Testing the feasibility of a system-based approach to deliver a smoking cessation and food nudging intervention at food pantry sites.

Food-insecure adults disproportionately experience high cardiovascular risk. Guided by the Feeding America recommendations, we tested the feasibly of a system-based approach to address the cardiovascular risk behaviors of current smoking and dietary choice at food distribution sites. Food pantries affiliated with the Food Bank of Delaware organization (N = 14) were invited to take part. Pantries who agreed solicited personnel within the pantry (i.e., staff, active volunteers) to become trained as quit-smoking coaches and/or food environment "nudging" interventionists. After training, trained personnel implemented the evidence-based treatments. Across a 6-month observation period, quit coaches reported each month on the number of (a) enrolled food pantry clients, (b) total quit-smoking sessions scheduled and attended, and (c) the smoking status of clients who attended the final, third session. Trained evaluators visited participating pantries once per month across the observation period to assess adherence to nudging guidelines. One in five (21%; 3/14) invited pantries participated in the study, and five personnel were trained to deliver intervention components. Across the observation period, quit coaches reported that 86 new smoking cessation clients were enrolled, 228 quit coaching sessions were scheduled, and 187 attended (82% attendance rate). Smoking cessation rates were estimated at 19%-36%. A 100% adherence to the food nudging approach was observed. These data demonstrate the feasibility of a system-based approach to build the capacity of food distribution sites and personnel to deliver smoking cessation quit-coaching and food nudging interventions on-site.