Food Insecurity
Conditions
Keywords
Diet quality, Cooking, Food security, Food access, Community food environment, Mental health
Brief summary
This is a research study to test if fruit and vegetable prescription vouchers (FVRx) and a cooking skills program (Home Plate) can improve dietary quality, food security (access to a sufficient quantity of affordable, nutritious food), feelings about the home and community food environments, and caregiver mental health.
Detailed description
The purpose of this research study is to determine the effect of produce prescriptions (vouchers that can be redeemed for produce at participating locations, FVRx) and a cooking skills program (Home Plate) on dietary quality, food security, perceptions of the food environment, and mental health. Investigators also aim to determine the feasibility and acceptability of the programs.
Interventions
OTHERHome Plate Lite
Home Plate Lite comprises electronic educational content (e.g. recipes, instructional videos) disbursed at least weekly over six weeks.
OTHERHome Plate
Home Plate comprises six 1.5-hour weekly sessions where parents work together with a study staff member to discuss the learning objectives and prepare the components of a meal, including entrees, side dishes, and desserts.
All families will receive FVRx over two months; FVRx can be redeemed for fresh, frozen, or canned produce at participating retailers in Philadelphia
Sponsors
McClay Foundation
University of Pennsylvania
The Leo and Peggy Pierce Family Foundation
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to 5 Years
Healthy volunteers
Yes
Inclusion criteria
1. At least one child in the household is age 2 to 5 years. 2. Household is food insecure and/or low-income with an age-eligible, overweight or obese child. * If a child meets the above criteria, any sibling age 2-5 is also eligible.
Exclusion criteria
1\. Caregiver or eligible children have a medical condition that significantly affects diet or eating habits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Diet quality | baseline and 8 weeks | Diet quality of the child will be measured by use of an automated self-administered 24-hour dietary recall system (ASA24), completed by the child's caregiver. The ASA24 is a web-based tool that enables automatically coded, self-administered 24-hour diet recalls, providing high-quality dietary data. The ASA24 system is adapted from the United States Department of Agriculture (USDA) Automated Multiple-Pass Method, which has been validated. Validation and evaluation studies of ASA24 have found close agreement with standardized interview-administered 24 hour recall. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Food security - Hunger Coping Scale | baseline and 8 weeks | Food security status will be assessed using the Hunger Coping Scale. The five items from the Hunger Coping Scale question the time period (e.g. last 30 days) and specify lack of resources as the reason for the behavior or experience (e.g. couldn't afford more food, or there was not enough money for food) to determine the level food security (very low, low, marginal, and full). Participants are asked to check boxes next to statements that best describe their behavior. These surveys will be administered via REDCap with telephonic support by study staff at baseline and 8 weeks following the initiation of the intervention. |
| Change in Food security - 2-item Nutrition Security Screener (NSS) | baseline and 8 weeks | Food security status will be assessed using the NSS. These surveys will be administered via REDCap with telephonic support by study staff at baseline and 8 weeks following the initiation of the intervention. |
| Change in Caregiver diet quality | baseline and 8 weeks | Caregiver diet quality will be measured by the caregivers completion of the automated self-administered 24-hour dietary recall system (ASA24) for themselves at baseline and 8 weeks following the initiation of the nutrition education intervention. The ASA24, is a web-based tool that enables automatically coded, self-administered 24-hour diet recalls, providing high-quality dietary data. The ASA24 system is adapted from the USDA Automated Multiple-Pass Method, which has been validated. |
| Change in Caregiver perceived food environment | baseline and 8 weeks | Perceptions of food environment will be assessed using the Perceived Nutrition Environment Measures survey (NEMS-P). The survey is completed by the person who does the majority of the food shopping in a household to learn about his/her perceptions of the nutrition environments (where food is consumed or purchased, and in the home). Participants are asked to check boxes next to statements that best describe their behavior (e.g. strongly disagree to strongly agree or never or rarely to almost always. Components within the survey ar examined individually. The survey can discriminate perceptions of nutrition environments between residents of higher- and lower-socioeconomic status (SES) neighborhoods. The NEMS-P will be administered via REDCap with telephonic support by study staff at baseline and 8 weeks following the initiation of the nutrition education intervention. |
| Change in Caregiver mental health - Loneliness | baseline and 8 weeks | Caregiver mental health will be measured using the Revised UCLA (R-UCLA) Loneliness Scale designed to measure one's subjective feelings of loneliness as well as feelings of social isolation. Participants rate each item on a scale from hardly ever to often. Minimum score is 3 maximum score is 9; higher scores indicate worse outcome. |
| Change in Food security - Food Security Survey | baseline and 8 weeks | Food security status will be assessed using the USDA Food Security Survey. The 18-item USDA Food Security Survey the time period (e.g. last 30 days) and specify lack of resources as the reason for the behavior or experience (e.g. couldn't afford more food, or there was not enough money for food) to determine the level food security (very low, low, marginal, and full). Participants are asked to check boxes next to statements that best describe their behavior. These surveys will be administered via REDCap with telephonic support by study staff at baseline and 8 weeks following the initiation of the intervention. |
| Program feasibility - Home Plate Class Attendance | 8 weeks | Program feasibility will be assessed through virtual Home Plate class attendance |
| Program feasibility - Participant Satisfaction | 8 weeks | Program feasibility will be assessed through participant feedback measured by completion of the participant satisfaction surveys and phone interviews post intervention. |
| Change in Urine Metabolites | Baseline and 8 weeks | Urine samples will be collected from subjects at baseline and 8 weeks and measured by metabolomic analysis to quantify association with dietary biomarkers. |
| Change in Caregiver mental health - Depression | baseline and 8 weeks | The Center for Epidemiologic Studies Depressive Scale (CES-D) is a 20-item questionnaire that includes a brief self-report for which the scale is designed to measure self-reported symptoms associated with depression experienced in the past week. Participants rate each item on a scale from 0= Rarely or none of the time (less than 1-day), 1= Some or a little of the time (1-2 days), 2= Occasionally or a moderate amount of the time (3-4 days, or 3=Most or all of the time (5-7 days).The scale will be administered via REDCap with telephonic support by study staff at baseline and 8 weeks following the initiation of the interventions. High scores indicating greater depressive symptoms. |
| Program feasibility - Voucher Redemption | 8 weeks | Program feasibility will be assessed through voucher redemption |
Countries
United States
Outcome results
None listed