Nutrition Education and e-Texting to Increase Access to Fresh Produce

Study Overview
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Brief Summary
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The proposed project, Nutrition Ed, Access and Texting (NEAT): Combining the Hartford Mobile Market with e-Marketing , uses an e-technology social marketing strategy to promote use of a recently launched mobile produce market among SNAP-Ed recipients. This study will potentially increase fresh produce access and intake by combining an innovative food system change (produce mobile market) with existing SNAP-Ed nutrition education curriculum and the use of e-marketing technology.

Detailed Description
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The proposed project, Nutrition Ed, Access and Texting (NEAT): Combining the Hartford Mobile Market with e-Marketing uses an e-technology social marketing strategy to promote use of a recently launched mobile produce market among SNAP-Ed recipients. This study will potentially increase fresh produce access and intake by combining an innovative food system change (produce mobile market) with existing SNAP-Ed nutrition education curriculum and the use of e-marketing technology. Thus, the study combines key elements that have been deemed necessary for increasing produce intake among low income communities. The goal of the NEAT study is to assess the impact of a texting-based social marketing campaign on SNAP-Ed participants' access to and purchase of fresh produce on a recently launched mobile produce market, and their subsequent produce intake. Objectives include: 1) Compare the impact of nutrition education alone to nutrition education plus promotional text messaging on purchase of fruits and vegetables; 2) Compare the impact of nutrition education alone to nutrition education plus promotional text messaging on consumption of fruits and vegetables; and 3) Assess the effectiveness of coupon distribution on coupon redemption at a mobile produce market. The NEAT design will be a randomized controlled trial using a pre-post assessment comparing change in behavior. Both intervention and control groups will receive SNAP-Ed education as currently delivered by the Hispanic Health Council. The intervention group will receive additional promotional text messaging related to use of the mobile market. The control group will receive text messaging about free activities taking place at the Hartford Public Library and other community locations. Participants will be interviewed via phone at baseline, then randomized to intervention and control groups, and re-interviewed again 6 weeks after they start receiving the text messages, which it will be 2 weeks after the one-month texting period ends.

Official Title
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Nutrition Ed, Access and Texting (NEAT): Combining the Hartford Mobile Market With e-Marketing

Conditions
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Healthy Eating

Intervention / Treatment
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* Other: Mobile


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: SNAP eligible participants with children under 5 years old living at home. Living in Hartford, CT. Having a cell phone with unlimited smart phone data plans. Exclusion Criteria: Not living in Hartford Less than 18 years old

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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Baseline interviews will be conducted after participation in nutrition education activity. Upon completing baseline, participants will be randomized into intervention (HMM text messaging) or control (non-health-related texting) groups. Texting will begin the day after randomization is completed and will occur once daily during business days for a duration of one month. In addition to HMM access messages, intervention group participants will receive texts with links to four $5.00 incentive coupons for the Hartford Mobile Market, one during each of the four weeks that the texting will take place. Follow-up interviews will be conducted two weeks after the end of the one-month texting period.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>The intervention group will receive daily text messages with information on: (i) HMM stop locations and schedule; (ii) information on HMM weekly produce specials and sales; (iii) motivational messages encouraging use of the HMM; and (iv) links to produce coupons that they can exchange at HMM- $5 coupons received weekly for the four-week texting period. | Other: Mobile<br> <br> |
| No Intervention: Control<br>The control group will receive the same dosage of daily text messages covering free activities taking place at the Hartford Public Library and other community locations. The control group will not receive incentive coupons. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in consumption of fruits | Measured with one question about daily consumption of fruits from a seven item fruit and vegetable checklist developed by Townsend et.al. | Baseline and 6 weeks follow up | 
| Change in consumption of vegetables. | Measured with a one question from a seven item fruit and vegetable checklist developed by Townsend et.al. | Baseline and 6 weeks follow up | 
| Change in fruits eating behaviors Increase consumption of fruits and vegetables | Measured with a readiness 5 item continuous scale item for fruits from fruit and vegetable inventory validated by Townsend et.al. | Baseline and 6 weeks follow up | 
| Change in vegetables eating behaviors. Increase consumption of fruits and vegetables | Measured with a 5 item continuous scale from vegetables from fruit and vegetable inventory validated by Townsend et.al. | Baseline and 6 weeks follow up | 
| Change in amount of money spent on fruits and vegetables. | self-reported amount of money spent on fresh produce per month. | Baseline and at 6 week follow up | 
| Change in amount of money spent on fruits. | self-reported amount of money spent on fruit per week. | Baseline and at 6 week follow up | 
| Change in amount of money spent on vegetables. | self-reported amount of money spent on vegetables per week. | Baseline and at 6 week follow up | 
| Change in self reported usage of the Hartford Mobile Market for buying fresh produce | self-reported participant's usage of mobile market (yes/no) | baseline and at 6 weeks follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant utilization of coupons | Based on one yes/no question about coupon redemption | 6 week follow up | 
| Participant's satisfaction with e-texting messages (likeness) | Self reported satisfaction with nutrition messages using a 5- likert scale (like it very much to dislike it very much) | 6 weeks follow up | 
| Participant's assessment of usefulness of the messages | Self reported continuous 4 likert scale from not useful to very much useful. | 6 weeks follow up | 
| Participant's assessment of usefulness of the coupons | Self reported continuous 4 likert scale from not useful to very much useful. | 6 week follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food Access, Food Security, Fruits and Vegetables, Low-Income