1
|
Lu I, Sheppard B, Chapman L, Barnes L, De Marco M. Evaluation of a Sparkling Water Promotion Intervention on Sales at Convenience Stores in the Southeastern US. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:310-320. [PMID: 38466245 DOI: 10.1016/j.jneb.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE This study investigated the feasibility of in-store signage promoting sparkling water and the impact of this signage on sparkling water sales in convenience stores. DESIGN We conducted a randomized control trial. SETTING Convenience stores in North Carolina. PARTICIPANTS Twenty-four convenience stores in neighborhoods with a higher proportion of Supplemental Nutrition Assistance Program-eligible households. INTERVENTION(S) The 24 eligible stores were randomized to receive the in-store signage promoting sparkling water or to the control condition of no change. One poster was hung on the beverage cooler doors in front of the sparkling water selections at each of the 12 participating stores. Weekly sales data and fidelity checks were collected. MAIN OUTCOME MEASURE(S) The primary outcome measure was sales of total water, and the subanalysis was sales of sparkling water. ANALYSIS T tests were conducted to assess changes in total water and sparkling water sales between intervention and control stores. RESULTS In-store signage did not significantly increase sales of sparkling water, or all water, during the intervention. CONCLUSIONS AND IMPLICATIONS Signage alone may not be enough to impact healthy beverage purchasing, and signage should be paired with other promotional components to increase healthy beverage purchases in convenience stores.
Collapse
Affiliation(s)
- Isabel Lu
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Brett Sheppard
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Leah Chapman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lee Barnes
- Institute for Social Innovation at Fielding Graduate University, Santa Barbara, CA
| | - Molly De Marco
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
2
|
Caruso OT, McEachern LW, Minaker LM, Gilliland JA. The Influence of the School Neighborhood Food Retail Environment on Unhealthy Food Purchasing Behaviors Among Adolescents: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:145-161. [PMID: 38284954 DOI: 10.1016/j.jneb.2023.11.005] [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: 06/05/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Adolescents are often exposed to food retailers selling unhealthy food items during their lunch breaks and school commutes. This systematic review examines the influence of school neighborhood food retail environments on adolescent food purchasing. METHODS A systematic search of 6 databases. Observational studies published from January 2012 to December 2022 that measured food availability, accessibility, or exposure, measured food purchasing, and focused on adolescents (aged 10-19 years) were eligible for inclusion. RESULTS Twelve studies with 97 findings were included. Thirty-one findings indicated that a school neighborhood with a high density of unhealthy food retail, a school with unhealthy food retail nearby, or exposure to unhealthy food retail on the journey to/from school was associated with higher prevalence and frequency of unhealthy food purchases. DISCUSSION Adolescents' food purchasing behaviors may be meaningfully affected by their school neighborhood food retail environment; however, the included studies have many methodological shortcomings. IMPLICATIONS FOR RESEARCH AND PRACTICE Results identify the need for new studies that measure food purchasing, use comprehensive definitions of food retail environments, and adopt more rigorous methods to approximate exposure to food retail. More robust evidence would strengthen the rationale for policy or program interventions and potentially indicate specific targets for intervention.
Collapse
Affiliation(s)
- Olivia T Caruso
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Louise W McEachern
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Department of Pediatrics, Western University, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| |
Collapse
|
3
|
Zorbas C, Blake MR, Brown AD, Peeters A, Allender S, Brimblecombe J, Cameron AJ, Whelan J, Ferguson M, Alston L, Boelsen-Robinson T. A systems framework for implementing healthy food retail in grocery settings. BMC Public Health 2024; 24:137. [PMID: 38195419 PMCID: PMC10777568 DOI: 10.1186/s12889-023-17075-8] [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: 05/26/2023] [Accepted: 10/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Food retailers can be reluctant to initiate healthy food retail activities in the face of a complex set of interrelated drivers that impact the retail environment. The Systems Thinking Approach for Retail Transformation (START) is a determinants framework created using qualitative systems modelling to guide healthy food retail interventions in community-based, health-promoting settings. We aimed to test the applicability of the START map to a suite of distinct healthy food marketing and promotion activities that formed an intervention in a grocery setting in regional Victoria, Australia. METHODS A secondary analysis was undertaken of 16 previously completed semi-structured interviews with independent grocery retailers and stakeholders. Interviews were deductively coded against the existing START framework, whilst allowing for new grocery-setting specific factors to be identified. New factors and relationships were used to build causal loop diagrams and extend the original START systems map using Vensim. RESULTS A version of the START map including aspects relevant to the grocery setting was developed ("START-G"). In both health-promoting and grocery settings, it was important for retailers to 'Get Started' with healthy food retail interventions that were supported by a proof-of-concept and 'Focus on the customer' response (with grocery-settings focused on monitoring sales data). New factors and relationships described perceived difficulties associated with disrupting a grocery-setting 'Supply-side status quo' that promotes less healthy food and beverage options. Yet, most grocery retailers discussed relationships that highlighted the potential for 'Healthy food as innovation' and 'Supporting cultural change through corporate social responsibility and leadership'. CONCLUSIONS Several differences were found when implementing healthy food retail in grocery compared to health promotion settings. The START-G map offers preliminary guidance for identifying and addressing commercial interests in grocery settings that currently promote less healthy foods and beverages, including by starting to address business outcomes and supplier relationships.
Collapse
Affiliation(s)
- Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia.
| | - Miranda R Blake
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Andrew D Brown
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Steve Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Julie Brimblecombe
- Department of Nutrition and Dietetics, Monash University, 264 Ferntree Gully Rd, Notting Hill, VIC, Australia
| | - Adrian J Cameron
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Jill Whelan
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, St Lucia, QLD, Australia
| | - Laura Alston
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
- Deakin Rural Health, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Tara Boelsen-Robinson
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| |
Collapse
|
4
|
Petimar J, Moran AJ, Grummon AH, Anderson E, Lurie P, John S, Rimm EB, Thorndike AN. In-Store Marketing and Supermarket Purchases: Associations Overall and by Transaction SNAP Status. Am J Prev Med 2023; 65:587-595. [PMID: 36878416 PMCID: PMC10475490 DOI: 10.1016/j.amepre.2023.02.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION In-store placement promotions are used widely in supermarkets, but their effects on customer purchases remain largely unknown. This study examined associations of supermarket placement promotions with customer purchases overall and by Supplemental Nutrition Assistance Program (SNAP) benefit use. METHODS Data on in-store promotions (e.g., endcaps, checkout displays) and transactions (n=274,118,338) were obtained from a New England supermarket chain with 179 stores from 2016 to 2017. Product-level analyses examined multivariable-adjusted changes in products' sales when they were promoted (versus not) across all transactions and stratified by whether the transaction was paid for with SNAP benefits. Food group-level analyses examined the extent to which a 20% increase from the mean number of weekly promotions for a food group (e.g., increasing the number of candy promotions from 17.0 to 20.4) was associated with total food group sales. Analyses were conducted in 2022. RESULTS Across stores, the mean (SD) number of promotions per week was highest for sweet/salty snacks (126.3 [22.6]), baked goods (67.5 [18.4]), and sugar-sweetened beverages (48.6 [13.8]) and lowest for beans (5.0 [2.6]) and fruits (6.6 [3.3]). Product sales were between 16% (low-calorie drinks) and 136% (candy) higher when promoted versus not promoted. In 14 of 15 food groups, associations were stronger among transactions made with SNAP benefits than among those not made with SNAP benefits. The number of in-store promotions was generally not associated with total food group sales. CONCLUSIONS In-store promotions, which were mostly for unhealthy foods, were associated with large product sales increases, particularly among SNAP purchasers. Policies limiting unhealthy in-store promotions and incentivizing healthy promotions should be explored.
Collapse
Affiliation(s)
- Joshua Petimar
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Alyssa J Moran
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Anna H Grummon
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emma Anderson
- Department of Population Health Management, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Peter Lurie
- Center for Science in the Public Interest, Washington, District of Columbia
| | - Sara John
- Center for Science in the Public Interest, Washington, District of Columbia
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Anne N Thorndike
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
5
|
Chan JA, Koster A, Eussen SJPM, Pinho MGM, Lakerveld J, Stehouwer CDA, Dagnelie PC, van der Kallen CJ, van Greevenbroek MMJ, Wesselius A, Bosma H. The association between the food environment and adherence to healthy diet quality: the Maastricht Study. Public Health Nutr 2023; 26:1775-1783. [PMID: 37340803 PMCID: PMC10478064 DOI: 10.1017/s1368980023001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The purpose of this study is to determine if healthier neighbourhood food environments are associated with healthier diet quality. DESIGN This was a cross-sectional study using linear regression models to analyse data from the Maastricht Study. Diet quality was assessed using data collected with a FFQ to calculate the Dutch Healthy Diet (DHD). A buffer zone encompassing a 1000 m radius was created around each participant home address. The Food Environment Healthiness Index (FEHI) was calculated using a Kernel density analysis within the buffers of available food outlets. The association between the FEHI and the DHD score was analysed and adjusted for socio-economic variables. SETTING The region of Maastricht including the surrounding food retailers in the Netherlands. PARTICIPANTS 7367 subjects aged 40-75 years in the south of the Netherlands. RESULTS No relationship was identified between either the FEHI (B = 0·62; 95 % CI = -2·54, 3·78) or individual food outlets, such as fast food (B = -0·07; 95 % CI = -0·20, 0·07) and diet quality. Similar null findings using the FEHI were identified at the 500 m (B = 0·95; 95 % CI = -0·85, 2·75) and 1500 m (B = 1·57; 95 % CI = -3·30, 6·44) buffer. There was also no association between the food environment and individual items of the DHD including fruits, vegetables and sugar-sweetened beverages. CONCLUSION The food environment in the Maastricht area appeared marginally unhealthy, but the differences in the food environment were not related to the quality of food that participants reported as intake.
