1
|
Karnik H, Hanawa Peterson H. Promoting healthful food purchases through in-store interventions: Empirical evidence from rural food deserts. Appetite 2024; 197:107305. [PMID: 38521414 DOI: 10.1016/j.appet.2024.107305] [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: 11/24/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
Effective ways to promote healthful food intake in rural areas are understudied. The paper evaluated whether a two-component, in-store intervention designed to encourage healthy food purchases was associated with improved healthfulness scores of food items purchased by shoppers in rural food deserts. One component introduced a point-of-sales label that assigned a single numerical score to each food item facilitating direct comparisons of the product's nutrition with those of other products shelved around it. The other component was a one-day nutrition education workshop promoted within the store. Interventions took place in 2015 at two stores in rural counties in the U.S. Midwest. Four stores in similar communities were selected as the control group. We applied a difference-in-difference model to estimate changes in the healthfulness of food items purchased attributable to the intervention among shoppers at the treatment stores (n = 486) and control stores (n = 10,759) using store transaction data. Healthfulness of food items was measured in terms of food scores published by the Environmental Working Group on a 1-10 scale. Both components had minimal impacts on the scores, although 0.2 and 0.1 points increases in the score per item and score per dollar were statistically significant at the 1% level respectively. A year after the intervention, these small effects of the intervention further diminished compared to the immediately after implementation. Results suggest the average effects of intervention across the study communities had limited practical significance but benefited some rural residents who were exposed to the intervention.
Collapse
Affiliation(s)
- Harshada Karnik
- Center for Public Health Systems, University of Minnesota-School of Public Health, USA; Department of Applied Economics, University of Minnesota, USA.
| | | |
Collapse
|
2
|
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:S1499-4046(24)00024-1. [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] [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
|
3
|
Magdaleno L, Rolling T, Waits Galia S, Ayala GX. Evaluation of a front-of-pack food labeling intervention on a college campus. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2417-2425. [PMID: 34519632 DOI: 10.1080/07448481.2021.1970563] [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: 09/01/2020] [Revised: 07/28/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Objective: To evaluate the process of implementation and impact of a front-of-pack labeling intervention on purchases of labeled food products. Participants: A convenience sample of 111 college students were recruited to complete a survey as they exited markets where the intervention was being implemented. Participants had to have purchased at least one consumable item. Methods: Intercept surveys and audits were conducted at three markets, two times each over a period of three weeks. Results: The audits indicated high implementation fidelity (82% overall). However, customer surveys revealed that only 42% noticed the front-of-pack sticker, and the majority (89%) did not purchase an item with the sticker. However, customers who noticed the sticker were significantly more likely to purchase an item with the sticker (p = .002). Conclusions: These findings provide preliminary evidence for the feasibility and effectiveness of a front-of-pack labeling intervention in a university market setting.
Collapse
Affiliation(s)
- Lauren Magdaleno
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Tyler Rolling
- Well-being and Health Promotion Department, San Diego State University, San Diego, California, USA
| | - Stephanie Waits Galia
- Well-being and Health Promotion Department, San Diego State University, San Diego, California, USA
| | - Guadalupe X Ayala
- Division of Health Promotion and Behavioral Science, School of Public Health, The Institute for Behavioral and Community Health, and SDSU HealthLINK Center, San Diego State University, San Diego, California, USA
| |
Collapse
|
4
|
Winkler LL, Toft U, Glümer C, Bloch P, Buch-Andersen T, Christensen U. Involving supermarkets in health promotion interventions in the Danish Project SoL. A practice-oriented qualitative study on the engagement of supermarket staff and managers. BMC Public Health 2023; 23:706. [PMID: 37072841 PMCID: PMC10111755 DOI: 10.1186/s12889-023-15501-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 03/21/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Supermarkets have been suggested as relevant settings for environmental and educational initiatives encouraging healthier shopping and eating decisions, but in the literature, limited attention has been paid to the context, perspectives, and everyday practices of supermarket staff. The aim of this study was to examine the engagement of supermarket staff in a health promotion project from a practice-oriented perspective. METHODS The study was based on qualitative data collected in the supermarket setting of Project SoL; a community-based health promotion project in Denmark. We conducted 26 in-depth interviews with store managers and other key staff members in seven participating supermarkets. In addition, we collected data on planning, implementation, and perceptions of supermarket staff of in-store interventions and other project-related activities. These field data included short telephone interviews, observational notes, photos, and audiotapes of meetings. Data were analysed from the perspective of practice theory. RESULTS Although supermarket staff found community-based health promotion meaningful to engage in, the study observed that their engagement was challenged by a business mindset, practical routines and structural requirements favouring sales promotion over health promotion. Nevertheless, there were also examples of how health promotion activities and ways of thinking were successfully incorporated in everyday staff practices during and after Project SoL. CONCLUSIONS Our findings point to both potentials and challenges for using supermarkets as settings for health promotion. The voluntary engagement of supermarket staff in community-based health projects cannot stand alone but should be supplemented by more long-lasting strategies and policies regulating this and other food environments. Context-sensitive and practice-oriented analyses in local food environments could inform such strategies and policies to make sure they target unwanted elements and practices and not just individual behavior.
