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Houghtaling B, Serrano E, Dobson L, Chen S, Kraak VI, Harden SM, Davis GC, Misyak S. Rural independent and corporate Supplemental Nutrition Assistance Program (SNAP)-authorized store owners' and managers' perceived feasibility to implement marketing-mix and choice-architecture strategies to encourage healthy consumer purchases. Transl Behav Med 2020; 9:888-898. [PMID: 31570926 DOI: 10.1093/tbm/ibz091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Supplemental Nutrition Assistance Program (SNAP) participants could benefit from exposure to marketing-mix and choice-architecture (MMCA) strategies that encourage healthy consumer purchases. However, the perceived feasibility of independent and corporate SNAP-authorized store owners and managers (e.g., retailers) to implement healthy MMCA strategies is understudied. The purpose of this study was to inform a healthy food retail program that meets both public health and business expectations by prioritizing retailer perspectives. A mixed methods approach was used. Retailers completed a card sorting exercise to determine perceived feasibility to implement MMCA strategies place, profile, portion, pricing, promotion, priming, prompting, and proximity. This process was audio-recorded. Chi-square was used to identify potential differences in perceived feasibility to implement healthy MMCA strategies between independent and corporate SNAP-authorized retailers. Qualitative data were coded among a panel to construct themes. Themes were organized by barriers and facilitators and coded for strategy acceptability, appropriateness, and feasibility. SNAP-authorized retailers' (n = 29) considered prompting (e.g., labeling; 83%) and proximity (e.g., location; 90%) strategies to encourage healthy consumer purchases highly feasible. Few differences were detected between independent and corporate retailers' perceived feasibility to implement healthy MMCA strategies. The largest barriers to implementing healthy MMCA strategies were related to strategy appropriateness. Priorities for healthy food retail initiatives included prompting and proximity changes that highlight products aligned with the DGA, without altering products available to consumers that are misaligned with the DGA. Future work is required to understand how other healthy MMCA strategies may be adapted to enhance their appropriateness for these settings.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Elena Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Liza Dobson
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Susan Chen
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Sarah Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
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The complexities of selling fruits and vegetables in remote Navajo Nation retail outlets: perspectives from owners and managers of small stores. Public Health Nutr 2020; 23:1638-1646. [PMID: 32019628 DOI: 10.1017/s1368980019003720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Navajo Nation residents experience extreme rates of poverty, food insecurity and diet-related diseases. While many residents travel far to shop at grocery stores, there are small stores closer to home that could provide more healthy options, like fruits and vegetables (F&V). Little is known from the perspective of store owners and managers regarding the barriers and facilitators to offering F&V; the present study contributes to filling that gap. DESIGN Data were collected through structured interviews from a sampling frame of all store owners or managers in the setting (n 29). SETTING Small stores in Navajo Nation, New Mexico, USA. Navajo Nation is predominantly rural and the largest federally recognized Native American tribe in the USA. PARTICIPANTS Sixteen managers and six owners at twenty-two stores. RESULTS When asked about the types of foods that were most commonly purchased at their stores, most participants reported snacks and drinks (82 and 68 %, respectively). Many participants reported they would like to offer more fresh F&V. However, barriers included varying perceived customer demand, limited F&V choices from distributors and (for some managers) limited authority over product selection. CONCLUSIONS Findings contribute to the discussion on engaging store owners and managers in providing quality, healthy foods close to home in low-income, rural regions.
