Penn Medicine Food Market Study

NCT06283394 | Active Not Recruiting

• 1 other identifier: 854803
• Study Type: interventional
• Target: 214
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this interventional study is to test ways to improve the effectiveness of a healthy foods prescription program in increasing the purchase of healthy foods for patients who have both obesity (BMI \>or= 30) and diabetes (last A1C\>8 in the 90 days from data pull). The main questions it aims to answer are: Aim 1: Examine feasibility and engagement among participants by assessing percent enrollment among those identified as eligible, rates of Instacart platform use, amount of the subsidy used each week, and amounts of healthy foods ordered. Aim 2: Examine strategies to optimize the user experience of trial participation, including communication strategies and on-boarding, to increase uptake and engagement in this and subsequent studies. Usual Care (Control): Participants in the usual care arm will not receive weekly subsidies on Instacart, and they will not receive any modifications to the virtual storefront on Instacart. They will have access to the standard Instacart platform and Instacart + memberships with $5 per week to cover service and delivery fees and delivery tips for 3 months. Intervention Arms: The four treatment groups will also each receive a $160 subsidy per month for 3 months to be used on produce (fruits and vegetables).

Conditions

Obesity; Diabetes

Outcome Measures

Primary Outcomes (1)

• The primary outcome will be the total expenditures spent on fruits and vegetables (dollars spent inclusive of application of subsidies)

  The primary outcome will be the total expenditures spent on fruits and vegetables (dollars spent inclusive of application of subsidies)

  At the end of the 3 month intervention

Secondary Outcomes (3)

• Mean percentage of the $160 subsidy used each month in the intervention arms.

  At the end of the 3 month intervention

• Change in hemoglobin A1c

  At the end of the 3 month intervention

• Percentage of expenditures spent on eligible fruits and vegetables

  At the end of the 3 month intervention

Study Arms (5)

Usual Care

NO INTERVENTION

Participants in the usual care arm will not receive weekly subsidies on Instacart, and they will not receive any modifications to the virtual storefront on Instacart. They will have access to the standard Instacart platform and Instacart + memberships with a $5 per week to cover service and delivery fees and coverage of delivery tips for 3 months.

Non Choice Architecture (Arm A)

EXPERIMENTAL

Arm A will receive a $160 subsidy per month for 3 months to be used on healthy foods (fruits and vegetables, whole grains, etc.). They will see the Instacart storefront without choice architecture manipulation and will see the discount applied at checkout. They will have Instacart + memberships for 3 months.

Behavioral: Fresh Funds

Choice Architecture (Arm B)

EXPERIMENTAL

Arm B will receive a $160 subsidy per month for 3 months to be used on healthy foods (fruits and vegetables, whole grains, etc.). They will see a storefront with choice architecture manipulation (healthy items for diabetics appear first and less healthy items are less visible) and will see the discount applied at checkout. They will have Instacart + memberships for 3 months.

Behavioral: Storefront Choice Architecture; Behavioral: Fresh Funds

Non Choice Architecture + Loss Framing (Arm C)

EXPERIMENTAL

Arm C will receive a $160 subsidy per month for 3 months to be used on produce.They will see the usual Instacart storefront and will see the discount applied at checkout. They will also receive text messages detailing how much of their $160 subsidy is left (beginning of weeks 1, 2, 3, and 4 and following the end of the month). They will have Instacart + memberships.

Behavioral: Fresh Funds; Behavioral: Loss Framing

Choice Architecture + Loss Framing (Arm D)

EXPERIMENTAL

Arm D will receive a $160 subsidy per month for 3 months to be used on produce. They will see a storefront with choice architecture manipulation (healthy items for diabetics appear first and less healthy items are less visible) and will see the discount applied at checkout. They will also receive text messages detailing how much of their $160 subsidy is left (as in arm C). They will have Instacart + memberships.

Behavioral: Storefront Choice Architecture; Behavioral: Fresh Funds; Behavioral: Loss Framing

Interventions

Fresh Funds BEHAVIORAL

The treatment groups will each receive a $160 subsidy per month for 3 months to be used on produce through Instacart.

Choice Architecture (Arm B); Choice Architecture + Loss Framing (Arm D); Non Choice Architecture (Arm A); Non Choice Architecture + Loss Framing (Arm C)

Storefront Choice Architecture BEHAVIORAL

An Instacart storefront with choice architecture manipulation (healthy items for diabetics appear first and less healthy items are less visible)

Choice Architecture (Arm B); Choice Architecture + Loss Framing (Arm D)

Loss Framing BEHAVIORAL

They will receive text messages detailing how much of their $160 subsidy is left (beginning of weeks 1, 2, 3, and 4 and following end of the month).

Choice Architecture + Loss Framing (Arm D); Non Choice Architecture + Loss Framing (Arm C)

Eligibility Criteria

• Age: 30 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Between the ages of 30 and 70
• Patients in the Penn Medicine system who have obesity (BMI\>or=30) and diabetes (last A1C\>8 in the 90 days prior to data pull)
• Self-report being comfortable online shopping
• Have a backup payment option available to use in registering for Instacart

You may not qualify if:

• Not fluent in English
• Opted out of research
• The patient does not have a Primary care provider assigned
• The patient is part of a Penn primary care practice engaged with the Healthy Heart Program

Sponsors & Collaborators

• University of Pennsylvania: lead

Study Sites (1)

The University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

• Hua SV, Klaiman T, Coratti S, White J, John A, Putt ME, Dixon E, Posner H, Volpp KG. Using a human-centered design framework and behavioral economic interventions to increase fruit and vegetable purchases in an online grocery store: Study design and methodologies. Contemp Clin Trials. 2025 Jun;153:107921. doi: 10.1016/j.cct.2025.107921. Epub 2025 Apr 17.

  PMID: 40252826 DERIVED

MeSH Terms

Conditions

Obesity; Diabetes Mellitus

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases

Study Officials

• Kevin Volpp, MD,PhD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 21, 2024
• First Posted: February 28, 2024
• Study Start: August 1, 2024
• Primary Completion: May 1, 2025
• Study Completion (Estimated): December 21, 2026
• Last Updated: April 28, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)