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Bogard JR, Downs S, Casey E, Farrell P, Gupta A, Miachon L, Naughton S, Staromiejska W, Reeve E. Convenience as a dimension of food environments: A systematic scoping review of its definition and measurement. Appetite 2024; 194:107198. [PMID: 38176442 DOI: 10.1016/j.appet.2023.107198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/12/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
Convenience is a major driver of food choice throughout the world, yet it is often inconsistently conceptualised, defined and measured. This limits the scope for food systems policy and interventions to leverage convenience to improve diet and nutrition outcomes. We conducted a systematic literature review to determine how convenience is both defined and measured in food environment and nutrition research. Six databases were systematically searched and studies were screened by two independent reviewers based on pre-defined eligibility criteria, yielding 243 studies for inclusion in the final review. 77% of studies did not explicitly define convenience. Among those that did, the dimensions and components within definitions varied. 83% of studies used perceived measures of convenience rather than objective measures. Convenience was most commonly measured in high income countries (64%) and in relation to the home food environment (53%), followed by formal retail (40%). Very few studies measured convenience in relation to the informal retail or cultivated food environments, and no studies considered convenience in relation to wild food environments. The vast majority of studies did not consider the validity or reliability of the measures of convenience. Based on our findings we propose a definition of convenience as a characteristic that results in reduced requirement for resources including time, physical effort, mental effort and skills by the consumer in relation to the planning, acquisition, preparation, storage, transport, consumption or clean-up of food. This definition can be used to help guide the development of measurement tools that can be used to assess convenience across different dimensions and contexts in a more comprehensive way. We also propose a framework for considering convenience as an entry point in food systems to improve diets and nutrition outcomes.
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Affiliation(s)
- Jessica R Bogard
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia.
| | - Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Elodie Casey
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Penny Farrell
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Lais Miachon
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Shaan Naughton
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Wiktoria Staromiejska
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Erica Reeve
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Russell C, Whelan J, Love P. Assessing the Cost of Healthy and Unhealthy Diets: A Systematic Review of Methods. Curr Nutr Rep 2022; 11:600-617. [PMID: 36083573 PMCID: PMC9461400 DOI: 10.1007/s13668-022-00428-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Poor diets are a leading risk factor for chronic disease globally. Research suggests healthy foods are often harder to access, more expensive, and of a lower quality in rural/remote or low-income/high minority areas. Food pricing studies are frequently undertaken to explore food affordability. We aimed to capture and summarise food environment costing methodologies used in both urban and rural settings. RECENT FINDINGS Our systematic review of high-income countries between 2006 and 2021 found 100 relevant food pricing studies. Most were conducted in the USA (n = 47) and Australia (n = 24), predominantly in urban areas (n = 74) and cross-sectional in design (n = 76). All described a data collection methodology, with just over half (n = 57) using a named instrument. The main purpose for studies was to monitor food pricing, predominantly using the 'food basket', followed by the Nutrition Environment Measures Survey for Stores (NEMS-S). Comparatively, the Healthy Diets Australian Standardised Affordability and Price (ASAP) instrument supplied data on relative affordability to household incomes. Future research would benefit from a universal instrument reflecting geographic and socio-cultural context and collecting longitudinal data to inform and evaluate initiatives targeting food affordability, availability, and accessibility.
