An Interventional Study to Reduce Social Disparities in Diet Quality in the Northern Districts of Marseille

Study Overview
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Brief Summary
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The Opticourses project aims to improve the nutritional quality/price (NQP) ratio of the food purchases of people claiming to be facing financial problems. Following one of the main principles of the French National Nutrition and Health Program (PNNS), the project starts from the principle that to modify food consumption favourably and durably, one must act on both the demand and the supply (see figure). The demand part of the project is based on participatory workshops, and the supply part relies on intervention of social marketing in shops.

Detailed Description
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The demand part of the project is based on intervention sessions consisting in five two-hour workshops with about ten participants. The workshops were based on the people's actual purchases and notably on their till receipts. During the five sessions, the receipts were used as intervention tools: participants and research staff discussed the receipts brought in by them all, and exchanged ideas and experiences around food purchasing behaviors. First workshop: Opticourses intervention presentation, discussion about grocery shopping strategies, explanation of protocol for receipt collection and annotation, two quiz on nutritional knowledge, food shopping exercise on a catalog; Second workshop: discussion about the receipt collection and help to participants encountering difficulties, food groups teaching; Third workshop: till receipts delivery by each participant, food with a high nutritional quality for their price teaching; Fourth workshop: individual return on the nutritional quality of food purchase on the basis of till receipts analysis, individual objectives to improve the nutritional quality of food purchase at no additional cost, discussion about discount food representations, two quiz on nutritional knowledge, food shopping exercise on a catalog; Fifth workshop: assessment of the Opticourses intervention with the participants, discussion about their behavioral modification regarding grocery shopping. The supply part of the project aims at influencing the supply by means of social marketing. The research team intervenes in two discount shops (DIA retailer) in the northern districts in order to influence the food supply. In collaboration with the agency Link Up, a specialist in social marketing, a campaign to promote foods with a good NQP ratio has been launched (from January until June 2014). This public health campaign has the aim of making good NQP foods visible, available and attractive. For 6 months, all the foods with a good NQP ratio in the shop (identified by the research team) are put at the front of the shelves. Consumers can spot them thanks to a logo, EAT TOP, accompanied by the claim Nutritious and inexpensive; that's TOP. Good NQP foods are presented with the support of flyers and recipes, simple and accessible to everyone. Also, placing at the head of the gondola and in-store exhibitions are planned around star foods of the month. During the first two months, fish and canned foods will be given the most prominence. Consumers will find in the flyers made available: nutritional information, tips and tricks for cooking them, simple cheap recipes (less than 1€ per person) combining these good NQP foods (sardine rillettes, tuna pâté, etc.) and a TOP selection of good NQP foods available in the store.

Official Title
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An Interventional Study to Reduce Social Disparities in Diet Quality in the Northern Districts of Marseille (Opticourses)

Conditions
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Nutritional Quality of Food Purchases

Intervention / Treatment
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* Behavioral: Opticourses


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: living in the northern districts of Marseille willingness to be involved in an intervention session aimed at improving the nutritional quality of food purchases under budgetary constraints Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Opticourses education intervention<br>People living in the northern districts of Marseille with in very deprived social situation: very low incomes, heavy financial dependence on social benefits, over-representation of people covered by arrangements for controlling poverty and people covered by free social security | Behavioral: Opticourses<br>* An intervention session consisted of five two-hour educative workshops which aimed to help people to improve the nutritional quality of food purchases under budgetary constraints.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic of nutritional quality of food purchases | Opticourses participants collected food purchase receipts for their household over a one-month period which constituted a detailed record of the quantities of food entering their household. They were asked to save all till receipts for foods consumed at home. To facilitate data collection, participants were given a notebook of food purchases in which they could find step-by-step instructions, example receipts, and, on the last page, an envelope in which to collect the receipts. In case of incomplete or ambiguous printed information regarding the name of the shop, the name of a food, the quantities purchased or the price paid for a food, participants were instructed to write it on the receipt. Expenditure without receipts (gifts or other sources) was to be recorded in the notebook. The participants were also requested to ask other household members to keep their till receipts. | One-month - Between the first and the third workshop | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nutritional knowledge assessment: food groups | At the first workshop, Opticourses participants had to answer a quiz about food groups in order to assess their knowledge prior to the Opticourses intervention. At the fourth workshop, they answered the same quiz which permitted us to measure the intervention effect. | At the first workshop and 6 weeks later at the fourth | 
| Nutritional knowledge assessment: food with a high nutritional quality for their price | At the first workshop, Opticourses participants had to answer a quiz about their knowledge of what is a food with a high nutritional quality for its price prior to the Opticourses intervention. At the fourth workshop, they answered the same quiz which permitted us to measure the intervention effect. | At the first workshop and 6 weeks later at the fourth | 
| Experimental economics: food purchases on catalog | At the first workshop, Opticourses participants were asked to shop for food for two days and for all the members of their household on the basis of a food catalog. This catalog included food items with different price options. At the fourth workshop, they did it once again which permitted it to evaluate the intervention effect on their purchase intention regarding nutritional quality and price. | At the first workshop and 6 weeks later at the fourth | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nutrition economics, food expenditure, nutritional quality, low income