Developing a Support Application for Food Pantries (SAFPAS) to Improve Client Access to Healthy Foods & Enhance Emergency Preparedness

项目摘要 粮食银行和食品储藏室是解决粮食不安全问题的关键社区机构， 与肥胖、心血管疾病、2型糖尿病和癌症有关。有效性和效率 粮食援助计划的实施受到许多因素的制约，包括： 工作人员/志愿者;满足客户对可接受的健康选择的需求;并提供实时信息， 规划和紧急行动。2020年，COVID-19疫情加剧了所有这些问题， 继续这样做。在大流行之前、期间和之后，对食品储藏室的有效管理是一个最重要的问题， 由于资源有限，通信往往是分散的，内部的适应能力 实践到在线设置几乎是不存在的。此外，食品储藏室志愿者，通常是老年人， 他们既是食品储藏室的主要支持人员，也是最有可能受到COVID-19严重健康影响的人。基于 大量的初步数据和二十多年的经验，努力改善巴尔的摩的食物 系统，本NHLBI临床试验试点研究将开发和试点一个工作移动的支持应用程序， Food PAntrieS（SAFPAS）应用程序（app）可以解决这些挑战。没有这样的应用程序提供的功能 工作人员/志愿者招募、培训和日程安排;营养教育和与客户的信息传递;安全的 客户选择的形式;和/或目前用于应急准备和反应的双向通信 存在.我们对巴尔的摩食品储藏室和马里兰州食品银行人员的形成性研究发现， 正如我们最近对食品储藏室主任的全国调查所显示的那样，人们对结合了这些功能的应用程序充满热情。 这项研究将开发和试点应用程序，并评估其可行性和对食品储藏室员工紧急情况的影响 准备，库存，和客户摄取健康食品和饮料在巴尔的摩，与以下 目标：1）开发和优化一个技术稳定，功能强大的应用程序，以改善食品储藏室服务， 巴尔的摩; 2）与巴尔的摩的食品储藏室和客户（马里兰州食品公司）一起试点SAFPAS应用程序 银行，和巴尔的摩的紧急行动中心团队，并评估其可行性;和3）评估 SAFPAS对360名低收入人群中食品储藏室客户获得的食品健康的影响 城市客户（基线），从20个茶水间，在一个随机的干预前后测量 对照试验。调查结果将使我们能够：1）生产一个功能和可接受的应用程序; 2）提供 为未来的全面试验计算功效提供初步数据; 3）产生并完善影响和过程 评估工具并制定执行标准;以及4）制定协议并展示我们的 招聘和留住食品储藏室和食品储藏室客户的能力。我们将评估应用程序的潜在可扩展性 通过与底特律的食品储藏室工作人员和客户进行形成性和可行性评估。这些发现 将支持一项全面的临床试验，该试验将测试SAFPAS应用程序的多城市部署 并评估其对食品储藏室客户健康结果，饮食和食品安全的影响。

PROJECT SUMMARY Food banks and food pantries are critical community-based institutions for addressing food insecurity, which is associated with obesity, cardiovascular disease, type 2 diabetes, and cancer. The effectiveness and efficiency of food assistance programs are constrained by many factors, including: recruitment and training of of staff/volunteers; meeting client needs for acceptable, healthy choices; and providing real-time information for planning and emergency operations. In 2020, the COVID-19 pandemic exacerbated all of these problems and continues to do so. The effective management of food pantries, before, during, and after the pandemic, is a top priority as resources are limited, communications are often decentralized, and the in-house ability to adapt practices to an online setting is nearly non-existent. As well, pantry volunteers, commonly older adults, are both the main support staff at food pantries and the most at risk for severe COVID-19 health effects. Based on substantial preliminary data and more than two decades of experience working to improve Baltimore’s food system, this NHLBI Clinical Trial Pilot Study will develop and pilot a working mobile Support Application for Food PAntrieS (SAFPAS) application (app) to address these challenges. No such app that offers capabilities for staff/volunteer recruitment, training, and scheduling; nutrition education and messaging with clients; a safe form of client choice; and/or bidirectional communications for emergency preparedness and response currently exists. Our formative research with Baltimore food pantry and Maryland Food Bank personnel found high enthusiasm for an app that combines these features, as did our recent national survey of food pantry directors. This study will develop and pilot the app, and evaluate its feasibility and impact on food pantry staff emergency preparedness, stocking, and client uptake of healthful foods and beverages in Baltimore, with the following aims: 1) to develop and optimize a technically stable, functional app to improve food pantry services in Baltimore; 2) to pilot the SAFPAS app with Baltimore-based food pantries and clients, the Maryland Food Bank, and Baltimore’s Emergency Operations Center team, and assess its feasibility; and 3) to evaluate the impact of SAFPAS on the healthiness of foods received by food pantry clients in a sample of 360 low-income urban clients (at baseline), drawn from 20 pantries measured pre- and post-intervention in a randomized controlled pilot trial. Findings will allow us to: 1) produce a functional and acceptable app; 2) provide preliminary data for power calculations for a future full-scale trial; 3) generate and refine impact and process evaluation instruments and set standards for implementation; and 4) establish protocols and demonstrate our ability to recruit and retain food pantries and food pantry clients. We will assess potential scalability of the app by conducting formative and feasibility assessments with food pantry staff and clients in Detroit. The findings from this R34 study will support a full-scale clinical trial that will test a multi-city deployment of the SAFPAS app and assess its impact on food pantry client health outcomes, diet, and food security.