Progress 07/15/12 to 03/15/17

Outputs
Target Audience:From its inception, this project has aimed to improve nutrition among low-income clients of food pantries. However, results and products from our work can be used to improve nutrition in any households where meals are prepared, regardless of income level or whether or not the households patronize pantries. The range of data-gathering when building, field testing, and disseminating our app has been narrower, though. We have focused on people whose primary language is either English or Spanish, who are their household's principal cook, who are mothers (or, occasionally, grandmothers) of a 9-14-year-old, who are owners of at least a basic cell phone (not necessarily a smartphone), and finally, 9-14-year-old children themselves. Changes/Problems:We deviated from our original protocol in the randomized field trial. We had started the experiment intending that pantry clients would receive six weeks of supplemental vegetables. Three control pantries and one experimental site were fielded using this six-week regime, before it became clear that we lacked budget to sustain the plan. The remaining 11 pantries followed a four-week protocol. For convenience in exposition, however, we have described the distribution of research-vegetables as lasting for four weeks throughout. (Whether four or six weeks, all cooks were questioned about the same vegetables to measure use of pantry-supplied foods. Electronic capture of making "booklets" in the app were tallied for just the four weeks when standardized supplemental distributions of vegetables were offered.) Fortunately, our rhetorical simplification does not distort results that compare control and experimental conditions. This is because, as it turned out, the six control sites averaged nearly alike on our main outcome measure, preparations using pantry-suppled vegetables, whether they had experienced four or six weeks of supplemental vegetables. And, as it turned out, the lone six-week experimental site actually scored next-to-lowest on pantry-supplied vegetables, among the nine pantries with Quick Help for Meals. Change scores on usage of vegetables in general also did not differ by length of distribution (p = .73). There is additional reassurance that findings about the app's effectiveness are conservatively reported. We observed that across all 15 pantries experimental cooks prepared 38 percent more vegetable servings than control cooks. That calculation would be 63 percent more vegetable servings, if we were to base it on just the 11 sites studied after the budget-driven adjustment in protocol. Thus, it seems unlikely that combining the 4- and 6-week protocols exaggerated experimental differences in favor of the app's effectiveness. See earlier progress reports for other changes. What opportunities for training and professional development has the project provided?Our project has employed and trained staff to conduct nutrition outreach to low-income families at food pantries and other locations. We have also trained staff in bi-lingual interviewing skills, for low-income participants. Research training for doctoral students has yielded independent conference papers by them about issues related to the project's goals, including technology brokering by children with their parents. Research training has also included the complexities and science of conducting field trials and formative studies that involve extremely low-income populations in natural, community-based settings. How have the results been disseminated to communities of interest?Earlier progress reports have listed publications. And, two technical reports have been completed in 2017, one of which is under review by a journal. These are: S.H. Evans and P. Clarke, Designing a Nutrition App for Low-Income Households: Three Kinds of Formative Studies, Technical Report, Annenberg School for Communication and Journalism. Also, under review by the Journal of Medical Internet Research. S.H. Evans, P. Clarke & D. Neffa-Creech, New Mobile App Increases Vegetable-Based Preparations by Low-Income Household Cooks, Technical Report, Annenberg School for Communication and Journalism. In addition to journal articles and technical reports (to be turned into additional publications), and media interviews and visits with journalists, we have made presentations in the following venues: NIFA's Webinar Series, sponsored by the Institute for Food Safety and Nutrition International Communication Association American Public Health Association Society for Nutrition Education and Behavior New York Academy of Sciences American Psychological Society National Collaborative on Childhood Obesity Research USA Science and Engineering Festival Annual meeting of the Michigan Fitness Foundation We have also produced a 15-minute demonstration of the app, available on You Tube. To find it, enter these search terms in You Tube's window: Quick Help for Meals, Clarke, Evans. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? All major project goals have been achieved, as amended in earlier progress reports. We have: Built an Android-based mobile phone app, Quick Help for Meals, in both English and Spanish. Added and broadened recipes, compared to the tablet-based predecessor to our app, bringing the total to 260. Created for the app a library of 80 "tip sheets" (now called Secrets to Better Eating) that promote the appreciation of food tastes, textures, and portion sizes, among other themes. These are divided into Breakfast Secrets, Lunch Secrets, Dinner Secrets, Snack Secrets, and Shopping Secrets. Formatively evaluated materials in the app, and conducted a variety of usability trials with targeted populations, to assure pertinence of the app's content for users, and ease of navigation in the app. Conducted a pilot field experiment to test the design and instruments for the intervention trial. Conducted an intervention trial of the app with 15 pantries and 224 households assigned to control and experimental groups, assessing the app's impact on household use of fresh vegetables, cooks' confidence in the kitchen, children's communication and behavior related to food, and other outcomes. Analyzed results from the intervention trial. Consulted with food banks about disseminating Quick Help--including Los Angeles, San Francisco, Albuquerque, San Antonio, Chicago, and Raleigh. Conducted dissemination experiments and are now analyzing results in collaboration with four partners: SNAP-Ed (State of Michigan), two food banks (Greater Chicago Food Depository and San Antonio Food bank), and a school district (Whittier, CA). Results of these efforts are, in summary: Quick Help is easy to use, by both adults and children. The app is frequently accessed by both household cooks and their 9-14-year-old children. Evidence comes from both interviews and from electronic capture of actual app usage. Cooks with the app prepare 38 percent more vegetable-based servings than control cooks provided the same foods by their panties over a four-week period. Experimental and control pantries were matched on a variety of variables describing food use and demographic composition, before the field trial. Experimental cooks with the app show significantly greater use of a wide range of vegetables five weeks after the field trial ended, whereas control cooks show the same use of vegetables, or even less. Experimental cooks volunteer that they feel more confident in the kitchen and that their families are eating more healthily. Control cooks seldom voice these feelings while receiving vegetable supplements by their pantries, across the same four-week period. In experimental households, many 9-14-year-old children start voicing their interest in what's for dinner, making food shopping requests, and even helping in the kitchen. Diverse organizations are eager to participate in trials of disseminating Quick Help. These experimental projects disclose that, on average, half of people approached want to download the app (if they have Android devices). Dissemination trials also suggest that the app's effectiveness is greatly amplified by: a) giving out free vegetables, so that downloaders can use Quick Help immediately; b) providing downloading help by staff who recipients see regularly and with whom they can talk about their food interests; c) enabling printed output of app content, compared to having output just on the phone; and d) introducing the app to both a household cook and her child.

