- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06116422
Nutrition and Obesity in Under-Represented Populations: Food Insecurity Research to Advance Science and Improve Health (NOURISH)
March 20, 2024 updated by: Duke University
Nutrition and Obesity in Under-Represented Populations: Food Insecurity Research to Advance Science and Improve Health: A Multi-disciplinary Approach for Study and Mitigation of Food Insecurity and Obesity
Food insecurity is associated with obesity in children, and childhood obesity leads to long term health consequences.
While existing research shows that food benefit programs reduce food insecurity, little is known about the mediating factors between food benefit programs and child health.
The purpose of this study is to understand if the resolution of food insecurity in young children with early onset obesity can improve body mass index (BMI) over one year, and if so, by what mechanisms.
The investigators will conduct a randomized comparative effectiveness study among infants (n=228) aged 12 months at risk for food insecurity and deliver two different food security interventions.
Both will provide families with $50/week for one year of study enrollment.
The first group will receive this as an unrestricted cash benefit ("cash benefit group") and the second group will receive this as a benefit limited to grocery purchases with the support of a trained nutrition expert to guide healthy grocery purchasing ("grocery benefit group").
The investigators will also construct a contemporary comparison cohort of infants meeting the inclusion/exclusion criteria from the electronic health record, using propensity score matching to allow comparisons between both intervention groups and usual care.
The primary endpoint is difference in BMI at 12 months post-enrollment (24 months of age).
Secondary outcomes include measures of nutrition, food security, electronic health record data related to general child health, and other factors related to parental stress and unmet social needs.
Patients will have the opportunity to participate in post-study interviews to report on intervention satisfaction, and facilitators and barriers of infant feeding.
Data analysis will be conducted by a trained statistician (Duke Biostatistics, Epidemiology, and Research Design; BERD) and will employ a two-means test for a repeated-measures design.
The benefits to participants outweigh the minimal risks of loss of privacy, and confidential information will be managed carefully to minimize this risk.
Study Overview
Status
Not yet recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
228
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Janna Howard, MPH
- Phone Number: 919-620-4793
- Email: janna.howard@duke.edu
Study Contact Backup
- Name: Steph Bryant, MPH, RD
- Phone Number: 919-620-5305
- Email: stephanie.l.bryant@duke.edu
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Yes
Description
Inclusion:
- Aged 9-12 months and their primary caregiver "parent".
- Medicaid and WIC-eligible (proxy for "at risk for food insecurity")
- World Health Organization BMI ≥ 95%ile at current or most recent encounter (early-onset obesity)
- Caregiver speaks either English or Spanish as their primary language.
- Infant was born as a singleton infant at ≥ 35 weeks gestational age with birth weight ≥ 3% per the sex-specific WHO growth standard (also could use our criteria for SGA, which is <10% for Olsen reference)
Exclusion:
- Diagnosed with monogenic obesity.
- Diagnosis affecting growth or feeding (e.g., congenital heart disease, cleft lip/palate, inborn errors of metabolism, malabsorption, Prader-Willi disease, etc.)
- Current enrollment of a household member in Healthy Lifestyles, adult obesity treatment program, or active enrollment in a nutrition or obesity-related intervention
- Plans to move from the area in the next 12 months.
- Parent is currently pregnant.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Cash Benefit Group
Provides financial support weekly, in the form of an unrestricted cash benefit.
The investigators will partner with Held to provide the card to participants, load the card with $50/week for the 12 months of enrollment, and view the purchases at the vendor level using an existing dashboard Held maintains.
Participants will also receive a monthly nutrition guidance brochure tailored to the infant's developmental stage.
|
Receives financial support in an unrestricted fashion (i.e., can use the money for whatever they need).
|
Active Comparator: Grocery Benefit Group
Provides financial support weekly in the form of a grocery benefit.
The investigators will enroll participants in the Food Lion MVP program, linking the account to a Duke email address.
The study team will work with the participants to order $50 worth of groceries from Food Lion, for the participants to pick up from the store.
Groceries will be ordered weekly for the 12 months of enrollment and coordinators will have access to view items purchased at Food Lion by each participant.
|
Receives financial support restricted to the purchase of items at a grocery store, and with monthly grocery shopping coaching from a trained nutrition expert.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in BMI (Body Mass Index)
Time Frame: 1 year
|
At 12 months post-enrollment (24 months of age).
|
1 year
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Food Security
Time Frame: baseline, 3, 6, 9 and 12 months
|
As measured by an 18 item food insecurity screen to assess food insecurity levels.
|
baseline, 3, 6, 9 and 12 months
|
Change in Infant Dietary Quality
Time Frame: baseline, 6 months, and 12 months
|
As measured by the USDA multipass food recall tool (ASA24).
|
baseline, 6 months, and 12 months
|
Change in Unmet social needs
Time Frame: baseline, 6 months, and 12 months
|
Changes in social determinants of health affecting the family as measured by the HealthLeads questionnaire.
|
baseline, 6 months, and 12 months
|
Perceived stress scale
Time Frame: baseline, 6 months, and 12 months
|
As measured by a 10 item perceived stress scale for parents.
|
baseline, 6 months, and 12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
April 15, 2024
Primary Completion (Estimated)
December 31, 2025
Study Completion (Estimated)
December 31, 2026
Study Registration Dates
First Submitted
October 24, 2023
First Submitted That Met QC Criteria
October 30, 2023
First Posted (Actual)
November 3, 2023
Study Record Updates
Last Update Posted (Actual)
March 21, 2024
Last Update Submitted That Met QC Criteria
March 20, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00114248
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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