SAFPAS App for Improving Healthy Food Access

(SAFPAS Trial)

Overseen By Cara Shipley, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins Bloomberg School of Public Health

Disqualifiers: Moving, Pregnant, At risk, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

537 Participants Needed

Trial Summary

What is the purpose of this trial?

Food pantries face many challenges, including recruitment and training of staff/volunteers, communications with staff/volunteers and clients, providing client choice, and emergency preparedness. The investigators will develop, implement, and evaluate the Support Application for Food Pantries (SAFPAS), a mobile application to address these concerns under normal and emergency operations, and assess its impact on 20 Baltimore food pantries, and on the healthiness of foods received by 360 food pantry clients using a randomized controlled trial design. If successful, the tested and refined app will support local food assistance programs throughout the United States.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the SAFPAS App treatment for improving healthy food access?

The Fruit and Vegetable Prescription (FVRx) program, which is similar to the SAFPAS App, showed that providing produce prescriptions and nutrition education significantly increased fruit and vegetable intake and improved food purchasing practices among low-income adults. This suggests that programs like SAFPAS, which aim to improve food access and nutrition, can be effective in enhancing healthy eating behaviors. ^{1 2 3 4 5}

How does the SAFPAS App treatment differ from other treatments for improving healthy food access?

The SAFPAS App is unique because it uses digital technology to improve access to healthy food through food pantries, which is a novel approach compared to traditional in-person food assistance programs. This app leverages mobile health strategies to provide features like online shopping and inventory management, aiming to enhance or replace in-person services and address food insecurity in a more accessible and efficient way. ^{6 7 8 9 10}

Research Team

Joel Gittlesohn, PhD

Principal Investigator

Johns Hopkins Bloomberg School of Public Health

Eligibility Criteria

This trial is for adults over 18 who regularly use one of the participating food pantries at least once a month and have been doing so for the past year. Participants must be willing and able to use a mobile app on their smartphone or another device to make selections and communicate.

Inclusion Criteria

Willing and able to use a mobile app through a smart phone (or other device) for making electronic Choice (echoice) selections and engaging in other communications

I have been getting food from a pantry monthly for the last year and am over 18.

Exclusion Criteria

Anticipate moving out of Baltimore in the next 12 months (for pilot study)

Pregnant (due to changes in diet, weight and body composition)

No access to a smart phone or other web-enabled device and Wi-Fi

Timeline

Formative Research

Conduct formative research to refine the SAFPAS app through in-depth interviews with stakeholders.

2 months

SAFPAS App Development

Develop the SAFPAS mobile app incorporating results from formative research.

3 months

SAFPAS Pilot Evaluation

Evaluate the feasibility and impact of the SAFPAS app in a pilot study with 20 food pantries.

4 months

SAFPAS Pilot App Implementation

Pilot the SAFPAS app in 10 intervention food pantries over a 12-month period.

12 months

Post-Intervention Data Collection

Collect data post-intervention to assess changes associated with the SAFPAS intervention.

2 months

Data Analysis

Analyze data to test hypotheses related to the impact of the SAFPAS intervention.

1 month

Treatment Details

Interventions

• Support Application for Food Pantries (SAFPAS)

Trial Overview The trial is testing SAFPAS, an app designed to help food pantries manage volunteer staffing, improve client choice in food selection safely, and enhance communication levels especially during emergencies. It will be evaluated in 20 Baltimore food pantries with feedback from 360 clients.

Participant Groups

Group I: Food Pantries receiving SAFPAS intervention Experimental Treatment 1 Intervention

Food Pantries in this arm will receive access to all functions of the SAFPAS application

Group II: Food Pantries not receiving SAFPAS intervention Active Control 1 Intervention

Food Pantries in the arm will not receive access to the SAFPAS application

Who Is Running the Clinical Trial?

Johns Hopkins Bloomberg School of Public Health

Lead Sponsor

Trials

441

Recruited

2,157,000+

Oakland University

Collaborator

Trials

15

Recruited

3,300+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Findings from Research

A new screening process for food insecurity was successfully implemented in a hospital setting, increasing the screening rate from just 2.2% to 61.5% over 28 weeks, demonstrating the effectiveness of integrating a validated screening tool into the nursing workflow.

Out of the patients screened, 5.8% were identified as food insecure, highlighting the importance of such screenings in connecting vulnerable patients with necessary food resources, even amidst challenges like staff turnover and the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing a Process for Screening Hospitalized Adults for Food Insecurity at a Tertiary Care Center. Gore, E., DiTursi, J., Rambuss, R., et al.[2023]

The Fruit and Vegetable Prescription (FVRx) program, tested with 54 SNAP-eligible adults over 6 months, successfully retained 77.3% of participants, who utilized nearly 90% of their produce prescriptions, indicating strong engagement and feasibility.

Participants in the FVRx program significantly increased their intake of fruits and vegetables, improved their knowledge of food preparation, and changed their food purchasing habits compared to a control group, demonstrating the program's effectiveness in enhancing nutrition-related behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pilot Fruit and Vegetable Prescription (FVRx) Program Improves Local Fruit and Vegetable Consumption, Nutrition Knowledge, and Food Purchasing Practices. Slagel, N., Newman, T., Sanville, L., et al.[2023]

Clinicians and clinic staff from 17 health care clinics in Houston provided insights on a food prescription program, highlighting its potential to address food insecurity and improve health outcomes.

Key themes included the necessity of value-based care strategies, the barriers faced by patients and food pantries, the importance of coordination between organizations, and the need for better integration of food prescriptions into clinic workflows.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perspectives of Health Care Staff on Predictors of Success in a Food Prescription Program: A Qualitative Study. McWhorter, JW., Aiyer, JN., Ranjit, N., et al.[2023]

In a study of 322 food-insecure patients referred to the Mid-Ohio Farmacy (MOF) program, 51% visited a food pantry at least once, indicating that the program effectively connects patients to food resources.