Collapse
Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Simone JPM Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Maria Gabriela M Pinho
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Coen DA Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Marleen MJ van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Anke Wesselius
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
6
|
Kelley K, Peacock C, Wright L, Yakes Jimenez E. Cross-Sectional Food Environment Observations Conducted for Small Supplemental Nutrition Assistance Program Authorized Retailers in Pinellas County, Florida, Suggest Limited Availability and High Cost of Some Healthful Food Items. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023. [DOI: 10.1080/19320248.2023.2174061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Kathryn Kelley
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | | | - Lauri Wright
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, USA
| | - Elizabeth Yakes Jimenez
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, USA
- Departments of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| |
Collapse
|
7
|
Kalbus A, Cornelsen L, Ballatore A, Cummins S. Associations between the food environment and food and drink purchasing using large-scale commercial purchasing data: a cross-sectional study. BMC Public Health 2023; 23:72. [PMID: 36627591 PMCID: PMC9831883 DOI: 10.1186/s12889-022-14537-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/03/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Evidence for an association between the local food environment, diet and diet-related disease is mixed, particularly in the UK. One reason may be the use of more distal outcomes such as weight status and cardiovascular disease, rather than more proximal outcomes such as food purchasing. This study explores associations between food environment exposures and food and drink purchasing for at-home and out-of-home (OOH) consumption. METHODS We used item-level food and drink purchase data for London and the North of England, UK, drawn from the 2019 Kantar Fast Moving Consumer Goods panel to assess associations between food environment exposures and household-level take-home grocery (n=2,118) and individual-level out-of-home (n=447) food and drink purchasing. Density, proximity and relative composition measures were created for both supermarkets and OOH outlets (restaurants and takeaways) using a 1 km network buffer around the population-weighted centroid of households' home postcode districts. Associations between food environment exposure measures and frequency of take-home food and drink purchasing, total take-home calories, calories from fruits and vegetables, high fat, salt and sugar products, and ultra-processed foods (UPF), volume of take-home alcoholic beverages, and frequency of OOH purchasing were modelled using negative binomial regression adjusted for area deprivation, population density, and individual and household socio-economic characteristics. RESULTS There was some evidence for an inverse association between distance to OOH food outlets and calories purchased from ultra-processed foods (UPF), with a 500 m increase in distance to the nearest OOH outlet associated with a 1.1% reduction in calories from UPF (IR=0.989, 95%CI 0.982-0.997, p=0.040). There was some evidence for region-specific effects relating to purchased volumes of alcohol. However, there was no evidence for an overall association between food environment exposures and take-home and OOH food and drink purchasing. CONCLUSIONS Despite some evidence for exposure to OOH outlets and UPF purchases, this study finds limited evidence for the impact of the food environment on household food and drink purchasing. Nonetheless, region-specific effects regarding alcohol purchasing indicate the importance of geographical context for research and policy.
Collapse
Affiliation(s)
- Alexandra Kalbus
- grid.8991.90000 0004 0425 469XDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Laura Cornelsen
- grid.8991.90000 0004 0425 469XDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrea Ballatore
- grid.13097.3c0000 0001 2322 6764Department of Digital Humanities, King’s College London, London, UK
| | - Steven Cummins
- grid.8991.90000 0004 0425 469XDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
8
|
Gomes Cordeiro N, Mendes LL, Jardim MZ, Claro RM, Pessoa MC, Granado FS, Cristina de Souza Andrade A, de Lima Costa BV. Do Food and Nutrition Public Establishments Influence Availability to Healthy Food in Neighborhood? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2155095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Larissa Loures Mendes
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Zogbi Jardim
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda Serra Granado
- Public Health Postgraduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | |
Collapse
|
9
|
Winkler MR, Lenk K, Erickson DJ, Laska MN. Retailer Marketing Strategies and Customer Purchasing of Sweetened Beverages in Convenience Stores. J Acad Nutr Diet 2022; 122:2050-2059. [PMID: 35240342 PMCID: PMC9420172 DOI: 10.1016/j.jand.2022.02.017] [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: 12/10/2021] [Revised: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Marketing strategies for sweetened beverages (SBs) are pervasive across food retail. Yet few studies have examined how these strategies associate with planned and unplanned SB purchasing. OBJECTIVE This study aimed to examine whether customers with greater exposure to SB retail marketing (eg, advertisements and product placement) were more likely to purchase an SB and whether this varied by customer characteristics. DESIGN This was an observational, cross-sectional study using objective customer purchasing and store assessment data from convenience and other small food stores. PARTICIPANTS/SETTING Participants were 1,604 food and beverage customers at 144 randomly sampled convenience and other small food stores in Minneapolis-St Paul, MN. EXPOSURE Marketing strategies, including SB advertisements, placement, and shelf space were included. MAIN OUTCOME MEASURES We determined the probability of customers purchasing ≥4 fluid ounces of a ready-to-drink sugar and/or artificially sweetened beverage. STATISTICAL ANALYSES PERFORMED Associations between marketing strategies and purchasing were estimated using mixed regression models, controlling for customer characteristics and accounting for customers nested within stores. RESULTS Fifty-six percent of customers purchased an SB; 14% also specified that it was an unplanned purchase. Customers were more likely to purchase an SB when exterior advertisements (P < .001) and advertisements hanging from the ceiling (P < .001) that promoted SBs were present. Customers with moderate and high cumulative exposure to SB marketing were significantly more likely to purchase SBs (51.2% and 54.9%, respectively) than those with lower exposure (34%); this effect was particularly salient for men. There were no significant associations between retail marketing strategies and unplanned purchases. CONCLUSIONS Findings demonstrate that feasible and sustainable approaches are required from policy makers, retailers, and public health professionals to shift store environments away from cues that promote unhealthy beverage selections. Given that numerous retail actors are invested in the availability, promotion, and sales of SBs, changing the predominance of SB marketing in convenience stores will likely be challenging and require cross-sector collaboration.
Collapse
Affiliation(s)
- Megan R Winkler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Kathleen Lenk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Darin J Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
10
|
Hill AB, Kaur R, Sundermeir SM, Kasprzak C, Winkler M, John S, Dombrowski RD, Bode B, Gittelsohn J. Refining the Nutrition Environment Measures Survey (NEMS) for Healthy Community Stores: Adaptations to Capture Alternative Food Retailers and Align with Dietary Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912875. [PMID: 36232175 PMCID: PMC9566451 DOI: 10.3390/ijerph191912875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 05/27/2023]
Abstract
Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will focus on the NEMS-HCS development process, findings, and HFAHEI application. All food items were more likely to be found at grocery stores rather than corner stores. Food pricing was often above the Consumer Price Index averages for six food items. The NEMS-HCS assessment better aligned with the HEI because it included a wider variety of meats, frozen fruits and vegetables, and an increased selection of whole grains. HFAHEI scoring was inclusive of non-traditional and alternative community stores with a health focus, making it suitable for use at the local level, especially in neighborhoods where supermarkets and large chain stores are less common.
Collapse
Affiliation(s)
- Alex B. Hill
- Detroit Food Map Initiative and Department of Urban Studies and Planning, College of Liberal Arts and Sciences, Wayne State University, Detroit, MI 48202, USA
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA
| | - Samantha M. Sundermeir
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Christina Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA
| | - Megan Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University San Marcos, San Marcos, CA 92096, USA
| | - Bree Bode
- Division of Kinesiology, Heath and Sport Studies, College of Education, Detroit, MI 48202, USA
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| |
Collapse
|
11
|
Sharma A. Older Adult Mortality From COVID-19: Food Access as a Determinant Within a Socio-ecological Framework. THE GERONTOLOGIST 2022; 62:452-463. [PMID: 35072729 PMCID: PMC8807209 DOI: 10.1093/geront/gnab159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Low access to food can have an adverse impact on health yet there is limited research on how it is related to coronavirus disease 2019 (COVID-19). The objective of this study was to (a) better understand how inadequate food access was associated with older adult mortality from COVID-19 and (b) determine the spatial distribution of mortality from low food access utilizing a socio-ecological framework. RESEARCH DESIGN AND METHODS This study area was the larger Midwest, a region of the United States, which included the following states: Minnesota, Wisconsin, Iowa, Illinois, Indiana, Michigan, Ohio, and Pennsylvania. Data were aggregated from multiple sources at the county-level. Because the spatial data used in this study violated several assumptions of the global regression framework, geographically weighted regression (GWR) was employed. RESULTS Results from GWR revealed low access to food was positively associated with mortality from COVID-19 for older adults but the association varied in (a) magnitude and (b) significance across the larger Midwest. More specifically, the socio-ecological framework suggested low access to food, female-headed households, and percentage Hispanic played a meaningful role in explaining older adult mortality for the western region of the larger Midwest. This was not as evident for the eastern portion. DISCUSSION AND IMPLICATIONS Such a finding calls attention to the importance of capturing the local context when devising policies to reduce mortality for older adults from COVID-19. Regional policymakers can collaborate with public health professionals when applying these results to formulate local action plans that recognize variations across geographic space.
