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Brooker PG, Howlett CA, Brindal E, Hendrie GA. Strategies associated with improved healthiness of consumer purchasing in supermarket interventions: a systematic overview of reviews and evaluation of primary articles. Front Public Health 2024; 12:1334324. [PMID: 38983251 PMCID: PMC11232481 DOI: 10.3389/fpubh.2024.1334324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/03/2024] [Indexed: 07/11/2024] Open
Abstract
Background Growing evidence suggests that it is possible to change the retail food environment to enable healthier choices via in-store interventions. It has been difficult to draw clear conclusions as to which interventions are most effective in positively influencing consumer purchasing behaviour given the significant heterogeneity within the food retail research literature. The aim of this study was to (1) summarise current high-quality systematic, scoping, and/or narrative reviews (Part I: overview of reviews); and (2) synthesise high-quality original research, to understand the range, types and effectiveness of strategies implemented in food retail settings (Part II: evaluation of primary studies). Methods To identify reviews describing the effects of intervention strategies aiming to improve the healthiness of consumer purchasing in supermarkets, a systematic search across seven electronic databases was completed in April 2023. The methodological quality of reviews was assessed using the risk of bias in systematic reviews for systematic and scoping reviews, and the Scale for the Assessment of Narrative Review Articles for narrative reviews. High-quality reviews were further inspected and synthesised narratively (Part I). Next, to understand strategies associated with improved healthiness of consumer purchasing high-quality, primary articles from high-quality reviews identified in Part I were retrieved, and the strategies implemented within these interventions were summarised (Part II). Results Thirty-eight reviews met the inclusion criteria for Part I; two-thirds (n = 25, 66%) were rated as high-quality (66%). These reviews indicated that pricing strategies had the greatest proportion of reported positive or promising effects on outcomes (n = 8 of 11 reviews, 73%). Twenty reviews met the inclusion criteria for Part II and the 771 primary articles from these reviews were screened with 23 high-quality primary articles included in analysis. Findings indicated that promotional strategies in combination with another strategy appeared to be most successful among regular shoppers (the general population), whereas pricing was most successful in low socio-economic status and rural sub-groups. Conclusion Promotion, pricing and prompting were the most commonly tested strategies across the overview of reviews and review of primary articles. Promotion, in combination with other strategies, and pricing appear to be most promising, but the effectiveness of pricing strategies may vary by sub-groups of the population. How pricing and promotion in combination with other strategies can be implemented responsibly and sustainably to change purchase habits towards healthier items should be explored further. Systematic Review registration OSF, https://osf.io/jyg73/.
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Affiliation(s)
- Paige G. Brooker
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, SA, Australia
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Haley CO, Singleton CR, King LE, Dyer L, Theall KP, Wallace M. Association of Food Desert Residency and Preterm Birth in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:412. [PMID: 38673324 PMCID: PMC11049944 DOI: 10.3390/ijerph21040412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Food deserts are a major public health concern. Inadequate access to healthy food has been associated with poor nutrition and the development of dietary related chronic conditions. OBJECTIVE To determine the association between geographic access to nutritious food and preterm birth and whether gestational hypertension mediates this relationship. METHODS Food access data was retrieved from the U.S. Department of Agriculture Food Access Research Atlas (2019) and used to quantify the percentage of Census tracts within each county that were food deserts: low-income tracts with limited access to grocery stores, supermarkets, or other sources of healthy, nutritious foods. These data were merged with US birth records from 2018 to 2019 by using the maternal county of residence (n = 7,533,319). We fit crude and adjusted logistic regression models with generalized estimating equations to determine the association between living in a food desert and the odds of preterm birth. We conducted a secondary within-group analysis by stratifying the fully adjusted model by race for non-Hispanic White and non-Hispanic Black birthing people. RESULTS In the fully adjusted model, we found a dose-response relationship. As the prevalence of tract-level food deserts within counties increased, so did the likelihood of preterm birth (mid-range: odds ratio (OR) = 1.04, 95% confidence interval (C.I.) 1.01-1.07; high: OR = 1.07, 95% C.I. 1.03-1.11). Similar results were seen in the White-Black stratified models. However, a disparity remained as Black birthing people had the highest odds for preterm birth. Lastly, gestational hypertension appears to mediate the relationship between nutritious food access and preterm birth (natural indirect effect (NIE) = 1.01, 95% CI = 1.00, 1.01). CONCLUSION It is salient, particularly for Black birthing people who experience high rates of adverse birth outcomes, that the role of food desert residency be explored within maternal and child health disparities.
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Affiliation(s)
- Chanell O. Haley
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Chelsea R. Singleton
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Lily E. King
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Lauren Dyer
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Katherine P. Theall
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Maeve Wallace
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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Ghazaryan A, Carlson AC, Rhone A, Roy K. Association Between County-Level Food Retail and Socioeconomic Environment and Nutritional Quality of Household Food Purchases, 2015. J Acad Nutr Diet 2023; 123:796-808. [PMID: 37096644 PMCID: PMC10848244 DOI: 10.1016/j.jand.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND About 40 million Americans do not have easy access to affordable nutritious foods. Healthier foods are less likely to be available to those living in rural and/or lower-income communities. OBJECTIVE The objective of this study was to analyze the association between nutritional quality of household food purchases and county-level food retail environment; county-level demographic, health, and socioeconomic indicators; and household composition, demographic characteristics, and socioeconomic characteristics. DESIGN This study is a secondary analysis of the 2015 Information Resources Inc Consumer Network panel; Purchase-to-Plate Crosswalk, which links US Department of Agriculture nutrition databases to Information Resources Inc scanner data; County Health Rankings; and the Food Environment Atlas data. PARTICIPANTS AND SETTINGS A total of 63,285 households, representative of the contiguous US population, consistently provided food purchase scanner data from retail stores throughout 2015. MAIN OUTCOME MEASURES Nutritional quality of retail food purchases was assessed using the Healthy Eating Index 2015 (HEI-2015). STATISTICAL ANALYSIS Multivariate linear regression analysis was used to simultaneously test the relationship between the main outcome and household-level demographic and socioeconomic characteristics as well as the county-level demographic, health, socioeconomic, and retail food environment. RESULTS Household heads who had higher education and households with higher incomes purchased food of better nutritional quality (ie, higher HEI-2015 scores). Also, the association between retail food purchase HEI-2015 scores and the food environment was weak. Higher density of convenience stores was associated with lower retail food purchase nutritional quality for higher-income households and households living in urban counties, whereas low-income households in counties with higher specialty (including ethnic) store density purchased higher nutritional quality food. Both in the full sample and when stratified by household income or county rural vs urban status, no association was found between grocery store, supercenters, fast-food outlets, and full-service restaurant densities and retail food purchase HEI-2015 scores. HEI-2015 scores were negatively correlated with the county average number of mental health days for higher income and urban households. CONCLUSIONS The study findings suggest that availability of healthier food alone may not improve healthfulness of retail food purchases. Future studies examining the influence of demand-side factors/interventions, such as habits, cultural preferences, nutrition education, and cost/affordability, on household purchasing patterns could provide complementary evidence to inform effective intervention strategies.