Collapse
Affiliation(s)
- Lise L Winkler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark.
| | - Ulla Toft
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
| | - Charlotte Glümer
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
- Center for Diabetes, Vesterbrogade 121, 3rd floor, København V, 1620, Denmark
| | - Paul Bloch
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, 2730, Denmark
| | - Tine Buch-Andersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, København K, 1123, Denmark
| |
Collapse
|
5
|
Hedrick VE, Farris AR, Houghtaling B, Mann G, Misyak SA. Validity of a Market Basket Assessment Tool for Use in Supplemental Nutrition Assistance Program Education Healthy Retail Initiatives. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:776-783. [PMID: 35623937 DOI: 10.1016/j.jneb.2022.02.018] [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: 09/13/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess the validity of the Market Basket Analysis Tool (MBAT) for food environment quality within various retail environments compared to the Nutrition Environment Measures Survey in Stores (NEMS-S). METHODS In-store assessments using the MBAT and the NEMS-S on the same day in a given store were conducted in grocery stores, corner stores, pharmacies, and dollar stores in a metropolis, and urban and rural counties across 4 states: Louisiana, Mississippi, North Carolina, and Virginia. Descriptive statistics, correlations, and ANOVAs were used to assess store location, store type differences, and MBAT and NEMS-S scores. RESULTS Market Basket Analysis Tool and NEMS-S data were collected from 114 stores. Market Basket Analysis Tool and NEMS-S total and all individual component scores were significantly correlated (r = 0.84, P ≤ 0.0001; r range, 0.51-0.88; P ≤ 0.0001). CONCLUSIONS AND IMPLICATIONS The MBAT offers a methodology to measure the food retail environment focusing on the availability of healthful food items with a reduced training time and streamlined data collection compared with the NEMS-S. Future work can assess the completion time of the MBAT compared with the NEMS-S and the ability of the MBAT to detect changes in food environment quality post healthy food retail interventions.
Collapse
Affiliation(s)
- Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
| | - Alisha R Farris
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University AgCenter, Baton Rouge, LA
| | - Georgianna Mann
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS
| | - Sarah A Misyak
- Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| |
Collapse
|
6
|
Gittelsohn J, Lewis EC, Martin NM, Zhu S, Poirier L, Van Dongen EJI, Ross A, Sundermeir SM, Labrique AB, Reznar MM, Igusa T, Trujillo AJ. The Baltimore Urban Food Distribution (BUD) App: Study Protocol to Assess the Feasibility of a Food Systems Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9138. [PMID: 35897500 PMCID: PMC9329906 DOI: 10.3390/ijerph19159138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/17/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023]
Abstract
Low-income urban communities in the United States commonly lack ready access to healthy foods. This is due in part to a food distribution system that favors the provision of high-fat, high-sugar, high-sodium processed foods to small retail food stores, and impedes their healthier alternatives, such as fresh produce. The Baltimore Urban food Distribution (BUD) study is a multilevel, multicomponent systems intervention that aims to improve healthy food access in low-income neighborhoods of Baltimore, Maryland. The primary intervention is the BUD application (app), which uses the power of collective purchasing and delivery to affordably move foods from local producers and wholesalers to the city's many corner stores. We will implement the BUD app in a sample of 38 corner stores, randomized to intervention and comparison. Extensive evaluation will be conducted at each level of the intervention to assess overall feasibility and effectiveness via mixed methods, including app usage data, and process and impact measures on suppliers, corner stores, and consumers. BUD represents one of the first attempts to implement an intervention that engages multiple levels of a local food system. We anticipate that the app will provide a financially viable alternative for Baltimore corner stores to increase their stocking and sales of healthier foods, subsequently increasing healthy food access and improving diet-related health outcomes for under-resourced consumers. The design of the intervention and the evaluation plan of the BUD project are documented here, including future steps for scale-up. Trial registration #: NCT05010018.
Collapse
Affiliation(s)
- Joel Gittelsohn
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Emma C Lewis
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Nina M Martin
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Siyao Zhu
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, MD 21205, USA
| | - Lisa Poirier
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | - Alexandra Ross
- Nutrition Epidemiology, School of Global Public Health, University of North Carolina Gillings, Chapel Hill, NC 27599, USA
| | - Samantha M Sundermeir
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Alain B Labrique
- Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Melissa M Reznar
- Interdisciplinary Health Sciences, Oakland University School of Health Sciences, Detroit, MI 48309, USA
| | - Takeru Igusa
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, MD 21205, USA
| | - Antonio J Trujillo
- Health Systems, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| |
Collapse
|
7
|
Taniguchi T, Haslam A, Sun W, Sisk M, Hayman J, Jernigan VBB. Impact of a Farm-to-School Nutrition and Gardening Intervention for Native American Families from the FRESH Study: A Randomized Wait-List Controlled Trial. Nutrients 2022; 14:nu14132601. [PMID: 35807781 PMCID: PMC9268191 DOI: 10.3390/nu14132601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 02/08/2023] Open
Abstract
Establishing healthy eating habits during childhood is critical to prevent chronic diseases that develop in adulthood. Tribally owned Early Childhood and Education (ECE) programs signify fundamental influence in childhood obesity disparities. A strategy to improve diet is the use of school gardens; however, few studies have used rigorous methods to assess diet and health outcomes. The purpose of this manuscript is to describe results from the six-month Food Resource Equity for Sustainable Health (FRESH) study among Native American families. We aimed to recruit 176 families of children attending Osage Nation ECE programs in four communities. Two communities received the intervention and two served as wait-list controls. Outcomes included change in dietary intake, body mass index, health status, systolic blood pressure (adults only), and food insecurity in children and parents. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Vegetable intake significantly increased in intervention children compared to controls for squash (p = 0.0007) and beans (p = 0.0002). Willingness to try scores increased for beans in intervention children (p = 0.049) and tomatoes in both groups (p = 0.01). FRESH is the first study to implement a farm-to-school intervention in rural, tribally owned ECEs. Future interventions that target healthy dietary intake among children should incorporate a comprehensive parent component in order to support healthy eating for all household members.
Collapse
Affiliation(s)
- Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
- Correspondence:
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Wenjie Sun
- Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
| | - Margaret Sisk
- Osage Nation, Harvest Land, Pawhuska, OK 74056, USA; (M.S.); (J.H.)
| | - Jann Hayman
- Osage Nation, Harvest Land, Pawhuska, OK 74056, USA; (M.S.); (J.H.)
