Research Description
Maintaining a healthy diet is the cornerstone for the management of diabetes. However, the modern food environments pose challenges to selecting a healthy diet, especially for those with low income, who often face barriers such as limited physical access or transportation to grocery stores, lack of nutrition literacy, and financial and time constraints. Online retail can help address these barriers by reducing access, transportation, and time barriers while also leveraging the online format to nudge and incentivize healthier food choices. The increased popularity of online grocery shopping and the rapid expansion of the SNAP online purchasing program presents an opportunity to develop and test novel digital technologies and financial incentives to promote healthier food choices, improve diet, and support diabetes management among low-income Americans with diabetes. This study will design and evaluate interventions specifically tailored to address the needs of this important population, delivered through a highly scalable online retail setting. The learnings from this project have the potential to address several of the social and structural barriers to accessing healthy foods and maintaining a healthy diet, especially for the most vulnerable populations with diabetes.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?Adhering to a healthy diet is fundamental for effectively managing diabetes. Individuals of low socioeconomic status, particularly participants in the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) are disproportionally burdened by poor diet and diabetes. Notably, compared to income-matched Americans not on SNAP, SNAP recipients have less optimal nutrition and a higher risk of diabetes and diabetes-related mortality. Innovative, sustainable, and scalable strategies are needed to address some of the major barriers to healthy eating among SNAP recipients, such as limited physical access or transportation to grocery stores, lack of nutrition literacy, and financial and time constraints to improve diet quality, advance nutrition security, and improve equity in diabetes health. The rapid rise of online grocery shopping and concomitant rapid expansion of online SNAP EBT provides a timely, high-impact opportunity to develop and test interventions leveraging online retail to address persistent diet-related diabetes disparities by promoting healthier food choices in SNAP. This project will develop, implement, and evaluate intervention strategies integrated into the real-world online grocery retail setting to promote healthier food purchases, improve diet, and improve health outcomes among diabetes patients receiving SNAP benefits. The learnings from this project have the potential to address several of the social and structural barriers to accessing healthy foods and maintaining a healthy diet, especially for the most vulnerable populations with diabetes.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?Prior research has identified promising interventions for promoting healthier food choices and improving diets among low-income individuals, including financial incentives for healthy foods, nutrition education, and behavioral nudges. We will integrate these strategies into real-life online grocery retail settings, and tailor them to address the diverse needs of diabetes patients with low socioeconomic status. Ultimately, this research will generate key evidence that can help diabetes patients with low socioeconomic status to navigate healthier food choices, achieve nutrition security, and improve diabetes management. This research also serves as an exploration of collaboration pathways between academics and industry for promoting healthier food choices in online grocery settings, which is an important step toward establishing a healthier food environment that promotes the prevention and management of diabetes, while also improving equity.
Why important for you, personally, to become involved in diabetes research? What role will this award play?My interest in diabetes research and the proposed project stems from both professional and personal experiences. My research experience has established my understanding of the striking health and economic burdens of diet-related chronic diseases, as well as the health disparities driven by inequalities in dietary quality among socio-economic subgroups. My research also highlighted the potential for mitigating these burdens through nutrition programs that simultaneously address the nutrition and social needs of populations with low socioeconomic status. Recognizing diabetes as a paramount public health challenge, wherein maintaining a healthy diet is crucial for daily disease management and health outcomes are highly responsive to dietary interventions, I am driven to translate my knowledge into the field of diabetes research. My firsthand experience navigating the challenges of adhering to a healthy diet during gestational diabetes further drives me to envision environmental changes in our daily lives that can make healthy food choices easier. This ADA-funded research will bring together the complementary background and expertise of my mentor and key collaborators to enable me to build upon my current skills and obtain additional training and expertise in mixed-method research, consumer behavior theories, and the design and implementation of clinical trials. By opening up new research avenues, this initiator award will facilitate my growth as an independent investigator with my niche in line with my combination of interests. My overarching goal is to use my interdisciplinary skills and expertise to translate evidence from nutrition and behavioral science to the prevention and control of type 2 diabetes.
In what direction do you see the future of diabetes research going?I believe one major direction for the future of diabetes research will be in addressing the role of nutrition and social determinants of health--major contributors to health inequities in diabetes. There is a necessity for research aimed at conceiving, implementing, and evaluating novel, sustainable, and scalable strategies to tackle the social and structural barriers to achieving healthy eating and effective diabetes management, particularly among the most vulnerable population. Moreover, collaborative efforts of various stakeholders from the academy, patients, industry, and government are needed to ultimately create a social and food environment that supports the prevention and treatment of diabetes.