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Affiliation(s)
- Armen Ghazaryan
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia.
| | - Andrea C Carlson
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Alana Rhone
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Kakoli Roy
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia
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Appelhans BM. The Cognitive Burden of Poverty: A Mechanism of Socioeconomic Health Disparities. Am J Prev Med 2023; 64:293-297. [PMID: 36180316 PMCID: PMC10176429 DOI: 10.1016/j.amepre.2022.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/12/2022] [Accepted: 08/19/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Bradley M Appelhans
- From the Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, Illinois; and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois.
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Agarwal S, Fertig AR, Trofholz AC, Tate AD, Robinson J, Berge JM. Exploring the associations between neighbourhood food environment, household food insecurity and child weight-related outcomes in socio-economically and racially/ethnically diverse families. Public Health Nutr 2022; 25:1-10. [PMID: 36210770 PMCID: PMC9991713 DOI: 10.1017/s1368980022002130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine associations among neighbourhood food environments (NFE), household food insecurity (HFI) and child's weight-related outcomes in a racially/ethnically diverse sample of US-born and immigrant/refugee families. DESIGN This cross-sectional, observational study involving individual and geographic-level data used multilevel models to estimate associations between neighbourhood food environment and child outcomes. Interactions between HFI and NFE were employed to determine whether HFI moderated the association between NFE and child outcomes and whether the associations differed for US-born v. immigrant/refugee groups. SETTING The sample resided in 367 census tracts in the Minneapolis/St. Paul, MN metropolitan area, and the data were collected in 2016-2019. PARTICIPANTS The sample was from the Family Matters study of families (n 1296) with children from six racial/ethnic and immigrant/refugee groups (African American, Latino, Hmong, Native American, Somali/Ethiopian and White). RESULTS Living in a neighbourhood with low perceived access to affordable fresh fruits and vegetables was found to be associated with lower food security (P < 0·01), poorer child diet quality (P < 0·01) and reduced availability of a variety of fruits (P < 0·01), vegetables (P < 0·05) and whole grains in the home (P < 0·01). Moreover, residing in a food desert was found to be associated with a higher child BMI percentile if the child's household was food insecure (P < 0·05). No differences in associations were found for immigrant/refugee groups. CONCLUSIONS Poor NFE were associated with worse weight-related outcomes for children; the association with weight was more pronounced among children with HFI. Interventions aiming to improve child weight-related outcomes should consider both NFE and HFI.
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Affiliation(s)
- Sarthak Agarwal
- Humphrey School of Public Affairs, University of Minnesota, 130 Hubert H. Humphrey Center, 301 19th Ave South, Minneapolis, MN55455, USA
| | - Angela R Fertig
- Humphrey School of Public Affairs, University of Minnesota, 130 Hubert H. Humphrey Center, 301 19th Ave South, Minneapolis, MN55455, USA
| | - Amanda C Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Allan D Tate
- College of Public Health, University of Georgia, Athens, GA, USA
| | - Jenna Robinson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Robitaille É, Paquette MC, Durette G, Bergeron A, Dubé M, Doyon M, Mercille G, Lemire M, Lo E. Implementing a Rural Natural Experiment: A Protocol for Evaluating the Impacts of Food Coops on Food Consumption, Resident's Health and Community Vitality. Methods Protoc 2022; 5:33. [PMID: 35448698 PMCID: PMC9025453 DOI: 10.3390/mps5020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Local food environments are recognized by experts as a determinant of healthy eating. Food cooperatives (coop) can promote the accessibility to healthier foods and thus improve the health of the population, particularly in remote rural communities. OBJECTIVE To measure the effects of implementing a food coop in a disadvantaged community with poor access to food. We have two main research questions: (1). Does the establishment of a food coop in rural areas described as food deserts have an impact on accessibility, frequency of use, food consumption, food quality, and ultimately the health of individuals? (2). Does the establishment of a food coop in rural areas described as food deserts have an impact on food security and community vitality? DESIGN A natural experiment with a mixed pre/post method will be used. The sample is composed of households that came from geographically isolated communities (population: 215 to 885 inhabitants) which qualified as food deserts and located in rural areas of Quebec (Canada). All communities plan to open a food coop (in the years 2022-2023), and as their opening will be staggered over time, participants from communities with a new food coop (intervention) will be compared to communities awaiting the opening of their food coop (control). Data collection was carried out at three time points: (1) before; (2) 1 to 5 months after; and (3) 13 to 17 months after the opening of the coop. Questionnaires were used to measure sociodemographic variables, dietary intake, residents' health, and community vitality. Semi-structured interviews were conducted with community stakeholders. RESULTS Few natural experiments have been conducted regarding the impact of implementing food coops. Gathering concrete data on the effectiveness and processes surrounding these interventions through natural experiments will help to quantify their impact and guide knowledge users and policymakers to make more informed decisions.
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Affiliation(s)
- Éric Robitaille
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Département de Médecine Sociale et Préventive, Université de Montréal, École de Santé Publique de l’Université de Montréal, Montréal, QC H3T 1A8, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3T 1A8, Canada;
| | - Marie-Claude Paquette
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada
| | - Gabrielle Durette
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Amélie Bergeron
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Marianne Dubé
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Mélanie Doyon
- Département de Géographie, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
| | - Geneviève Mercille
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3T 1A8, Canada;
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada
| | - Marc Lemire
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Ernest Lo
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada
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Ayala GX, Pickrel JL, Baquero B, Sanchez-Flack J, Lin SF, Belch G, Rock CL, Linnan L, Gittelsohn J, Ji M, Elder JP, Mayer J. The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption. Int J Behav Nutr Phys Act 2022; 19:19. [PMID: 35177070 PMCID: PMC8851758 DOI: 10.1186/s12966-021-01220-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
Background Modifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months. Trial design Clustered randomized controlled trial Methods Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team’s support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees’ capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors. Results The study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects. Conclusions Structural and social change interventions can modify customers’ behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products). Trial registration NCT01475526 Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01220-w.