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK 74135, USA;
| |
Collapse
|
8
|
Wei Y, Shannon J, Lee JS. Impact of Grocery Store Proximity on Store Preference Among Atlanta SNAP-Ed Participants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:263-268. [PMID: 35277223 DOI: 10.1016/j.jneb.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To assess the association between grocery store proximities and the individual's grocery store preferences among Supplemental Nutrition Assistance Program Education participants in Atlanta. METHODS University of Georgia Supplemental Nutrition Assistance Program Education participants (n = 615, response rate is 36%) in 3 counties provided their preferred grocery store chains. The association between store proximity (both network distance and driving time) and store preference was measured through logistic regression controlling for age, sex, and race. RESULTS Descriptive statistics showed participants had widely varying proximities to grocery stores. Model results were significant for all smaller chains (Aldi, Big Bear, Wayfield, Food Depot, and Save-A-Lot), Kroger (P < 0.01), as well as for Walmart (time only, P = 0.002). CONCLUSIONS AND IMPLICATIONS Future studies might identify whether local groceries are more willing to partner on interventions or are more effective at reaching local residents. Surveys or techniques such as sketch mapping could also show whether individuals shop in neighborhoods close to work or friends and family.
Collapse
Affiliation(s)
- Yangjiaxin Wei
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA.
| | - Jerry Shannon
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA; Department of Financial Planning, Housing, and Consumer Economics, College of Family and Consumer Sciences, University of Georgia, Athens, GA
| | - Jung Sun Lee
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA
| |
Collapse
|
9
|
Petrovskis A, Baquero B, Bekemeier B. Involvement of Local Health Departments in Obesity Prevention: A Scoping Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E345-E353. [PMID: 33729187 PMCID: PMC8781226 DOI: 10.1097/phh.0000000000001346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Local health department (LHD) obesity prevention (OP) efforts, particularly by rural LHDs, are seemingly uncommon, in part, due to limited infrastructure, workforce capacity, accessible data, and available population-level interventions aimed at social determinants of health (SDOH). METHODS We conducted a scoping review to determine LHD roles in OP efforts and interventions. Inclusion criteria were articles including evidence-based OP and LHD leaders or staff. Articles were coded by type of LHD involvement, data use, intervention characteristics, use of an SDOH lens, and urban or rural setting. RESULTS We found 154 articles on LHD OP-52 articles met inclusion criteria. Typically, LHDs engaged in only surveillance, initial intervention development, or evaluation and were not LHD led. Data and SDOH lens use were infrequent, and interventions typically took place in urban settings. CONCLUSION LHDs could likely play a greater role in OP and population-level interventions and use data in intervention decision making. However, literature is limited. Future research should focus on LHD capacity building, including academic-public health partnerships. Studies should include rural populations, data, and SDOH frameworks addressing "upstream" factors.
Collapse
Affiliation(s)
- Anna Petrovskis
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Barbara Baquero
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Betty Bekemeier
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| |
Collapse
|
10
|
Lewis EC, Harper KM, Poirier LK, Gittelsohn J. Feasibility of using mobile point-of-sale technology in Baltimore City corner stores tracking sales: A brief report. J Public Health Res 2021; 11. [PMID: 34711045 PMCID: PMC8883529 DOI: 10.4081/jphr.2021.2607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
Small food retail stores in many underserved urban settings keep no electronic records, making documentation of program impact on sales difficult to obtain. We examined the feasibility of introducing a point-of-sale tablet (POST) application to track sales of foods and beverages in Baltimore City corner stores. A sample of four geographically and ethnically diverse corner store owners were trained to use POST to track sales of 14 items for eleven days. Feasibility was documented via a structured survey and open-ended interviews. POST had high economic and cultural acceptability, operability, and perceived sustainability, regardless of language differences or familiarity with mobile technology. All store owners reported willingness to use POST again. It is feasible to train corner store owners to use a point-ofsale application for sales monitoring. An upcoming trial will help to ensure that POST provides sufficient value added for corner store owners. Significance for public health In recent decades, research on healthy food purchasing behaviors in small food retail stores has increased. Urban retail food environments lacking in healthy foods and abundant in unhealthy foods are often located in areas with high proportions of underserved African-American residents. Retail food environments such as these are particularly concerning, as they are associated with alarming rates of obesity and chronic disease in ethnic minority populations. Children are also being increasingly affected by what is available for purchase in small food retail stores, leading to lifetime risk for obesity and related diseases. In order for store owners to be better equipped to handle stocking and sales of healthy food items, they require efficient and effective technology to better control business operations. Mobile point-of-sale technology has the potential to improve small food retail environments and can inform future research on the stocking, purchasing, and consumption of healthy foods in similar settings and beyond.
Collapse
Affiliation(s)
- Emma C Lewis
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Batlimore, MD.
| | - Kaitlyn M Harper
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Batlimore, MD.
| | - Lisa K Poirier
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Batlimore, MD.
| | - Joel Gittelsohn
- Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Batlimore, MD.
| |
Collapse
|
11
|
Janda KM, Ranjit N, Salvo D, Nielsen A, Akhavan N, Diaz M, Lemoine P, Casnovsky J, van den Berg A. A Multi-Pronged Evaluation of a Healthy Food Access Initiative in Central Texas: Study Design, Methods, and Baseline Findings of the FRESH-Austin Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10834. [PMID: 34682578 PMCID: PMC8535966 DOI: 10.3390/ijerph182010834] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
Food insecurity and limited healthy food access are complex public health issues and warrant multi-level evaluations. The purpose of this paper was to present the overall study design and baseline results of the multi-pronged evaluation of a healthy food access (i.e., Fresh for Less (FFL)) initiative in Central Texas. The 2018-2021 FRESH-Austin study was a natural experiment that utilized a cluster random sampling strategy to recruit three groups of participants (total n = 400): (1) customers at FFL assets, (2) residents that lived within 1.5 miles of an FFL asset, and (3) residents from a comparison community. Evaluation measures included annual cohort surveys, accelerometers and GPS devices, store-level audits, and built environment assessments. Data are being used to inform and validate an agent-based model (ABM) to predict food shopping and consumption behaviors. Sociodemographic factors and food shopping and consumption behaviors were similar across the three groups; however, customers recruited at FFL assets were lower income and had a higher prevalence of food insecurity. The baseline findings demonstrate the need for multi-level food access interventions, such as FFL, in low-income communities. In the future, ABM can be used as a cost-effective way to determine potential impacts of future large-scale food environment programs and policies.
