Background Poor maternal diets increase the risk of excess gestational weight gain which can contribute to serious intergenerational morbidity for both the mother and infant. Pregnant young women with low incomes have disproportionately high rates of inadequate fruit and vegetable consumption as well as excess weight gains during pregnancy. Objective Our aim was to describe the feasibility and acceptability of Special Delivery, a longitudinal nutrition intervention that delivers healthy foods to pregnant youth (aged 14-24 years) with low incomes. Methods The Special Delivery pilot study, conducted in Michigan, enrolled pregnant young women with low incomes. Study participants were sent twice-monthly grocery deliveries consisting of US $35 worth of healthy foods, primarily fruits and vegetables. Between grocery deliveries, participants received daily SMS text message prompts to confirm receipt of delivery and document diet and weight. Program feasibility was assessed by the number of grocery orders placed, delivered, and confirmed by participants. Qualitative interviews and SMS text message data were used to determine acceptability by assessing participants’ perspectives on grocery delivery, participants’ perspectives on dietary impact of the program, and foods consumed by participants. Results A total of 27 participants were enrolled in the pilot study. The mean age was 20.3 years (SD 2.0), and 59.3% (16/27) were African American or Black. During the pilot, 263 deliveries were sent with 98.5% (259/263) successful deliveries and 89.4% (235/263) deliveries confirmed by participants. Participants reported that grocery delivery was convenient; that delivered foods were high quality; and that the program improved their diet, increased access to healthy foods, and promoted healthy habits during pregnancy. Conclusions A grocery delivery–based weight gain and nutrition intervention is both feasible and acceptable among low-income pregnant youth. Grocery deliveries were successfully completed and participants were willing and able to receive grocery deliveries, eat the healthy foods that were delivered, and communicate via SMS text message with study coordinators. The Special Delivery program warrants further evaluation for efficacy in promoting healthy weight gain for low-income youth during pregnancy.
Objectives During the COVID-19 pandemic, the Centers for Disease Control and Prevention has recommended limiting in-person grocery store visits by using online delivery and pick-up. We sought to understand how the pandemic has impacted grocery shopping patterns among adolescents and young adults, including the shopping mediums (i.e., in-person, pick-up, or delivery) and types of goods purchased. Methods This research is part of MyVoice, a national text message survey of US adolescents and young adults between 14 and 24 years old. In November 2020, this cohort was asked these open-ended questions: 1) During the pandemic, how have you or your family been getting groceries (in-person, pick-up, delivery)? Why? 2) If you or your family have shopped for groceries online during the pandemic, was it pick-up or delivery? How did it go? 3) During the pandemic, have you or your family changed the types of food you are buying? Tell us about it. Responses were assessed using thematic analysis. Quantitative data were summarized using descriptive statistics. Results Among 889 responses (RR = 77.6%), 47% were female, 56% were White, 13% were Hispanic, and median age was 18 (interquartile range 17, 21). Since the pandemic began, 86% of respondents reported at least use of in-person grocery shopping. Meanwhile, 46% indicated they had used a form of online grocery shopping; 26% reported use of delivery and 27% reported use of pick-up. Over half of participants using online shopping had a positive experience. Half of respondents changed their grocery purchase choices since the pandemic began, among whom 33% reported healthier purchases, 27% bought more snack foods, 24% bought in bulk and/or more non-perishable foods, and 10% bought more foods to cook at home. Conclusions Among young people, online grocery shopping is widely utilized with generally positive perceptions, although in-person shopping remains most prevalent. While many young people reported healthier purchases, there was a tendency toward more snack and non-perishable foods. Further investigation is needed to understand reasons behind changes in purchasing habits of adolescents and young adults and the impact of these changes on diet quality during the pandemic. Funding Sources Michigan Institute for Clinical & Health Research, University of Michigan MCubed program, University of Michigan Department of Family Medicine
We sought to understand online grocery shopping during the COVID-19 pandemic, especially among youth, rural residents, and Supplemental Nutrition Assistance Program (SNAP) participants. We completed a national text-messaging poll of youth (14-24 years-old) (n=867). We found that during the pandemic online grocery shopping was used frequently (46.7%). Safety and convenience were the primary reasons for preferring a shopping mode (in-person or online). Most online shoppers had positive experiences (59.4%), primarily due to convenience; negative experiences (28.3%) were from inaccuracies, inconveniences of the process, and delivery costs. Rural and suburban residence was associated with higher pickup (OR 2.02 and 1.51, respectively, p=.03) and lower delivery use (OR 0.33 and 0.72, respectively, p=.003) compared to urban residence. SNAP participation was not associated with any type of online grocery shopping. In conclusion, online grocery shopping is common among youth and their families regardless of rurality or SNAP participation, but there are several youth-identified areas for improvement.
OBJECTIVES/GOALS: Most pregnant youth (ages 14-24) gain more weight during pregnancy than recommended by clinical guidelines. We aim to describe the feasibility and acceptability of home grocery delivery of fruits, vegetables, and healthy snacks to promote healthy weight gain in this vulnerable population. METHODS/STUDY POPULATION: Participants were low-income pregnant youth in Michigan. Each participant was sent biweekly grocery deliveries consisting of $35 worth of fresh fruits, vegetables, and healthy snacks via the app-based delivery service, Shipt. Between deliveries, participants were prompted to respond to weekly text message-based surveys of a 24-hour food recall. This validated nutritional assessment quantifies consumption of fruit and vegetable servings. In addition, participants were asked to send daily photos and descriptions of foods they were eating. This study was approved by the University of Michigan Institutional Review Board. RESULTS/ANTICIPATED RESULTS: To date, 27 participants have been enrolled. Thirteen participants have completed their participation, 4.3 months on average, and were sent an average of 10 grocery deliveries each. In total, over 200 deliveries have been sent with 86% confirmed by the study participant (179/207). Additional outcomes to be assessed include: 1) text message response rates by participants and 2) content from photos and text descriptions of food eaten by participants. The 24-hour recall and text and photo messaging provided in-context data about grocery utilization. DISCUSSION/SIGNIFICANCE OF IMPACT: Grocery delivery is both feasible and acceptable to our youth participants. Use of grocery delivery constitutes a novel intervention to promote healthy weight gain in pregnancy for vulnerable populations through improving access to healthy food options.
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