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Affiliation(s)
- Guadalupe X Ayala
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA. .,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA.
| | - Julie L Pickrel
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Barbara Baquero
- Health System and Population Health, School of Public Health, University of Washington, Box 35480, Seattle, WA, 98195, USA
| | - Jennifer Sanchez-Flack
- Department of Pediatrics, University of Illinois Cancer Center, Chicago, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, WROB 478, Chicago, IL, 60608, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - George Belch
- Marketing Department, Fowler College of Business, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive #0901, La Jolla, CA, 92093, USA
| | - Laura Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 359 Rosenau Hall, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599, USA
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, 12901, USA
| | - John P Elder
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Joni Mayer
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
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Gittelsohn J, Kasprzak CM, Hill AB, Sundermeir SM, Laska MN, Dombrowski RD, DeAngelo J, Odoms-Young A, Leone LA. Increasing Healthy Food Access for Low-Income Communities: Protocol of the Healthy Community Stores Case Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:690. [PMID: 35055512 PMCID: PMC8775718 DOI: 10.3390/ijerph19020690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
Improving healthy food access in low-income communities continues to be a public health challenge. One strategy for improving healthy food access has been to introduce community food stores, with the mission of increasing healthy food access; however, no study has explored the experiences of different initiatives and models in opening and sustaining healthy food stores. This study used a case study approach to understand the experiences of healthy food stores in low-income communities. The purpose of this paper is to describe the methodology used and protocol followed. A case study approach was used to describe seven healthy food stores across urban settings in the U.S. Each site individually coded their cases, and meetings were held to discuss emerging and cross-cutting themes. A cross-case analysis approach was used to produce a series of papers detailing the results of each theme. Most case studies were on for-profit, full-service grocery stores, with store sizes ranging from 900 to 65,000 square feet. Healthy Food Availability scores across sites ranged from 11.6 (low) to 26.5 (high). The papers resulting from this study will detail the key findings of the case studies and will focus on the challenges, strategies, and experiences of retail food stores attempting to improve healthy food access for disadvantaged communities. The work presented in this special issue will help to advance research in the area of community food stores, and the recommendations can be used by aspiring, new, and current community food store owners.
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Affiliation(s)
- Joel Gittelsohn
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Christina M. Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA; (C.M.K.); (L.A.L.)
- Community Health Interventions Lab, University at Buffalo, Buffalo, NY 14260, USA
| | - Alex B. Hill
- Urban Studies and Planning and Detroit Food Map Initiative, Wayne State University, Detroit, MI 48202, USA;
| | - Samantha M. Sundermeir
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Melissa N. Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Rachael D. Dombrowski
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - Julia DeAngelo
- Departments of Health Policy Management & Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Angela Odoms-Young
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY 14850, USA;
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA; (C.M.K.); (L.A.L.)
- Community Health Interventions Lab, University at Buffalo, Buffalo, NY 14260, USA
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The role of food and activity environment in a bariatric surgery population: impact on postoperative weight loss. Surg Obes Relat Dis 2021; 18:365-372. [PMID: 35016840 DOI: 10.1016/j.soard.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/29/2021] [Accepted: 12/05/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Food and activity factors may have an impact on weight in the general population, but little is known about how this affects postbariatric surgery weight loss. OBJECTIVES To understand the impact of environmental food and activity factors on weight loss after bariatric surgery. SETTING A multidisciplinary integrated health system with an accredited bariatric surgery program. METHODS An institutional review board-approved retrospective review of patients who underwent bariatric surgery from 2001-2018 was completed. Food security, food retailers, and activity factors associated with postoperative percentage of total body weight loss (TBWL) at short-term (1-2 yr), medium-term (3-5 yr), and long-term (≥6 yr) follow-up were evaluated. RESULTS Overall, 1673 patients were included; 90% experienced ≥20% TBWL in the short term and 65% in the long term. No differences in mean TBWL were observed for food deserts or areas with high versus low food insecurity. Mean TBWL was significantly different for low versus high healthy food density (32.5% versus 33.4%, P = .024) and low versus high fitness facility density (32.6% versus 33.4%, P = .048) at short-term follow-up. Increased mean TBWL was observed for counties with more versus less exercise opportunities at short and medium-term follow-up (33.4% versus 32.5%, P = .025; 31.2% versus 29.7%, P = .019). CONCLUSION Patients experienced significant TBWL after bariatric surgery. Living in a food desert or area with high food insecurity did not significantly impact mean TBWL. Healthy food density, fitness facility density, and exercise opportunities had a short- to medium-term impact on TBWL. These data can be used to support patients to maximize the benefits of bariatric surgery.
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10
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Moffat LF, Ritchie LD, Gosliner W, Plank KR, Au LE. Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study. Nutrients 2021; 13:3681. [PMID: 34835936 PMCID: PMC8619213 DOI: 10.3390/nu13113681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children's diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children's fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013-2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents' perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = -0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.
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Affiliation(s)
- Laurel F. Moffat
- Youth and Families Unit, Extension, Washington State University, Spokane, WA 99202, USA;
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Wendi Gosliner
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Kaela R. Plank
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Lauren E. Au
- Department of Nutrition, University of California, Davis, CA 95616, USA
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11
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Sharpe PA, Stucker J, Wilcox S, Liese AD, Bell BA. Recruitment and Retention for the Evaluation of a Healthy Food Initiative in Economically Disadvantaged, Majority African American Communities. FAMILY & COMMUNITY HEALTH 2021; 44:43-51. [PMID: 33214409 PMCID: PMC7682748 DOI: 10.1097/fch.0000000000000259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Effective recruitment and retention supports equitable participation in research. The aim of this article is to describe recruitment and retention methods among residents of highly disadvantaged, predominantly African American communities in the southeastern United States during the evaluation of a healthy food access initiative. We proposed that active and passive recruitment methods, intensive retention strategies, community outreach and involvement, over-enrollment to anticipate attrition, and applied principles of community participation would achieve the study's recruitment and retention goals. The enrollment goal of 560 was met at 94% (n = 527), and the retention goal of 400 was achieved (n = 408).
