Healthy Options At Pantries (HOAP) Study (HOAP)

Community-engaged Design and Implementation of a Behavioral Economics Food Choice Intervention in Food Pantries to Improve Cardiovascular Health

This study will evaluate a digital nudge intervention, Healthy Options At Pantries (HOAP), in the online food pantries of three large charitable food organizations. The study will use a hybrid effectiveness-implementation design, meaning it will evaluate whether the intervention works and how it can best be rolled out in an online food pantry setting. Intervention effectiveness will be evaluated using an interrupted time series analysis to identify changes in how healthy foods ordered by shoppers are (primary outcome) by comparing food ordering data over time before and after HOAP is introduced. The study will also evaluate the possibility of collecting dietary and clinical outcomes in a small subgroup of online pantry shoppers over time comparing both in-person and at-home approaches.

Study Overview

• Status: Not yet recruiting
• Conditions: Food Insecurity; Diet, Healthy; Behavioral Economics; Implementation Science; Food Choice
• Intervention / Treatment: Behavioral: Behavioral economics-based Healthy Options At Pantries (HOAP) digital nudge intervention

Detailed Description

This study will pilot and evaluate the Healthy Options At Pantries (HOAP) digital nudge intervention that was co-designed by pantry shoppers to encourage healthier food choices in online food pantries. We will evaluate the preliminary effectiveness of HOAP using an interrupted time series (ITS) to determine if HOAP implementation is associated with healthier online pantry orders by shoppers across three community organizations who operate online food pantries. The ITS analysis will compare 6 months of pre-intervention data to 6 months of during-intervention data to assess changes in food selection. The primary outcome is the healthfulness of items ordered by shoppers. In addition, we will qualitatively identify implementation factors that influence intervention success, including facilitators and barriers. We will also assess the feasibility and acceptability of longitudinally collecting diet quality, blood pressure, body composition, and weight data in 30 pantry shoppers comparing in-person and remote approaches to data collection over a 6- to 12-month period. Feasibility outcomes will include data completeness and acceptability of data collection procedures.

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Emily Research Study Coordinator, MS; Phone Number: 312-503-4917; Email: emily.romero@northwestern.edu

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Northwestern University
      • Contact: Emily Research Study Coordinator, MS; Phone Number: 312-503-4917; Email: emily.romero@northwestern.edu
      • Principal Investigator: Jenny Jia, MD, MSc

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Eligibility Criteria:

• Adults age 18 years or older
• Speak English or Spanish
• Access to a smartphone
• Have ordered from the online food pantry at least half of the available times over the past 6 pantry eligible periods (for example, at least 3 times in the past 6 weeks for online food pantries that allow weekly ordering or at least 3 times in the past 6 months for online food pantries that allow monthly ordering), during the 6-month period prior to implementation of the HOAP program (i.e., months -6 to -1)
• Plan to continue ordering from the online food pantry for the next 6 months

Exclusion Criteria:

• Weigh more than 300 pounds
• Have a pacemaker, defibrillator, or other cardiac implant
• Plan to move out of metro Chicago in the next 6 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: HOAP Intervention Cohort; Online pantry shoppers will receive the behavioral digital nudge intervention informed by the Healthy Eating Research guidelines. Nudges include: 1) traffic light labeling of foods as green (choose often), yellow (choose sometimes), or orange (choose rarely) based on levels of saturated fat, sodium, and added sugar, displayed using colored dots and borders; 2) traffic light filters for food items; 3) choice architecture to display healthier items first; 4) a nutrition summary bar to display the number and proportion of items in cart by traffic light color; and 5) opt-out healthy default nudges styled as Healthy Bonus Items. A subgroup of adult shoppers will participate in a feasibility study comparing in-person to remote collection of dietary and clinical outcomes. Subgroup participants will complete ASA24 diet recalls and provide blood pressure, weight, and body composition measurements.

Behavioral: Behavioral economics-based Healthy Options At Pantries (HOAP) digital nudge intervention; Intervention will include behavioral digital nudges over a 6-month period to promote healthier food selection among online food pantry shoppers.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Healthfulness of Shopper Food Selection	The primary outcome is change in the healthfulness of shopper food selection over time, measured using the Charitable Food Network Index (CFNI). At each time point, food orders will be categorized into proportions of green, yellow, and orange items based on the Healthy Eating Research (HER) guidelines. These proportions will be combined into a composite CFNI score. CFNI scores range from 0 to 100, with higher scores indicating healthier overall food selections.	6 months pre-intervention and 6 months post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diet quality	Diet quality will be measured through up to two 24-hour dietary recalls using the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24).	3-6 months pre-intervention and 3-6 months post-intervention
Blood Pressure	Blood pressure will be measured using an automated blood pressure cuff. Blood pressure will be systolic and diastolic measures in mmHg. At each collection point, three blood pressure measurements will be obtained, and the average of the second and third measurements will be used for analysis.	3-6 months pre-intervention and 3-6 months post-intervention
Body Weight	Body weight will be measured in pounds using a medical-grade scale.	3-6 months pre-intervention and 3-6 months post-intervention
Body Composition	Body composition measures will include body fat percentage (range: 5-60%), visceral fat level (range: 1-30, lower values indicate lower visceral fat), and skeletal muscle percentage (range: 5-50%).	3-6 months pre-intervention and 3-6 months post-intervention

Collaborators and Investigators

• Sponsor: Northwestern University
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI)
• Investigators: Principal Investigator: Jenny Jia, MD, MSc, Northwestern University

Publications and helpful links

General Publications

• Schwartz M, Levi R, Lott M, Arm K, Seligman H. Healthy Eating Research Nutrition Guidelines for the Charitable Food System. Healthy Eating Research. Accessed Oct 7, 2021. https://healthyeatingresearch.org/wp-content/uploads/2020/02/her-food-bank_FINAL.pdf
• Gombi-Vaca MF, Xu R, Schwartz M, Battista Hesse M, Martin K, Caspi CE. Validating a Nutrition Ranking System for Food Pantries Using the Healthy Eating Index-2015. Nutrients. 2022 Sep 21;14(19):3899. doi: 10.3390/nu14193899.

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): January 31, 2028
• Study Completion (Estimated): March 31, 2029

Study Registration Dates

• First Submitted: July 22, 2026
• First Submitted That Met QC Criteria: July 22, 2026
• First Posted (Actual): July 27, 2026

Study Record Updates

• Last Update Posted (Actual): July 27, 2026
• Last Update Submitted That Met QC Criteria: July 22, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Body composition; Blood pressure; Diet quality; Weight; Food insecurity; Digital nudges
• Additional Relevant MeSH Terms: Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Body Weight
• Other Study ID Numbers: STU00221030; K23HL173655 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data that underlie the results of this study will be shared. De-identified study data will be made available to the research community through the Inter-university Consortium for Political and Social Research (ICPSR), an open-access data repository.
• IPD Sharing Time Frame: Shared data will be made available as soon as possible, and no later than the time of publication or the end of the funding period. Data will be available for at least 7 years thereafter.
• IPD Sharing Access Criteria: All de-identified study data will be made available through ICPSR as public-use data without restriction.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No