Multi-Level, Multi-Perspective Formative Research to Develop a Mobile Application to Improve Healthy Food Access in Low-Income Urban Settings

Abstract

Abstract Objectives Small urban corner stores typically have low access to healthy foods to stock due to an inadequate food distribution system. Strategies to increase access to healthier foods are needed in low-income urban settings where consumers depend on these stores to meet their main food shopping needs. We conducted multi-level, multi-perspective formative research and user-centered design to inform the development of the Baltimore Urban food Distribution (BUD) mobile application (app), which aims to provide a sustainable, cost-effective, and culturally-acceptable strategy for purchasing and delivering fresh produce to corner stores through local suppliers within the Baltimore City food system. Methods In-depth interviews (N = 36) were conducted across multiple stages of formative research with increasing refinement of the BUD app design. Stakeholders included producers (n = 5), wholesalers (n = 12), representatives of city agencies (n = 4), and corner store owners (n = 15). Future research will include community members. Data were collected regarding participants’ role within the local food system and feedback was elicited during a researcher-led demonstration of a prototype app. Results Stakeholders at multiple levels of the food system found the BUD app to have high feasibility (acceptability, operability, perceived sustainability). In-depth interviews revealed that suppliers (producers, wholesalers) were willing to use the app but had concerns about transportation and storage of produce. Corner store owners desired features such as in-app collaborative purchasing and low-cost delivery. City agency representatives emphasized the need to focus on promotion of local suppliers. Limitations included language barriers and payment security. Strengths included options for networking within the app. Conclusions The BUD app aims to provide a digital solution to address a critical gap in the food distribution system in a low-income urban setting. Multi-level, multi-perspective formative research that is user-centered is a crucial first step to developing a feasible app that appropriately addresses the needs of the community. Future research demonstrating the BUD prototype to stakeholders will enable further development of the app for use in Baltimore and other cities nationwide. Funding Sources NHLBI, NIH, award number R34HL145368.