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Affiliation(s)
- Patricia A Sharpe
- Arnold School of Public Health, University of South Carolina, Columbia (Drs Sharpe, Wilcox, and Liese and Ms Stucker); and College of Social Work, University of South Carolina, Columbia (Dr Bell)
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12
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Turcu C, Crane M, Hutchinson E, Lloyd S, Belesova K, Wilkinson P, Davies M. A multi-scalar perspective on health and urban housing: an umbrella review. BUILDINGS & CITIES 2021; 2:734-758. [PMID: 34738085 PMCID: PMC7611930 DOI: 10.5334/bc.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With more than half the world's population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth's natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.
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Affiliation(s)
- Catalina Turcu
- The Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Melanie Crane
- The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Hutchinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
| | - Simon Lloyd
- Climate and Health Programme (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Kristine Belesova
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, Faculty of the Built Environment, University College London, London, UK
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13
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Dixon BN, Ugwoaba UA, Brockmann AN, Ross KM. Associations between the built environment and dietary intake, physical activity, and obesity: A scoping review of reviews. Obes Rev 2021; 22:e13171. [PMID: 33369097 PMCID: PMC8629168 DOI: 10.1111/obr.13171] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta-analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land-use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight-related outcomes.
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Affiliation(s)
- Brittney N. Dixon
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Umelo A. Ugwoaba
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Andrea N. Brockmann
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Kathryn M. Ross
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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14
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Monsivais P, Thompson C, Astbury CC, Penney TL. Environmental approaches to promote healthy eating: Is ensuring affordability and availability enough? BMJ 2021; 372:n549. [PMID: 33785485 PMCID: PMC8008259 DOI: 10.1136/bmj.n549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Pablo Monsivais
- Elson S Floyd College of Medicine, Washington State University, Spokane, USA
| | - Claire Thompson
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | - Chloe Clifford Astbury
- School of Global Health, Global Strategy Lab, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Tarra L Penney
- School of Global Health, Global Strategy Lab, Faculty of Health, York University, Toronto, Ontario, Canada
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15
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Kelly C, Callaghan M, Gabhainn SN. 'It's Hard to Make Good Choices and It Costs More': Adolescents' Perception of the External School Food Environment. Nutrients 2021; 13:nu13041043. [PMID: 33804848 PMCID: PMC8063803 DOI: 10.3390/nu13041043] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/04/2022] Open
Abstract
Research on the impact of school and community food environments on adolescent food choice is heavily reliant on objective rather than subjective measures of food outlets around schools and homes. Gaining the perspective of adolescents and how they perceive and use food environments is needed. The aim of this study was to explore adolescent’s perception and use of the food environment surrounding their schools. Purposive sampling was used to recruit schools. Mapping exercises and discussion groups were facilitated with 95 adolescents from six schools. Thematic analysis showed that adolescents are not loyal to particular shops but are attracted to outlets with price discounts, those with ‘deli’ counters and sweets. Cost, convenience and choice are key factors influencing preference for food outlets and foods. Quality, variety and health were important factors for adolescents but these features, especially affordable healthy food, were hard to find. Social factors such as spending time with friends is also an important feature of food environments that deserves further attention. Adolescents’ perceptions of their food environment provide insights into features that can be manipulated to enable healthy choices.
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16
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Daniel L, Hinman SJ, Harper K, Ali SH, Gu Y, Poirier L, Park R, Trujillo A, Gittelsohn J. Exploring the Reasons for Low Usage and Informing Strategies to Improve Use of a Nonprofit Grocery Store in Baltimore City. Ecol Food Nutr 2021; 60:722-736. [PMID: 33757390 DOI: 10.1080/03670244.2021.1899916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introducing new grocery stores into low-income communities has been a focus of policy efforts to improve the food environment. Yet, evidence of the impact of this strategy on diet and health outcomes is inconsistent. In Baltimore, a not-for-profit grocery store was opened by the Salvation Army in March 2018 with the goal of improving healthy food access. Unfortunately, the store has so far failed to attract sufficient customers. This study explored the reasons for low usage from the perspective of community members and staff members. A qualitative, formative research study was conducted at the store, which included semi-structured interviews (n = 21), direct observations (n = 8), and sociodemographic surveys (n = 152). Reasons for low store usage included high prices, confusion regarding the nature of the store, and lack of product variety. Reducing prices, increasing community engagement, and using promotional materials were all recommended strategies to increase usage. The Salvation Army is interested in potentially opening other nonprofit grocery stores. The results of this study will be used to help the Salvation Army refine their nonprofit grocery store model and in their future planning.
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Affiliation(s)
- Leena Daniel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah J Hinman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kaitlyn Harper
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shahmir H Ali
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yuxuan Gu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Poirier
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Reuben Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Antonio Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Gomi T, Kitayuguchi J, Okuyama K, Kamada M, Inoue S, Kamioka H, Mutoh Y. Relationship between neighborhood food environment and diet variety in Japanese rural community-dwelling elderly: a cross-sectional study. J Epidemiol 2021; 32:290-297. [PMID: 33456021 PMCID: PMC9086309 DOI: 10.2188/jea.je20200415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Food access is an important aspect of health promotion for the elderly. The aim of this study was to investigate the relationship between distance to the nearest food store and diet variety in rural community-dwelling elderly Japanese. Methods This cross-sectional study analyzed data from 1,103 elderly participants surveyed by mail in rural areas of Japan. Diversity of food intake was assessed using the diet variety score (DVS). Street network distance from home to food store was calculated and categorized by quartile using a geographic information system and analyzed in relation to diet using multivariable regression with the primary outcome as low DVS. Sub-analysis of the association with DVS was conducted for each food store category (convenience store, supermarket, and small food store). The association between intake frequency of each food group and distance was also analyzed. Results Participants in the fourth quartile of distance to food store had significantly higher prevalence ratio (1.15; 95% CI, 1.01–1.32) for low DVS than those in the first quartile. There was a significant tendency between greater distance to food store and lower DVS (P for trend = 0.033). Supermarkets and convenience stores, in particular, showed significant associations. Greater distance was significantly associated with lower frequency of meat and fruit intake. Conclusion There was significant association between distance to nearest food store and diet variety in rural Japanese elderly. These findings suggest the importance of interventions for areas at high risk of low diet variety, such as places far away from food stores.