Collapse
Affiliation(s)
- Andy Sharma
- Public Policy Studies, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
12
|
The Impact of a Grocery Store Closure in One Rural Highly Obese Appalachian Community on Shopping Behavior and Dietary Intake. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063506. [PMID: 35329193 PMCID: PMC8951354 DOI: 10.3390/ijerph19063506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
Abstract
Research has examined how the entry of grocery stores into neighborhoods influences dietary outcomes, yet limited evidence suggests a direct correlation between opening a store and changes in dietary intake. A factor that might influence individuals’ behavior more directly is the closing of a grocery store where residents shop. This study aims to examine how a grocery closure in a rural Appalachian high poverty county is associated with dietary intake. A cohort of n = 152 individuals were recruited to participate in a longitudinal study examining purchasing habits and dietary intake. At time point two, one year later, n = 74 individuals completed the survey via phone. Results indicate those that switched from shopping at a local grocery store to a supercenter significantly increased their dietary intake of fruit (0.2 ± 0.8), fruits and vegetables (1.4 ± 2.7), alcohol (grams) (17.3 ± 54.1), and tomato sauce (0.1 ± 0.3). A local grocery store closure was associated with a change in shopping behavior and dietary intake. Community-level interventions targeting dietary behaviors must account for neighborhood food environment influences, including grocery store availability. Policy aimed at improving food access in rural communities need to consider approaches to improving a variety of food venues with affordable healthy food, while addressing the evolving grocery shopping behaviors of consumers.
Collapse
|
13
|
Russell C, Whelan J, Love P. Assessing the Cost of Healthy and Unhealthy Diets: A Systematic Review of Methods. Curr Nutr Rep 2022; 11:600-617. [PMID: 36083573 PMCID: PMC9461400 DOI: 10.1007/s13668-022-00428-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Poor diets are a leading risk factor for chronic disease globally. Research suggests healthy foods are often harder to access, more expensive, and of a lower quality in rural/remote or low-income/high minority areas. Food pricing studies are frequently undertaken to explore food affordability. We aimed to capture and summarise food environment costing methodologies used in both urban and rural settings. RECENT FINDINGS Our systematic review of high-income countries between 2006 and 2021 found 100 relevant food pricing studies. Most were conducted in the USA (n = 47) and Australia (n = 24), predominantly in urban areas (n = 74) and cross-sectional in design (n = 76). All described a data collection methodology, with just over half (n = 57) using a named instrument. The main purpose for studies was to monitor food pricing, predominantly using the 'food basket', followed by the Nutrition Environment Measures Survey for Stores (NEMS-S). Comparatively, the Healthy Diets Australian Standardised Affordability and Price (ASAP) instrument supplied data on relative affordability to household incomes. Future research would benefit from a universal instrument reflecting geographic and socio-cultural context and collecting longitudinal data to inform and evaluate initiatives targeting food affordability, availability, and accessibility.
Collapse
Affiliation(s)
- Cherie Russell
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jillian Whelan
- School of Medicine, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia ,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| |
Collapse
|
14
|
Caspi CE, Davey C, Barsness CB, Wolfson J, Peterson H, Pratt RJ. Applying the Healthy Eating Index-2015 in a Sample of Choice-Based Minnesota Food Pantries to Test Associations Between Food Pantry Inventory, Client Food Selection, and Client Diet. J Acad Nutr Diet 2021; 121:2242-2250. [PMID: 34103273 PMCID: PMC8530893 DOI: 10.1016/j.jand.2021.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/15/2021] [Accepted: 05/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Food pantry clients are at a high risk for diet-related chronic disease and suboptimal diet. Relatively little research has examined diet quality measures in choice-based food pantries where clients can choose their own food. OBJECTIVE This study tested whether the diet quality scores for food at the pantry were associated with client food selection scores, and whether client food selection scores at the pantry were associated with client diet intake scores. DESIGN This cross-sectional regression analysis, part of a larger evaluation study (SuperShelf), used baseline data from client and food pantry surveys, food pantry inventories, assessments of client food selections ("client carts"), and single 24-hour client dietary recalls. PARTICIPANTS/SETTING The analysis includes 316 clients who completed a survey (282 of whom completed a dietary recall measure) from one of 16 choice-based Minnesota food pantries during 2018-2019. Adult English, Spanish, or Somali-speaking clients were eligible in the case that they had selected food on the day of recruitment at their food pantry visit. MAIN OUTCOME MEASURES A Healthy Eating Index-2015 (HEI-2015) Total score and 13 subcomponent scores were calculated for: pantry food inventories of food available on the shelf, client carts, and a 24-hour client dietary recall. STATISTICAL ANALYSIS Descriptive statistics were generated for client and food pantry characteristics, and for HEI-2015 Total score and subcomponent scores. Linear regression models tested the association between HEI-2015 Total score and subcomponent scores for food pantry inventory and client carts, and for client carts and dietary recalls, adjusted for covariates. RESULTS Food pantry inventory HEI-2015 Total score averaged 65.1, client cart Total score averaged 60.8, and dietary recall Total score averaged 50.9. The diet quality scores for inventory were not associated with client cart scores, except for Added Sugars (P = .005). Client cart HEI-2015 Total score was positively associated with client diet HEI-2015 Total score (P = .002) and associations for Total Fruits, Whole Fruits, Total Vegetables, Greens and Beans, Whole Grains, Seafood and Plant Proteins, and Added Sugars subcomponents were statistically significant. CONCLUSIONS In choice-based Minnesota food pantries, the diet quality of food selected by clients was positively associated with client diet quality.
Collapse
Affiliation(s)
- Caitlin E Caspi
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford; Department of Allied Health Sciences, University of Connecticut, Storrs; Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis.
| | - Cynthia Davey
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis
| | - Christina Bliss Barsness
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Julian Wolfson
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | - Hikaru Peterson
- Department of Applied Economics, University of Minnesota, St Paul
| | - Rebekah J Pratt
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| |
Collapse
|
15
|
Anderson E, Wei R, Liu B, Plummer R, Kelahan H, Tamez M, Marrero A, Bhupathiraju S, Mattei J. Improving Healthy Food Choices in Low-Income Settings in the United States Using Behavioral Economic-Based Adaptations to Choice Architecture. Front Nutr 2021; 8:734991. [PMID: 34692747 PMCID: PMC8526839 DOI: 10.3389/fnut.2021.734991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022] Open
Abstract
Low diet quality is a significant public health problem in the United States, especially among low-income populations. The food environment influences dietary choices. When applied to eating behavior, behavioral economics (BE) recognizes that decision biases instigated by a food environment saturated with unhealthy foods may lead people to purchase such foods, even when they possess the necessary information and skills to make healthy dietary choices. Choice architecture, a BE concept that involves modifying the appeal or availability of choices to “nudge” people toward a certain choice, retains freedom of choice but makes unhealthy options less convenient or visible. Choice architecture has been demonstrated to influence food choices in various settings, including supermarkets, convenience stores, and food pantries. These modifications are low-cost and feasible to implement, making them a viable strategy to help “nudge” patrons toward healthier choices in food establishments serving low-income populations, including food pantries and retailers accepting the Supplemental Nutrition Assistance Program. This narrative review searched, appraised, and underscored the strengths and limitations of extant research studies that used choice architecture adaptations to influence food choices among low-income populations in the United States. Findings from studies in food pantry settings suggest the potential of BE strategies to improve the healthfulness of food choices and dietary intake in low-income populations. In food retail settings, research suggests that BE strategies increase sales of healthy foods, like fruits and vegetables. We identify new areas of research needed to determine if BE-based modifications in low-income settings have sustained impacts on diet quality.
Collapse
Affiliation(s)
- Emma Anderson
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Ruobin Wei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Binkai Liu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Rachel Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Heather Kelahan
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Abrania Marrero
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa Bhupathiraju
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
16
|
Zavala GA, Tenorio-Palos Y, Campos-Ponce M, Elton-Puente JE, López-González CA, Doak CM, Rosado JL, García OP. Proximity and High Density of Convenience Stores Was Associated With Obesity in Children of a Rural Community of Mexico: Using a Geographic Information System Approach. Food Nutr Bull 2021; 42:490-501. [PMID: 34427148 DOI: 10.1177/03795721211033146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Food environment (FE) has been linked to obesity in urban areas, but there is limited information in rural areas, particularly in developing countries, where prevalence of obesity is high. OBJECTIVE To determine the association between FE and childhood obesity using Geographic Information Systems (GIS). METHODS A total of 218 (8-10 years) children participated in a cross-sectional study. Weight, height, and body fat were measured. Geolocation of convenience stores (CS) and participants' households was collected, and the amount of processed food (PF) in the stores was measured. The proximity to the nearest CS and the number of CS within a 250-m buffer from each participant's household was calculated using GIS. Linear regression models between obesity measurements and FE were performed. RESULTS The combined prevalence of overweight and obesity was 32%. A total of 91% of the children had access to a CS within 250 m. On average, 48% of the shelf-space of the CS were occupied with PF. A positive association between the density of CS with body fat % (β = .145; 95% CI, 0.048-0.241, P = .004), abdominal fat % (β = .206; 95% CI, 0.048-0.241, P = .003), and body mass index (BMI)-for-age z-score (BMIz; β = .028; 95% CI, 0.005-0.062, P = .005) was found. Living closer to CS was associated with increases in body fat % (β = -0.009; 95% CI, -0.017 to -0.001, P = 0.025), abdominal fat % (β = -0.012; 95% CI, -0.023 to -0.001, P = 0.033), and BMIz (β = -0.002, 95% CI, -0.004 to -0.001, P = 0.003). CONCLUSION In a rural community in Mexico, a high density and low proximity to CS is associated with obesity in school-aged children.
