Abstract 013: Exploring Facilitators and Barriers for Personalized Dietary Incentives among Online Shoppers at Cardiovascular Risk and Key Informants to Inform an Automated Shopping Platform

The Smart Cart trial found that a personalized healthy food incentive platform (grocery incentives, education, &recipes) improved grocery purchase quality, especially among adults at cardiovascular risk. To maximize reach, it will be essential to automate the platform (Smart Cart 2.0) and to integrate stakeholder feedback before testing. This convergent, parallel mixed methods study identified facilitators and barriers to healthy eating and app acceptability and sustainability for online grocery shopping among adults at cardiovascular risk. Shoppers (age 18+, grocery shop online,&with obesity/hypertension, n=19) and key informants (health professionals, n=11) in the northeast were recruited. Shoppers completed a 20-min survey in Qualtrics and 45-min in-depth interview. Key informants completed 30-min in-depth interviews. Surveys queried sociodemographics, diet habits, and app acceptability; interview guides were developed with validated implementation science frameworks. Mock-up app images were sent before conducting Zoom-recorded interviews and participants shared experiences for themselves or their clients. Descriptive statistics were calculated with Stata; interviews were transcribed and dual-coded for thematic analysis with Atlas.ti. Shoppers were female (89%), White (63%), had a mean age of 38y; 32% were nutrition insecure. Primary barriers to healthy eating were money and time (26%), and most (55%) said health was their primary driver when shopping. There was high acceptability (>60%) for 4/5 app elements, and most wanted healthy recipes (90%). Four themes emerged from interviews:1) buying and consuming healthy foods consistently is hard- barriers related to food cost, meal planning, and tech and cultural literacy were common; 2) a one-stop shop for healthy meal planning would help -the benefits of personalized healthy recipes and ability to shop those recipes were often noted; 3) the app addresses shoppers’ short-term needs and the app’s functionality was a facilitator, and 4) some changes to the app would promote long-term sustainability. Key informants found ways the app could integrate within existing programs and how health outcome data would support app sustainability; both groups suggested new features like gamification. Smart Cart 2.0 addressed many barriers to healthy eating and app use, and participants were optimistic that it would support their diet goals. Feedback will be integrated into the app and tested in a mock shopping trial.