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Affiliation(s)
- Tatsunosuke Gomi
- Physical Education and Medicine Research Center UNNAN.,Department of Environmental Symbiotic Studies, Tokyo University of Agriculture
| | | | - Kenta Okuyama
- Center for Primary Health Care Research, Lund University
| | - Masamitsu Kamada
- Department of Health and Social Behavior, School of Public Health, Graduate School of Medicine, The University of Tokyo
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Hiroharu Kamioka
- Department of Environmental Symbiotic Studies, Tokyo University of Agriculture
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18
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Foley L, Francis O, Musuva R, Mogo ER, Turner-Moss E, Wadende P, Were V, Obonyo C. Impacts of a New Supermarket on Dietary Behavior and the Local Foodscape in Kisumu, Kenya: Protocol for a Mixed Methods, Natural Experimental Study. JMIR Res Protoc 2020; 9:e17814. [PMID: 33346736 PMCID: PMC7781801 DOI: 10.2196/17814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background Access to healthy food is considered a key determinant of dietary behavior, and there is mixed evidence that living near a supermarket is associated with a healthier diet. In Africa, supermarkets may contribute to the nutrition transition by offering both healthy and unhealthy foods and by replacing traditional food sellers. In Kisumu, Kenya, a planned hypermarket (ie, a supermarket combined with a department store) will form the basis for a natural experimental evaluation. Objective The aim of this study is to explore the impacts of a new hypermarket on food shopping practices, dietary behaviors, physical activity patterns, and body composition among local residents and to identify concurrent changes in the local foodscape. We also aim to explore how impacts and associations vary by socioeconomic status. Methods We employ a mixed methods, longitudinal study design. Two study areas were defined: the hypermarket intervention area (ie, Kisumu) and a comparison area with no hypermarket (ie, Homabay). The study is comprised of 4 pieces of primary data collection: a quantitative household survey with local residents, a qualitative study consisting of focus group discussions with local residents and semistructured interviews with government and private sector stakeholders, an audit of the local foodscape using on-the-ground data collection, and an intercept survey of shoppers in the hypermarket. Assessments will be undertaken at baseline and approximately 1 year after the hypermarket opens. Results Baseline assessments were conducted from March 2019 to June 2019. From a total sampling frame of 400 households, we recruited 376 of these households, giving an overall response rate of 94.0%. The household survey was completed by 516 individuals within these households. Across the two study areas, 8 focus groups and 44 stakeholder interviews were conducted, and 1920 food outlets were geocoded. Conclusions This study aims to further the understanding of the relationship between food retail and dietary behaviors in Kenya. Baseline assessments for the study have been completed. International Registered Report Identifier (IRRID) DERR1-10.2196/17814
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Affiliation(s)
- Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Oliver Francis
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Rosemary Musuva
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Ebele Ri Mogo
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Pamela Wadende
- Faculty of Education and Human Resources, Kisii University, Kisii, Kenya
| | - Vincent Were
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Charles Obonyo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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Yoder AD, Proaño GV, Handu D. Retail Nutrition Programs and Outcomes: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1866-1880.e4. [PMID: 33229206 DOI: 10.1016/j.jand.2020.08.080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
As nutrition-related diseases contribute to rising health care costs, food retail settings are providing a unique opportunity for registered dietitian nutritionists (RDNs) to address the nutritional needs of consumers. Food as Medicine interventions play a role in preventing and/or managing many chronic conditions that drive health care costs. The objective of this scoping review was to identify and characterize literature examining Food as Medicine interventions within food retail settings and across consumer demographics. An electronic literature search of 8 databases identified 11,404 relevant articles. Results from the searches were screened against inclusion criteria, and intervention effectiveness was assessed for the following outcomes: improvement in health outcomes and cost-effectiveness. One-hundred and eighty-six papers and 25 systematic reviews met inclusion criteria. Five categories surfaced as single interventions: prescription programs, incentive programs, medically tailored nutrition, path-to-purchase marketing, and personalized nutrition education. Multiple combinations of intervention categories, reporting of health outcomes (nutritional quality of shopping purchases, eating habits, biometric measures), and cost-effectiveness (store sales, health care dollar savings) also emerged. The intervention categories that produced both improved health outcomes and cost-effectiveness included a combination of incentive programs, personalized nutrition education, and path-to-purchase marketing. Food as Medicine interventions in the food retail setting can aid consumers in navigating health through diet and nutrition by encompassing the following strategic focus areas: promotion of health and well-being, managing chronic disease, and improving food security. Food retailers should consider the target population and desired focus areas and should engage registered dietitian nutritionists when developing Food as Medicine interventions.
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Understanding the Intersection of Race/Ethnicity, Socioeconomic Status, and Geographic Location: A Scoping Review of U.S. Consumer Food Purchasing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207677. [PMID: 33096828 PMCID: PMC7593902 DOI: 10.3390/ijerph17207677] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 01/11/2023]
Abstract
Disparities in diet quality persist in the U.S. Examining consumer food purchasing can provide unique insight into the nutritional inequities documented by race/ethnicity, socioeconomic status (SES), and geographic location (i.e., urban vs. rural). There remains limited understanding of how these three factors intersect to influence consumer food purchasing. This study aimed to summarize peer-reviewed scientific studies that provided an intersectional perspective on U.S. consumer food purchasing. Thirty-four studies were examined that presented objectively measured data on purchasing outcomes of interest (e.g., fruits, vegetables, salty snacks, sugar-sweetened beverages, Healthy Eating Index, etc.). All studies were of acceptable or high quality. Only six studies (17.6%) assessed consumer food purchases at the intersection of race/ethnicity, SES, or geographic location. Other studies evaluated racial/ethnic or SES differences in food purchasing or described the food and/or beverage purchases of a targeted population (example: low-income non-Hispanic Black households). No study assessed geographic differences in food or beverage purchases or examined purchases at the intersection of all three factors. Overall, this scoping review highlights the scarcity of literature on the role of intersectionality in consumer food and beverage purchasing and provides recommendations for future studies to grow this important area of research.
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Abstract
OBJECTIVE To examine cross-sectional associations of four aspects of the consumer food environment - price, availability, marketing and product placement - with BMI and fruit and vegetable intake. DESIGN This cross-sectional study measured the consumer food environment using grocery store audits and surveys. Outcomes were measured through surveys and physical exams. Multivariable linear regression models were run; models were all adjusted for age, neighbourhood, education, race/ethnicity and financial burden. SETTING Non-proportional quota sample of four socio-economically and racial/ethnically diverse neighbourhoods in Chicago, IL. PARTICIPANTS Women (n 228) aged 18-44 years. RESULTS Participants who reported seeing healthy food marketing had a higher vegetable intake (β = 0·24, 95 % CI 0·06, 0·42). There was some suggestive evidence that participants who shopped at stores that were more expensive (β = -0·90, 95 % CI -1·94, 0·14) had lower BMI, but this association was not statistically significant. Multivariable regression models did not indicate any significant association between any measure of the consumer food environment and fruit intake. CONCLUSIONS Our findings add to the growing interest in the role of the consumer food environment in health behaviours. Further research is needed to better understand the role of price and marketing characteristics on eating behaviours and BMI.
