Grocery Delivery of Healthy Foods to Pregnant Young Women With Low Incomes: Feasibility and Acceptability Mixed Methods Study

Background: Poor maternal diets increase the risk of excess gestational weight gain which can contribute to serious intergenerational morbidity for both the mother and infant. Pregnant young women with low incomes have disproportionately high rates of inadequate fruit and vegetable consumption as well as excess weight gains during pregnancy.

Objective: Our aim was to describe the feasibility and acceptability of Special Delivery, a longitudinal nutrition intervention that delivers healthy foods to pregnant youth (aged 14-24 years) with low incomes.

Methods: The Special Delivery pilot study, conducted in Michigan, enrolled pregnant young women with low incomes. Study participants were sent twice-monthly grocery deliveries consisting of US $35 worth of healthy foods, primarily fruits and vegetables. Between grocery deliveries, participants received daily SMS text message prompts to confirm receipt of delivery and document diet and weight. Program feasibility was assessed by the number of grocery orders placed, delivered, and confirmed by participants. Qualitative interviews and SMS text message data were used to determine acceptability by assessing participants' perspectives on grocery delivery, participants' perspectives on dietary impact of the program, and foods consumed by participants.

Results: A total of 27 participants were enrolled in the pilot study. The mean age was 20.3 years (SD 2.0), and 59.3% (16/27) were African American or Black. During the pilot, 263 deliveries were sent with 98.5% (259/263) successful deliveries and 89.4% (235/263) deliveries confirmed by participants. Participants reported that grocery delivery was convenient; that delivered foods were high quality; and that the program improved their diet, increased access to healthy foods, and promoted healthy habits during pregnancy.

Conclusions: A grocery delivery-based weight gain and nutrition intervention is both feasible and acceptable among low-income pregnant youth. Grocery deliveries were successfully completed and participants were willing and able to receive grocery deliveries, eat the healthy foods that were delivered, and communicate via SMS text message with study coordinators. The Special Delivery program warrants further evaluation for efficacy in promoting healthy weight gain for low-income youth during pregnancy.