Patients who had previously visited food pantries were more likely to utilize the MOF resources, suggesting that outreach efforts may need to focus on encouraging first-time users, especially those with uncontrolled hypertension who were less likely to visit after referral.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Utilization Patterns of a Food Referral Program: Findings from the Mid-Ohio Farmacy. Walker, DM., DePuccio, MJ., Hefner, JL., et al.[2021]

The 8-week personalized nutrition intervention for mobile food pantry users resulted in a significant average weight loss of 2.3% among participants, indicating its effectiveness in promoting weight management.

While the treatment group showed a greater improvement in diet quality compared to the control group, this change was not statistically significant, suggesting that while the intervention is promising, further research is needed to confirm its impact on dietary habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Feasibility and Pilot Study of a Personalized Nutrition Intervention in Mobile Food Pantry Users in Northeastern Connecticut. Marmash, D., Ha, K., Sakaki, JR., et al.[2021]

A scoping review of 39 studies on digital tools in food assistance programs revealed that most tools are still in early development, with websites being the most common type (56.4%) and a significant focus on features like online shopping.

There is a critical need for more user-centered design and research on the effectiveness of these digital tools, especially in enhancing access to food assistance during situations like pandemics, where remote support is essential.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Moving Food Assistance into the Digital Age: A Scoping Review. Martin, NM., Barnett, DJ., Poirier, L., et al.[2022]

A study involving qualitative interviews with 26 SNAP beneficiaries and 12 SNAP-Ed staff identified key factors influencing the implementation of healthy eating interventions in food pantries, highlighting the importance of food pantry capacity and logistics, as well as community relationships.

Five main themes emerged as critical for successful interventions, with food pantry capacity and logistics being the most important, indicating that tailored approaches are necessary to effectively promote healthy eating in these settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pantry clients and Supplemental Nutrition Assistance Program-Education practitioners' perspectives on factors influencing healthy eating policy, system and environmental interventions in food pantries. Yamoah, O., Schulte, J., Osborn, L., et al.[2023]

A study involving 16 food pantries and 317 adult clients found that a behavioral intervention aimed at promoting healthy food selection did not significantly improve overall diet quality or cardiovascular health outcomes as measured by the Healthy Eating Index (HEI-2015) or Life's Simple 7 (LS7) scores.

However, clients in intervention pantries showed improved scores for refined grain intake, while those in control pantries experienced a decline in saturated fat scores and an increase in physical activity, indicating mixed results in dietary components and health behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Cluster-Randomized Evaluation of the SuperShelf Intervention in Choice-Based Food Pantries. Caspi, CE., Gombi-Vaca, MF., Barsness, CB., et al.[2023]

The study analyzed food items from eight food pantries in Indiana and South Dakota, revealing that the National Nutrient Database for Standard Reference version 28 provided a better match for the nutrient profiles of these foods compared to the Food and Nutrient Database for Dietary Studies 2013-2014.

Significant differences in nutrient means, such as fiber, calcium, and vitamins, were found between the two databases, indicating that using the more accurate database could enhance interventions aimed at improving food pantry offerings for individuals with low food security.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

US Department of Agriculture Food Composition Databases, the Food and Nutrient Database for Dietary Studies 2013-2014, and the National Nutrient Database for Standard Reference Version 28 Yield Significantly Different Nutrient Totals of Food Items from Eight Midwestern Food Pantry Inventories. Pickford, C., McCormack, L., Liu, Y., et al.[2022]

The Supporting Wellness at Pantries (SWAP) system was successfully implemented in two large food pantries in New Haven, Connecticut, reaching over 12,200 individuals annually, and led to an increase in the percentage of healthy 'Green' foods offered.

Despite challenges posed by the COVID-19 pandemic, the pantries adapted the SWAP implementation, demonstrating its flexibility and effectiveness as a nutritional intervention to improve food quality for those experiencing food insecurity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Implementation of a Nutrition Intervention in Food Pantries: The Spirit of SWAP. Morales, SI., Vicente, G., LaMonaca, K., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Implementing a Process for Screening Hospitalized Adults for Food Insecurity at a Tertiary Care Center. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

A Pilot Fruit and Vegetable Prescription (FVRx) Program Improves Local Fruit and Vegetable Consumption, Nutrition Knowledge, and Food Purchasing Practices. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Perspectives of Health Care Staff on Predictors of Success in a Food Prescription Program: A Qualitative Study. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Utilization Patterns of a Food Referral Program: Findings from the Mid-Ohio Farmacy. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

A Feasibility and Pilot Study of a Personalized Nutrition Intervention in Mobile Food Pantry Users in Northeastern Connecticut. [2021]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Moving Food Assistance into the Digital Age: A Scoping Review. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Pantry clients and Supplemental Nutrition Assistance Program-Education practitioners' perspectives on factors influencing healthy eating policy, system and environmental interventions in food pantries. [2023]

8. England pubmed.ncbi.nlm.nih.gov

A Cluster-Randomized Evaluation of the SuperShelf Intervention in Choice-Based Food Pantries. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

US Department of Agriculture Food Composition Databases, the Food and Nutrient Database for Dietary Studies 2013-2014, and the National Nutrient Database for Standard Reference Version 28 Yield Significantly Different Nutrient Totals of Food Items from Eight Midwestern Food Pantry Inventories. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

The Implementation of a Nutrition Intervention in Food Pantries: The Spirit of SWAP. [2023]