Collapse
Affiliation(s)
- Gerardo Antonio Zavala
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico.,Faculty of Health Sciences, 8748University of York, York, United Kingdom
| | - Yessica Tenorio-Palos
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico
| | - Maiza Campos-Ponce
- Faculty of Health Sciences, 8748University of York, York, United Kingdom
| | - Juana Elizabeth Elton-Puente
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico
| | - Carlos Alberto López-González
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico
| | | | - Jorge L Rosado
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico
| | - Olga P García
- Facultad de Ciencias Naturales, School of Natural Sciences, 27772Universidad Autónoma de Querétaro, Querétaro, Mexico
| |
Collapse
|
17
|
Singleton CR, Adeyemi OS, Parab KV, Roehll AM, Flores E, Adams AM, Quintiliani LM, Bell BM, Dulin-Keita A. Society of Behavioral Medicine (SBM) position statement: provide funding for incentive programs to expand healthy food offerings in SNAP-authorized small food stores. Transl Behav Med 2021; 11:1283-1285. [PMID: 33200771 DOI: 10.1093/tbm/ibaa111] [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: 11/13/2022] Open
Abstract
Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.
Collapse
Affiliation(s)
- Chelsea R Singleton
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Oluwafikayo S Adeyemi
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Kaustubh V Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Alexandra M Roehll
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Edson Flores
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ashley M Adams
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Lisa M Quintiliani
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Brooke M Bell
- Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, USA
| | - Akilah Dulin-Keita
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
18
|
U.S. Adolescents' Diet Consumption Patterns Differ between Grocery and Convenience Stores: National Health and Nutrition Examination Survey 2011-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168474. [PMID: 34444223 PMCID: PMC8394683 DOI: 10.3390/ijerph18168474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/29/2021] [Accepted: 08/07/2021] [Indexed: 11/16/2022]
Abstract
Among U.S. adolescents, foods/beverages that are store-bought (i.e., from grocery and convenience stores) are significant contributors of energy intake. However, it remains unclear (1) what foods/beverages are consumed by U.S. adolescents from grocery and convenience stores and (2) if there are differences in foods/beverages consumed by store type. Therefore, we analyzed 29,216 eating occasions from adolescents (12–19 years; n = 4065) in the National Health and Nutrition Examination Survey 2011–2018 to report food/beverage groups and nutrients consumed from grocery and convenience stores. Differences in food/beverage groups and nutrient densities by store type were calculated using multiple logistic and linear regressions. Adolescents were more likely to consume “Beverages” and “Snacks and Sweets” and less likely to consume “Grains”, “Protein”, “Milk and Dairy”, “Condiments and Sauces”, and “Fruits” from convenience compared to grocery stores (all p < 0.0025). Foods/beverages from convenience stores were higher in carbohydrates, total sugar, and added sugar and lower in protein, fat, saturated fat, sodium, and fiber than those from grocery stores (all p < 0.0025). In conclusion, while foods/beverages from convenience stores are more energy-dense and nutrient-poor, there is a critical need to increase the availability, accessibility, and affordability of healthier foods/beverages in both store types to encourage healthier dietary behaviors among U.S. adolescents.
Collapse
|
19
|
Examining changes to food and beverage availability and marketing in a low-income community after the opening of a new supermarket. Public Health Nutr 2021; 24:5837-5846. [PMID: 34342260 DOI: 10.1017/s1368980021003165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE In 2016, a Whole Foods Market© opened in the Englewood community of Chicago, IL - a predominately low-income African American community. This study aimed to examine changes to food and beverage availability and marketing in Englewood's existing food stores after the opening of this supermarket. DESIGN Quasi-experimental study. SETTING Two low-income African American communities in Chicago, IL. PARTICIPANTS Fieldworkers audited all small grocery and limited service stores (e.g. convenience stores, liquor stores and dollar/discount stores) located within one-square mile of the new supermarket and a one-square mile area of a demographically comparable community that also lacked a supermarket. Stores were audited before (2016) and after (2017 and 2018) the supermarket opened. RESULTS Of the 78 stores audited at baseline, 71·8 % were limited service stores and 85·9 % accepted Supplemental Nutrition Assistance Program (SNAP) benefits. Overall, the availability of healthy food and beverage options in nearby small stores was low at baseline and both follow-up periods. Difference-in-difference regression models revealed a significant increase in: (1) the percentage of stores in the intervention community (i.e. Englewood) offering regular cheese and promoting salty snacks at check-out from 2016 to 2017; and (2) the percentage of stores in the comparison community with interior store promotions for other sweetened beverages from 2016 to 2018. CONCLUSIONS Minimal changes in food and beverage availability and marketing occurred 1 and 2 years after the opening of a new supermarket. However, the wide range of staple food items offered by the supermarket expanded healthy food retail in Chicago's Englewood community.
Collapse
|
20
|
Lovasi GS, Johnson NJ, Altekruse SF, Hirsch JA, Moore KA, Brown JR, Rundle AG, Quinn JW, Neckerman K, Siscovick DS. Healthy food retail availability and cardiovascular mortality in the United States: a cohort study. BMJ Open 2021; 11:e048390. [PMID: 34244272 PMCID: PMC8273445 DOI: 10.1136/bmjopen-2020-048390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/26/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability. DESIGN Cohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data. SETTING Across the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models. PARTICIPANTS 2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters. PRIMARY AND SECONDARY OUTCOME MEASURES Cardiovascular mortality (primary) and all-cause mortality (secondary). RESULTS 82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20). CONCLUSIONS In this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.
Collapse
Affiliation(s)
- Gina S Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Norman J Johnson
- Center for Administrative Records and Research Applications, Census Bureau, Washington, District of Columbia, USA
| | - Sean F Altekruse
- National Heart Lung and Blood institute, Division of Cardiovascular Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Janene R Brown
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Andrew G Rundle
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - James W Quinn
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - Kathryn Neckerman
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | | |
Collapse
|
21
|
Gray HL, Berumen JH, Lovett SM, Himmelgreen D, Biswas D, Bohn J, Peacock C, Buro AW. A Mixed-methods Study to Understand Food Environments and Grocery Shopping Patterns of Community Residents in Underserved Neighborhoods in Tampa, Florida. Ecol Food Nutr 2021; 60:435-453. [PMID: 33356564 DOI: 10.1080/03670244.2020.1862098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A mixed methods study was conducted to better understand food access, food retail store environment, and perspectives of community residents on their grocery store shopping patterns and access to healthy foods in underserved, predominantly African American neighborhoods. GIS mapping, grocery store observations (n = 4), a food access and grocery store environment survey (n = 126), and focus groups (n = 48) were used. The results indicate that these neighborhoods have a low density of grocery stores, and only two out of four grocery stores meet the standard for a healthy retail store. Barriers to getting healthy foods and solutions to improve food access are discussed.
Collapse
Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Jessica H Berumen
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Sharonda M Lovett
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - David Himmelgreen
- Department of Anthropology and the Center for the Advancement of Food Security & Healthy Communities, College of Arts and Sciences, University of South Florida, Tampa, Florida, USA
| | - Dipayan Biswas
- School of Marketing and Innovation, Muma College of Business, University of South Florida, Tampa, Florida, USA
| | - Joe Bohn
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | | | - Acadia W Buro
- College of Public Health, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
22
|
Shaw SC, Ntani G, Baird J, Vogel CA. A systematic review of the influences of food store product placement on dietary-related outcomes. Nutr Rev 2021; 78:1030-1045. [PMID: 32483615 PMCID: PMC7666915 DOI: 10.1093/nutrit/nuaa024] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Context Product placement strategies have been used to influence customers’ food purchases in food stores for some time; however, assessment of the evidence that these techniques can limit unhealthy, and promote healthy, food choices has not been completed. Objective This systematic review aimed to determine how product placement strategies, availability, and positioning, in physical retail food stores located in high-income countries, influence dietary-related behaviors. Data Sources From a search of 9 databases, 38 articles, 17 observational studies, and 22 intervention studies met the study inclusion criteria. Data Extraction Two reviewers independently extracted data relating to study design, study population, exposures, outcomes, and key results. Each study was also assessed for risk of bias in relation to the research question. Data Analysis Meta-analysis was not possible owing to heterogeneous study designs and outcomes. As recommended by Cochrane, results were synthesized in effect direction plots using a vote-counting technique which recorded the direction of effect and significance level according to the expected relationship for health improvement. Conclusions The majority of studies showed that greater availability and more prominent positioning of healthy foods, or reduced availability and less prominent positioning of unhealthy foods, related to better dietary-related behaviors. A large number of results, however, were nonsignificant, which likely reflects the methodological difficulties inherent in this research field. Adequately powered intervention studies that test both the independent and additive effects of availability and positioning strategies are needed. Systematic Review Registration PROSPERO registration no. 42016048826
Collapse
Affiliation(s)
- Sarah C Shaw
- MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Georgia Ntani
- UK Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Christina A Vogel
- MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
23
|
Evaluating the implementation and impact of a healthier checkout programme at a regional convenience store chain. Public Health Nutr 2021; 24:3520-3529. [PMID: 33820587 DOI: 10.1017/s1368980021001488] [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: 11/06/2022]
Abstract
OBJECTIVE To test the feasibility of implementing and evaluating a healthier checkout pilot study in a convenience store chain. DESIGN A quasi-experimental study was conducted comparing a 3-month 'healthier checkouts' intervention in ten convenience stores which stocked eight healthier items in the checkout space and ten comparison stores assigned to continue stocking their current checkout space product mix. All aspects of the intervention were implemented by the retailer. The research team conducted in-person fidelity checks to assess implementation. Sales data were collected from the retailer in order to compare mean baseline to intervention sales of the eight healthier items in intervention and comparison groups while controlling for overall store sales. SETTING Convenience store chain. PARTICIPANTS Twenty convenience stores in New Hampshire. RESULTS The increases in sales of healthier items between the baseline and intervention periods among the intervention and comparison stores were not statistically significant; however, the overall pattern of the results showed promising changes that should be expanded on in future studies. Intervention fidelity checks indicated that results may have been attenuated by variability in intervention implementation. CONCLUSIONS This study advances the evidence for effective promotion of healthier food purchases in the convenience store chain setting and adds to the current literature on retail checkout space interventions. Additional research is needed to confirm and expand these results.
