A Cluster-Randomized Evaluation of the SuperShelf Intervention in Choice-Based Food Pantries

Abstract

Background Interventions in food pantry settings have the potential to improve health among clients at risk of diet-related disease. Purpose This study evaluates whether a cluster-randomized, behavioral intervention in food pantries resulted in improved client outcomes. Methods Sixteen Minnesota food pantries were randomized to an intervention (n = 8) or control condition (n = 8). The intervention offered pantries technical assistance to improve healthy food supply and implement behavioral economics strategies to promote healthy food selection. A convenience sample of adult clients were enrolled (paired sample, 158 intervention, 159 control) and followed for 1 year. Additional clients were enrolled at follow-up to assess food selection (follow-up sample, 85 intervention, 102 control). Analysis was limited to data from 11 pantries (5 intervention, 6 control) due to COVID-19. Outcome measures included Healthy Eating Index-2015 (HEI-2015) total and subcomponent scores for 24-hr dietary recalls and client cart selections, and Life’s Simple 7 (LS7) total and subcomponent scores. Multilevel mixed-effects models tested whether client outcomes differed by intervention condition. Results In adjusted models, there were no statistically significant differences by intervention condition in HEI-2015 or LS7 scores. Clients in intervention food pantries had improved Refined Grain subcomponent scores (p = .004); clients in control pantries had worsened Saturated Fat subcomponents scores (p = .019) and improved physical activity scores (p = .007). Conclusions The intervention did not result in improved diet quality or cardiovascular health as measured by HEI-2015 or LS7. Coordinated efforts across settings are needed to address health risks facing this population.

Effect of a Multicomponent Food Pantry Intervention in Client Subgroups

“…This secondary analysis used data from the SuperShelf group-randomized, controlled trial (NCT03421106) [ 21 ]. Eligible food pantries were full “client-choice”, meaning clients could select any foods from the food pantry, akin to commercial stores, had staffing for SuperShelf activities, and were in Minnesota.…”

“…SuperShelf was a site-randomized evaluation of a food pantry intervention to improve healthy food inventory and promote healthy choices [ 21 ]. To encourage clients to choose and consume healthier foods, the SuperShelf team worked with food pantries to maximize healthy sourcing to increase availability of healthy groceries and applied choice architecture to pantry shopping spaces to increase accessibility and visibility of healthy groceries.…”

Construct validity of the Charitable Food Nutrition Index

“…This study is a secondary analysis using data collected in a group-randomized intervention study of food pantries in Minnesota ( Caspi et al, 2023 , SuperShelf: Evaluation, n.d. ). The pre-intervention (baseline) data were collected in two waves in 2018 and 2019, and the post-intervention (follow-up) data were collected at each pantry one year after the pre-intervention measure.…”

“…SuperShelf was a behavioral economics intervention that aimed to transform food pantries (known as “food shelves” in Minnesota) by creating welcoming environments and greater access to a variety of appealing, healthy foods ( Caspi et al, 2023 , SuperShelf, n.d. ). The intervention components were community-led and supported by early evidence that behavioral economics is an effective strategy to increase healthy food selection ( Caspi et al, 2019 , Wilson et al, 2017 ).…”

“…Participating pantries were located in Minnesota and were required to have “full client-choice”, meaning a food distribution process in which food from all food groups was displayed on shelves for clients to select or decline ( Caspi et al, 2023 , Caspi et al, 2022 , Caspi et al, 2021 ). The selected pantries were placed into pairs prior to randomization based on region and urbanicity using Rural-Urban Commuting Area (RUCA) Codes 1–10 ( USDA ERS - Rural-Urban Commuting Area Codes, n.d. ).…”