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Affiliation(s)
- Cherie Russell
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Jillian Whelan
- School of Medicine, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Livingstone KM, Lamb KE, Abbott G, Worsley T, McNaughton SA. Ranking of meal preferences and interactions with demographic characteristics: a discrete choice experiment in young adults. Int J Behav Nutr Phys Act 2020; 17:157. [PMID: 33261647 PMCID: PMC7708905 DOI: 10.1186/s12966-020-01059-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The diet of young adults is poor, yet little is known about the relative importance of influences on healthy eating in a decision-making context. The aim of this exploratory study was to understand the relative ranking of influences on meal choices in young adults and to investigate interactions between meal preferences and demographic and health characteristics. METHODS Adults aged 18-30 years (n = 92, mean age: 23.9 (SD 3.4) years) completed an online discrete choice experiment. Participants were presented with 12 choice sets reflecting a typical weekday meal and were asked to choose between four meal options. Each meal consisted of a combination of five meal attributes (preparation time, cost, taste, familiarity and nutrition content) that each had three attribute levels. Data were analysed using conditional logit models. Subgroup analyses were performed by sex, education, income, weight status and meeting fruit and vegetable recommendations. RESULTS Comparing the highest and lowest attribute levels, meal preferences were higher for better taste (B = 0.38; 95% CI: 0.12, 0.63), familiarity (B = 0.37; 95% CI: 0.21, 0.54) and nutrition content (B = 1.11; 95% CI: 0.81, 1.41) and lower for increased preparation times (B = -0.33; 95% CI: - 0.53, - 0.12) and cost (B = -0.50; 95% CI: - 0.75, - 0.24). Nutrition content was the most important influence on meal choice. Cost was the second most important, followed by taste, familiarity and preparation time. Compared to males, females had a higher preference for better nutrition content, taste and familiarity and a lower preference for increased cost. Higher educated participants had a higher preference for better nutrition content, familiarity and taste compared to lower educated participants. Young adults who met recommendations for fruit and vegetable intake had a higher preference for better nutrition content compared to participants who did not meet recommendations. CONCLUSION Nutrition content was the most important influence on young adults' meal choices, followed by cost, taste, familiarity and preparation time. Preferences varied by demographics and health characteristics, suggesting that the focus of dietary interventions may benefit from being tailored to specific young adult groups.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Karen E Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Tony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Food Marketing as a Special Ingredient in Consumer Choices: The Main Insights from Existing Literature. Foods 2020; 9:foods9111651. [PMID: 33198136 PMCID: PMC7698179 DOI: 10.3390/foods9111651] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
The choices and preferences of food consumers are influenced by several factors, from those related to the socioeconomic, cultural, and health dimensions to marketing strategies. In fact, marketing is a determinant ingredient in the choices related to food consumption. Nonetheless, for an effective implementation of any marketing approach, the brands play a crucial role. Creating new brands in the food sector is not always easy, considering the relevant amount of these goods produced within the agricultural sector and in small food industries. The small dimension of the production units in these sectors hinders both brand creation and respective branding. In this context, it would seem important to analyse the relationships between food marketing and consumer choice, highlighting the role of brands in these frameworks. For this purpose, a literature review was carried out considering 147 documents from Scopus database for the topics of search “food marketing” and “choices” (search performed on 16 October 2020). As main insights, it is worth highlighting that the main issues addressed by the literature, concerning food marketing and consumer choices, are the following: economic theory; label and packaging; marketing strategies; agriculture and food industry; market segments; social dimensions; brand and branding. In turn, food marketing heavily conditions consumer choices; however, these related instruments are better manipulated by larger companies. In addition, this review highlights that bigger companies have dominant positions in these markets which are not always beneficial to the consumers’ objectives.
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Changes in Beverage Marketing at Stores Following the Oakland Sugar-Sweetened Beverage Tax. Am J Prev Med 2020; 58:648-656. [PMID: 32192801 DOI: 10.1016/j.amepre.2019.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION In July 2017, Oakland, California implemented a 1 cent/ounce sugar-sweetened beverage tax. This study examined changes in store marketing practices-advertising and price promotions-for sugar-sweetened beverages, artificially sweetened beverages, and unsweetened beverages following the introduction of the tax. METHODS The study employed a quasi-experimental research design and included Oakland as the intervention site and Sacramento, California as a comparison site. Based on data collected pretax (May-June 2017), 6 months post-tax (January 2018), and 12 months post-tax (June 2018) at 249 stores across the 2 sites, exterior and interior advertising for 4 taxed sugar-sweetened beverage subtypes and 6 untaxed artificially sweetened and unsweetened beverage subtypes, as well as price promotions for 59 specific taxed products and 69 untaxed products were examined. In 2019, difference-in-differences logistic regressions estimated pre-post changes in Oakland relative to Sacramento. RESULTS At 6 months post-tax, the odds of sugar-sweetened beverage price promotions fell 50% in Oakland but only 22% in Sacramento. Price promotions for regular soda in particular declined in Oakland post-tax, by 47% at 6 months and 39% at 12 months (versus no change in Sacramento). Moreover, the odds of artificially sweetened beverage price promotions fell by a similar magnitude as sugar-sweetened beverages in Oakland, 55% at 6 months and 53% at 12 months, which differed significantly from Sacramento. No significant post-tax changes were found in sugar-sweetened or artificially sweetened beverage exterior or interior advertising. CONCLUSIONS Rather than increasing marketing, retailers and manufacturers may have tried to offset revenue losses by reducing price promotions for sugar-sweetened beverages, particularly regular soda, and artificially sweetened beverages.
