Comparative Effectiveness of Pulse Promotion Strategies Using Multiphase Optimization: A Pilot Study
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Healthy dietary patterns, including pulse consumption, are associated with decreased risk of chronic diseases. Pulse consumption is low in Canada, therefore there is interest in increasing pulse consumption among Canadians. Changing diet patterns require multicomponent strategies. The multiphase optimization strategy (MOST) is a framework that researchers use to systematically examine interventions that attain desired outcomes given limitations. The aim of this study was to identify the intervention components as well as possible moderators and mediators in promoting pulse consumption by using the consensus process and completing a pilot test to assess the feasibility of the intervention components and their effect on intention to try pulses and pulse consumption. A consensus meeting with 14 stakeholders was used to determine possible mediators, moderators and to identify important interventions in pulse consumption. Results of the consensus meeting were used to develop the study questionnaires, and cognitive interviews were used to assess the validity of the questionnaires. During the pilot phase, 16 participants between 21-57 years old were assigned to one of 16 experimental conditions in a fractional factorial design. Food literacy, time constraints, food habits, health cognitions, family food culture, intrinsic product attributes, demographic characteristics, and exposure to food promotion were determined as the most important factors associated with pulse consumptions. The most promising interventions voted by stakeholders were meal kits, promotional activities, reward programs, and convenience packaging. Suggested interventions were modified to be applicable for this pilot study, including taste testing, cash incentives, cookbooks, Facebook discussion group, and diet counselling. Results of the pilot study showed that none of the interventions had any significant effect on intention to try pulses, confidence to cook pulses, and pulse consumption. Interventions were feasible to implement except for peer support through the Facebook group, and cash incentives. Among the different methods used in data collection, submitting receipts was not feasible. As part of the MOST framework, the critical preparation phase was completed. The results of the feasibility pilot study informed critical decisions about inclusion criteria, delivery, implementation, frequency and content of the interventions, and data collection before using them in a fully powered factorial optimization trial.