Evaluating the Impact of a Full-service Mobile Food Market on Food Security, Diet Quality and Food Purchases: a Cluster Randomised Trial Protocol and Design Paper

Overview

Journal BMJ Open

Specialty General Medicine

Date 2025 Mar 6

PMID 40050056

Authors

Melissa L Horning

Kristen S Gorman

Stephanie Wagner

Jayne A Fulkerson

Julian Wolfson

Melissa N Laska

Lisa Harnack

Affiliations

Soon will be listed here.

Abstract

Introduction: Mobile food markets may help to mitigate diet-related and weight-related inequities by bringing low-cost, nutritious food directly to underserved populations. By stocking foods to meet a range of dietary needs, full-service mobile markets may improve multiple aspects of diet, food security and fruit and vegetable procurement with a convenient one-stop shop.

Methods And Analysis: This cluster randomised trial is evaluating the impact of a full-service mobile market, the Twin Cities Mobile Market (TCMM). The TCMM sells staple foods at affordable prices from a retrofitted bus that regularly visits communities experiencing low incomes. The trial's primary outcome is participant diet quality. Secondary outcomes include intake of specific foods and nutrients, food security and servings of fruits and vegetables procured for the home.Together with our partners, we enrolled four subsidised community housing sites in three waves (12 total sites), aimed to recruit 22 participants per site (N=264) and collected baseline data. Sites were then randomised to either receive the full-service TCMM intervention or serve as a waitlist control, and the full-service TCMM began implementing at intervention sites. Follow-up data collection is occurring at 6 months post-implementation. After follow-up data collection for each wave, the full-service TCMM intervention is being implemented at the waitlist control sites. Waves 1 and 2 are complete and Wave 3 is in progress.At baseline and follow-up data collection, dietary quality and intake are being assessed through three, interviewer-administered, 24-hour dietary recalls, food insecurity is being assessed by the 18-item Food Security Screening Module and fruit and vegetable procurement is being measured by collecting one month of food procurement tracking forms.We will use intent-to-treat analyses to determine if participant diet quality, food security and procurement of fruits and vegetables improve in the sites that received the full-service TCMM intervention relative to the participants in the waitlist control condition.

Ethics And Dissemination: Trial procedures have been approved by the University of Minnesota Institutional Review Board. We plan to disseminate main outcomes in Grant Year 5 in both scientific and community spaces.

Trial Registration Number: ClinicalTrials.gov: NCT05672186.

References

Gorham G, Dulin-Keita A, Risica P, Mello J, Papandonatos G, Nunn A . Effectiveness of Fresh to You, a Discount Fresh Fruit and Vegetable Market in Low-Income Neighborhoods, on Children's Fruit and Vegetable Consumption, Rhode Island, 2010-2011. Prev Chronic Dis. 2015; 12:E176. PMC: 4611858. DOI: 10.5888/pcd12.140583. View

Gans K, Risica P, Keita A, Dionne L, Mello J, Cooksey Stowers K . Multilevel approaches to increase fruit and vegetable intake in low-income housing communities: final results of the 'Live Well, Viva Bien' cluster-randomized trial. Int J Behav Nutr Phys Act. 2018; 15(1):80. PMC: 6102886. DOI: 10.1186/s12966-018-0704-2. View

Tester J, Yen I, Laraia B . Using mobile fruit vendors to increase access to fresh fruit and vegetables for schoolchildren. Prev Chronic Dis. 2012; 9:E102. PMC: 3457766. DOI: 10.5888/pcd9.110222. View

Zepeda L, Reznickova A, Lohr L . Overcoming challenges to effectiveness of mobile markets in US food deserts. Appetite. 2014; 79:58-67. DOI: 10.1016/j.appet.2014.03.026. View

Bucher T, Collins C, Rollo M, McCaffrey T, De Vlieger N, van der Bend D . Nudging consumers towards healthier choices: a systematic review of positional influences on food choice. Br J Nutr. 2016; 115(12):2252-63. DOI: 10.1017/S0007114516001653. View

Leone L, Tripicchio G, Haynes-Maslow L, McGuirt J, Grady Smith J, Armstrong-Brown J . Cluster randomized controlled trial of a mobile market intervention to increase fruit and vegetable intake among adults in lower-income communities in North Carolina. Int J Behav Nutr Phys Act. 2018; 15(1):2. PMC: 5756418. DOI: 10.1186/s12966-017-0637-1. View

AbuSabha R, Namjoshi D, Klein A . Increasing access and affordability of produce improves perceived consumption of vegetables in low-income seniors. J Am Diet Assoc. 2011; 111(10):1549-55. DOI: 10.1016/j.jada.2011.07.003. View

Horning M, Bell A, Porter L, Wagner S, Alver B, Kamdar N . Differences in mobile food market customer outcomes between 2019 and 2021. Public Health Nurs. 2023; 40(5):603-611. PMC: 10527819. DOI: 10.1111/phn.13202. View

de Boer M, Waterlander W, Kuijper L, Steenhuis I, Twisk J . Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate. Int J Behav Nutr Phys Act. 2015; 12:4. PMC: 4310023. DOI: 10.1186/s12966-015-0162-z. View

10.

Hsiao B, Sibeko L, Wicks K, Troy L . Mobile produce market influences access to fruits and vegetables in an urban environment. Public Health Nutr. 2018; 21(7):1332-1344. PMC: 10261273. DOI: 10.1017/S1368980017003755. View

11.

Van Horn L, Stumbo P, Moag-Stahlberg A, Obarzanek E, Hartmuller V, Farris R . The Dietary Intervention Study in Children (DISC): dietary assessment methods for 8- to 10-year-olds. J Am Diet Assoc. 1993; 93(12):1396-403. DOI: 10.1016/0002-8223(93)92241-o. View

12.

Hu E, Steffen L, Coresh J, Appel L, Rebholz C . Adherence to the Healthy Eating Index-2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality. J Nutr. 2019; 150(2):312-321. PMC: 7373820. DOI: 10.1093/jn/nxz218. View

13.

Horning M, Porter L, Hassan A, Edson E . Full-Service Twin Cities Mobile Market Impact: Qualitative Findings From Focus Groups With Customers. J Acad Nutr Diet. 2020; 120(9):1548-1556.e1. DOI: 10.1016/j.jand.2020.02.016. View

14.

Horning M, Alver B, Porter L, Lenarz-Coy S, Kamdar N . Food insecurity, food-related characteristics and behaviors, and fruit and vegetable intake in mobile market customers. Appetite. 2021; 166:105466. PMC: 8445326. DOI: 10.1016/j.appet.2021.105466. View