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Samuel-Nakamura C, Hodge FS, Sokolow S, Ali AMS, Robbins WA. Metal(loid)s in Cucurbita pepo in a Uranium Mining Impacted Area in Northwestern New Mexico, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142569. [PMID: 31323819 PMCID: PMC6679051 DOI: 10.3390/ijerph16142569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 12/22/2022]
Abstract
More than 500 unreclaimed mines and associated waste sites exist on the Navajo Nation reservation as a result of uranium (U) mining from the 1940s through the 1980s. For this study, the impact of U-mine waste on a common, locally grown crop food was examined. The goal of this site-specific study was to determine metal(loid) concentration levels of arsenic (As), cadmium (Cd), cesium (Cs), molybdenum (Mo), lead (Pb), thorium (Th), U, vanadium (V) and selenium (Se) in Cucurbita pepo Linnaeus (squash), irrigation water, and soil using inductively coupled plasma-mass spectrometry. The concentrations of metal(loid)s were greatest in roots > leaves > edible fruit (p < 0.05), respectively. There were significant differences between metal(loid)s in squash crop plot usage (<5 years versus >30 years) for V (p = 0.001), As (p < 0.001), U (p = 0.002), Cs (p = 0.012), Th (p = 0.040), Mo (p = 0.047), and Cd (p = 0.042). Lead and Cd crop irrigation water concentrations exceeded the United States Environmental Protection Agency (USEPA) Maximum Contaminant Levels for drinking water for those metals. Edible squash concentration levels were 0.116 mg/kg of As, 0.248 mg/kg of Pb, 0.020 mg/kg of Cd, and 0.006 mg/kg of U. Calculated human ingestion of edible squash did not exceed Provisional Tolerable Weekly Intake or Tolerable Upper Limit levels from intake based solely on squash consumption. There does not appear to be a food-ingestion risk from metal(loid)s solely from consumption of squash. Safer access and emphasis on consuming regulated water was highlighted. Food intake recommendations were provided. Continued monitoring, surveillance, and further research are recommended.
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Affiliation(s)
- Christine Samuel-Nakamura
- School of Nursing, University of California, Los Angeles (UCLA), 4-246 Factor Bldg., Mailcode 691821, Los Angeles, CA 90095, USA.
| | - Felicia S Hodge
- School of Nursing, University of California, Los Angeles (UCLA), 5-940 Factor Bldg., Mailcode 691921, Los Angeles, CA 90095, USA
| | - Sophie Sokolow
- School of Nursing, University of California, Los Angeles (UCLA), 5-238 Factor Bldg., Mailcode 691921, Los Angeles, CA 90095, USA
| | - Abdul-Mehdi S Ali
- Department of Earth and Planetary Sciences, University of New Mexico, Northrop Hall MSCO 3-2040 Albuquerque, NM 87131, USA
| | - Wendie A Robbins
- Center for Occupational and Environmental Health Fielding School of Public Health, Environmental Health Sciences, University of California, Los Angeles (UCLA), 5-254 Factor Bldg., Mailcode 956919, Los Angeles, CA 90095, USA
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Houghtaling B, Serrano EL, Kraak VI, Harden SM, Davis GC, Misyak SA. A systematic review of factors that influence food store owner and manager decision making and ability or willingness to use choice architecture and marketing mix strategies to encourage healthy consumer purchases in the United States, 2005-2017. Int J Behav Nutr Phys Act 2019; 16:5. [PMID: 30642352 PMCID: PMC6332888 DOI: 10.1186/s12966-019-0767-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Altering food store environments is a promising approach to encourage healthy product purchases by consumers to improve their diet quality and health. Food store owners and managers are intermediaries to ensure that environmental changes are enacted. Despite their role as gatekeepers to implement and sustain healthy food environment changes, no systematic review has been published that examines food store owner and manager (retailer) data. Thus a review of retailer information available within the expansive United States (US) food environment literature was the purpose of this research. Methods The PRISMA protocol was used. A search strategy, including published articles from years 1980–2017, was applied to six databases to locate relevant articles that addressed the perspective of food store retailers in the US. Data were extracted, organized, and agreed upon between two authors based on pre-designed constructs: (1) a social-ecological model to capture factors that influence retailer decision making; and (2) a marketing-mix and choice-architecture framework to examine perspectives of applied (or the prospective application of) strategies at the store-level. Study quality was assessed using quality criteria checklists for qualitative and quantitative research. Results Thirty-one articles met inclusion criteria and most studies (n = 22) were qualitative and conducted in urban food stores (n = 23). Multiple social-ecological factors influenced retailer decision making and ability or willingness to use marketing-mix and choice-architecture strategies to improve consumers’ healthy choices to support dietary quality. These factors included: conflicting training outcomes to enhance retailers’ knowledge and skills (individual, n = 9); the importance of trust (interpersonal, n = 8); views about marketing-mix and choice-architecture strategies in the food environment (n = 25); consumer demand or demographics (community, n = 19); supplier and food store management variables (systems or sectors, n = 18); local and federal policy (n = 8); and support for community health (norms/values, n = 8). Conclusions Research partnerships can support favorable business and public health outcomes to align with retailers’ business models and available resources. A participatory and translational approach to food environment research will likely maximize public health impact. Urban and rural food store retailers are important actors for future research to inform the feasibility of store retailers to apply MMCA strategies that are profitable and promote health. Electronic supplementary material The online version of this article (10.1186/s12966-019-0767-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, 337 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, Virginia, VA, 24061, USA.
