Source: BOSTON UNIVERSITY MEDICAL CENTER submitted to NRP
COVID RELIEF 2019-70030-30413: BMC FRESHCONNECT (PRX)
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1026761
Grant No.
2021-70034-34988
Cumulative Award Amt.
$437,532.45
Proposal No.
2021-06441
Multistate No.
(N/A)
Project Start Date
Sep 1, 2021
Project End Date
Aug 31, 2025
Grant Year
2021
Program Code
[PRX]- GusCRR produce prescription projects
Recipient Organization
BOSTON UNIVERSITY MEDICAL CENTER
732 HARRISON AVE., 2ND FLOOR
BOSTON,MA 02118
Performing Department
Pediatrics
Non Technical Summary
Theaimsof the original GusNIP PPR Project,BMC Fresh Connect,are to:1) increase the consumption of fruits and vegetables (F&V) among Boston Medical Center (BMC) patients; 2) reduce food insecurity in these patients; and 3) reduce health care utilization and costs.To achieve these aims, we are currently conducting a randomized trial in which participants in the active arm receive monthly produce prescriptions toFresh Connect, which allow shoppers easy access to fresh F&Vs through a mobile grocery store and neighborhood farmers' markets.After a pause in research activities imposed by the pandemic, this trial is now well underway. The proposed GusNIP PRX Project will expand upon our original project by harnessing a separate, novel outreach system -Project REACH- to address food insecurity in our pediatric patients and their families whose access to fresh F&Vs has been compromised by the COVID-19 pandemic.Initiated in April 2020, Project REACH assesses the health-related social needs of our pediatric patients and their families in their home communities. To date, it has reached the families of over 5,000 children, 40% of whom have expressed critical food needs. Through Project REACH,we propose to provide F&V prescriptions that families can redeem through Fresh Connect to approximately245 additional food-insecure families of pediatric patients over and above those in our current study. In addition, we will evaluate the effectiveness of Project REACH as a new model to address food insecurity in low-income families whose access to healthy foods has been compromised by COVID-19.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70450101170100%
Knowledge Area
704 - Nutrition and Hunger in the Population;

Subject Of Investigation
5010 - Food;

Field Of Science
1170 - Epidemiology;
Goals / Objectives
Our goalsunder the GusNIP PRX are to:Disburse F&V produce prescriptions to approximately 245 additional food-insecure families of pediatric patients, over and above those in our current study; andEvaluate the effectiveness of Project REACH as a model to address food insecurity in low-income families whose access to healthy foods has been compromised by the COVID-19 pandemic.
Project Methods
With IRB approval, we will gather and analyze measures offood security; dietary intake; unmet social needs; family wellness, stress, and mental health; and COVID-specific experiences.A subset of these measures align directly with shared metrics mandated by the GusNIP NTAE - including the F&V intake, food security, and COVID outcomes. Data will be analyzed descriptively to determine distribution, sufficient variability for analyses, missing values, outliers, and correlations across repeated measures. We will conduct longitudinal analyses to examine associations of outcome trajectories with our primary predictor of interest:receipt of Fresh Connect services.We will also examine outcomes with respect to time-invariant predictors (e.g., demographic characteristics) and time varying factors (e.g. COVID status, receipt of other Project REACH services).We will fully collaborate with the GusNIP NTAE as in our current PPR project.