Collapse
Affiliation(s)
- Kathryn M. Janda
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Nalini Ranjit
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Aida Nielsen
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Nika Akhavan
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Martha Diaz
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Pablo Lemoine
- Centro Nacional de Consultoría, Bogotá 110221, Colombia;
| | | | - Alexandra van den Berg
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| |
Collapse
|
12
|
Zhu S, Mitsinikos C, Poirier L, Igusa T, Gittelsohn J. Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City. Nutrients 2021; 13:nu13093055. [PMID: 34578934 PMCID: PMC8465929 DOI: 10.3390/nu13093055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/29/2022] Open
Abstract
Policy interventions to improve food access and address the obesity epidemic among disadvantaged populations are becoming more common throughout the United States. In Baltimore MD, corner stores are a frequently used source of food for low-income populations, but these stores often do not provide a range of affordable healthy foods. This research study aimed to assist city policy makers as they considered implementing a Staple Food Ordinance (SFO) that would require small stores to provide a range and depth of stock of healthy foods. A System Dynamics (SD) model was built to simulate the complex Baltimore food environment and produce optimal values for key decision variables in SFO planning. A web-based application was created for users to access this model to optimize future SFOs, and to test out different options. Four versions of potential SFOs were simulated using this application and the advantages and drawbacks of each SFO are discussed based on the simulation results. These simulations show that a well-designed SFO has the potential to reduce staple food costs, increase corner store profits, reduce food waste, and expand the market for heathy staple foods.
Collapse
Affiliation(s)
- Siyao Zhu
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218, USA; (C.M.); (T.I.)
- Correspondence: ; Tel.: +1-517-775-9441
| | - Cassandra Mitsinikos
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218, USA; (C.M.); (T.I.)
| | - Lisa Poirier
- Global Obesity Prevention Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (L.P.); (J.G.)
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Takeru Igusa
- Department of Civil and Systems Engineering, Johns Hopkins Whiting School of Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218, USA; (C.M.); (T.I.)
- Global Obesity Prevention Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (L.P.); (J.G.)
| | - Joel Gittelsohn
- Global Obesity Prevention Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (L.P.); (J.G.)
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| |
Collapse
|
13
|
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
|
14
|
Yoder AD, Proaño GV, Handu D. Retail Nutrition Programs and Outcomes: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1866-1880.e4. [PMID: 33229206 DOI: 10.1016/j.jand.2020.08.080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
As nutrition-related diseases contribute to rising health care costs, food retail settings are providing a unique opportunity for registered dietitian nutritionists (RDNs) to address the nutritional needs of consumers. Food as Medicine interventions play a role in preventing and/or managing many chronic conditions that drive health care costs. The objective of this scoping review was to identify and characterize literature examining Food as Medicine interventions within food retail settings and across consumer demographics. An electronic literature search of 8 databases identified 11,404 relevant articles. Results from the searches were screened against inclusion criteria, and intervention effectiveness was assessed for the following outcomes: improvement in health outcomes and cost-effectiveness. One-hundred and eighty-six papers and 25 systematic reviews met inclusion criteria. Five categories surfaced as single interventions: prescription programs, incentive programs, medically tailored nutrition, path-to-purchase marketing, and personalized nutrition education. Multiple combinations of intervention categories, reporting of health outcomes (nutritional quality of shopping purchases, eating habits, biometric measures), and cost-effectiveness (store sales, health care dollar savings) also emerged. The intervention categories that produced both improved health outcomes and cost-effectiveness included a combination of incentive programs, personalized nutrition education, and path-to-purchase marketing. Food as Medicine interventions in the food retail setting can aid consumers in navigating health through diet and nutrition by encompassing the following strategic focus areas: promotion of health and well-being, managing chronic disease, and improving food security. Food retailers should consider the target population and desired focus areas and should engage registered dietitian nutritionists when developing Food as Medicine interventions.
Collapse
|
15
|
Snelling AM, Yamamoto JJ, Belazis LB, Seltzer GR, McClave RL, Watts E. Incentivizing Supplemental Nutrition Assistance Program Purchases with Fresh Produce in Corner Stores to Reduce Food Inequity in Underserved Areas of Washington DC. Health Equity 2020; 4:386-393. [PMID: 32964176 PMCID: PMC7501949 DOI: 10.1089/heq.2020.0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose: Maintaining a healthy eating pattern plays a key role in ensuring optimal health outcomes, yet, in areas considered “food deserts” and lower-income neighborhoods where the accessibility of healthy foods and beverages is limited, the pursuit of adequate nutrient intake is rendered cumbersome. This pilot program aims to improve access to healthful foods by supporting corner stores in stocking and promoting the purchase of produce. Methods: DC Central Kitchen's Healthy Corners program in Washington, DC piloted a nutrition incentive model in 17 corner stores that were upgraded to stock an increased variety and quantity of fresh produce. This program, entitled “5-for-5,” provided a $5 coupon toward the purchase of fresh produce to Supplemental Nutrition Assistance Program (SNAP) shoppers making a qualifying purchase of $5 or more with SNAP benefits. Results: Evaluation based on store owner buy-in and customer intercept surveys indicated overall satisfaction in program offerings with 77% of SNAP shoppers polled indicating an increase in produce consumption as a direct result of the program. Coupon distribution data indicated that in the 5-for-5 program's first year, 76.5% of all 57,989 distributed coupons were redeemed, amounting to $221,770 worth of incentivized fresh produce sales. Conclusion: The results of the incentive program were promising with increases in the amount of produce purchased as a result of the program. Lessons learned concerning the use of a financial incentive to encourage the purchase of produce at corner stores is explored, as well as the feasibility of the corner store as a sustainable venue to increase produce consumption in underserved communities.