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Atoloye AT, Durward C. Being Motivated by Nutrition Is Associated With Healthy Home Food Environment of Supplemental Nutrition Assistance Program (SNAP) Recipients. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:101-106. [PMID: 30201282 DOI: 10.1016/j.jneb.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/12/2018] [Accepted: 07/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the relationship between food shopping motivating factors and the home food environment (HFE). METHODS Participants in the Supplemental Nutrition Assistance Program (n = 123) who were taking part in the Utah State Double-Up Food Bucks evaluation program were interviewed about their HFE, factors motivating shopping, and food security status. Composite HFE scores were derived from the Perceived Nutrition Environment Measure Survey questionnaire and food security score from the 6-item US Household Food Security Survey questionnaire. Analysis included multiple linear regression. RESULTS Mean age was 46 ± 16.1 years. Regression models showed significant associations of being motivated by nutrition, education, and food security with HFE (β = 4.70, P = .03; β = 1.44, P = .06; and β = 1.44, P = .06, respectively). CONCLUSION AND IMPLICATIONS In-store interventions to improve perceived nutrition importance among shoppers may be a useful tool to improve home food supplies. Further research is recommended examining the association between food shopping motivators and the HFE in a larger population.
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Affiliation(s)
- Abiodun T Atoloye
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT
| | - Carrie Durward
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT.
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How Do African-American Caregivers Navigate a Food Desert to Feed Their Children? A Photovoice Narrative. J Acad Nutr Diet 2018; 118:2045-2056. [PMID: 29934282 DOI: 10.1016/j.jand.2018.04.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 04/24/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To determine how African-American caregivers living in a food desert navigate neighborhood resources to procure foods for their children and to identify actions to improve those resources. DESIGN Using the Photovoice approach, we conducted two sets of individual in-depth interviews with 16 African-American primary caregivers of children (total of 32 interviews) and one culminating workshop (n=10 participants). Data were systematically analyzed according to the Social Ecological Framework to evaluate the role of different environments in shaping individual decisions. SETTING Urban, low-income and geographically marginalized neighborhoods. RESULTS Despite the challenges of living in a food desert, caregivers perceived that they were providing the foods that they wanted for their children. These perceptions were based on their own health concerns, food customs, time and convenience, and responses to their children's food preferences. Caregivers were resourceful in how they procured these foods, searching for quality and better-priced foods. They relied on their friends, family, and local/national programs to mitigate the challenges of the food desert. Caregivers were interested in taking action to improve the underlying determinants of food access and choice (eg, affordable housing, job training, nutrition knowledge, food shopping experience). CONCLUSION These African-American caregivers procured foods they thought were best for their children by relying on their strong social relationships and national and local food programs to navigate the food desert. Public health nutrition interventions that aim to reduce diet-related disparities should look beyond the presence or absence of supermarkets in food deserts to address multisectoral determinants of access while shaping food choices.
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Nau C, Kumanyika S, Gittelsohn J, Adam A, Wong MS, Mui Y, Lee BY. Identifying Financially Sustainable Pricing Interventions to Promote Healthier Beverage Purchases in Small Neighborhood Stores. Prev Chronic Dis 2018; 15:E12. [PMID: 29369758 PMCID: PMC5798217 DOI: 10.5888/pcd15.160611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Residents of low-income communities often purchase sugar-sweetened beverages (SSBs) at small, neighborhood “corner” stores. Lowering water prices and increasing SSB prices are potentially complementary public health strategies to promote more healthful beverage purchasing patterns in these stores. Sustainability, however, depends on financial feasibility. Because in-store pricing experiments are complex and require retailers to take business risks, we used a simulation approach to identify profitable pricing combinations for corner stores. Methods The analytic approach was based on inventory models, which are suitable for modeling business operations. We used discrete-event simulation to build inventory models that use data representing beverage inventory, wholesale costs, changes in retail prices, and consumer demand for 2 corner stores in Baltimore, Maryland. Model outputs yielded ranges for water and SSB prices that increased water demand without loss of profit from combined water and SSB sales. Results A 20% SSB price increase allowed lowering water prices by up to 20% while maintaining profit and increased water demand by 9% and 14%, for stores selling SSBs in 12-oz cans and 16- to 20-oz bottles, respectively. Without changing water prices, profits could increase by 4% and 6%, respectively. Sensitivity analysis showed that stores with a higher volume of SSB sales could reduce water prices the most without loss of profit. Conclusion Various combinations of SSB and water prices could encourage water consumption while maintaining or increasing store owners’ profits. This model is a first step in designing and implementing profitable pricing strategies in collaboration with store owners.