Publications

Progress 07/15/15 to 07/14/16

Outputs
Target Audience:Target Audience All project Activities focus on low-income families (who are clients of community food pantries) with 9-14 year old children, and on the social agencies that serve their needs. Changes/Problems:Changes In this progress report, we concentrate on project achievements that are exceeding expectations that NIFA and we shared when our funding began. We have been able to improve on project goals by securing other funding, adding to support from NIFA. Three kinds of accomplishments stand out, bearing on the app we have built, research into the app's effectiveness, and widespread dissemination of the app to low-income people. The app. We had originally expected that the app's content that focuses on mindful eating and healthier food management in the household would contain just ten illustrative pieces of content (enabling a proof-of-concept). Instead, we have built a fully operational section, Secrets to Better Eating, with five chapters that offer 80 pieces of content that users can customize to their interests and needs. In addition, we have built a non-print version of the app, adding to the print-enabled version, making Quick Help a more flexible tool for dovetailing with the resources of dissemination partners (such as the Michigan Fitness Foundation). We have also founded Quick Help for Meals, LLC, as an entity for collaborating with dissemination partners. The LLC provides a means for partners to reimburse the costs of branding the app to each collaborating organization's desires during dissemination. And the LLC provides a mechanism to pay server costs and other telecommunication functions necessary in order to offer app users Quick Help's customization features. Research into the app's effectiveness. We have added two lines of inquiry to the research design our original proposal advanced. One, supervised by doctoral student Deborah Neffa-Creech, examines how children's brokering of technologies in the family affects app usage and impacts. The second, supervised by doctoral student Nazli Senuva, examines how children visually represent their family's typical dinners, drawing plates of recent meals. Senuva also gathers other interview data from the children. Widespread app dissemination. Discussions with our Advisory Board and with food banks (pertinent to Activity 4) convinced us to actually experiment with dissemination strategies, rather than just talk about them. Accordingly, we are undertaking trials with three kinds of partnering organizations, to reveal a wider set of options than originally contemplated. One collaborator, the Michigan Fitness Foundation, is government-based, a statewide entity that propagates education and community mobilization, advocating for healthy lifestyles, but does not distribute tangible goods or benefits. Second is hospital groups, like PIH Health, which deliver health outreach in community settings as a means of cementing their brand in a local marketplace and in response to Federal mandates. Third is local, non-profit food banks which deliver food (through hundreds of neighborhood agencies), tangible goods of high and immediate value to their beneficiaries. Among larger, forward-leaning food banks, outreach on behalf of better nutrition has become a valued, second function. These food banks have hired professional nutritionists and deploy them in a range of community-based activities. Conclusion. We will be happy to report more details about any of these improvements. What opportunities for training and professional development has the project provided?What opportunities for training and professional development has the project provided? We are training doctoral students in community-based, participatory research. Other project staff have also mastered new research skills. How have the results been disseminated to communities of interest?How have the results been disseminated to communities of interest? Recent Presentations: Quick Help for Meals booth at the 4th USA Science and Engineering Festival, Walter E. Washington Convention Center, Washington, D.C., April 16-17, 2016. "Fighting Obesity among Low-Income 9-14 Year Olds: A Home-Based Intervention Using Mobile Phones to Deliver Customized Nutrition Outreach," Society for Nutrition Education and Behavior annual conference, San Diego, CA, August 2, 2016. "Mobile App Changes Household Eating and Communication Patterns among Low-Income Pantry Clients," American Public Health Association annual conference, Denver, CO, October 30, 2016. Also, see description below under Changes, of project dissemination activities, our grant's Activity 4. What do you plan to do during the next reporting period to accomplish the goals?What do you plan to do during the next reporting period to accomplish the goals? We have secured a no-cost time extension to allow completion of Activities, including analyses of project data.