Collapse
Affiliation(s)
- Anastasia M Snelling
- American University Department of Health Studies, Washington, District of Columbia, USA
| | - Jessica J Yamamoto
- American University Department of Health Studies, Washington, District of Columbia, USA
| | - Laura B Belazis
- DC Central Kitchen Department of Food Access and Education, Washington, District of Columbia, USA
| | - Gabriella R Seltzer
- DC Central Kitchen Department of Food Access and Education, Washington, District of Columbia, USA
| | - Robin L McClave
- American University Department of Health Studies, Washington, District of Columbia, USA
| | - Erin Watts
- American University Department of Health Studies, Washington, District of Columbia, USA
| |
Collapse
|
16
|
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
|
17
|
Machín L, Curutchet MR, Gugliucci V, Vitola A, Otterbring T, de Alcantara M, Ares G. The habitual nature of food purchases at the supermarket: Implications for policy making. Appetite 2020; 155:104844. [PMID: 32810573 DOI: 10.1016/j.appet.2020.104844] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022]
Abstract
Supermarkets have become the most important provider of food products worldwide. However, empirical evidence about how consumers make their food purchase decisions in this environment is still scarce. The present field study aimed to: i) explore how people make their in-store food purchases, and ii) identify the information they search for when making those purchases. Consumers (n = 144) were intercepted when entering the facilities of three supermarkets in two Uruguayan cities. They were asked to wear a mobile eye-tracker while they made their purchases as they normally do. The great majority of the consumers bought at least one food product or beverage (92%) and, on average, examined products from 2.8 sections. In total, they investigated 37 categories within 13 self-service sections, corresponding to 26 categories of ultra-processed products. For 67% of the products, consumers went straight to the product they seemed to be looking for, grabbed it and put it in their shopping basket or cart, without making any comparison among products. A limited information search was observed. On average, consumers spent 22 s examining products within self-service sections and only 6.9 s were elapsed from the moment they grabbed a product until they put it in the shopping cart. These results provide empirical evidence of the habitual nature of supermarket food purchases in a context characterized by wide availability of ultra-processed products. Taken together, the findings suggest that policies and interventions aimed at reducing purchases of ultra-processed products should disrupt habitual decisions at the point of purchase. In this sense, policies targeted at introducing salient changes on food packages hold potential to disrupt food purchases and encourage consumers to establish new and more healthful food purchase habits.
Collapse
Affiliation(s)
- Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Uruguay
| | - María Rosa Curutchet
- Observatorio de Seguridad Alimentaria y Nutricional, Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Uruguay
| | | | - Agustina Vitola
- Espacio Interdisciplinario, Universidad de la República, Uruguay
| | - Tobias Otterbring
- Department of Management, School of Business and Law, University of Agder, Norway
| | - Marcela de Alcantara
- PDJ-CNPq/Embrapa Agroindústria de Alimentos, Av. das Américas, 29501, CEP 23.020-470, Rio de Janeiro/RJ, Brazil
| | - Gastón Ares
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Uruguay; Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Uruguay.
| |
Collapse
|
18
|
Taniguchi TE, Salvatore AL, Williams MB, Love CV, Noonan CJ, Cannady TK, Standridge J, Fox J, Spiegel J, Owens J, Grammar M, Wiley A, Jernigan VBB. Process Evaluation Tool Development and Fidelity of Healthy Retail Interventions in American Indian Tribally Owned Convenience Stores: the Tribal Health Resilience in Vulnerable Environments (THRIVE) Study. Curr Dev Nutr 2020; 4:33-41. [PMID: 32258997 PMCID: PMC7101486 DOI: 10.1093/cdn/nzz073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/16/2019] [Accepted: 06/17/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Tribal Health Resilience in Vulnerable Environments (THRIVE) study aimed to increase healthy food access in 2 rural American Indian communities. The intervention sought to increase fruit and vegetable availability, variety, and convenience through placement, promotion, and pricing of healthy foods and beverages in tribal convenience stores. OBJECTIVE The aim of this study was to describe the development and implementation of the study process evaluation tool to assess intervention fidelity as part of this cluster-controlled trial. METHODS Eight stores (2 intervention and 2 control stores per Nation) participated in the study, implemented from May 2016 to May 2017. A web-based survey tailored to store layouts and intervention components assessed how often intervention items were available, approximate quantity available, and whether placement of healthier food items and promotional materials were implemented as designed. After pilot testing the survey, tribal staff members implemented it to collect process evaluation data in the 8 stores during a period of 9-12 mo, assessing study implementation and potential changes in control stores. RESULTS Promotional materials were available ≥75% of the time for most intervention locations. Fruit availability was similar in Nation A and Nation B intervention stores (79-100% compared with 70-100%), whereas fresh vegetable availability was higher in Nation B compared with Nation A (95-96% compared with 55-75%). Both control stores in Nation A and 1 control store in Nation B had moderate fruit and vegetable availability, ranging from 45% to 52%. No control stores in either Nation used intervention promotional materials. CONCLUSIONS Process evaluation data indicate that the study was implemented with moderate to high fidelity. The development and implementation of the tool can inform future healthy retail interventions that aim to improve rural and tribal food environments.
