Diet, Healthy, Food Security
Conditions
Keywords
Food security, Food pantry, Diet quality, Intervention
Brief summary
The specific aims of this pilot study are: Aim 1) To identify whether no prep ready to eat meals (intervention) or ingredient bundles (control) have higher client acceptability, liking, satisfaction, and perceived diet quality ratings. Aim 2) To identify whether no prep ready to eat meals (intervention) or ingredient bundles (control) have higher feasibility ratings with food pantry staff. Exploratory Aim) To identify whether no prep ready to meals (intervention) or ingredient bundles (control) lead to greater improvements in food security, perceived diet quality, and fruit and vegetable consumption.
Detailed description
To test the first hypothesis, we will use a randomized repeated measures between-subjects design with half of the participants randomized to receive 14-days of no prep ready-to-eat meals (intervention, n=35) and half of the participants randomized to receive 14-days of ingredient bundles (control, n=35). To test the second hypothesis, we will use a mixed-methods approach with food pantry staff (N=15), including questionnaires with fixed and open-ended items on feasibility and satisfaction of each distribution strategy followed by 30-minute semi-structured 1-1 interviews conducted by UT Southwestern study staff.
Interventions
BEHAVIORALNo prep ready-to-eat meals
Pantry clients will select no prep ready-to-eat meals for up to 14-days' worth of meals for themselves and 2-members of their household using an online food selection platform. The food retailer supplying the meals produces over 70 meals. We have elected to study 14-days of meals to offer clients variety and determine which flavors are most desirable to clients. After ordering, meals will be retrieved from a refrigeration unit, boxed by pantry staff, and brought to the participant to take home. An example dinner is Teriyaki Chicken with Roasted Potatoes and Broccoli, and an example breakfast is Omelet with Peppers and Zucchini. Meals can be stored in a refrigerator or freezer and eaten immediately or after reheating depending on the meal and consumer preference.
BEHAVIORALIngredient bundles (e.g. meal kits)
Ingredient bundles will group individual meal ingredients (e.g., chicken, teriyaki, broccoli, potatoes) in a bag or box and pair those healthy food items with a recipe that instructs the client on how to make a healthier meal. Similar to the no prep ready-to-eat meal initiative, clients will select ingredient bundles for themselves and 2-members of their household using the food pantry online food selection platform. The ingredient bundles will closely replicate the no prep ready-to-eat meals.
Sponsors
University of Texas Southwestern Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Randomized repeated measures between-subjects design
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 18 years of age or older; * ability to read, write, and speak English or Spanish; * ability to provide informed consent; * current or new pantry user at our community partner; * willing to participate; * no dietary restrictions, allergies, or sensitivities that would put the participant at-risk of harm from consuming study foods.
Exclusion criteria
* Under 18 years of age; * inability to read, write, and speak English or Spanish; * unable to provide informed consent; * not a pantry user at our community partner or uninterested in becoming a pantry user; * not wanting to participate; * dietary restrictions, allergies, or sensitivities that would put the participant at-risk of harm from consuming study foods.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hedonic Liking of Study Foods | 14-days | Liking of study foods will be measured by showing the name and picture of the meal or ingredient bundle and asking participants to respond to a hedonic 9-point bipolar scale (this scale does not have an official name or title, therefore, 9-point hedonic liking scale can be considered the unabbreviated scale name). The scale has four measures of liking (6-9) and four measures of dislike (1-4) and a neutral neither like nor dislike (5). A higher score = more liking of the food. The average of all hedonic liking ratings for each meal was taken to create a hedonic liking score across meals. |
| Satisfaction of Study Foods | 14-days | Satisfaction items were adapted from previously validated food pantry client satisfaction surveys (e.g., How satisfied are you with the amount/variety/frequency of food that you and others in your household receive at this food pantry?) (Dunmire M. Level of satisfaction among food pantry clients, staff/volunteers, and directors and its association with client choice in food pantry layouts. South Dakota State University; 2019.). Response options were Strongly agree Agree Disagree and Strongly disagree. The items were summed to create an Intervention Satisfaction variable with the lowest possible score of 4 if all responses were Strongly disagree and the highest possible score of 20 if all responses were Strongly agree. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceived Diet Quality | 14-days | Perceived dietary quality will be measured using a single validated item that asks participants to rate their overall diet quality as excellent, very good, good, fair, or poor (5 = Excellent, 1 = Poor). Perceived diet quality is the scale title. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Fruit and Vegetable Frequency | 14-days | Fruit & Vegetable Screener from the Eating at America's Table Study (EATS) - this is the measure title. Information on how to score the measure can be found at cancer.gov (https://epi.grants.cancer.gov/diet/screeners/fruitveg/instrument.html). The measure is cups of fruits and vegetables per day. A higher number is better. |
Countries
United States
Participant flow
Pre-assignment details
Out of the total 85 participants enrolled, 70 were pantry clients that are part of the RCT, 15 pantry staff were not part of this RCT. Pantry staff group (No intervention Group) participated in qualitative interviews (anonymous) only. No demographic or other identifiable information were collected from them. They were not randomized. They did not receive an intervention.