Impacts
What was accomplished under these goals? What was accomplished under these goals? Project Activities: Completed deployment of, and data collection from a randomized field trial of Quick Help for Meals. Tasks included: Finished recruitment of pantry sites Finished enrollment of qualified families at 15 pantry-distributions in the Los Angeles area Finished random assignment of pantry-distributions to control and experimental conditions Conducted baseline, face-to-face interviews with mothers (principal cooks) and interviews and anthropometric measures with a designated 9-14 yr. old child for each of 224 households (mother-child pairs), distributed across the 15 distributions Provided supplementary vegetables at 4 weekly days-of-operation at each of the 15 pantry-distributions Collected weekly data from participants, face-to-face when attending their pantries' days-of-operation Conducted telephone interviews with mothers (principal cooks), following third or following fourth weekly supplementary vegetable offers Conducted follow-up, face-to-face interviews and anthropometric measures with pairs of mothers and designated children, at pantry sites, four weeks after the conclusion of weekly supplementary vegetable offers Conducted "positive-deviance," intensive interviews with selected heavy users of the app, 2-3 months following participation in the field trial Cleaned data sets, preparing them for analysis. Began index and scale construction for measures of primary interest, for example: household consumption of vegetables past week, household consumption of processed foods (separately for snacking items and for meal components) past week, cooks' confidence in performing fundamental kitchen tasks, extent of emotional and of self-actualization rewards that mothers derive from cooking, socio-emotional features of family dining, breakfast eating behaviors, and much more. Coded open-ended observations from weekly encounters with study participants, during supplementary vegetable offers Coded numbers of unique vegetable-based preparations following third and fourth scheduled vegetable distributions Conducted trial analyses of the app's automatic, electronic capture of users' interactions with Quick Help, including making (and re-making) VeggieBooks and SecretsBooks, and accessing the app to use recipes and other content. Obtained early results from the randomized field trial of Quick Help for Meals. Importantly, the app increases the variety and number of vegetable-based preparations that household cooks make by 38 percent, a benefit with practical as well as statistical significance. To explain. In the trial, we enrolled 224households with a 9-14 year old child at six control and at nine experimental pantry distribution days. Mothers (in a few cases, grandmothers) with their designated child attended baseline interviews, where we collected data from both. At experimental pantries, each mother-child pair wasalso given a smartphone, taught how to use it, and instructed in how to use the app. Then, for four weeks both control and experimental pantry clients were offered ample amounts of two fresh vegetables per week in addition to regular pantry supplies. At week-3, half the mothers were telephone interviewed about uses they had made of the previous week's pair of vegetables (broccoli and green beans). At week-4 the remaining mothers were interviewed about uses they had made of that week's supply (cauliflower and zucchini). Interviews were completed with 170, or 76 percent of enrolled household cooks. Mothers, who were the households' principal cooks, provided open-ended descriptions of any preparations they had made in the five days since pantry distributions, that used the vegetables of interest. Descriptions were coded for number of unique dishes and snacks (coding reliability ranged between .87 and .98 acrossthe 15 pantry distribution days). The difference between experimental and control conditions was substantial. The average for 9experimental sites was 4.17 unique vegetable preparations, compared to the average of 3.03across the6 control sites. Analysis of variance (Mann-Whitney U) between experimental and control conditions was significant at the .03 level (z = 1.83, one-tailed). Having Quick Help for Meals increased usage of fresh vegetables, and in the variety of preparations--exactly the outcomes that our app was built to enable. There is strong evidence about why Quick Help contributed to this substantial boost in variety and number of preparations, drawn from other interview data and from automatic, electronic capture of each mother and each child's sign-ins to the app. We will share findings in future reports. To continue our accomplishments during this final year of our grant: We began field work with the Michigan Fitness Foundation, promoting our app at pantry locations in statewide SNAP-Ed outreach (Activity 4). This included training community nutritionists in app promotion and designing a protocol and instruments for evaluating the dissemination. We began collaboration with two food banks (Chicago and San Antonio, TX), securing funding from the Aetna Foundation to support experimental app promotions that use food banks as strategic partners for app dissemination (Activity 4). We began collaboration with a hospital group, PIH Health in Whittier, CA, using its community-based health outreach programs to families as vehicles for app dissemination (Activity 4).