Collapse
Affiliation(s)
- Tori E Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Mary B Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Charlotte V Love
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Carolyn J Noonan
- Initiative for Research and Education to Advance Community Health, Washington State University, Pullman, WA, USA
| | - Tamela K Cannady
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - Joy Standridge
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jill Fox
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jennifer Spiegel
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - JoAnna Owens
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Mandy Grammar
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - AnDina Wiley
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| |
Collapse
|
19
|
Middel CNH, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JEW. Systematic review: a systems innovation perspective on barriers and facilitators for the implementation of healthy food-store interventions. Int J Behav Nutr Phys Act 2019; 16:108. [PMID: 31752885 PMCID: PMC6868845 DOI: 10.1186/s12966-019-0867-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Due to their central position in the modern food system, food stores present a unique opportunity to promote healthy dietary behaviour. However, there is a lack of insight into the factors that impede or enhance the implementation of nutritional interventions in food stores. We applied a systems innovation and implementation science framework to the identification of such barriers and facilitators. METHODS We conducted a systematic literature review. A search string was developed to identify qualitative and quantitative articles on environmental nutritional interventions in the food store. Four databases were systematically searched for studies published between 2000 and 2018. Eligible publications described study designs or original studies, focused on stimulating healthier dietary behaviour through environmental changes in retail settings and contained information on the perceptions or experiences of retailers or interventionists regarding the implementation process of the intervention. Context-descriptive data was extracted and a quality assessment was performed. RESULTS We included 41 articles, of which the majority was conducted in the USA and involved single stores or a mix of single and multi-store organisations. We categorized barriers and facilitators into 18 themes, under five domains. In the 'outer setting' domain, most factors related to consumers' preferences and demands, and the challenge of establishing a supply of healthy products. In the 'inner setting' domain, these related to conflicting values regarding health promotion and commercial viability, store lay-out, (insufficient) knowledge and work capacity, and routines regarding waste avoidance and product stocking. In the 'actors' domain, no major themes were found. For the 'intervention 'domain', most related to intervention-context fit, money and resource provision, material quality, and the trade-offs between commercial costs and risks versus commercial and health benefits. For the 'process' domain, most factors related to continuous engagement and strong relationships. CONCLUSIONS This review provides a comprehensive overview of barriers and facilitators to be taken into account when implementing nutritional interventions in food stores. Furthermore, we propose a novel perspective on implementation as the alignment of intervention and retail interests, and a corresponding approach to intervention design which may help avoid barriers, and leverage facilitators. TRIAL REGISTRATION PROSPERO; CRD42018095317.
Collapse
Affiliation(s)
- Cédric N. H. Middel
- Athena Institute, Faculty of Science, VU University, De Boelelaan 1085, 1081 HV Amsterdam, Netherlands
| | | | - Joreintje D. Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centres, VU University Medical Center, Amsterdam, the Netherlands
| | - Jacqueline E. W. Broerse
- Athena Institute, Faculty of Science, VU University, De Boelelaan 1085, 1081 HV Amsterdam, Netherlands
| |
Collapse
|
20
|
Nam CS, Ross A, Ruggiero C, Ferguson M, Mui Y, Lee BY, Gittelsohn J. Process Evaluation and Lessons Learned From Engaging Local Policymakers in the B'More Healthy Communities for Kids Trial. HEALTH EDUCATION & BEHAVIOR 2019; 46:15-23. [PMID: 29969930 PMCID: PMC6440198 DOI: 10.1177/1090198118778323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Partnerships linking researchers to the policymaking process can be effective in increasing communication and supporting health policy. However, these policy partnerships rarely conduct process evaluation. The Policy Working Group (Policy WG) was the policy-level intervention of the multilevel B'More Healthy Communities for Kids (BHCK) trial. The group sought to align interests of local policymakers, inform local food and nutrition policy, introduce policymakers to a new simulation modeling, and sustain intervention levels of BHCK. We conducted an evaluation on the Policy WG between July 2013 and May 2016. We evaluated process indicators for reach, dose-delivered, and fidelity and developed a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The policy intervention was implemented with high reach and dose-delivered. Fidelity measures improved from moderate to nearly high over time. The number of health-related issues on policymakers' agenda increased from 50% in the first 2 years to 150% of the high standard in Year 3. SWOT analysis integrated a stakeholder feedback survey to consider areas of strength, weakness, opportunity, and threats. Although the fidelity of the modeling was low at 37% of the high standard, stakeholders indicated that the simulation modeling should be a primary purpose for policy intervention. Results demonstrate that process evaluation and SWOT analysis is useful for tracking the progress of policy interventions in multilevel trials and can be used to monitor the progress of building partnerships with policymakers.
