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Topical Area: Protocols

Protocols (Poster Session)

(P22-025-23) Formative Research for a Healthy Food Intervention Among Independently-Owned Restaurants Located in Baltimore City and the Greater D.C. Metropolitan Area

Sunday, July 23, 2023
11:45 AM – 12:45 PM ET
Location: Poster Board 391

    Presenting Author(s)

  • Shuxian Hua, BE

    Master Student Research Assistant
    Johns Hopkins Bloomberg School of Public Health
    Baltimore, Maryland, United States

    • Co-Author(s)

  • Emma C. Lewis, MS

    Doctoral Candidate
    Johns Hopkins Bloomberg School of Public Health
    Baltimore, Maryland, United States

  • LP

    Lisa K. Poirier, MHS

    Johns Hopkins Bloomberg School of Public Health
    Baltimore, Maryland, United States

  • JG

    Joel Gittelsohn, PhD

    Professor
    Johns Hopkins Bloomberg School of Public Health
    Baltimore, Maryland, United States

  • UC

    Uriyoan Colon-Ramos, ScD, MPA

    Associate Professor of Nutrition & Global Health
    The George Washington University Milken Institute School of Public Health
    Washington, District of Columbia, United States

Disclosure(s):
Shuxian Hua, BE: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Small independently-owned restaurants in low-income urban minority communities often serve calorie-dense fried foods and sugar-sweetened beverages at affordable prices, increasing risk for poor diets among regular customers. The Focus on Restaurant Engagement to Strengthen Health (FRESH) intervention aims to improve access to and promote healthy food in this setting by leveraging an innovative systems science approach focused on cooking methods. Presently, we describe our formative research to inform the design of a culturally-acceptable and sustainable intervention.

Methods: Formative research is being conducted in neighborhoods of Baltimore City, Maryland, and the Greater D.C. Metropolitan Area (D.C.) identified as having 1) a high proportion of African American residents ( > 40%) in Baltimore City or Latinx residents ( > 35%) in D.C.; 2) at least three independently-owned restaurants; and 3) > 15% of residents below poverty level. Data collectors employ an adapted Nutrition Environment Measurement Survey-Restaurants (NEMS-R) tool, followed by in-depth interviews with owners/managers and suppliers, and an observation of the restaurant’s kitchen. Group model building workshops will convene with residents and local stakeholders to create a causal loop diagram for better understanding this setting. Data will be transcribed and coded using thematic analysis.

Results: Thematic results from the in-depth interviews and observation protocols will be presented to inform the intervention components of FRESH and system dynamics model development. As of February 2023, target neighborhoods have been identified in Baltimore City and informal in-person observations have begun. A cross-case comparison between D.C. and Baltimore City will demonstrate various community needs to be prioritized in later phases of the intervention.

Conclusions: FRESH aims to systematically address a large-scale public health issue at multiple levels of supply and demand. Findings from the formative research described here will direct the creation of a system dynamic model to inform FRESH intervention components. Next steps following this phase of work are to develop a web-based interactive dashboard of the calibrated system dynamics model and evaluate the impact of FRESH via a multisite group-randomized controlled trial (RCT) design.

Funding Sources: NIH R01MD018022