Publications

Progress 07/15/14 to 07/14/15

Outputs
Target Audience:Deployment of the field experimentreached low-income clients of community food pantries, our project's target audience. Participants had children age 9-14 living at home, and were divided between Spanish and English speakers. Changes/Problems:Changes/Problems We have successfully completed Activities 1 and 2, and the formative research portion of Activity 3 of our project. We have also commenced work on Activity 4, the final phase. We need, however, to amend features of our randomized field experiment, the remainder of Activity 3. 1. We have decided to give smartphones to experimental participants (Samsung S5s), rather than loaning phones. We will also provide use-plans of three months (unlimited voice and texting and 2 GB of data). This will vastly improve the ecological validity of results. This will also sharpen our understanding of participants' dependence on printed output from our app, Quick Help for Meals. We have been able to contract with a provider of phones and use-plans, within the budget allocation originally intended for loaned devices. 2. We have already written Deirdra Chester, our NIFA Program Contact, (on April 15, 2015) to describe another change. Our original proposal had contemplated Arm #1 in the field design wherein pantry clients would be enrolled first as control participants and then converted to experimental participants. That, however, lengthened the required period for their involvement to 19 weeks, compared to 12-13 weeks for Arms #2 and #3, which are conventional control and experimental groups. We have reallocated research resources from Arm #1 to Arms #2 and #3, because it has proven impossible to secure continuous participant involvement for 19 weeks without suffering unacceptable rates of attrition. 3. In fact, we have discovered that continuous participant involvement for even 12-13 weeks is problematic. We have now deployed our field research protocol in four pantries, both control and experimental. Two discoveries stand out. First, usage of food pantries by low-income families has changed since the aftermath of the depression in 2011, when our field experiment was designed. Then, clients tended to visit their pantry continuously on every occasion when it was open. Now, with an improved economy, increasing numbers of clients visit pantries sporadically. This shift forces us to shorten the period of families' involvement in the field research protocol, in order to contain participants' attrition at an acceptable level. Our second discovery is that the research protocol's agenda of measurement is burdensome, also discouraging persistent involvement by participants. Let us explain. As our proposal forecast, we now enroll pantry clients with a short interview that maps family demographics. Subsequently, household cooks and one 9-14 year old child attend a baseline session at their pantry (on a Saturday, to avoid conflicting with school) where both are interviewed face-to-face and anthropometric measures of the child are taken. Between enrollment and baseline, we phone the child at home to administer a 24-hour dietary recall. Six weeks later, phone interviews with the household cook collect a variety of measures that tap household eating and differences between control and experimental conditions. Six weeks following those phone interviews, the cook and child attend a final pantry session on Saturday for second face-to-face interviews and anthropometric measures. And within days, we also administer a second telephone 24-hour dietary recall with the child. Many participants have complained about this intensive menu of data collections. These objections are mirrored in participant attrition, especially in the control condition where families receive extra vegetables at their pantries but no smartphone with our app, Quick Help for Meals. 