Advancing North Shore Community Health Through Ocean-raised and faRm-grown Foods (ANCHOR Study)

• Medically supportive meal kits (Behavioral), also known as Medically supportive groceries, Food is Medicine, Meal kits: Participants in this single-arm pilot study will receive a nutrition-focused meal kit intervention delivered through a community food pantry. Over a 12-week period, participants will receive three meal kits per week during their regular pantry visits. Each meal kit includes fresh produce, locally sourced seafood, and pantry staple ingredients (e.g., grains, seasonings), bundled together with simple, culturally relevant recipes designed to support preparation of healthy meals at home. In addition to meal kit distribution, participants will be invited to attend optional onsite cooking demonstrations led by community partners, which provide hands-on guidance for preparing the recipes and using the provided ingredients. Participants will also complete a baseline and follow-up survey, and a subset may be invited to participate in focus groups to share feedback on their experience with the program.

Primary outcomes

• Feasibility and Acceptability of Medically Supportive Meal Kit Program [From enrollment to the end of the study (end of 12-weeks)]: The primary outcome assesses whether providing meal kits with locally sourced seafood and produce through a food pantry is practical and well-received. This includes measures such as participation and retention rates, adherence to receiving meal kits, and participant feedback on satisfaction, ease of use, and cultural relevance of the meal kits and materials.

Other outcomes

• Food security [From enrollment to the end of the study (end of 12-weeks)]: Changes in participants' ability to reliably access enough food for an active, healthy life, measured using a standardized food security survey (USDA 6-item module).
• Nutrition Security [From enrollment to the end of the study (end of 12-weeks)]: Changes in consistent access to foods that support health and prevent disease, assessed using a brief validated screening tool (Tufts Nutrition Security Screener) focused on access to nutritious foods.
• Cooking & Food Preparation Skills [From enrollment to the end of the study (end of 12-weeks)]: Changes in participants' confidence and ability to prepare meals at home, including using new ingredients and following recipes, assessed through validated cooking skills measures using Lavalle et al. 2017.
• Engagement in Nutrition Education [From enrollment to the end of the study (end of 12-weeks)]: Participant exposure to and engagement with educational components, including attending cooking demonstrations and using recipes or educational materials provided with the meal kits.
• Diet quality [From enrollment to the end of the study (end of 12-weeks)]: Changes in overall dietary patterns and alignment with healthy eating recommendations, measured using a validated diet quality instrument (e.g., MINI-EAT).

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

Participants must meet all of the following:

* Be 18 years of age or older
* Be a client of The Open Door food pantry in Gloucester, MA
* Be able to provide informed consent

Exclusion Criteria:

* Under age 18
* Unable to provide informed consent
* Have a food allergy, medical condition, or dietary restriction that makes it unsafe to eat the study foods (e.g., seafood or milk allergy, liquid diet)
* Another member of the same household is already participating (only one participant per household)
* Planning to move out of the area within the next 4 months
* Previously participated in a healthy meal kit program at The Open Door
* Do not have reliable transportation to pick up meal kits

• Kelseanna Hollis-Hansen, PhD, MPH, Principal investigator, Tufts University