Collapse
|
24
|
Contributions of Food Environments to Dietary Quality and Cardiovascular Disease Risk. Curr Atheroscler Rep 2021; 23:14. [PMID: 33594516 DOI: 10.1007/s11883-021-00912-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW To evaluate the multidimensional influence of food environments on food choice, dietary quality, and diet-related health and identify critical gaps necessary to develop effective population interventions that influence food choice. RECENT FINDINGS Multicomponent interventions that interact with multiple layers of the food environment show limited but consistent effects on dietary behaviors and may have wider and substantive population-level reach with greater incorporation of validated, holistic measurement tools. Opportunities to use smartphone technology to measure multiple components of the food environment will facilitate future interventions, particularly as food environments expand into online settings and interact with consumers in novel ways to shape food choice. While studies suggest that all dimensions of the food environment influence diet and health outcomes, robust and consistent measurements of food environments that integrate objective and subjective components are essential for developing stronger evidence needed to shift public policies.
Collapse
|
25
|
Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
Collapse
Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
| |
Collapse
|
26
|
Leschewski AM, Davis DE. The Nutritional Quality of Food Purchases at SNAP-Authorized and Unauthorized Non-Traditional Retailers. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1787289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Andrea M. Leschewski
- Ness School of Management and Economics, South Dakota State University, Brookings, South Dakota, USA
| | - David E. Davis
- Ness School of Management and Economics, South Dakota State University, Brookings, South Dakota, USA
| |
Collapse
|
27
|
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.
Collapse
|
28
|
Tan SB, Arcaya M. Where we eat is who we are: a survey of food-related travel patterns to Singapore's hawker centers, food courts and coffee shops. Int J Behav Nutr Phys Act 2020; 17:132. [PMID: 33081793 PMCID: PMC7574174 DOI: 10.1186/s12966-020-01031-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background The development of empirically-grounded policies to change the obesogenic nature of urban environment has been impeded by limited, inconclusive evidence of the link between food environments, dietary behaviors, and health-related outcomes, in part due to inconsistent methods of classifying and analyzing food environments. This study explores how individual and built environment characteristics may be associated with how far and long people travel to food venues,that can serve as a starting point for further policy-oriented research to develop a more nuanced, context-specific delineations of ‘food environments’ in an urban Asian context. Methods Five hundred twenty nine diners in eight different neighborhoods in Singapore were surveyed about how far and long they travelled to their meal venues, and by what mode. We then examined how respondents’ food-related travel differed by socioeconomic characteristics, as well as objectively-measured built environment characteristics at travel origin and destination, using linear regression models. Results Low-income individuals expended more time traveling to meal destinations than high-income individuals, largely because they utilized slower modes like walking rather than driving. Those travelling from areas with high food outlet density travelled shorter distances and times than those from food-sparse areas, while those seeking meals away from their home and work anchor points had lower thresholds for travel. Respondents also travelled longer distances to food-dense locations, compared to food-sparse locations. Conclusion Those seeking to improve food environments of poor individuals should consider studying an intervention radius pegged to typical walking distances, or ways to improve their transport options as a starting point. Policy-focused research on food environments should also be sensitive to locational characteristics, such as food outlet densities and land use.
Collapse
Affiliation(s)
- Shin Bin Tan
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, 02139, MA, USA. .,Lee Kuan Yew School of Public Policy, National University of Singapore, 469C Bukit Timah Rd, Singapore, 259772, Singapore.
| | - Mariana Arcaya
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, 02139, MA, USA
| |
Collapse
|
29
|
A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207591. [PMID: 33086537 PMCID: PMC7589434 DOI: 10.3390/ijerph17207591] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 12/26/2022]
Abstract
The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and scientific advances in the field suggest the time is ripe to revisit this conceptualization. In this paper, we propose the Retail Food Environment and Customer Interaction Model to convey the evolving variety of factors and relationships that convene to influence food choice at the point of purchase. The model details specific components of the RFE, including business approaches, actors, sources, and the customer retail experience; describes individual, interpersonal, and household characteristics that affect customer purchasing; highlights the macro-level contexts (e.g., communities and nations) in which the RFE and customers behave; and addresses the wide-ranging outcomes produced by RFEs and customers, including: population health, food security, food justice, environmental sustainability, and business sustainability. We believe the proposed conceptualization helps to (1) provide broad implications for future research and (2) further highlight the need for transdisciplinary collaborations to ultimately improve a range of critical population outcomes.
Collapse
|
30
|
Hecht AA, Perez CL, Polascek M, Thorndike AN, Franckle RL, Moran AJ. Influence of Food and Beverage Companies on Retailer Marketing Strategies and Consumer Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7381. [PMID: 33050424 PMCID: PMC7600709 DOI: 10.3390/ijerph17207381] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 01/20/2023]
Abstract
The retail food environment plays an important role in shaping dietary habits that contribute to obesity and other chronic diseases. Food and beverage manufacturers use trade promotion-incentives paid to retailers-to influence how products are placed, priced, and promoted in stores. This review aims to: (1) catalogue trade promotion practices that manufacturers use to influence retailer marketing strategies, and (2) describe how these retailer marketing strategies affect consumer purchasing behavior and attitudes. Researchers searched five databases, Academic Search Ultimate, Business Source Ultimate, PsycINFO, PubMed, and Web of Science, to identify literature from industry and academic sources published in English through November 2019. Twenty articles describing manufacturer trade promotion practices were synthesized and provided insight into four types of trade promotion practices: category management, slotting allowances, price discounts, and cooperative advertising. Fifty-four articles describing the impact of retailer marketing on consumers were synthesized and graded for quality of evidence. While comparison across studies is challenging, findings suggest that retailer marketing strategies, such as price promotions and prominent placement, lead to increased sales. Results can guide efforts by policymakers, public health practitioners, and food retailers to design retail environments that improve healthy eating while maintaining retailer financial interests. Additional research should measure the impact of retailer marketing strategies on consumer diet quality and retailer outcomes (e.g., return-on-investment).
Collapse
Affiliation(s)
- Amelie A. Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
| | - Crystal L. Perez
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
| | - Michele Polascek
- Westbrook College of Health Professions, University of New England, Portland, ME 04103, USA;
| | - Anne N. Thorndike
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA;
| | - Rebecca L. Franckle
- Program in Global Public Health and the Common Good, Department of Biology, Boston College, Chestnut Hill, MA 02467, USA;
| | - Alyssa J. Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (C.L.P.); (A.J.M.)
| |
Collapse
|
31
|
Leak TM, Gangrade N, Setiono FJ, Mudrak E. Facilitators and Barriers to Preparing and Selling Whole Grain Snack Packs in New York City Corner Stores Participating in a Healthy Retail Program. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1785363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Tashara M. Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Navika Gangrade
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Erika Mudrak
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| |
Collapse
|
32
|
Winkler MR, Lenk KM, Erickson DJ, Caspi CE, Laska MN. Longitudinal Fruit and Vegetable Sales in Small Food Retailers: Response to a Novel Local Food Policy and Variation by Neighborhood Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155480. [PMID: 32751326 PMCID: PMC7432731 DOI: 10.3390/ijerph17155480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 11/18/2022]
Abstract
Small food retailers, including corner/convenience stores, pharmacies, gas-marts, and dollar stores, have historically stocked limited fruits and vegetables, though this may be changing. We examined increases in sales, customer purchasing, and stocking of fresh and/or frozen fruits and vegetables in small food stores over time and in relation to: (a) a local food policy (the Minneapolis Staple Foods Ordinance) and (b) neighborhood socioeconomic status (SES). We used longitudinal data (2014–2017) from 147 randomly-sampled stores in Minneapolis/St. Paul, USA, collected using interviewer-administered manager surveys (measuring sales and stocking) and customer intercepts/observations (measuring purchasing, n = 3039). The local policy required Minneapolis stores to meet minimum stocking standards for fresh/frozen produce and other healthy foods. No ordinance existed in St. Paul. Mixed regression models examined overall change over time and change by city and neighborhood SES. We observed significant increases over time (p < 0.05) in sales and purchasing of fresh fruit and in stocking of fresh fruit, frozen fruit, and frozen vegetables. We did not identify consistent statistical evidence for differential change in sales, purchasing, or stocking by city or neighborhood SES. Key study findings suggest limited differential effects of the local ordinance and/or neighborhood SES. However, findings also indicate significant time trends for some products, including consistent improvements in sales, customer purchasing, and stocking of fresh fruit. Given the ready-to-eat convenience of many fresh fruits and their broad appeal, fresh fruit appears a promising target for advancing the healthfulness of small food retailers.
