determine if BE interventions will increase pantries’ implementation of SWAP (Implementation, Adoption) and improve clients’ food selection and dietary intake, assessed with the PRIME diet screener and Veggie Meter skin carotenoid measure over 24 months (Effectiveness, Maintenance). Aim 3 will evaluate the budget impact and cost-effectiveness of BE strategies (Implementation, Effectiveness) from the food bank’s and pantries’ perspectives. Results of this research will inform Feeding America and other national and local hunger relief organizations about the implementation and dissemination of evidence-based nutrition recommendations that can improve the diet and health of marginalized families at highest risk for cardiometabolic diseases.

大约十分之一的美国家庭经历粮食不安全，这与心脏代谢有关。 疾病风险。联邦食品援助计划往往不足，因此慈善食品系统， 主要由向伙伴机构分发粮食的粮食银行组成（例如，是一种常见的食物。 每年为5300万人提供饮用水。食品储藏室提供的食物质量和客户消费的食物质量往往会 不符合美国饮食指南。食品储藏室的干预措施，以促进更健康的食物选择可以提高客户的 但由于实施方面的障碍，尚未得到广泛采用。该项目的总体目标是 使用多层次的行为经济学（BE）干预措施来实施基于证据的战略，以改善 由茶水间提供并由客户选择和消费的食物的饮食质量。交通灯营养 排名是一种基于证据的BE策略，用于在多种环境中增加健康食品的选择。喂养 美国最大的私人饥饿救济组织美国发布了2021年食品银行的建议 在他们的订餐平台上实现流量轻营养排行。支持茶水间的健康（SWAP） 是一个程序，以指导两个交通灯标签上使用的订购平台和食品货架，以及食品 厨房布局，以告知客户，并鼓励健康食品的选择。尽管如此， 由于时间限制和优先事项相互竞争等障碍，全部门办法具有挑战性。拟建项目 与大波士顿食品银行（GBFB）合作，测试BE战略（选择架构，框架， 社会规范和激励措施），以实施循证干预措施（红绿灯营养 在慈善食品系统的两个层面：食品银行和食品储藏室。我们将进行 混合型II有效性-实施研究，以实用、稳健、实施和 可持续性模型（PRISM），用于检查覆盖有效性采用实施维护（RE- AIM）域。目标1是一项随机对照试验，涉及600个GBFB合作机构，以确定是否使用BE 在GBFB订购平台上的策略将增加代理商对平台交通灯营养的利用 标签（范围）和他们的健康食品订单超过12个月（有效性和维持）。目标2是一个 30个GBFB茶水间的等待名单对照随机试验，以确定BE干预是否会增加茶水间的 实施SWAP（实施、采纳）和改善客户食物选择和饮食摄入， 通过24个月的PRIME饮食筛查和Veggie Meter皮肤类胡萝卜素测量进行评估 （有效性，维护）。目标3将评估预算影响和BE战略的成本效益 （实施，有效性）从食品银行和茶水间的角度来看。这项研究的结果将 向“喂养美国”和其他国家和地方饥饿救济组织通报执行情况， 传播可以改善饮食和健康的循证营养建议， 处于社会边缘地位的家庭患心脏代谢疾病的风险最高。