Participants by arm
| Arm | Count |
|---|---|
| No Prep Ready-to-eat Meals No prep ready-to-eat meals: Pantry clients will select no prep ready-to-eat meals for up to 14-days' worth of meals for themselves and 2-members of their household using an online food selection platform. The food retailer supplying the meals produces over 70 meals. We have elected to study 14-days of meals to offer clients variety and determine which flavors are most desirable to clients. After ordering, meals will be retrieved from a refrigeration unit, boxed by pantry staff, and brought to the participant to take home. An example dinner is Teriyaki Chicken with Roasted Potatoes and Broccoli, and an example breakfast is Omelet with Peppers and Zucchini. Meals can be stored in a refrigerator or freezer and eaten immediately or after reheating depending on the meal and consumer preference. | 35 |
| Ingredient Bundles (e.g. Meal Kits) Ingredient bundles (e.g. meal kits): Ingredient bundles will group individual meal ingredients (e.g., chicken, teriyaki, broccoli, potatoes) in a bag or box and pair those healthy food items with a recipe that instructs the client on how to make a healthier meal. Similar to the no prep ready-to-eat meal initiative, clients will select ingredient bundles for themselves and 2-members of their household using the food pantry online food selection platform. The ingredient bundles will closely replicate the no prep ready-to-eat meals. | 35 |
| Total | 70 |
Baseline characteristics
| Characteristic | Ingredient Bundles (e.g. Meal Kits) | Total | No Prep Ready-to-eat Meals |
|---|---|---|---|
| Age, Continuous | 60.43 years STANDARD_DEVIATION 13.71 | 58.57 years STANDARD_DEVIATION 13.62 | 56.71 years STANDARD_DEVIATION 13.48 |
| Race/Ethnicity, Customized Race and Ethnicity African American or Black | 10 Participants | 22 Participants | 12 Participants |
| Race/Ethnicity, Customized Race and Ethnicity American Indian or Alaskan Native | 1 Participants | 1 Participants | 0 Participants |
| Race/Ethnicity, Customized Race and Ethnicity Hispanic or Latino(a) | 24 Participants | 44 Participants | 20 Participants |
| Race/Ethnicity, Customized Race and Ethnicity Multiracial | 0 Participants | 2 Participants | 2 Participants |
| Race/Ethnicity, Customized Race and Ethnicity White | 0 Participants | 1 Participants | 1 Participants |
| Region of Enrollment United States | 35 Participants | 70 Participants | 35 Participants |
| Sex: Female, Male Female | 32 Participants | 63 Participants | 31 Participants |
| Sex: Female, Male Male | 3 Participants | 7 Participants | 4 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 35 | 0 / 35 |
| other Total, other adverse events | 0 / 35 | 0 / 35 |
| serious Total, serious adverse events | 0 / 35 | 0 / 35 |
Outcome results
Primary
Hedonic Liking of Study Foods
Liking of study foods will be measured by showing the name and picture of the meal or ingredient bundle and asking participants to respond to a hedonic 9-point bipolar scale (this scale does not have an official name or title, therefore, 9-point hedonic liking scale can be considered the unabbreviated scale name). The scale has four measures of liking (6-9) and four measures of dislike (1-4) and a neutral neither like nor dislike (5). A higher score = more liking of the food. The average of all hedonic liking ratings for each meal was taken to create a hedonic liking score across meals.