| | - Elena L Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia, USA
| | - Sarah A Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
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Ornelas IJ, Deschenie D, Jim J, Bishop S, Lombard K, Beresford SA. Yéego Gardening! A Community Garden Intervention to Promote Health on the Navajo Nation. Prog Community Health Partnersh 2017; 11:417-425. [PMID: 29332855 PMCID: PMC6582943 DOI: 10.1353/cpr.2017.0049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Yéego Gardening! is a community garden intervention to increase gardening behavior, increase access to low-cost fruit and vegetables, and ultimately increase consumption in Navajo communities. OBJECTIVES To design a theory-based, culturally relevant intervention with three components: a community garden, monthly workshops on gardening and healthy eating, and community outreach. METHODS Gardens were constructed and maintained in collaboration with community-based organizations in two Navajo communities. Monthly workshops were held throughout the growing season and incorporated aspects of Navajo culture and opportunities to build confidence and skills in gardening and healthy eating behaviors. In addition, program staff attended community events to promote gardening and healthy eating. CONCLUSIONS Community input was essential throughout the planning and implementation of the intervention. If effective, community gardens may be a way to increase fruit and vegetable availability and intake, and ultimately reduce risk of obesity and diabetes.
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Carbone ET, DiFulvio GT, Susi T, Nelson-Peterman J, Lowbridge-Sisley J, Collins J. Evaluation of an Urban Farm-to-Preschool and Families Program. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016; 36:177-87. [PMID: 26984184 DOI: 10.1177/0272684x16637722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past 30 years, the rate of childhood obesity has risen dramatically. Despite recent declines in prevalence among preschool-aged children, child obesity is still a significant public health concern. Healthy People 2020 objectives include increasing fruit and vegetable consumption among children over 2 years of age and increasing the number of schools that offer access to fresh fruits and vegetables. To reach these objectives, farm-to-school programs are being implemented across the United States. The purpose of this evaluation was to: (a) identify factors that facilitate adoption of the Farm-to-Preschool and Families program in Springfield, MA, specifically; and (b) provide recommendations and guidelines for successful implementation of Farm-to-Preschool and Families programs generally. Using a combination of classroom observations of preschoolers, teacher and food service interviews, and administrator surveys, the findings suggest that having a strong programmatic infrastructure, administrative support, and external support from families is important to sustain a Farm-to-Preschool and Families program.
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Affiliation(s)
- Elena T Carbone
- Department of Nutrition, University of Massachusetts Amherst, Amherst, MA, USA
| | - Gloria T DiFulvio
- Department of Community Health Education, University of Massachusetts Amherst, Amherst, MA, USA
| | - Toni Susi
- Department of Nutrition, University of Massachusetts Amherst, Amherst, MA, USA
| | | | | | - Jessica Collins
- Partners for a Healthier Community Inc., Springfield, MA, USA
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Trude ACB, Kharmats A, Jock B, Liu D, Lee K, Martins PA, Pardilla M, Swartz J, Gittelsohn J. Patterns of Food Consumption are Associated with Obesity, Self-Reported Diabetes and Cardiovascular Disease in Five American Indian Communities. Ecol Food Nutr 2015; 54:437-54. [PMID: 26036617 DOI: 10.1080/03670244.2014.922070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The relationship between dietary patterns and chronic disease is underexplored in indigenous populations. We assessed diets of 424 American Indian (AI) adults living in 5 rural AI communities. We identified four food patterns. Increased prevalence for cardiovascular disease was highly associated with the consumption of unhealthy snacks and high fat-food patterns (OR 3.6, CI=1.06, 12.3; and OR 6.0, CI=1.63, 22.1), respectively. Moreover, the food-consumption pattern appeared to be different by community setting (p<.05). We recommend culturally appropriate community-intervention programs to promote healthy behavior and to prevent diet-related chronic diseases in this high-risk population.
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Affiliation(s)
- Angela C B Trude
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health,, Baltimore, Maryland, USA
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