Collapse
Affiliation(s)
- Megan R. Winkler
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (K.M.L.); (D.J.E.); (M.N.L.)
- Correspondence:
| | - Kathleen M. Lenk
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (K.M.L.); (D.J.E.); (M.N.L.)
| | - Darin J. Erickson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (K.M.L.); (D.J.E.); (M.N.L.)
| | - Caitlin E. Caspi
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
| | - Melissa N. Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (K.M.L.); (D.J.E.); (M.N.L.)
| |
Collapse
|
33
|
Kids in a Candy Store: An Objective Analysis of Children's Interactions with Food in Convenience Stores. Nutrients 2020; 12:nu12072143. [PMID: 32708485 PMCID: PMC7400802 DOI: 10.3390/nu12072143] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 01/18/2023] Open
Abstract
Increasing rates of childhood obesity worldwide has focused attention on the obesogenic food environment. This paper reports an analysis of children's interactions with food in convenience stores. Kids'Cam was a cross-sectional study conducted from July 2014 to June 2015 in New Zealand in which 168 randomly selected children aged 11-14 years old wore a wearable camera for a 4-day period. In this ancillary study, images from children who visited a convenience store were manually coded for food and drink availability. Twenty-two percent of children (n = 37) visited convenience stores on 62 occasions during the 4-day data collection period. Noncore items dominated the food and drinks available to children at a rate of 8.3 to 1 (means were 300 noncore and 36 core, respectively). The food and drinks marketed in-store were overwhelmingly noncore and promoted using accessible placement, price offers, product packaging, and signage. Most of the 70 items purchased by children were noncore foods or drinks (94.6%), and all of the purchased food or drink subsequently consumed was noncore. This research highlights convenience stores as a key source of unhealthy food and drink for children, and policies are needed to reduce the role of convenience stores in the obesogenic food environment.
Collapse
|
34
|
Examining Shopping Patterns, Use of Food-Related Resources, and Proposed Solutions to Improve Healthy Food Access Among Food Insecure and Food Secure Eastern North Carolina Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103361. [PMID: 32408632 PMCID: PMC7277759 DOI: 10.3390/ijerph17103361] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
In the Southern United States (U.S.), food insecurity rates are higher in rural (20.8%) versus urban communities (15%). Food insecurity can exacerbate diet-related disease. Thus, the purpose of this study was to examine differences in the use of food-related community resources and potential solutions proposed among food insecure versus food secure residents. A community survey (n = 370) was conducted in rural eastern North Carolina, with questions pertaining to food security status and food-related resources. The IBM SPSS Statistics software and SAS software were used to examine differences in food-related resources, and qualitative data analysis was used to examine differences in solutions offered between food insecure and food secure participants. Of the 370 respondents, forty-eight-point-six percent were classified as food insecure. Food insecure participants were more likely to report shopping for groceries at a convenience/discount store, less likely to use their own vehicle for transportation, and less likely to purchase food from local producers. Food insecure participants were more likely to suggest solutions related to reducing the cost of healthy food, while food secure participants were more likely to suggest educational or convenience-related interventions.
Collapse
|
35
|
Healthful and less-healthful foods and drinks from storefront and non-storefront businesses: implications for 'food deserts', 'food swamps' and food-source disparities. Public Health Nutr 2020; 23:1428-1439. [PMID: 32223780 DOI: 10.1017/s1368980019004427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Conceptualisations of 'food deserts' (areas lacking healthful food/drink) and 'food swamps' (areas overwhelm by less-healthful fare) may be both inaccurate and incomplete. Our objective was to more accurately and completely characterise food/drink availability in urban areas. DESIGN Cross-sectional assessment of select healthful and less-healthful food/drink offerings from storefront businesses (stores, restaurants) and non-storefront businesses (street vendors). SETTING Two areas of New York City: the Bronx (higher-poverty, mostly minority) and the Upper East Side (UES; wealthier, predominantly white). PARTICIPANTS All businesses on 63 street segments in the Bronx (n 662) and on 46 street segments in the UES (n 330). RESULTS Greater percentages of businesses offered any, any healthful, and only less-healthful food/drink in the Bronx (42·0 %, 37·5 %, 4·4 %, respectively) than in the UES (30 %, 27·9 %, 2·1 %, respectively). Differences were driven mostly by businesses (e.g. newsstands, gyms, laundromats) not primarily focused on selling food/drink - 'other storefront businesses' (OSBs). OSBs accounted for 36·0 % of all food/drink-offering businesses in the Bronx (more numerous than restaurants or so-called 'food stores') and 18·2 % in the UES (more numerous than 'food stores'). Differences also related to street vendors in both the Bronx and the UES. If street vendors and OSBs were not captured, the missed percentages of street segments offering food/drink would be 14·5 % in the Bronx and 21·9 % in the UES. CONCLUSIONS Of businesses offering food/drink in communities, OSBs and street vendors can represent substantial percentages. Focusing on only 'food stores' and restaurants may miss or mischaracterise 'food deserts', 'food swamps', and food/drink-source disparities between communities.
Collapse
|
36
|
A systematic review, and meta-analysis, examining the prevalence of price promotions on foods and whether they are more likely to be found on less-healthy foods. Public Health Nutr 2020; 23:1281-1296. [PMID: 32209142 PMCID: PMC7196736 DOI: 10.1017/s1368980019004129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: There are concerns that price promotions encourage unhealthy dietary choices. This review aims to answer the following research questions (RQ1) what is the prevalence of price promotions on foods in high-income settings, and (RQ2) are price promotions more likely to be found on unhealthy foods? Design: Systematic review of articles published in English, in peer-review journals, after 1 January 2000. Setting: Included studies measured the prevalence of price promotions (i.e. percentage of foods carrying a price promotion out of the total number of foods available to purchase) in retail settings, in upper-mid to high-income countries. Participants: ‘Price promotion’ was defined as a consumer-facing temporary price reduction or discount available to all customers. The control group/comparator was the equivalent products without promotions. The primary outcome for this review was the prevalence of price promotions, and the secondary outcome was the difference between the proportions of price promotions on healthy and unhealthy foods. Results: Nine studies (239 344 observations) were included for the meta-analysis for RQ1, the prevalence of price promotions ranged from 6 % (95 % CI 2 %, 15 %) for energy-dense nutrient-poor foods to 15 % (95 % CI 9 %, 25 %) for cereals, grains, breads and other starchy carbohydrates. However, the I-squared statistic was 99 % suggesting a very high level of heterogeneity. Four studies were included for the analysis of RQ2, of which two supported the hypothesis that price promotions were more likely to be found on unhealthy foods. Conclusions: The prevalence of price promotions is very context specific, and any proposed regulations should be supported by studies conducted within the proposed setting(s).
Collapse
|
37
|
Holston D, Stroope J, Cater M, Kendall M, Broyles S. Implementing Policy, Systems, and Environmental Change Through Community Coalitions and Extension Partnerships to Address Obesity in Rural Louisiana. Prev Chronic Dis 2020; 17:E18. [PMID: 32105589 PMCID: PMC7085905 DOI: 10.5888/pcd17.190284] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Community coalitions and agents funded by the Louisiana State University Agricultural Center's Healthy Communities program implemented multilevel obesity prevention interventions in 3 rural parishes (ie, counties) with an obesity prevalence of 40% or higher. The Healthy Communities coalitions appraised local health concerns through needs assessments and community forums. On the basis of local needs and the evidence base, the coalitions identified and implemented policy, systems, and environmental (PSE) strategies and supporting education to promote healthy behavior change among residents, overcoming barriers in the process. Interventions varied by parish but included Complete Streets implementation plans, healthy retail initiatives, play space improvements, downtown beautification projects, and Smarter Lunchrooms.
