Baltimore Healthy Carryouts

BHC Logo


  • Seung Hee Lee, PhD, MS, LD


The Goal of Baltimore Healthy Carryouts (BHC) project is to develop, implement and evaluate a culturally appropriate multi-component carry-out intervention to reduce risk factors for diet-related chronic diseases in a low income urban setting. BHC was funded by the Diabetes Research & Training Center and the Center for a Livable Future.

Primary Aims

  • Conduct formative research on the availability, pricing and consumption of carry-out foods

  • Develop and test interventions

  • Develop and pilot instruments to assess the efficacy of environmental interventions in carry-outs

Project Features

The intervention trial utilizes a systems-based approach to test and evaluate multilevel structural interventions.
Our trial will:

  1. improve the healthy food supply chain from wholesalers, to small stores/carryouts, to consumers;
  2. create cost-effective partnerships between small urban food source owners and wholesalers,
  3. develop strategies to increase individual and retailer demand for healthy foods,
  4. reveal barriers and enhancing factors to scaling up these interventions city-wide via policy changes, and
  5. provide the evidence and data needed to develop and refine multi-level obesity-prevention systems-models, enhance GIS mapping systems of the urban food environment.

The federal government has recently tested programs to further subsidize costs of specific foods within existing programs, such as SNAP. It is crucial to understand how stakeholders can work together to maximize the impact of such discounts, and to determine ways to enhance consumer demand for healthy foods.

Phases of Research

Phase Date Phase Name Description of Each Phase
2/7 ~ 3/6
Baseline Collected baseline demographic information from the customers
3/7 ~ 5/1
Environmental change – Replaced existing menu boards with new boards which emphasized healthier foods with full-color photographs and menu labeling
– Provided owners with paper menus and visual materials
Healthy sides and new cooking methods – Promoted already-existing healthy sides (Ex. bottled water) using posters
– Introduced cost-neutral, culturally-appropriate healthy sides and beverages
– Provided initial stocks of healthy sides when owners were reluctant to purchase
Healthy combo meals and new preparation methods – Promoted healthy combo meals of equal or lesser price than original combo meals
– Changed food preparation and cooking methods (Ex. introduced low-fat mayonnaise as a substitute for regular mayonnaise)
– Added menu entrées using healthy food preparations (Ex. Grilled chicken instead of fried chicken)


Jeffries J, Lee SH, Frick K, Gittelsohn J. Preferences for Carry-Out Meals in Low-Income Neighborhoods of Baltimore City. Health Promotion & Practice. Published online before print November 26, 2012, doi:10.1177/1524839912465290.

Lee SH, Rowan M, Powell L, Newman S, Anderson J, Klassen C, Frick K, Gittelsohn J. (2010) “Characteristics of prepared food sources in low-income neighborhoods of Baltimore City.” Ecology of Food and Nutrition, 49(6): 409-430.

Lee SH, Hoffman V, Bleich S, Gittelsohn J. Frequency of visiting and food dollars spent at carry-outs among low-income urban African-American adults. Journal of Hunger and Environmental Nutrition 2013; 7(4):459-467.

Noormohamed A, Lee SH, Batorsky B, Jackson A, Newman S, Gittelsohn J. Factors Influencing Ordering Practices at Baltimore City Carryouts: Qualitative Research to Inform an Obesity Prevention Intervention. Ecology of Food and Nutrition 2012; 51(6):481-91.

Yong R, Lee SH, Freishtat H, Bleich S, Gittelsohn J. Availability of healthy foods in prepared food sources in urban public markets. Journal of Hunger and Environmental Nutrition 2013;7(4):468-481.

If you would like the data collection forms please email Joel Gittelsohn. 

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