4. Accordingly, we are slimming the research protocol to a manageable level, that we expect will preserve acceptable levels of continuous involvement by participants in both control and experimental groups. This design will provide a robust test of the app's effects on household eating, if over a shorter time span than originally intended. We summarize the new schedule below: We show the occasions for data collection and the details. Enrollment in project: Consenting and demographics Baseline face-to-face with cook and child: Includes anthropometrics with child Phone with cook: Following a 4-week, rather than a 6-week period of enhanced distribution of vegetables at pantries, control and experimental Final face-to-face with cook and child: Four weeks, rather than 6-weeks after enhanced distributions end; includes anthropometrics with child Our questionnaires for these data collections collect an ambitious range of information about family eating, before and after the availability of our phone app Quick Help for Meals. What opportunities for training and professional development has the project provided?Staff have mastered new research skills. How have the results been disseminated to communities of interest?Recent Presentations: "Using a Mobile App to Strengthen SNAP-Ed," meetings of the Michigan Fitness Foundation, Dearborn, MI, March 12, 2015. "Mobile Phone App for Improved Nutrition Attracts High Use among Many Pantry Clients," meetings of the American Psychological Society, New York, NY, May 22, 2015. "Fighting Obesity among Low-Income 9-14 Year Olds Using Mobile Phones," meetings of the Society for Nutrition Education and Behavior, Pittsburgh, PA, July 28, 2015. Requests from Others to Use Our Materials: Michigan Fitness Foundation (Statewide SNAP-Ed); and from the Greater Chicago Food Depository, San Antonio Food Bank, Interfaith Food Shuttle in Raleigh, Roadrunner Food Bank in Albuquerque, San Francisco and Marin Food Bank, and Nevada SNAP-Ed outreach. Met with Consultants: Robert Cialdini Brian Wansink Deborah Cohen Met with Advisory Board Members: Neal Baer Arvind Singhal Marianne Haver Hill What do you plan to do during the next reporting period to accomplish the goals?Continue on the trajectory of tasks that were forecast in our original proposal.

Impacts
What was accomplished under these goals? Project Activities: Completed all interview questionnaires: Recruitment of participants (pantry clients) and demographics Baseline face-to-face for mothers and for 9-14 year old children Mid-intervention phone with mothers, control and experimental versions End face-to-face for mothers and for 9-14 year old children, control and experimental versions Translated questionnaires into Spanish Contracted with data collection entities: Pennsylvania State University (PSU) for children's 24-hour dietary recall measures by phone; Sentient Research Inc. for baseline andend interviews; NORC at the University of Chicago for mid-intervention surveys Trained interviewers at three entities (PSU, Sentient, NORC) and other field staff in alldata collection procedures Designed and instituted quality-control procedures for deployment of field experimentand all phases of data collection Secured IRB approvals for all phases of field work in randomized field experiment Re-negotiated with provider for improved and less costly provision of smartphones for experimental participants and for use-plans Launched deployment of field experimental design at four pantries, control andexperimental; more pantries forthcoming Developed a protocol for training experimental participants (mothers and children) onphone operation and use of our app Hired and trained staff to train participants on phones and our app Collaborated with Michigan Fitness Foundation on deployment of our app, Quick Helpfor Meals, in a statewide SNAP-Ed dissemination (Activity 4) Conferred with food banks in Illinois, North Carolina, Texas, and California ondeployment of Quick Help for Meals (Activity 4)

Publications

Progress 07/15/13 to 07/14/14

Outputs
Target Audience: Operability studies and pilot studies reached low-income clients of community food pantries, our project's target audience. Participants had children age 9-14 living at home, and were divided between Spanish and English speakers. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Requests from others to use our materials: Michigan Fitness Foundation Shared project materials with two studentscompletingMaster's theses. How have the results been disseminated to communities of interest? Presentations (see above) have prompted numerous requests for use of the mobile app. It is not ready for dissemination. What do you plan to do during the next reporting period to accomplish the goals? Analyze pilot study data, fine-tuneresearch instruments, recruit collaborating food pantries, and conduct a randomized field trial.

