Nick Borja

Nick Borja

Jan 05, 2018

Group 6 Copy 459
4

Results

During the enrollment process, we introduced Nosha to 235 food pantry shoppers. A total of 103 individuals, comprising 44% of food pantry shoppers, expressed interest in Nosha and the program. Of these interested food pantry clients, 75 individuals chose to enroll in the study. Over the course of the study, 36 out of the initial 75 participants maintained active engagement with the program (Figure 1). 

The study population of 75 individuals had a mean age of 56 years, and was 58% female, 42% male. The most common ethnicity was African-American, representing 49% of the population, followed by Hispanic representing 28% of the population. Participants had an average body mass index (BMI) of 30.2, which meets criteria for obesity. The majority of participants had permanent or stable housing status. Nevertheless, 37% of the study population was unemployed and another 33% reported inability to work due to disability. Participants had an average household size of 3 individuals, and monthly income of $1010. A total of 87% of the study population met criteria for food insecurity (Table 1).

After the program ran for the full 12 weeks, nearly 20% of the study participants completed the final survey. Their self-reports on Nosha consumption showed that 50% of the respondents drank a 1/2 pouch per day, while another 43% of respondents drank a whole pouch per day. A full 64% of respondents mixed Nosha in a shaker cup with water, juice or milk, while 29% used a blender and added additional fruit. Respondents almost evenly split between drinking Nosha for breakfast and drinking it for lunch (Table 2).

Survey responses on the economic benefits of drinking Nosha showed that 50% of respondents were saving between 10-30 minutes of time per day, and another 36% of respondents saved 30-60 minutes per day. When asked about the savings in food costs related to drinking Nosha, half of respondents believed they saved $1 - $4 per day, and the other half of respondents believed Nosha led to savings between $5 - $10 per day (Table 2).

To assess the overall health impact of regularly consuming Nosha, a linear mixed-effects regression was used to compare responses given by participants at the initial survey to the responses the same participants gave in the final survey. Drinking Nosha led to a statistically significant increase in physical activity among participants (p = 0.005). Nosha consumption also significantly improved participants’ sleep quality (p = 0.002) and overall mood (p = 0.018). Nosha use did not have a measurable effect on respondents’ dietary patterns or food insecurity (Table 3).

Discussion

In this study, participants who regularly drank Nosha reported time and financial savings related to their consumption, in addition to improvements in mood, sleep, and physical activity. These findings support our hypothesis that Nosha can be an effective nutritional solution for food-insecure individuals. Nevertheless, these benefits were only found among a select group of active program participants. Limitations in our study's program design and data collection mean the benefits may only apply to a narrow segment of the total food-insecure population. Further studies are needed to determine whether Nosha can truly address food-insecurity at scale.

Despite the positive results among active participants, drinking Nosha on a regular basis did not appeal to the majority of the food pantry shoppers, as less than one-third of food pantry shoppers chose to join the Nosha program. Even for those that did join, the attrition rate was over 50% by the end of the study. This indicates that changes to the Nosha product and/or program will need to be considered in order to increase adoption rates and meet the needs of the wider food-insecure population.

Our program design had several problems. Although survey respondents unanimously agreed that receiving Nosha at the food pantry was “very convenient,” many of the inactive participants later stated they were unaware that they had a continued supply of Nosha available at the food pantry. Even though we attempted to stay in touch with all enrollees on a monthly basis, contacting participants by phone or text was unreliable, with only 20-25% of participants able to be reached through one of the two methods. We also found that many participants shopped at the pantry on a infrequent basis, which precluded them from receiving their regular allotment of Nosha pouches. Thus, we expect that a program design that includes more frequent interactions with enrollees, perhaps with a biweekly cooking and nutrition class, would produce much lower attrition rates, and much higher final survey completion.

Future studies designed to confirm our results must make use of more robust methodology to improve the data’s validity. The implementation of a control group, with random allocation of participants between treatment and control groups, would be a meaningful improvement upon the current study’s design and reduce the risk of false positives.

The study also depends on self-reporting, which has the potential for more skewing than objective data parameters. We attempted to mitigate against skewing of our data by using survey questions that were independently validated in the peer-reviewed literature. Nevertheless, future studies would benefit from collecting a breadth of objective data, including changes in measured weight/BMI, changes in inflammatory markers, cholesterol profile, insulin sensitivity, etc. These efforts could better define the particular health impacts provided by Nosha and bolster the reliability of the study findings.

In conclusion, this study represents a first attempt at ascertaining if and how Nosha might impact food insecurity. Although the results of this study are far too limited to allow for any definitive inferences, we believe the benefits enjoyed by active program participants supports the need for further research.


Acknowledgements

Development and implementation of the program was done with the support of Matthew McBryde and the CitySquare Food Pantry staff.

Solutions IRB reviewed study methodology and consent procedure.

Study data was compiled and analyzed by Robert Moulder, B.S. at the University of Virginia, Department of Psychology.

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  • LeighPJoyce
    LeighPJoyce
    Congratulations on the great work and success!
    Sep 09, 2020
  • Cindy Wu
    Cindy Wu

    Survey responses on the economic benefits of drinking Nosha showed that 50% of respondents were saving between 10-30 minutes of time per day, and another 36% of respondents saved 30-60 minutes per day. When asked about the savings in food costs related to drinking Nosha, half of respondents believed they saved $1 - $4 per day, and the other half of respondents believed Nosha led to savings between $5 - $10 per day (Table 2).

    This is very interesting.
    Jan 04, 2018
  • Cindy Wu
    Cindy Wu

    nearly 20%

    ~15 people
    Jan 04, 2018
  • Cindy Wu
    Cindy Wu

    mean age of 56 years

    It would be interesting to see the distribution!
    Jan 04, 2018
  • Cindy Wu
    Cindy Wu

    African-American

    I'm curious what the ethnicity breakdown for the original 235 food pantry shoppers.
    Jan 04, 2018
  • Cindy Wu
    Cindy Wu

    average body mass index (BMI) of 30.2

    Oo! I'm interested in seeing the distribution for BMI too.
    Jan 04, 2018
  • Cindy Wu
    Cindy Wu

    study population

    I got a bit confused here what the "study population" was, but I see now that the "study population" refers to the 75 food pantry shoppers that joined the program after trying Nosha.
    Jan 04, 2018
  • Nick Borja
    Nick BorjaResearcher
    I put the standard deviation for age and BMI in the table. Or do you mean something else?
    Jan 05, 2018
  • Cindy Wu
    Cindy Wu
    Ah I see. That's science for you!
    Jan 05, 2018
  • Cindy Wu
    Cindy Wu
    Just interested in a visual graph distribution of the BMI. Don't worry about my requests 😆 I'm just always trying to dive deeper into the data.
    Jan 05, 2018

About This Project

In the United States, hunger is commonplace. 42 million Americans struggle to get the healthy foods they need. We want to find a solution. This study will provide a convenient, nutrient-rich meal called Nosha to food pantry shoppers. The study will assess whether access to Nosha supports food security, protects resources, and contributes to the health of this at-risk population. Our findings may offer a new strategy towards closing America's widening nutrition gap.

Blast off!

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