Collapse
Affiliation(s)
- Denise Holston
- Louisiana State University Agricultural Center, School of Nutrition and Food Sciences, Baton Rouge, Louisiana.,Louisiana State University Agricultural Center, 201 Knapp Hall, Baton Rouge, LA 70803.
| | - Jessica Stroope
- Louisiana State University Agricultural Center, School of Nutrition and Food Sciences, Baton Rouge, Louisiana
| | - Melissa Cater
- Louisiana State University Agricultural Center, Northeast Region, Winnsboro, Louisiana
| | - Michelle Kendall
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana
| | | |
Collapse
|
38
|
Caspi CE, Winkler MR, Lenk KM, Harnack LJ, Erickson DJ, Laska MN. Store and neighborhood differences in retailer compliance with a local staple foods ordinance. BMC Public Health 2020; 20:172. [PMID: 32019508 PMCID: PMC7001202 DOI: 10.1186/s12889-020-8174-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 01/07/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Policies to improve healthy food retail have been recognized as a potential means of reducing diet-related health disparities. The revised 2014 Minneapolis Staple Foods Ordinance instituted minimum stocking standards for healthy, staple foods. The objective of this study was to examine retailer compliance with the policy, and whether compliance varied by neighborhood and store characteristics. METHODS In this natural experiment, audits were conducted annually pre- and post-ordinance (2014-2017) in 155 small/nontraditional stores in Minneapolis, MN and a comparison city (St. Paul, MN). Compliance measures for 10 product categories included: (1) met requirements for ≥8 categories; (2) 10-point scale (one point for each requirement met); and (3) carried any item in each category. Store characteristics included store size and ownership status. Neighborhood characteristics included census-tract socioeconomic status and low-income/low-access status. Analyses were conducted in 2018. RESULTS All compliance measures increased in both Minneapolis and St. Paul from pre- to post-policy; Minneapolis increases were greater only for carrying any item in each category (p < 0.01). In Minneapolis, corporate (vs. independent) stores were generally more compliant. No differences were found by neighborhood characteristics. CONCLUSIONS Overall trends suggest broad movement among Minneapolis stores towards providing a minimum level of staple foods. Increases were greater in corporate stores. Trends do not suggest neighborhood-level disparities in compliance. STUDY REGISTRATION ClinicalTrials.gov NCT02774330, retrospectively registered May 17, 2016.
Collapse
Affiliation(s)
- Caitlin E Caspi
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, USA.
| | - Megan R Winkler
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Kathleen M Lenk
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Lisa J Harnack
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Darin J Erickson
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| |
Collapse
|
39
|
Improved Understanding of Interactions between Risk Factors for Child Obesity May Lead to Better Designed Prevention Policies and Programs in Indonesia. Nutrients 2020; 12:nu12010175. [PMID: 31936306 PMCID: PMC7019618 DOI: 10.3390/nu12010175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 12/23/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022] Open
Abstract
The nutrition transition in low-middle income countries is marked by rising intakes of highly caloric, low nutrient-dense (junk) foods, decreasing intakes of fruits and vegetables, and sedentary behavior. The objective of this study was to explore interactions among fruit-and-vegetable intake, junk food energy intake, sedentary behavior, and obesity in Indonesian children. We conducted this school-based, case-control study in 2013 in Yogyakarta Special Province, Indonesia. The cases were 244 obese children aged 7–12 years having a BMI ≥95th percentile of an age- and sex-specific distribution from the Centers for Disease Control and Prevention. The controls (n = 244) were classroom-matched children with a BMI <85th percentile. Using conditional logistic regression, the relative odds (95% confidence intervals; OR: 95% CI) of obesity given reported frequent fruit-and-vegetable intake (≥3 servings/day), low junk food energy (≤1050 kcal/day) intake and low sedentary behavior (<5 h/day) was 0.46 (0.30–0.69), 0.61 (0.37–0.98), and 0.18 (0.12–0.28), respectively. Effect sizes were dose-responsive and appeared additive. For example, children with low sedentary behavior and frequent fruit-and-vegetable intake were 92% less likely (OR = 0.08; 0.04–0.15) to be obese than children not exceeding either of these thresholds. Similarly, children frequently eating fruits and vegetables and reporting a low junk food energy intake were 70% less likely (OR = 0.30; 0.15–0.59) to be obese. The findings were unchanged after adjusting for child, maternal, and household covariates. Preventive interventions for child obesity need multiple components to improve diets and raise levels of physical activity rather than just addressing one of the three types of assessed behaviors.
Collapse
|
40
|
Rebouillat P, Bonin S, Kestens Y, Chaput S, Drouin L, Mercille G. Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010088. [PMID: 31877682 PMCID: PMC6981572 DOI: 10.3390/ijerph17010088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/06/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.
Collapse
Affiliation(s)
- Pauline Rebouillat
- Institut de Santé Publique d’Épidémiologie et de Développement (ISPED), Université de Bordeaux, 33000 Bordeaux, France
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
| | - Sarah Bonin
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Yan Kestens
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Sarah Chaput
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Louis Drouin
- Direction régionale de santé publique, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montréal, QC H2L 1M3, Canada
| | - Geneviève Mercille
- Département de nutrition, Université de Montréal, 2450 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada
- Centre de recherche en santé publique, 1301 Sherbrooke Est, Montréal, QC H2L 1M3, Canada
- Correspondence:
| |
Collapse
|
41
|
Evaluation of Store Environment Changes of an In-Store Intervention to Promote Fruits and Vegetables in Latino/Hispanic-Focused Food Stores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010065. [PMID: 31861788 PMCID: PMC6981808 DOI: 10.3390/ijerph17010065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/13/2019] [Accepted: 12/18/2019] [Indexed: 12/18/2022]
Abstract
Implementing interventions that manipulate food store environments are one potential strategy for improving dietary behaviors. The present study evaluated intervention effects, from the El Valor de Nuestra Salud (The Value of Our Health) study, on in-store environmental changes within Latino/Hispanic-focused food stores (tiendas). Sixteen tiendas were randomly assigned to either: a six-month structural and social food store intervention or a wait-list control condition. Store-level environmental measures of product availability, placement, and promotion were assessed monthly from baseline through six-months post-baseline using store audits. Linear mixed effects models tested for condition-by-time interactions in store-level environmental measures. Results demonstrated that the intervention was successful at increasing the total number of fruit and vegetable (FV) promotions (p < 0.001) and the number of FV promotions outside the produce department (p < 0.001) among tiendas in the intervention versus control condition. No changes in product availability or placement were observed. Results suggests changing the marketing mix element of promotions within small stores is measurable and feasible in an in-store intervention. Difficulties in capturing changes in product availability and placement may be due to intervention implementation methods chosen by tiendas. It is important to build upon the lessons learned from these types of interventions to disseminate evidence-based in-store interventions.
Collapse
|
42
|
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.
Collapse
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
| | | |
Collapse
|
43
|
BeLue R, NDao F, McClure S, Alexander S, Walker R. The Role of Social Issues on Food Procurement among Corner Store Owners and Shoppers. Ecol Food Nutr 2019; 59:35-46. [PMID: 31475574 DOI: 10.1080/03670244.2019.1659789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE We assessed corner store shopper and owner perceptions, barriers, and enablers related to food procurement in a sample of neighborhood corner stores where over 50% of families are SNAP eligible. DESIGN We conducted semi-structured interviews to identify inventory stocking, shopping and marketing approaches, and perspectives on healthy eating. PARTICIPANTS Five corner store owners and 20 corner store shoppers. RESULTS Corner store owners: 1) did not feel as though they belonged to the community where their corner store was located; 2) had difficulty in becoming authorized WIC retailers because of the perceived complexity of the process, and 3) stated tobacco products and hot food items are their best-selling items; fruits and vegetables were perceived as unmarketable. Corner store shoppers preferred shopping at local corner stores because: 1) lack of transportation made corner stores easier to access than full-service grocery stores; 2) hot foods are readily available and inexpensive; 3) some home kitchens lacked an oven or stovetop for meal preparation; 4) they need to shop daily for children or other family members. CONCLUSIONS Social issues such as housing quality, corner store owner sense of community, and acculturation should be addressed when considering food environment in limited resource communities.
Collapse
Affiliation(s)
- Rhonda BeLue
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Fatou NDao
- Penn State University College of Medicine, Hershey, PA, USA
| | - Stephanie McClure
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Suzanne Alexander
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Renee Walker
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| |
Collapse
|
44
|
Briggs AC, Black AW, Lucas FL, Siewers AE, Fairfield KM. Association between the food and physical activity environment, obesity, and cardiovascular health across Maine counties. BMC Public Health 2019; 19:374. [PMID: 30943942 PMCID: PMC6448221 DOI: 10.1186/s12889-019-6684-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/20/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Accounting for nearly one-third of all deaths, cardiovascular disease is the leading cause of mortality and morbidity in the United States. Adverse health behaviors are major determinants of this high incidence of disease. Examining local food and physical activity environments and population characteristics in a poor, rural state may highlight underlying drivers of these behaviors. We aimed to identify demographic and environmental factors associated with both obesity and overall poor cardiovascular health (CVH) behaviors in Maine counties. METHODS Our cross-sectional study analyzed 40,398 Behavioral Risk Factor Surveillance System (BRFSS) 2011-2014 respondents alongside county-level United States Department of Agriculture (USDA) Food Environment Atlas 2010-2012 measures of the built environment (i.e., density of restaurants, convenience stores, grocery stores, and fitness facilities; food store access; and county income). Poor CVH score was defined as exhibiting greater than 5 out of the 7 risk factors defined by the American Heart Association (current smoking, physical inactivity, obesity, poor diet, hypertension, diabetes, and high cholesterol). Multivariable logistic regression models described the contributions of built environment variables to obesity and overall poor CVH score after adjustment for demographic controls. RESULTS Both demographic and environmental factors were associated with obesity and overall poor CVH. After adjustment for demographics (age, sex, personal income, and education), environmental characteristics most strongly associated with obesity included low full-service restaurant density (OR 1.34; 95% CI 1.24-1.45), low county median household income (OR 1.31; 95% CI 1.21-1.42) and high convenience store density (OR 1.21; 95% CI 1.12-1.32). The strongest predictors of overall poor CVH behaviors were low county median household income (OR 1.30; 95% CI 1.13-1.51), low full-service restaurant density (OR 1.38; 95% CI 1.19-1.59), and low fitness facility density (OR 1.27; 95% CI 1.11-1.46). CONCLUSIONS In a rural state, both demographic and environmental factors predict overall poor CVH. These findings may help inform communities and policymakers of the impact of both social determinants of health and local environments on health outcomes.