Impacts
What was accomplished under these goals? Project Activities: Completed at-home recipe testing Operability trials for VeggieBook and navigation changes Developing Secrets content (80+ secrets) Testing content for “Secrets to better Eating” On-line competition for illustrator for Secrets Testing various illustrative styles for Secrets Designing 80+ illustrations for Secrets Development of materials for Pilot project, including: Consent and assent documents Baseline questionnaires for mother and for child Weekly assessment instrument Food Diary Weekly on-site staff report Staff protocol for on-site recruitment Staff protocol for client training Staff protocol for weekly vegetable distribution Introducing Secrets protocol Concluding interview Translation of all documents into Spanish IRB approval for all documents and pilot research protocol Staff hiring and training Designing and building analytics for collecting data from clients’ phone usage Obtaining phones and phone plans Testing color printers and deciding on system for the field Obtained agreements with sites (food pantries) Field work with families in pilot study Consultations with Food Bank partners, advisory Board members, and consultants: Consulted with food bank partners in Albuquerque, Los Angeles, San Francisco, and Chicago Met with Consultants: Robert Cialdini Brian Wansink Deborah Cohen Met with Advisory Board members: Michael Pollan Neal Baer Marianne Haver Hill Arvind Singal Amina Dickerson Media Attention: ·http://sc-ctsi.org/index.php/news-dev/usc-researchers-put-food-smarts-into-phones-to-improve-nutrition-and-reduce#.UjiLcozn-70 ·http://blog.uscannenberg.org/?p=5371 ·http://annenberg.usc.edu/News%20and%20Events/News/140108CanLivesBeSaved.aspx ?Recentpresentations Consumer Behavior and Food Science Innovations for Optimal Nutrition, March 26, 2014. The Sackler Institute for Nutrition Science, a program of The New York Academy of Sciences, New York, NY. Annual Meeting of the Society for Nutrition Education and Behavior, June 30, 2014. Fighting Obesity among Low-Income 9-14 Year Olds: A Home-Based Intervention Using Mobile Phones to Deliver Customized Nutrition Outreach. Milwaukee, WI. Exploring Ways to Nudge Healthy Purchases among SNAP Shoppers, July 10, 2014. National Collaborative on Childhood Obesity Research, a collaboration of the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Robert Wood Johnson Foundation (RWJF), and the U.S. Department of Agriculture (USDA), Washington, DC.

Publications

• Type: Journal Articles Status: Published Year Published: 2013 Citation: P. Clarke (2013) Fighting obesity among low-income 9-14 year olds: A home-based intervention using mobile phones to deliver customized nutrition outreach, J. Nutr. Educ. & Beh., 45:4S, S79.
• Type: Journal Articles Status: Under Review Year Published: 2014 Citation: P. Clarke & S.H. Evans "How do cooks actually cook vegetables? A field experiment with low-income households," Health Promotion Practice.
• Type: Journal Articles Status: Under Review Year Published: 2014 Citation: S.H. Evans & P. Clarke "Formative evaluation of a mobile app for nutrition: Ways to fine-tune illustration style and improve screen design," J. Nutr. Educ. & Beh.