Progress 09/01/23 to 08/31/24

Outputs
Target Audience:This primarily descriptive, prospective cohort of Fresh Connect services is designed to understand food insecurity, COVID infections, and other measures of family well-being during the COVID pandemic. Our efforts targeted families with children who receive care at the Boston Medical Center Department of Pediatrics through Project REACH - an outreach program where callers (who are part of the regular care team) are proactively reaching out to BMC pediatric families. Below are the inclusion criteria that must be met by study participants prior to being enrolled in the cohort: 1. Parent/guardian of at least one child receiving care at BMC Pediatrics 2. Parent/guardian is at least 18 years of age 3. Parent/guardian is comfortable speaking and receiving information in English or Spanish 4. Child received care at the BMC Department of Pediatrics 5. Child's parent/guardian contacted by Project REACH This cohort study has enrolled 117 English or Spanish-speaking food-insecure families of pediatric patients. Changes/Problems:One challenge for our research study team has been staffing changes, which impacted our workflows in recruiting new study participants. Our current fully-trained and staffed team is working to achieve the study targets. Another challenge for the study team was when About Fresh/Fresh Connect made changes to the pre-paid cards and our research study team had to work to inform all study participants of this change so that it would not impact their ability to access the program. What opportunities for training and professional development has the project provided?The project has allowed new student research assistants to be onboarded. These students have gained knowledge related to food insecurity and health-related social needs and have developed research skills related to participant recruitment, data collection, and data management. How have the results been disseminated to communities of interest?Enrollment for this study is ongoing, study results are pending and have not been disseminated. What do you plan to do during the next reporting period to accomplish the goals? Continue study recruitment and enrollment efforts About Fresh will continue to provide Fresh Connect services to study participants for 6 months after the last study participant is recruited Continue to conduct baseline assessments for new study participants and follow-up assessments for those who are already enrolled. Continue to submit monthly reports to the GusNIP NTAE Center Continue to meet with About Fresh and GusNIP NTAE Work with GusNIP NTAE to share data Work with Boston Medical Center to increase referrals to the study

Impacts
What was accomplished under these goals? The last IRB approval for revisions to the study application and protocol was approved on March 16, 2024 the revision was made to add $10 compensation for completing the baseline As of August 31, 2024, 117participants have been enrolled in the study. 117 baseline interviews have been completed as well. As of August 31, 2024, the study research has conducted 83 1-month interviews, 73 2-month interviews, 77 3-month interviews, 75 4-month interviews, 71 5-month interviews, 62 6-month interviews, 68 7-month interviews, 52 8-month interviews, 40 9-month interviews, 42 10-month interviews, 42 11-month interviews, and 27 12-month interviews. As of August 31, 2024, 94 study participants have completed the entire study. Submitted monthly reports to the GusNIP NTAE Center

Publications


    Progress 09/01/22 to 08/31/23

    Outputs
    Target Audience:This primarily descriptive, prospective cohort of Fresh Connect services is designed to understand food insecurity, COVID infections, and other measures of family well-being during the COVID pandemic. Our efforts targeted families with children who receive care at the Boston Medical Center Department of Pediatrics through Project REACH - an outreach program where callers (who are part of the regular care team) are proactively reaching out to BMC pediatric families. Below are the inclusion criteria that must be met by study participants prior to being enrolled in the cohort: 1. Parent/guardian of at least one child receiving care at BMC Pediatrics 2. Parent/guardian is at least 18 years of age 3. Parent/guardian is comfortable speaking and receiving information in English or Spanish 4. Child received care at the BMC Department of Pediatrics 5. Child's parent/guardian contacted by Project REACH This cohort study will enroll 245 English or Spanish-speaking food-insecure families of pediatric patients. As of July 21, 2023, 93 study participants have been enrolled in this cohort study. Changes/Problems:The research study team has learned to recruit and enroll potential study participants remotely. This can be challenging given that there is still a mix of work schedules for potential study participants as well as our own research study team has changes in availability due to time differences and other ongoing projects. Another major challenge has been obtaining referrals from the Pediatric clinic. While this issue was found to be an IT issue and was recently resolved, this impacted the research study team's ability to get in touch with potential study participants. Additionally, due to changes that About Fresh's Fresh Connect made to the card used, the research study had to stop recruitment and enrollment for about 3 months, from December 2022 to mid-February 2023. This impacted our ability to enroll new study participants. What opportunities for training and professional development has the project provided?The project has allowed research assistants to develop their database management and study participant management skills by assisting in training new research assistants. How have the results been disseminated to communities of interest?Enrollment for this study is ongoing, study results are pending and have not been disseminated. What do you plan to do during the next reporting period to accomplish the goals? Continue study recruitment and enrollment efforts About Fresh will continue to provide Fresh Connect services to study participants for 6 months after the last study participant is recruited Continue to conduct baseline assessments for new study participants and follow-up assessments for those that are already enrolled. Continue to submit monthly reports to the GusNIP NTAE Center Continue to meet with About Fresh and GusNIP NTAE Work with GusNIP NTAE to share data Work with Boston Medical Center to increase referrals to the study