Collapse
Affiliation(s)
- Cyd S. Nam
- The Joint Learning Initiative on Faith and Local Communities, Washington, DC, USA
| | | | - Cara Ruggiero
- Pennsylvania State University, University Park, PA, USA
| | | | - Yeeli Mui
- University at Buffalo—The State University of New York, Buffalo, NY, USA
| | | | | |
Collapse
|
21
|
Houghtaling B, Serrano EL, Kraak VI, Harden SM, Davis GC, Misyak SA. A systematic review of factors that influence food store owner and manager decision making and ability or willingness to use choice architecture and marketing mix strategies to encourage healthy consumer purchases in the United States, 2005-2017. Int J Behav Nutr Phys Act 2019; 16:5. [PMID: 30642352 PMCID: PMC6332888 DOI: 10.1186/s12966-019-0767-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Altering food store environments is a promising approach to encourage healthy product purchases by consumers to improve their diet quality and health. Food store owners and managers are intermediaries to ensure that environmental changes are enacted. Despite their role as gatekeepers to implement and sustain healthy food environment changes, no systematic review has been published that examines food store owner and manager (retailer) data. Thus a review of retailer information available within the expansive United States (US) food environment literature was the purpose of this research. Methods The PRISMA protocol was used. A search strategy, including published articles from years 1980–2017, was applied to six databases to locate relevant articles that addressed the perspective of food store retailers in the US. Data were extracted, organized, and agreed upon between two authors based on pre-designed constructs: (1) a social-ecological model to capture factors that influence retailer decision making; and (2) a marketing-mix and choice-architecture framework to examine perspectives of applied (or the prospective application of) strategies at the store-level. Study quality was assessed using quality criteria checklists for qualitative and quantitative research. Results Thirty-one articles met inclusion criteria and most studies (n = 22) were qualitative and conducted in urban food stores (n = 23). Multiple social-ecological factors influenced retailer decision making and ability or willingness to use marketing-mix and choice-architecture strategies to improve consumers’ healthy choices to support dietary quality. These factors included: conflicting training outcomes to enhance retailers’ knowledge and skills (individual, n = 9); the importance of trust (interpersonal, n = 8); views about marketing-mix and choice-architecture strategies in the food environment (n = 25); consumer demand or demographics (community, n = 19); supplier and food store management variables (systems or sectors, n = 18); local and federal policy (n = 8); and support for community health (norms/values, n = 8). Conclusions Research partnerships can support favorable business and public health outcomes to align with retailers’ business models and available resources. A participatory and translational approach to food environment research will likely maximize public health impact. Urban and rural food store retailers are important actors for future research to inform the feasibility of store retailers to apply MMCA strategies that are profitable and promote health. Electronic supplementary material The online version of this article (10.1186/s12966-019-0767-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, 337 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, Virginia, VA, 24061, USA.
| | - Elena L Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia, USA
| | - Sarah A Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| |
Collapse
|
22
|
Affordability of Food and Beverages in Mexico between 1994 and 2016. Nutrients 2019; 11:nu11010078. [PMID: 30609784 PMCID: PMC6356212 DOI: 10.3390/nu11010078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 11/17/2022] Open
Abstract
We estimated the affordability of food and beverages by energy density and nutrient quality in Mexico and tested for differential trends in affordability over time and by income quintile. We used the National Income and Expenditures Survey from 1994 to 2016, and information on the caloric and nutrient content of food and beverages from Mexican food composition tables. We estimated food energy density (kcal/kg) and nutrient quality of food and beverages using the nutrient-rich food index (NRFI). Affordability of food and beverages was defined as household monthly income needed to purchase 1000 kcal. The affordability index was expressed by quintiles of energy density and quintiles of the NRFI and by income quintile over time. We found that more energy-dense foods and food and beverages with lower nutrient quality were more affordable compared to healthier food and beverages. Food categories with lower energy density and a higher NRFI became less affordable over time for most income groups, but the burden was higher for lower-income households. A comprehensive national strategy should be implemented to make healthier options more affordable and discretional foods and beverages with lower nutrient quality less affordable.
Collapse
|
23
|
Wensel CR, Trude ACB, Poirier L, Alghamdi R, Trujillo A, Anderson Steeves E, Paige D, Gittelsohn J. B'more Healthy Corner Stores for Moms and Kids: Identifying Optimal Behavioral Economic Strategies to Increase WIC Redemptions in Small Urban Corner Stores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010064. [PMID: 30591654 PMCID: PMC6339089 DOI: 10.3390/ijerph16010064] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/09/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022]
Abstract
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) redemption rates have been declining in many low-income urban settings, potentially related to aspects of the food environment. B’more Healthy Corner Stores for Moms and Kids was a feasibility trial in Baltimore City that aimed to test multiple behavioral economic (BE) strategies in 10 corner stores (intervention = eight stores, comparison = two stores), to evaluate their influence on the stocking and redemptions of WIC foods. Tested strategies included in-person storeowner training, point of purchase promotion, product placement, and grouping of products in a display. All four strategies were feasible and implemented with high reach, dose delivered, and fidelity. Additionally, text messaging was found to be an acceptable form of intervention reinforcement for storeowners. Analyses to assess change in stocking of WIC foods, total sales of WIC foods, and sales of WIC foods to WIC clients, revealed consistent positive changes after implementation of the store owner training strategy, while changes after the implementation of other strategies were mixed. Furthermore, WIC food sales to WIC clients significantly increased after the simultaneous implementation of two strategies, compared to one (p > 0.05). Results suggest that store owner training was the most influential strategy and that the implementation of more BE strategies does not necessarily lead to proportional increases in stocking and sales. Selected BE strategies appear to be an effective way of increasing stocking and sales of WIC foods in small urban food stores.
Collapse
Affiliation(s)
- Caroline R Wensel
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Angela C B Trude
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Lisa Poirier
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Riyad Alghamdi
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Antonio Trujillo
- Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Elizabeth Anderson Steeves
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, 1215 W. Cumberland Ave., Knoxville, TN 37996, USA.
| | - David Paige
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| | - Joel Gittelsohn
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA.
| |
Collapse
|
24
|
Gittelsohn J, Novotny R, Trude ACB, Butel J, Mikkelsen BE. Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010030. [PMID: 30586845 PMCID: PMC6339209 DOI: 10.3390/ijerph16010030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 12/12/2022]
Abstract
Multi-level multi-component (MLMC) strategies have been recommended to prevent and reduce childhood obesity, but results of such trials have been mixed. The present work discusses lessons learned from three recently completed MLMC interventions to inform future research and policy addressing childhood obesity. B’more Healthy Communities for Kids (BHCK), Children’s Healthy Living (CHL), and Health and Local Community (SoL) trials had distinct cultural contexts, global regions, and study designs, but intervened at multiple levels of the socioecological model with strategies that address multiple components of complex food and physical activity environments to prevent childhood obesity. We discuss four common themes: (i) How to engage with community partners and involve them in development of intervention and study design; (ii) build and maintain intervention intensity by creating mutual promotion and reinforcement of the intervention activities across the multiple levels and components; (iii) conduct process evaluation for monitoring, midcourse corrections, and to engage stakeholder groups; and (iv) sustaining MLMC interventions and its effect by developing enduring and systems focused collaborations. The paper expands on each of these themes with specific lessons learned and presents future directions for MLMC trials.
