Fresh Shelves, Healthy Pantries: A Pilot Intervention Trial in Baltimore City Food Pantries

Abstract

The objective of this study was to evaluate the impact of a multi-modal pilot intervention on the stocking and acquisition of healthy foods in urban food pantries. An intervention that consisted of three 8-week phases, each focused on promotion of one food group: (1) lean & low-sodium proteins; (2) fruits & vegetables; and (3) healthy carbohydrates was conducted in 3 intervention and 4 comparison food pantries. Food stocking variety scores measured changes in the stocking of promoted healthful foods at pantries. Food Assortment Scoring Tool (FAST) scores measured healthfulness of client bags. Intervention and comparison pantries showed an increase during the study in the total variety score for promoted options, with no significant differences between groups. Mean healthfulness scores for intervention client bags (n = 34) significantly increased from 58.2 to 74.9 (p < 0.001). This pilot trial identified logistically feasible strategies to promote healthy options effectively in food pantries, even in pantries with limited resources.

Protocol for the Support Application for Food PAntrieS trial: design, implementation, and evaluation plan for a digital application to promote healthy food access and support food pantry operations

“…This study builds upon extensive prior formative research, including sharing a series of low-and high-fidelity wireframe mockup images designed collectively by the research team with food pantry directors, previous intervention work in Baltimore food pantries (7,38), two scoping reviews of the literature (12,13), and a national survey of food pantry directors (14). Across this work, we found that food pantries in Baltimore experienced challenges related to finding a sufficient number of staff/volunteers, provide client choice and support clients in making healthy choices, and lacked emergency preparedness and response training.…”

“…The Food Pantry Environmental Checklist (FPEC) was developed as part of the FSHP trial (7), and is used to assess the availability of healthy and unhealthy foods and beverages at food pantries. Foods and beverages are categorized based on the United States Department of Agriculture's five groups: dairy, fruits, vegetables, grains, and proteins.…”

“…The calculation was based a cluster-level t-test comparing the mean change in FAST scores of client bags at the intervention pantries to those at the comparison pantries. In our calculation, we used the reported mean change in FAST scores in comparison and intervention food pantries from the previous FSHP trial (7) with that hypothesis that there will be a trend toward increased FAST scores among intervention pantry clients compared to clients who are sampled from comparison pantries. Ultimately, sample-size assumed a difference in FAST Scores of 12 points, effect size of 0.8, intraclass correlation of 0.2, type I error of 5%, and power level set at 80%, to lead to a total sample size of 20 stores with 10 per arm and 18 clients per pantry (n = 360 at baseline).…”

“…One pantry was added to each arm of the study to account for possible attrition, leading to the final sample size of 40 pantries. Similarly, we have added 3 clients per pantry to allow for potential drop out and still have necessary power based on our previous trial (7).…”

“…For example, food pantries tend to have limited staff capacity and resources to provide a safe forum for client choice and to assist with making healthy selections (5,6). Additionally, food pantries are largely limited in what they can offer by what they receive from the central food banks, and thus tend to stock fewer healthy options despite their desire to emphasize healthy foods (7). As a result, previous studies have indicated that food pantry clients have lower diet quality (8).…”