Grocery Delivery and Healthy Weight Gain Among Low-income Pregnant Young Women

University of Michigan

Status: Enrolling

Conditions: Weight Gain; Pregnancy

Treatments: Behavioral: Grocery delivery; Behavioral: Unsweetened beverage delivery

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05000645

HUM00190614

1R01HD101522 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This project will increase knowledge about how a simple intervention, grocery delivery, impacts weight gain and diet among low-income pregnant young women. Results can then be used to support other pregnant young women.

Full description

The overall aim of this study is to determine whether an intervention that facilitates receipt of healthy food and unsweetened beverages will promote healthy weight gain and improve diet quality among pregnant young women age 14-26 living in Michigan. This hypothesis will be tested in a three-arm randomized controlled trial (RCT) using a parallel design; Arm 1: Usual WIC (Control), Arm 2: Usual WIC + Delivery of WIC-approved food, Arm 3: Usual WIC + Delivery of WIC-approved food PLUS unsweetened beverages. Three arms are necessary because our goal is to make three distinct comparisons. First, we need to determine the effect of food delivery (Arm 2) compared to usual WIC (Arm 1). Second, we need to determine the combined effect of food plus unsweetened beverage delivery (Arm 3) compared to usual WIC (Arm 1). Finally, we need to evaluate the effect of food delivery (Arm 2) compared with food plus unsweetened beverage delivery (Arm 3) to determine the individual impact of replacing SSBs, a major contributor to excessive pregnancy weight gain in our population. Our study does not assess the impact of delivering only unsweetened beverages compared to usual WIC because the potential policy implication is the delivery of WIC benefits. A widespread program that only delivers unsweetened beverages is not likely.

Upon completion of baseline screening and assessments, 570 pregnant young women will be randomly assigned to either the control group or one of the two experimental groups. Enrollment in the study is rolling and starts as early as possible in the pregnancy (must be before 21 weeks gestation). The intervention period begins at enrollment and continues to the end of pregnancy/birth. Thus, each participant will be enrolled for approximately seven months post-randomization. During the intervention period, all groups will receive usual WIC food, nutritional assessment, and counseling benefits, including monthly intensive nutritional counseling sessions based on a state-approved curriculum with trained nutritionists and peer counselors.

• The control group (Arm 1) will receive usual WIC counseling and food benefits loaded onto their electronic benefits card (EBT) for them to use in person at approved grocery stores.
• The first experimental group (Arm 2) will receive usual WIC counseling and food benefits, as well as twice-monthly home deliveries of WIC-approved foods.
• The second experimental group (Arm 3) will receive usual WIC counseling and food benefits as well as twice-monthly home deliveries of WIC-approved foods PLUS unsweetened beverages to replace their current SSB intake.

The primary outcome is weight gain during pregnancy as defined by the Institute of Medicine (IOM)/National Academy of Medicine (NAM) Guidelines. Secondary outcomes include Healthy Eating Index (HEI) scores and dietary intake of fruits, vegetables, whole grains, and SSBs; infant birth weight; and prenatal and delivery complications identified through postpartum medical record review (e.g., small/large for gestational age, gestational diabetes, hypertensive disorders, operative delivery).

Enrollment: 570 estimated patients

Sex: Female

Ages: 14 to 26 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Gestational age ≤ 20 weeks
• Text message capability
• Healthy singleton pregnancy
• Nulliparous
• Consume sugar sweetened beverages (SSBs)
• Living within delivery zone of a grocery delivery service

Exclusion criteria

• Non-English speaking
• Participants who live at the same address
• Physical, mental, or cognitive handicaps that prevent participation
• High risk pregnancy requiring specialized care (including pre-existing diabetes)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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570 participants in 3 patient groups

Women, Infants, and Children (WIC)

No Intervention group

Description:

Usual WIC counseling and food benefits for use in person at approved grocery stores.

WIC + grocery delivery

Experimental group

Description:

Usual WIC counseling and food benefits, as well as twice-monthly home deliveries of WIC-approved foods.

Treatment:

Behavioral: Grocery delivery

WIC + grocery delivery + unsweetened beverage delivery

Experimental group

Description:

Usual WIC counseling and food benefits as well as twice-monthly home deliveries of WIC-approved foods PLUS unsweetened beverages to replace their current sugar-sweetened beverages (SSB) intake.

Treatment:

Behavioral: Unsweetened beverage delivery

Behavioral: Grocery delivery