Mobilizing Young People in Community Efforts to Improve the Food Environment: Corner Store Conversions in East Los Angeles

How to increase community participation capacity in food environment policymaking: Results of a scoping review

Background: Food environment plays a major role in health outcomes. A growing interest in community-based participatory research (CBPR) has led to its application in the improvement of the food environment. This scoping review aims to compile and map the literature and identify key strategies used for increasing community participation capacity in the food environment policymaking process.

Methods: The scoping review of peer-reviewed articles on community participation and food environment policymaking followed the framework suggested by Arksey and O'Malley (2005). Scopus, PubMed, and Web of Science were searched. A charting table was developed to extract the key information of each identified study. A directed content analysis approach was used to assign retrieved codes into categories proposed by Foster-Fishman.

Results: A total of 28 studies were included in this review. Most studies used the CBPR approach to involve the community at least in the problem identification step of the policymaking process (n=12) and 7 studies reported their involvement in all the steps of policymaking. In 15 out of 28 studies, the level of community participation was at "involvement" and in 8 studies it was at "empowerment". Strategies for increasing relational capacity, member capacity, programmatic capacity, and organizational capacity of community participation were reviewed.

Conclusion: To improve food environment using the community-participation approach, identifying different strategies and adjusting them based on the social and political context of each society is of high importance.

Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health

Multilevel interventions are those that affect at least two levels of influence-for example, the patient and the health care provider. They can be experimental designs or natural experiments caused by changes in policy, such as the implementation of the Affordable Care Act or local policies. Measuring the effects of multilevel interventions is challenging, because they allow for interaction among levels, and the impact of each intervention must be assessed and translated into practice. We discuss how two projects from the National Institutes of Health's Centers for Population Health and Health Disparities used multilevel interventions to reduce health disparities. The interventions, which focused on the uptake of the human papillomavirus vaccine and community-level dietary change, had mixed results. The design and implementation of multilevel interventions are facilitated by input from the community, and more advanced methods and measures are needed to evaluate the impact of the various levels and components of such interventions.

Community Residents' Beliefs About Neighborhood Corner Stores in 2 Latino Communities: Implications for Interventions to Improve the Food Environment

We assessed community residents' perceptions of corner stores to better understand what facilitates and deters patronage at these food outlets. Data came from 978 household interviews in 2 Latino communities undergoing corner store interventions. Chi-square tests, an independent sample t test, and a multivariate logistic regression were conducted to assess the relationship between residents' perceptions about corner stores and their reported patronage at these food outlets. Residents reported that corner stores do not sell a variety of fruits and vegetables and are not places where one can get information about healthy eating. Convenience, cleanliness, positive customer service, availability of culturally appropriate items, and availability of quality fresh fruit increased the odds of store patronage. Simply providing healthy foods will not incentivize patrons to purchase them. Corner store interventions can be more effective if they address the characteristics that community residents prioritize.

A corner store intervention to improve access to fruits and vegetables in two Latino communities

OBJECTIVE

Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities.

DESIGN

A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions.

SETTING

Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA.

SUBJECTS

Store patrons were interviewed before (n550) and after (n407) the intervention.

RESULTS

Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V.

CONCLUSIONS

Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.

Training the Next Generation of Latino Health Researchers: A Multilevel, Transdisciplinary, Community-Engaged Approach

Reducing health disparities is a national public health priority. Latinos represent the largest racial/ethnic minority group in the United States and suffer disproportionately from poor health outcomes, including cardiovascular disease risk. Academic training programs are an opportunity for reducing health disparities, in part by increasing the diversity of the public health workforce and by incorporating training designed to develop a skill set to address health disparities. This article describes the Training and Career Development Program at the UCLA Center for Population Health and Health Disparities: a multilevel, transdisciplinary training program that uses a community-engaged approach to reduce cardiovascular disease risk in two urban Mexican American communities. Results suggest that this program is effective in enhancing the skill sets of traditionally underrepresented students to become health disparities researchers and practitioners.