Collapse
Affiliation(s)
| | - Adam W. Black
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - F. Lee Lucas
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - Andrea E. Siewers
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - Kathleen M. Fairfield
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| |
Collapse
|
45
|
Huang Y, Tovar A, Taylor J, Vadiveloo M. Staple Food Item Availability among Small Retailers in Providence, RI. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1052. [PMID: 30909551 PMCID: PMC6466143 DOI: 10.3390/ijerph16061052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/17/2022]
Abstract
Inventory requirements for authorized Supplemental Nutrition Assistance Program (SNAP) retailers have undergone several revisions to increase the availability of healthful foods. A proposed rule of 84 staple food items was not implemented due to concerns that stores would not withstand this expansion, resulting in a final rule requiring 36 items. This study used the Food Access Research Atlas data to characterize food provisions in 30 small retailers in areas with high and low proportions of SNAP and racial minority residents in Providence, Rhode Island (RI). Stores were assessed with an audit instrument to tally variety, perishability, and depth of stock of four staple food categories. Descriptive, analysis of variance, and chi-square analyses were performed. Across stores, 80% were compliant with the final rule, but 66.7% would need to expand their offerings to meet the proposed rule. Mean dairy variety was lowest among all categories (p < 0.05). Most stores met the perishability (92.3%) and depth-of-stock requirements (96.1%) under both rules. No difference was detected between areas with high and low proportions of SNAP and racial minority residents. Future expansion of requirements may increase healthful food availability without imposing undue burdens on retailers in Providence, RI, excluding increased requirements for dairy variety.
Collapse
Affiliation(s)
- Yuyao Huang
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - John Taylor
- Department of Plant Sciences and Entomology, University of Rhode Island, Kingston, RI 02881, USA.
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| |
Collapse
|
46
|
Variation in the food environment of small and non-traditional stores across racial segregation and corporate status. Public Health Nutr 2019; 22:1624-1634. [PMID: 30846012 DOI: 10.1017/s1368980019000132] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined differences in consumer-level characteristics and structural resources and capabilities of small and non-traditional food retailers (i.e. corner stores, gas-marts, pharmacies, dollar stores) by racial segregation of store neighbourhood and corporate status (corporate/franchise- v. independently owned). DESIGN Observational store assessments and manager surveys were used to examine availability-, affordability- and marketing-related characteristics experienced by consumers as well as store resources (e.g. access to distributors) and perceived capabilities for healthful changes (e.g. reduce pricing on healthy foods). Cross-sectional regression analyses of store and manager data based on neighbourhood segregation and store corporate status were conducted. SETTING Small and non-traditional food stores in Minneapolis and St. Paul, MN, USA.ParticipantsOne hundred and thirty-nine stores; seventy-eight managers. RESULTS Several consumer- and structural-level differences occurred by corporate status, independent of residential segregation. Compared with independently owned stores, corporate/franchise-owned stores were more likely to: not offer fresh produce; when offered, receive produce via direct delivery and charge higher prices; promote unhealthier consumer purchases; and have managers that perceived greater difficulty in making healthful changes (P≤0·05). Only two significant differences were identified by residential racial segregation. Stores in predominantly people of colour communities (<30 % non-Hispanic White) had less availability of fresh fruit and less promotion of unhealthy impulse buys relative to stores in predominantly White communities (P≤0·05). CONCLUSIONS Corporate status appears to be a relevant determinant of the consumer-level food environment of small and non-traditional stores. Policies and interventions aimed at making these settings healthier may need to consider multiple social determinants to enable successful implementation.
Collapse
|
47
|
Ylitalo KR, During C, Thomas K, Ezell K, Lillard P, Scott J. The Veggie Van: Customer characteristics, fruit and vegetable consumption, and barriers to healthy eating among shoppers at a mobile farmers market in the United States. Appetite 2019; 133:279-285. [DOI: 10.1016/j.appet.2018.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 09/04/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
|
48
|
Barnes TL, Lenk K, Caspi CE, Erickson DJ, Laska MN. Perceptions of a healthier neighborhood food environment linked to greater fruit and vegetable purchases at small and non-traditional food stores. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018; 14:741-761. [PMID: 31798762 DOI: 10.1080/19320248.2018.1549518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this study was to examine associations between perceived neighborhood food environments and food purchasing at small and non-traditional food stores. Intercept interviews of 661 customers were conducted in 105 small and non-traditional food stores. We captured (1) customer perceptions of the neighborhood food environment, (2) associations between customer perceptions and store-level characteristics, and (3) customers' perceptions and shopping behaviors. Findings suggest that customers with more favorable perceptions of the neighborhood food environment were more likely to purchase fruits and vegetables, despite no significant association between perceptions of the neighborhood and objectively measured store characteristics.
Collapse
Affiliation(s)
- Timothy L Barnes
- Children's Minnesota Research Institute, Children's Hospitals and Clinics of Minnesota, 2525 Chicago Ave. S, Minneapolis, MN 55404.,University of Minnesota, Division of Epidemiology and Community Health, Suite 300, 1300 South 2nd St., Minneapolis, MN 55454
| | - Kathleen Lenk
- University of Minnesota, Division of Epidemiology and Community Health, Suite 300, 1300 South 2nd St., Minneapolis, MN 55454
| | - Caitlin E Caspi
- University of Minnesota, Department of Family Medicine and Community Health, Program in Health Disparities Research, 717 Delaware St. SE, Minneapolis, MN 55414
| | - Darin J Erickson
- University of Minnesota, Division of Epidemiology and Community Health, Suite 300, 1300 South 2nd St., Minneapolis, MN 55454
| | - Melissa N Laska
- University of Minnesota, Division of Epidemiology and Community Health, Suite 300, 1300 South 2nd St., Minneapolis, MN 55454
| |
Collapse
|
49
|
Local Food Sources to Promote Community Nutrition and Health: Storefront Businesses, Farmers' Markets, and a Case for Mobile Food Vending. J Acad Nutr Diet 2018; 119:39-44. [PMID: 30447973 DOI: 10.1016/j.jand.2018.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/23/2018] [Accepted: 09/10/2018] [Indexed: 11/23/2022]
|
50
|
Au LE, Gurzo K, Paolicelli C, Whaley SE, Weinfield NS, Ritchie LD. Diet Quality of US Infants and Toddlers 7-24 Months Old in the WIC Infant and Toddler Feeding Practices Study-2. J Nutr 2018; 148:1786-1793. [PMID: 30383276 DOI: 10.1093/jn/nxy192] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/19/2018] [Indexed: 12/24/2022] Open
Abstract
Background Despite the important implications of childhood dietary intakes on lifelong eating habits and health, data are lacking on the diet quality of low-income infants and toddlers. Objective The objective of this study was to characterize diet quality in low-income US infants and toddlers. Methods A national observational study was conducted of 7- to 12-mo-old (n = 1261), 13-mo-old (n = 2515), and 24-mo-old (n = 2179) children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prenatally/at birth from 2013 to 2016. The study used a 24-h dietary recall and survey questions. For 7- to 12-mo-olds, an adapted Complementary Feeding Utility Index (CFUI) was used, and for 13- and 24-mo-olds, the Healthy Eating Index-2015 (HEI-2015) was used. Descriptive statistics were calculated for CFUI and HEI-2015 scores. Results For 7- to 12-mo-olds, the CFUI score (mean ± SE) was 0.56 ± 0.003 (range: 0.34-0.90, maximum possible 1.0). Most children met CFUI standards for exposure to iron-rich cereal (86.7%), and low exposure to energy-dense nutrient-poor foods (72.2%) and teas/broths (67.5%). Conversely, at 7-12 mo of age, exposure was low for vegetables (7.0%), fruits (14.4%), any sugary drinks (14.0%), and 12-mo breastfeeding duration (23.8%). At 13 and 24 mo of age, the HEI-2015 total score (maximum possible 100), on average, was 64.0. At both 13 and 24 mo of age, participants achieved, on average, maximal HEI-2015 component scores for total and whole fruits and dairy; however, scores for total vegetables, greens and beans, whole grains, seafood and plant proteins, fatty acids, and saturated fats were relatively low. Scores for refined grains, sodium, and added sugar were lower at 24 than at 13 mo of age, representing higher consumption, on average, over time. Conclusions Although findings demonstrate that young children are doing well on some dietary components, there is room for improvement, especially as children age. Findings may be used to inform the Pregnancy and Birth to 24-mo (P/B-24) Project. This trial was registered at clinicaltrials.gov as NCT02031978.
Collapse
Affiliation(s)
- Lauren E Au
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
| | - Klara Gurzo
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
| | - Courtney Paolicelli
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | | | | | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
| |
Collapse
|