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Sharpe PA, Bell BA, Liese AD, Wilcox S, Stucker J, Hutto BE. Effects of a food hub initiative in a disadvantaged community: A quasi-experimental evaluation. Health Place 2020; 63:102341. [PMID: 32543428 PMCID: PMC7357735 DOI: 10.1016/j.healthplace.2020.102341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/02/2020] [Accepted: 04/08/2020] [Indexed: 11/16/2022]
Abstract
A quasi-experiment evaluated a food hub's (FH) impact in a low-income/low-access (food desert) setting on fruit and vegetable (F&V) intake, diet quality, kilocalories, perceived food environment, BMI, and farmers' market shopping versus a matched community (n = 265 FH, n = 262 Comparison). Comparison shoppers had better baseline perceptions of their food environment, but FH shoppers improved significantly more than Comparison shoppers. Comparison shoppers significantly increased F&V intake versus FH shoppers. Effects were not significant for other diet outcomes, BMI, or farmers' market shopping. Factors besides spacial access to healthy food need consideration to address dietary intake and obesity in disadvantaged communities.
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Affiliation(s)
- Patricia A Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, United States.
| | - Bethany A Bell
- College of Social Work, University of South Carolina, 1512 Pendelton Street, Columbia, SC, 29208, United States.
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States.
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, United States; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, United States.
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, United States.
| | - Brent E Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, United States.
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Food Access and Nutritional Status of Rural Adolescents in India: Pune Maternal Nutrition Study. Am J Prev Med 2020; 58:728-735. [PMID: 31982230 DOI: 10.1016/j.amepre.2019.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The relationships among food access, foods consumed, and nutritional status and health in developing countries are not well understood. Between 2013 and 2018, differences in the rural food environment and access to food, nutritional status, and body size in the rural villages where the Pune Maternal Nutrition birth cohort was recruited were measured and analyzed. METHODS Food access measures included the number of shops per 1,000 population, water availability, and distance from the highway. A total of 418 adolescents (223 boys, 195 girls) aged 18 years had diet assessed by a quantitative food frequency questionnaire; height, weight, and waist measured; body fat percentage determined by dual x-ray absorptiometry; and blood biomarkers (vitamin B12 and hemoglobin) assayed. RESULTS By village, the number of shops per 1,000 population ranged from 3.85 to 23.29. Boys and girls from the 2 villages with the highest food access, year-round water availability, and closest to the highway were heavier and had higher BMI, waist circumference, and body fat percentage compared with those from the lowest tertile of food access (p<0.05 for all, adjusted for SES). Across all villages, dietary diversity was poor and B12 insufficiency and anemia were prevalent. With easier access to food, consumption of staple foods decreased and outside food increased. On multivariate regression analysis, higher BMI of the adolescents was significantly associated with higher food access, along with higher weight at birth, socioeconomic scores, and daily energy consumption. CONCLUSIONS Results demonstrate a strong link between rural food access, foods consumed, and measures of nutritional status in an undernourished, mostly vegetarian, rural population.
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Mah CL, Luongo G, Hasdell R, Taylor NGA, Lo BK. A Systematic Review of the Effect of Retail Food Environment Interventions on Diet and Health with a Focus on the Enabling Role of Public Policies. Curr Nutr Rep 2019; 8:411-428. [PMID: 31797233 PMCID: PMC6904419 DOI: 10.1007/s13668-019-00295-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Update the state of evidence on the effectiveness of retail food environment interventions in influencing diet and explore the underlying role of public policy, through a systematic review of population-level interventions to promote health in the retail food environment, including community and consumer environments. Diet-related outcomes included purchasing, dietary intakes, diet quality, and health including weight. We coded studies for enabling public policy levers underpinning the intervention, using two widely used conceptual frameworks. RECENT FINDINGS Of 86 articles (1974-2018), the majority (58 articles, 67%) showed at least one positive effect on diet. Thirteen articles (15%) discussed natural experiments, 27 articles (31%) used a design involving comparison groups including 23 articles (27%) specifically describing randomized controlled trials, and 46 (53%) were quasi-experimental (cross-sectional) evaluations. Across the "4Ps" of marketing (product, promotion, placement, and price), promotion comprised the greatest proportion of intervention strategies, especially in earlier literature (pre-2008). Few studies combined geographic access interventions with 4P strategies, and few used robust dietary intake assessments. Behavior change communication remains an intervention mainstay, but recent work has also incorporated environmental and social planning, and fiscal strategies. More recent interventions were multi-component. The retail food environment intervention literature continues to grow and has become more robust overall, with clearer evidence of the effect of interventions on diet-related outcomes, including consumer purchasing, dietary intakes, and health. There is still much scope for development in the field. Attention to enabling public policy could help to strengthen intervention implementation and evaluation in the retail food environment.
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Affiliation(s)
- Catherine L. Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2 Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON M5T 3M7 Canada
| | - Gabriella Luongo
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON M5T 3M7 Canada
| | - Rebecca Hasdell
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2 Canada
| | - Nathan G. A. Taylor
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS B3H 4R2 Canada
| | - Brian K. Lo
- Division of Nutritional Sciences, Cornell University, 417 Savage Hall, Ithaca, NY 14850 USA
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Pedraza LS, Popkin BM, Batis C, Adair L, Robinson WR, Guilkey DK, Taillie LS. The caloric and sugar content of beverages purchased at different store-types changed after the sugary drinks taxation in Mexico. Int J Behav Nutr Phys Act 2019; 16:103. [PMID: 31718664 PMCID: PMC6849184 DOI: 10.1186/s12966-019-0872-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/24/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Following the 2014 sugary drinks tax implementation in Mexico, promising reduction in the volume of purchases of taxed beverages were observed overall and at different store-types. However, the tax's effects on purchasing patterns of calories and sugar remain unclear. METHODS Using longitudinal data from Mexican households (n = 7038), we examined changes in volume, calories and total sugar of packaged beverages purchased from 2012 to 2016 overall and by store-type. We used fixed effects models to estimate means for volume, calories, and sugar of households. To address the potential selectivity from households shopping at different stores, we calculated inverse probability weights to model the purchases changes over time by store-type. RESULTS For taxed beverages, the volume of purchases declined by - 49 ml and -30 ml in the first year and second year post tax (2014 and 2015, respectively), while purchases leveled off in the third year of the tax (2016). Calories and sugar from taxed beverage purchases decreased over time, with the majority of the declines occurring in the first two years post-tax implementation. The volume of untaxed beverage purchases increased, whereas changes in calories and total sugar of untaxed beverages were minimal. Store level purchases of taxed beverages significantly decreased in the first two years post taxation (2014 and to 2015) only in supermarkets and traditional stores. The steepest declines in purchases of taxed beverages in 2014 were observed at supermarkets (- 40 ml or - 45%). The volume of purchases of untaxed beverages increased over time in almost all store-types, while calories and sugar minimally decreased over time. CONCLUSION Although the Mexican tax on SSBs has lowered the purchases of sugary drinks 3 years after the tax implementation, the tax should be strengthened and store-specific interventions should be implemented to further reduce SSBs purchases in the Mexican population.