Progress 07/15/12 to 07/14/13

Outputs
Target Audience: This project targets low-income clients of community food pantries with 9-14 year old children. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? One of the interviewers in the completed formative study above (see 2.) is a Master’s student in Social Work at the University of Southern California. The other two interviewers had B.A. degrees. All of the interviewers gained valuable experience in accruing research participants, gathering data, and protecting the rights of human subjects. A field staff member in the formative study underway (see 2.) is a student in Statistics and is learning about research design and applied field work. FTEs for these temporary staff are not included in the table below, because their programs of study are not at the University of Southern California. How have the results been disseminated to communities of interest? The PIs are presenting progress in this project at the Project Directors Annual USDA/NIFA NRI/AFRI Meeting, in conjunction with meetings of the Society for Nutrition Education and Behavior, Portland, OR, August 12, 2013. See Poster U7. We have shown the completed mobile phone app and reported other project developments to the food writer, Michael Pollan (author of Cooked, The Omnivore’s Dilemma, Food Rules, and other works). Pollan’s journalism about food and nutrition also appears in such publications as the New York Times, Harper’s, and Time. We have demonstrated the app to senior staff of the San Francisco Food Bank, including Paul Ash, executive director, and the food bank’s nutrition and community outreach leaders. We have demonstrated the app at the Los Angeles Regional Food Bank, to Michael Flood, President/CEO, and staff in charge of nutrition and community relations. We have shown the app to Marianne Haver Hill, President and CEO of MEND (in Pacoima, CA). She heads a large, multi-service agency for low-income families. The project has been featured by the online food news site, Zester Daily. See What do you plan to do during the next reporting period to accomplish the goals? We will complete content development of Secrets to Better Eating, and incorporate content into the app. This work includes formative research of clients’ receptivity to the content, and navigation through content options. (These options are being organized in a novel, and we believe powerful architecture.) And we will test optimum information designs in order to meet the differing requirements of screen display and of printed output at clients’ pantries. We will conclude the ongoing usability trials of the app. These are in two phases: first, with 15 clients to assess the app’s functionality; and second, with 30 clients to assess depth of app use when the app is linked to six pantry food distributions. We will assess pantry sites in the Los Angeles area to determine which are most appropriate for our randomized field trial. We will commence organization of the major randomized field trial that is intended to measure effects of Quick! Help for Meals on 9-14 year olds’ consumption of vegetables, BMI, and body fat--along with other household effects. (Quick! Help for Meals is the umbrella label for two services that our home-based intervention provides via mobile technology: VeggieBooks and Secrets to Better Eating.)

Impacts
What was accomplished under these goals? These six major tasks have been accomplished or have been launched. Essential budgetary approval for building the phone application was obtained from NIFA on December 3, 2012 (see Award Face Sheet, Provisions): The part of the phone application called VeggieBook is now complete. This section of our content-rich app covers recipes and food use tips. The portfolio of recipes has been expanded by 29 percent, including even more kid-friendly preparations and one-dish meals that include vegetables and meat. We have collaborated with Le Cordon Bleu and Modernist Cuisine to help develop and taste-test recipes, edit them for clients’ needs, and photograph plated servings. One formative study of this expanded content has been completed and a second study is underway. The completed study focused on titles of recipes/tips and related issues of information design. The study underway focuses on households’ reception of new recipes when they are prepared by the family’s principal cook in her own kitchen. Some participants in this second study also involved their 9-14 yr. old children in recipe preparations, which helps inform content to be added to our app’s section, Secrets to Better Eating (see item 4 below). Work entailed in items 1 and 2 drew two major expenditures: a) $63,325 of the $80,000 earmarked for development of the app by our sub-contractor; and b) approximately .36 FTE of temporary staff services--in addition to the table of “Actual FTEs for this Reporting Period” below (that table reports only FTEs for staff from the University of Southern California). Other project expenses have also been met. We have commenced creation of a section of tips about mindful eating and environmental cues that contribute to healthy eating. This section is called Secrets to Better Eating and will complete the mobile phone app. Secrets will contain low-literacy representations of evidence-based behavioral advice in five categories: healthy breakfasts, healthy lunches, healthy dinners, management of snacking, and food shopping. We have commenced formative research to assure the usability of the new mobile phone app. In this research we observe pantry clients navigating the app using loaner phones, while they are in line awaiting food distributions. Measures of usability include the app’s responsiveness to each client’s preferences for customized recipes and tips, ease and intuitiveness of navigation protocols, intelligibility of screen displays, understanding and execution of options for creating VeggieBook covers, and recipe-sharing (via e-mail, Facebook, and other channels) with friends and family. The PIs have maintained close liaison with collaborators and consultants who were expected to contribute to Year-1 activities. Included among collaborators are Spruijt-Metz, Baezconde-Garbanati, and Bar; included among consultants are Wansink, Cialdini, and Cohen. We have also reported progress and sought advice from members of our Advisory Board.

Publications