    Impacts
    What was accomplished under these goals? Last IRB approval for revisions to the study application and protocol was received on December 9, 2022 As of July 21, 2023, 93 study participants have been enrolled in the study. 93 baseline interviews have been completed as well. As of July 21, 2023, the study research team has conducted 77 1-month interviews, 65 2-month interviews, 61 3-month interviews,56 4 month interviews, 52 5-month interviews, 40 6-month interviews, 40 7-month interviews, 33 8-month interviews,30 9- month interviews, 26 10-month interviews, 29 11-month interviews, and 22 12-month interviews. As of July 31, 2023, 47 study participants will have received 6 months of Fresh Connect. As of July 21, 2023, 29 study participants have completed the entire study. Submitted monthly report to the GusNIP NTAE Center

    Publications


      Progress 09/01/21 to 08/31/22

      Outputs
      Target Audience:This largely descriptive, prospective cohort of Fresh Connect services is designed to understand food insecurity, COVID infections, and other measures of family wellbeing during the COVID pandemic. Our efforts targeted families with children who receive care at the Boston Medical Center Department of Pediatrics through Project REACH - an outreach program where callers (who are part of the regular care team) are proactively reaching out to BMC pediatric families. Below are the inclusion criteria that must be met by study participants prior to being enrolled in the cohort: Parent/guardian of at least one child receiving care at BMC Pediatrics Parent/guardian is at least 18 years of age Parent/guardian is comfortable speaking and receiving information in English or Spanish Child received care at the BMC Department of Pediatrics Child's parent/guardian contacted by Project REACH This cohorot study will enroll 245 English or Spanish-speaking food-insecure families of pediatiac patients. As of August 11, 2022, 37study participants have been enrolled in this cohort study. Changes/Problems:Our team has learned to manage how to continue recruiting and enrolling participants remotely and during a pandemic. However, this continues to be a challenge. We have had study staff members and their family member that have been impacted with COVID, thus, changing our team's availability. Additionally, we have had changes within our research study team that have impacted our person time but we have attempted to address some of these issues. Another major change that occurred was editing our protocol to reflect the $10 compensation that study participants would receive for completing the Baseline after we were awarded the GusNIP/GusCRR Data Collection Funding Support 2022 grant. As a result we had to set-up a new account through BMC's Clincard office and set-up a protocol to distributing clincards to research study participants. What opportunities for training and professional development has the project provided? Research Project Manager met with reserch study team members to train and review study protocol and databases Review data sharing systems with About Fresh How have the results been disseminated to communities of interest?Enrollment for study is ongoing, study results are pending and have not been disseminated. What do you plan to do during the next reporting period to accomplish the goals? Continue study recruitment and enrollment efforts till we reach 245 study participants About Fresh will continue to provide Fresh Connect services to study participants for 6 months after the last study participant is recurited. Continue to conduct baseline assessements for new study participants and follow-up assesements for those enrolled Continue to submit monthly reports to GusNIP NTAE Center Continue to meet with About Fresh and GusNIP NTAE.

      Impacts
      What was accomplished under these goals? Received IRB approval for the revised protocol on July 20, 2022 Research staff trainined reasearch team on study protocols and activities Research team launched study recruitment efforts in April 2022 As of August 11, 2022, we have enrolled 37total study participants and conducted 37baseline assesments About Fresh began providing Fresh Connect servcies to study participants on April 26, 2022 As of July 25, 2022, we have conducted 20 1-month interviews, 10 2-month interviews, and 3 3-month interviews Submitted monthly reports to GusNIP NTAE Center.

      Publications