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Affiliation(s)
- Lilia S. Pedraza
- Department of Nutrition, Carolina Population Center, Gillings School of Public Health, University of North Carolina at Chapel Hill, CB # 2107 Carolina Square, Chapel Hill, NC 27516-3997 USA
| | - Barry M. Popkin
- Department of Nutrition, Carolina Population Center, Gillings School of Public Health, University of North Carolina at Chapel Hill, CB # 2107 Carolina Square, Chapel Hill, NC 27516-3997 USA
| | - Carolina Batis
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos Mexico
| | - Linda Adair
- Department of Nutrition, Carolina Population Center, Gillings School of Public Health, University of North Carolina at Chapel Hill, CB # 2107 Carolina Square, Chapel Hill, NC 27516-3997 USA
| | - Whitney R. Robinson
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina USA
| | - David K. Guilkey
- Economics Department, University of North Carolina, Chapel Hill, North Carolina USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Carolina Population Center, Gillings School of Public Health, University of North Carolina at Chapel Hill, CB # 2107 Carolina Square, Chapel Hill, NC 27516-3997 USA
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Gustafson A, Ng SW, Jilcott Pitts S. The association between the “Plate it Up Kentucky” supermarket intervention and changes in grocery shopping practices among rural residents. Transl Behav Med 2019; 9:865-874. [DOI: 10.1093/tbm/ibz064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Abstract
Rural communities experience higher rates of obesity, and residents have a lower intake of fruits and vegetables. Innovative healthy food promotions in supermarkets may improve healthy food access and dietary intake among residents, yet few supermarket interventions have been translated to the rural context. The aim of this project was to determine whether a supermarket-based intervention “Plate it Up Kentucky” was associated with change in fruit, vegetable, and sugar-sweetened beverage (SSB) purchases among rural supermarket customers. Ten Kentucky supermarkets participated in an intervention titled “Plate It Up” to provide in-store promotions, including recipe cards, samples, price reductions for specific fruits and vegetables, and marketing on shopping carts. Six stores in rural Kentucky and North Carolina were controls. Two cross-sectional customer intercept surveys were conducted among grocery store customers in Spring of 2016 (baseline, n = 131 control and n = 181 intervention store customers) and Spring–Summer of 2017 (post-intervention, n = 100 control and n = 83 intervention store customers). Customers were asked to provide store receipts and participate in a survey assessing grocery shopping practices and dietary intake. The primary outcome was purchases in fruit and vegetable (obtained from receipt data). The secondary outcome was dietary intake (captured with the National Cancer Institute's Fruit and Vegetable Screener and BRFSS questionnaire). An adjusted, difference-in-difference model was used to assess the differences between control and intervention store customers at baseline, post-intervention, and then between the two time points. Post-intervention, there was a greater increase in customers stating that they “liked the food” as one main reason for shopping in the store where surveyed among intervention versus control store customers. The adjusted difference-in-difference model indicated that intervention store customers spent on average 8% more on fruits and vegetables from baseline to post-intervention (p = .001) when compared with customers from control stores. Among controls, spending on SSB decreased from $3.61 at baseline to $3.25 at post-intervention, whereas among intervention customers, spending on SSB decreased from $2.75 at baseline to $1.81 at post-intervention (p = .02). In-store promotions that provide recipe cards, samples, price reductions for specific fruits and vegetables, and marketing on shopping carts hold promise as a method to promote healthy food purchases among rural supermarket customers at two time points.
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Affiliation(s)
- Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, USA
| | - Shu Wen Ng
- Department of Nutrition, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Blow J, Patel S, Davies IG, Gregg R. Sociocultural aspects of takeaway food consumption in a low-socioeconomic ward in Manchester: a grounded theory study. BMJ Open 2019; 9:e023645. [PMID: 30833315 PMCID: PMC6443065 DOI: 10.1136/bmjopen-2018-023645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Takeaway foods form a growing proportion of the UK diet. This consumption is linked with poor health outcomes due to their adverse nutritional profile. However, there is little research regarding the sociocultural context surrounding the consumption of takeaway meals. This research aimed to explore the sociocultural factors that influence the consumption of takeaway foods. DESIGN The study employed constructivist grounded theory (GT) methodology. Data were collected using one-to-one semi-structured interviews from an inner-city area of Manchester (Rusholme). Data sorting and analysis was implemented using the GT constant comparative method. SETTING Rusholme, Manchester, UK. PARTICIPANTS Adult participants (aged 18 to 65 years) consuming takeaway meals at least once/month were recruited using social media and community settings. RESULTS 13 participants were interviewed (female 69%, mean age=38 years). Three superordinate themes were derived from data: social factors, personal factors and resources. Social Factors included the influence of routines and traditions, influential others and a sense of community in the bonding and affirming of relationships. Personal Factors explored the subordinate themes of controlling damage and values relating to food choice. The third theme 'Resources' included time, availability, cost and quality. CONCLUSION This study shows the sociocultural influences on food choice decisions are complex and may go beyond access and availability. Any policy change to limit takeaway consumption should acknowledge these vital processes in food choice to inform targeted effective approaches.