Time frame: 14-days
Population: There were anonymous qualitative interviews conducted with food pantry staff as a separate aim of this study. Food Pantry staff enrolled are not part of the pilot randomized controlled trial (RCT) for which this outcome measure is analyzed since out of the total participants enrolled, only the pantry clients are part of the RCT and the pantry clients who completed this study were analyzed for this outcome. So Food Pantry staff is not included as a separate arm here for this outcome.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| No Prep Ready-to-eat Meals | Hedonic Liking of Study Foods | 7.2 score on a scale | Standard Deviation 0.9 |
| Ingredient Bundles (e.g. Meal Kits) | Hedonic Liking of Study Foods | 7.2 score on a scale | Standard Deviation 1.1 |
Primary
Satisfaction of Study Foods
Satisfaction items were adapted from previously validated food pantry client satisfaction surveys (e.g., How satisfied are you with the amount/variety/frequency of food that you and others in your household receive at this food pantry?) (Dunmire M. Level of satisfaction among food pantry clients, staff/volunteers, and directors and its association with client choice in food pantry layouts. South Dakota State University; 2019.). Response options were Strongly agree Agree Disagree and Strongly disagree. The items were summed to create an Intervention Satisfaction variable with the lowest possible score of 4 if all responses were Strongly disagree and the highest possible score of 20 if all responses were Strongly agree.
Time frame: 14-days
Population: There were anonymous qualitative interviews conducted with food pantry staff as a separate aim of this study. Food Pantry staff enrolled are not part of the pilot randomized controlled trial (RCT) for which this outcome measure is analyzed since out of the total participants enrolled, only the pantry clients are part of the RCT and the pantry clients who completed this study were analyzed for this outcome. So Food Pantry staff is not included as a separate arm here for this outcome.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| No Prep Ready-to-eat Meals | Satisfaction of Study Foods | 15.74 score on a scale | Standard Deviation 2.7 |
| Ingredient Bundles (e.g. Meal Kits) | Satisfaction of Study Foods | 17.29 score on a scale | Standard Deviation 2.31 |
Secondary
Perceived Diet Quality
Perceived dietary quality will be measured using a single validated item that asks participants to rate their overall diet quality as excellent, very good, good, fair, or poor (5 = Excellent, 1 = Poor). Perceived diet quality is the scale title.
Time frame: 14-days
Population: There were anonymous qualitative interviews conducted with food pantry staff as a separate aim of this study. Food Pantry staff enrolled are not part of the pilot randomized controlled trial (RCT) for which this outcome measure is analyzed since out of the total participants enrolled, only the pantry clients are part of the RCT and the pantry clients who completed this study were analyzed for this outcome. So Food Pantry staff is not included as a separate arm here for this outcome.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| No Prep Ready-to-eat Meals | Perceived Diet Quality | 3.10 units on a scale | Standard Error 0.18 |
| Ingredient Bundles (e.g. Meal Kits) | Perceived Diet Quality | 3.4 units on a scale | Standard Error 0.16 |
Other Pre-specified
Fruit and Vegetable Frequency
Fruit & Vegetable Screener from the Eating at America's Table Study (EATS) - this is the measure title. Information on how to score the measure can be found at cancer.gov (https://epi.grants.cancer.gov/diet/screeners/fruitveg/instrument.html). The measure is cups of fruits and vegetables per day. A higher number is better.
Time frame: 14-days
Population: There were anonymous qualitative interviews conducted with food pantry staff as a separate aim of this study. Food Pantry staff enrolled are not part of the pilot randomized controlled trial (RCT) for which this outcome measure is analyzed since out of the total participants enrolled, only the pantry clients are part of the RCT and the pantry clients who completed this study were analyzed for this outcome. So Food Pantry staff is not included as a separate arm here for this outcome.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| No Prep Ready-to-eat Meals | Fruit and Vegetable Frequency | 2.81 cups of fruits and veg per day | Standard Error 2.45 |
| Ingredient Bundles (e.g. Meal Kits) | Fruit and Vegetable Frequency | 3.17 cups of fruits and veg per day | Standard Error 2.11 |