Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods
BackgroundHigh dietary quality can protect against diet-related chronic diseases. In the United States, racial and ethnic minorities and those with lower incomes consistently exhibit lower dietary quality. Independently-owned restaurants are a common prepared food source in minority low-income commu...
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Frontiers Media S.A.
2025-01-01
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| author | Uriyoán Colón-Ramos Emma C. Lewis Anna Claire Tucker Lisa Poirier Chathurangi H. Pathiravasan Michelle Estradé Takeru Igusa Julia A. Wolfson Yeeli Mui Veronica Vélez-Burgess Audrey E. Thomas Shuxian Hua Lawrence J. Cheskin Lawrence J. Cheskin Antonio J. Trujillo Ayoyemi T. Oladimeji Stacey Williamson Rosalinda Romero Patricia Sánchez Hernández Joel Gittelsohn |
| author_facet | Uriyoán Colón-Ramos Emma C. Lewis Anna Claire Tucker Lisa Poirier Chathurangi H. Pathiravasan Michelle Estradé Takeru Igusa Julia A. Wolfson Yeeli Mui Veronica Vélez-Burgess Audrey E. Thomas Shuxian Hua Lawrence J. Cheskin Lawrence J. Cheskin Antonio J. Trujillo Ayoyemi T. Oladimeji Stacey Williamson Rosalinda Romero Patricia Sánchez Hernández Joel Gittelsohn |
| author_sort | Uriyoán Colón-Ramos |
| collection | DOAJ |
| description | BackgroundHigh dietary quality can protect against diet-related chronic diseases. In the United States, racial and ethnic minorities and those with lower incomes consistently exhibit lower dietary quality. Independently-owned restaurants are a common prepared food source in minority low-income communities, but there are significant knowledge gaps on how to work with these restaurants to offer healthy food, due to underlying and dynamic complexities associated with providing healthy food options.MethodsThe Focus on Restaurant Engagement to Strengthen Health (FRESH) study addresses this complex problem by leveraging systems science approaches to work with independently-owned restaurants. FRESH has two interrelated objectives: (1) to test impact on regular customer dietary quality via a multisite cluster randomized controlled trial in two low-income urban areas (Baltimore and the Washington DC metropolitan area), and (2) to use systems science approaches to develop, parameterize, and calibrate a simulation model. The intervention is theory-and practice-based, comprising three phases: restaurant engagement, low-sugar beverages and healthy meals. The FRESH intervention will be implemented for 12 months in a total of 24 intervention and 24 comparison restaurants. The study is powered to detect a 5-point change in the Healthy Eating Index (HEI) score of regular customers, which would signify a meaningful shift toward healthier eating patterns.DiscussionThe FRESH study will test a novel, multilevel, multisite intervention that aims to improve access to healthier prepared food options among small, independently-owned restaurants located in under-resourced settings. The design of the FRESH intervention and its evaluation are described, as well as plans for the development of a system dynamics simulation model for policymakers and other stakeholders to virtually test future restaurant-based interventions.Clinical trial registrationhttps://clinicaltrials.gov, identifier, NCT05869149. |
| format | Article |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-03450118008d45dcaa9bf9a178df7f8e2025-01-07T06:40:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14277921427792Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foodsUriyoán Colón-Ramos0Emma C. Lewis1Anna Claire Tucker2Lisa Poirier3Chathurangi H. Pathiravasan4Michelle Estradé5Takeru Igusa6Julia A. Wolfson7Yeeli Mui8Veronica Vélez-Burgess9Audrey E. Thomas10Shuxian Hua11Lawrence J. Cheskin12Lawrence J. Cheskin13Antonio J. Trujillo14Ayoyemi T. Oladimeji15Stacey Williamson16Rosalinda Romero17Patricia Sánchez Hernández18Joel Gittelsohn19Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Civil and Systems Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Health Education and Health Communication, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Nutrition and Food Studies, George Mason University, Fairfax, VA, United StatesDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Civil and Systems Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, United StatesColumbian College of Arts and Sciences, George Washington University, Washington, DC, United StatesDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United StatesBackgroundHigh dietary quality can protect against diet-related chronic diseases. In the United States, racial and ethnic minorities and those with lower incomes consistently exhibit lower dietary quality. Independently-owned restaurants are a common prepared food source in minority low-income communities, but there are significant knowledge gaps on how to work with these restaurants to offer healthy food, due to underlying and dynamic complexities associated with providing healthy food options.MethodsThe Focus on Restaurant Engagement to Strengthen Health (FRESH) study addresses this complex problem by leveraging systems science approaches to work with independently-owned restaurants. FRESH has two interrelated objectives: (1) to test impact on regular customer dietary quality via a multisite cluster randomized controlled trial in two low-income urban areas (Baltimore and the Washington DC metropolitan area), and (2) to use systems science approaches to develop, parameterize, and calibrate a simulation model. The intervention is theory-and practice-based, comprising three phases: restaurant engagement, low-sugar beverages and healthy meals. The FRESH intervention will be implemented for 12 months in a total of 24 intervention and 24 comparison restaurants. The study is powered to detect a 5-point change in the Healthy Eating Index (HEI) score of regular customers, which would signify a meaningful shift toward healthier eating patterns.DiscussionThe FRESH study will test a novel, multilevel, multisite intervention that aims to improve access to healthier prepared food options among small, independently-owned restaurants located in under-resourced settings. The design of the FRESH intervention and its evaluation are described, as well as plans for the development of a system dynamics simulation model for policymakers and other stakeholders to virtually test future restaurant-based interventions.Clinical trial registrationhttps://clinicaltrials.gov, identifier, NCT05869149.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1427792/fullsystems sciencerestaurantsdietary qualityfood disparitiesgroup model buildingformative research |
| spellingShingle | Uriyoán Colón-Ramos Emma C. Lewis Anna Claire Tucker Lisa Poirier Chathurangi H. Pathiravasan Michelle Estradé Takeru Igusa Julia A. Wolfson Yeeli Mui Veronica Vélez-Burgess Audrey E. Thomas Shuxian Hua Lawrence J. Cheskin Lawrence J. Cheskin Antonio J. Trujillo Ayoyemi T. Oladimeji Stacey Williamson Rosalinda Romero Patricia Sánchez Hernández Joel Gittelsohn Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods Frontiers in Public Health systems science restaurants dietary quality food disparities group model building formative research |
| title | Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods |
| title_full | Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods |
| title_fullStr | Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods |
| title_full_unstemmed | Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods |
| title_short | Design of the Focus on Restaurant Engagement to Strengthen Health (FRESH) study: leveraging systems science to work with independently-owned restaurants to increase access to and promotion of healthful foods |
| title_sort | design of the focus on restaurant engagement to strengthen health fresh study leveraging systems science to work with independently owned restaurants to increase access to and promotion of healthful foods |
| topic | systems science restaurants dietary quality food disparities group model building formative research |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1427792/full |
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