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Affiliation(s)
- Jennifer Blow
- Health Professionals, Manchester Metropolitan University Faculty of Health Psychology and Social Care, Manchester, UK
| | - Sumaiya Patel
- Health Professionals, Manchester Metropolitan University Faculty of Health Psychology and Social Care, Manchester, UK
| | - Ian G Davies
- Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Rebecca Gregg
- Health Professionals, Manchester Metropolitan University Faculty of Health Psychology and Social Care, Manchester, UK
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Minkler M, Estrada J, Dyer S, Hennessey-Lavery S, Wakimoto P, Falbe J. Healthy Retail as a Strategy for Improving Food Security and the Built Environment in San Francisco. Am J Public Health 2019; 109:S137-S140. [PMID: 30785796 DOI: 10.2105/ajph.2019.305000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In low-income neighborhoods without supermarkets, lack of healthy food access often is exacerbated by the saturation of small corner stores with tobacco and unhealthy foods and beverages. We describe a municipal healthy retail program in San Francisco, California, focusing on the role of a local coalition in program implementation and outcomes in the city's low income Tenderloin neighborhood. By incentivizing selected corner stores to become healthy retailers, and through community engagement and cross-sector partnerships, the program is seeing promising outcomes, including a "ripple effect" of improvement across nonparticipating neighborhood stores.
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Affiliation(s)
- Meredith Minkler
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
| | - Jessica Estrada
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
| | - Shelley Dyer
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
| | - Susana Hennessey-Lavery
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
| | - Patricia Wakimoto
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
| | - Jennifer Falbe
- Meredith Minkler, is with the School of Public Health, University of California Berkeley. Jessica Estrada is with and Susana Hennessey-Lavery was with the San Francisco Department of Public Health, Community Health Equity and Promotion Branch, San Francisco, CA. Shelley Dyer is with the Tenderloin Neighborhood Development Corporation, Tenderloin Healthy Corner Store Coalition, San Francisco. Patricia Wakimoto is with the Nutrition Policy Institute, University of California, Davis. Jennifer Falbe is with the Human Development and Family Studies Unit, Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis
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Vogel C, Abbott G, Ntani G, Barker M, Cooper C, Moon G, Ball K, Baird J. Examination of how food environment and psychological factors interact in their relationship with dietary behaviours: test of a cross-sectional model. Int J Behav Nutr Phys Act 2019; 16:12. [PMID: 30700323 PMCID: PMC6354411 DOI: 10.1186/s12966-019-0772-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/15/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To improve population diet environmental strategies have been hailed the panacea because they require little agency or investment of personal resources; this contrasts with conventional strategies that rely on individuals to engage high levels of agency and make deliberate choices. There is an immediate need to improve understanding of the synergy between the psychological and environmental determinants of diet in order to optimise allocation of precious public health resources. This study examined the synergistic and relative association between a number of food environment and psychological factors and the dietary behaviours of a population sample of women with young children. METHODS Women in Hampshire were recruited from children's centres and asked about their demographic characteristics, psychological resources, dietary behaviours (food frequency questionnaire) and perceptions of healthy food access and affordability. Three local food environment factors were objectively assessed: i) spatial access to food outlets using activity spaces; ii) healthfulness of the supermarket where women did their main food shop, (based on nine in-store factors including price, placement and promotion on seven healthy and five less healthy foods); iii) nutrition environment of children's centres visited frequently by the women, assessed via staff-administered questionnaire. A theoretical model linking environmental factors to dietary behaviours, both directly and indirectly through three factors representing individual agency (psychological resources, perceived food affordability, perceived food accessibility), was tested using Structural Equation Modelling. RESULTS Complete data were available for 753 women. The environment of women's main supermarket was indirectly related to their dietary behaviours through psychological resources and perceived food affordability. Shopping at supermarkets classified as having a healthier in-store environment was associated with having greater psychological resources associated with healthy eating (standardised regression weight β = 0.14SD, p = 0.03) and fewer food affordability concerns (β = - 0.14SD, p = 0.01), which in turn related to healthier dietary behaviours (β = 0.55SD, < 0.001 and β = - 0.15, p = 0.01 respectively). The three food environment factors were not directly associated with dietary behaviour (p > 0.3). The overall model fit was good (CFI = 0.91, RMSEA = 0.05 [0.05, 0.06]). CONCLUSIONS This pathway analysis identified three focal points for intervention and suggests that high-agency interventions targeting individual psychological resources when combined with low-agency supermarket environment interventions may confer greater benefits on dietary behaviours than either intervention alone.
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Affiliation(s)
- Christina Vogel
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125 Australia
| | - Georgia Ntani
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD UK
| | - Mary Barker
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
| | - Graham Moon
- School of Geography and Environmental Science, University of Southampton, University Road, Southampton, SO17 1BJ UK
| | - Kylie Ball
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125 Australia
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
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McGuirt JT, Jilcott Pitts SB, Gustafson A. Association between Spatial Access to Food Outlets, Frequency of Grocery Shopping, and Objectively-Assessed and Self-Reported Fruit and Vegetable Consumption. Nutrients 2018; 10:E1974. [PMID: 30551652 PMCID: PMC6316649 DOI: 10.3390/nu10121974] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/04/2018] [Accepted: 12/11/2018] [Indexed: 12/30/2022] Open
Abstract
Because supermarkets are a critical part of the community food environment, the purpose of this paper is to examine the association between accessibility to the supermarket where participants were surveyed, frequency of shopping at the supermarket, and self-reported and objectively-assessed fruit and vegetable consumption. Accessibility was assessed using Geographic Information Systems (GIS) measured distance and multiple versions of the modified Retail Food Environment Index (mRFEI), including a localized road network buffer version. Frequency of shopping was assessed using self-report. The National Cancer Institute Fruit and Vegetable screener was used to calculate daily servings of fruits and vegetables. Skin carotenoids were assessed using the "Veggie Meter™" which utilizes reflection spectroscopy to non-invasively assess skin carotenoids as an objective measure of fruit and vegetable consumption. Bivariate and multivariable statistics were used to examine the associations in RStudio. There was a positive association between skin carotenoids and the Special Supplemental Nutrition Program for Women Infants and Children (WIC) and mRFEI scores, suggesting that WIC participation and a healthier food environment were associated with objectively-assessed fruit and vegetable consumption (skin carotenoids). Future research should examine these associations using longitudinal study designs and larger sample sizes.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, School of Human Environmental Sciences, University of Kentucky, Lexington, KY 40506, USA.
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Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102247. [PMID: 30322198 PMCID: PMC6210243 DOI: 10.3390/ijerph15102247] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/28/2022]
Abstract
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual's homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04⁻1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11⁻2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04⁻1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people's home is an important environmental factor in meeting fruit and vegetable consumption guidelines. "Food swamps" (areas with an abundance of unhealthy foods) rather than "food deserts" (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong's urban areas. We advanced international literature by providing evidence in a non-western setting.
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