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Affiliation(s)
- Claudia Nau
- Kaiser Permanente Southern California, Southern California Permanente Medical Group, Department for Research and Evaluation, Office 041R02, 100 S Los Robles, Pasadena CA 91101.
| | - Shiriki Kumanyika
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.,Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland
| | - Joel Gittelsohn
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Atif Adam
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michelle S Wong
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yeeli Mui
- Food Systems Planning and Healthy Communities Lab, University at Buffalo, State University of New York, Buffalo, New York
| | - Bruce Y Lee
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland.,Carey Business School, Johns Hopkins University, Baltimore, Maryland
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Pricing of Staple Foods at Supermarkets versus Small Food Stores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080915. [PMID: 28809795 PMCID: PMC5580618 DOI: 10.3390/ijerph14080915] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/06/2017] [Accepted: 08/12/2017] [Indexed: 12/22/2022]
Abstract
Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10-54% more expensive in smaller stores than in supermarkets (p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces.
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How Latina mothers navigate a 'food swamp' to feed their children: a photovoice approach. Public Health Nutr 2017; 20:1941-1952. [PMID: 28514988 DOI: 10.1017/s1368980017000738] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To understand how mothers who recently migrated from Central America to the USA feed their children in a neighbourhood saturated with unhealthful food choices ('food swamp') and to formulate a mother-driven plan of action to facilitate their acquisition of foods. Design/Setting/Subjects We purposively sampled mothers with children (<10 years old) who were recent immigrants/refugees from Central America and lived in a 'food swamp' neighbourhood. We used the photovoice approach to elicit textual data from thirty in-depth interviews, a participatory workshop, and visual data from photographs. Analyses were guided by the Social Ecological Framework and Social Cognitive Theory to identify barriers, facilitators and strategies that support parents in feeding their children. RESULTS Mothers valued foods that they considered to be 'traditional' and 'healthful'. They navigated their food retail environment looking for these foods (of good quality and well-priced). Food values were reinforced by pre-migration food customs and culture, health professionals' advice and, in some cases, by the desire to avoid conflict with their children. The neighbourhood food environment could directly influence children's food preferences and often created conflict between what the child wanted to eat and the foods that mothers valued. Mothers in this 'food swamp' wanted to be engaged in addressing the selection of foods offered in schools and in neighbourhood food venues to reflect their own food values. CONCLUSIONS These mothers' feeding choices were influenced directly by their food values, and indirectly by the neighbourhood and school food environments via their children's preferences.
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Sanchez-Flack JC, Baquero B, Linnan LA, Gittelsohn J, Pickrel JL, Ayala GX. What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California. Ecol Food Nutr 2016; 55:163-81. [PMID: 26800243 DOI: 10.1080/03670244.2015.1112282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers' grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and sociocultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers.
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Affiliation(s)
- Jennifer C Sanchez-Flack
- a San Diego State University-University of California at San Diego Joint Doctoral Program in Health Behavior , San Diego , California , USA.,b Institute for Behavioral and Community Health , San Diego , California , USA
| | - Barbara Baquero
- c University of Iowa , College of Public Health, Community & Behavioral Health , Iowa City , Iowa , USA
| | - Laura A Linnan
- d University of North Carolina at Chapel Hill , Gillings School of Global Public Health, Department of Health Behavior , Chapel Hill , North Carolina , USA
| | - Joel Gittelsohn
- e Center for Human Nutrition and Global Obesity Prevention Center, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Julie L Pickrel
- b Institute for Behavioral and Community Health , San Diego , California , USA
| | - Guadalupe X Ayala
- b Institute for Behavioral and Community Health , San Diego , California , USA.,f San Diego State University , College of Health & Human Services , San Diego , California , USA
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