Collapse
Affiliation(s)
- Joel Gittelsohn
- Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
| | - Rachel Novotny
- Children's Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources ⁻ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
| | - Angela Cristina Bizzotto Trude
- Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
| | - Jean Butel
- Children's Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources ⁻ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
| | - Bent Egberg Mikkelsen
- Department of Learning & Philosophy, Aalborg University, A.C. Meyers Vænge 15, DK-2450 Copenhagen SV, Denmark.
| |
Collapse
|
25
|
Jalali MS, Rahmandad H, Bullock SL, Lee-Kwan SH, Gittelsohn J, Ammerman A. Dynamics of intervention adoption, implementation, and maintenance inside organizations: The case of an obesity prevention initiative. Soc Sci Med 2018; 224:67-76. [PMID: 30763824 DOI: 10.1016/j.socscimed.2018.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 10/22/2018] [Accepted: 12/15/2018] [Indexed: 12/11/2022]
Abstract
Overall impact of public health prevention interventions relies not only on the average efficacy of an intervention, but also on the successful adoption, implementation, and maintenance (AIM) of that intervention. In this study, we aim to understand the dynamics that regulate AIM of organizational level intervention programs. We focus on two well-documented obesity prevention interventions, implemented in food carry-outs and stores in low-income urban areas of Baltimore, Maryland, which aimed to improve dietary behaviour for adults by providing access to healthier foods and point-of-purchase promotions. Building on data from field observations, in-depth interviews, and data discussed in previous publications, as well as the strategy and organizational behaviour literature, we developed a system dynamics model of the key processes of AIM. With simulation analysis, we show several reinforcing mechanisms that span stakeholder motivation, communications, and implementation quality and costs can turn small changes in the process of AIM into big difference in the overall impact of the intervention. Specifically, small changes in the allocation of resources to communication with stakeholders of intervention could have a nonlinear long-term impact if those additional resources can turn stakeholders into allies of the intervention, reducing the erosion rates and enhancing sustainability. We present how the dynamics surrounding communication, motivation, and erosion can create significant heterogeneity in the overall impact of otherwise similar interventions. Therefore, careful monitoring of how those dynamics unfold, and timely adjustments to keep the intervention on track are critical for successful implementation and maintenance.
Collapse
Affiliation(s)
- Mohammad S Jalali
- MGH Institute for Technology Assessment, Harvard Medical School, Boston, MA, USA; Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Hazhir Rahmandad
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Sally Lawrence Bullock
- Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), University of North Carolina at Chapel Hill, NC, USA.
| | - Seung Hee Lee-Kwan
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), University of North Carolina at Chapel Hill, NC, USA.
| |
Collapse
|
26
|
Loh IH, Schwendler T, Trude ACB, Anderson Steeves ET, Cheskin LJ, Lange S, Gittelsohn J. Implementation of Text-Messaging and Social Media Strategies in a Multilevel Childhood Obesity Prevention Intervention: Process Evaluation Results. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2018; 55:46958018779189. [PMID: 29865969 PMCID: PMC6022210 DOI: 10.1177/0046958018779189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Social media and text messaging show promise as public health interventions, but little evaluation of implementation exists. The B’more Healthy Communities for Kids (BHCK) was a multilevel, multicomponent (wholesalers, food stores, recreation centers) childhood obesity prevention trial that included social media and text-messaging components. The BHCK was implemented in 28 low-income areas of Baltimore City, Maryland, in 2 waves. The texting intervention targeted 241 low-income African American caregivers (of 283), who received 3 texts/week reinforcing key messages, providing nutrition information, and weekly goals. Regular posting on social media platforms (Facebook, Instagram, Twitter) targeted community members and local stakeholders. High implementation standards were set a priori (57 for social media, 11 for texting), with low implementation defined as <50%, medium as 50% to 99%, high as ≥100% of the high standard for each measure. Reach, dose delivered, and fidelity were assessed via web-based analytic tools. Between waves, social media implementation improved from low-moderate to high reach, dose delivered, and fidelity. Text messaging increased from moderate to high in reach and dose delivered, fidelity decreased from high to moderate. Data were used to monitor and revise the BHCK intervention throughout implementation. Our model for evaluating text messaging–based and social media–based interventions may be applicable to other settings.
Collapse
Affiliation(s)
- Ivory H Loh
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Angela C B Trude
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Sarah Lange
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joel Gittelsohn
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
27
|
Ruggiero CF, Poirier L, Trude ACB, Yang T, Schwendler T, Gunen B, Loh IH, Perepezko K, Nam CS, Sato P, Gittelsohn J. Implementation of B'More Healthy Communities for Kids: process evaluation of a multi-level, multi-component obesity prevention intervention. HEALTH EDUCATION RESEARCH 2018; 33:458-472. [PMID: 30202959 PMCID: PMC6293311 DOI: 10.1093/her/cyy031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/31/2018] [Accepted: 08/16/2018] [Indexed: 05/10/2023]
Abstract
B'More Healthy Communities for Kids was a multi-level, multi-component obesity prevention intervention to improve access, demand and consumption of healthier foods and beverages in 28 low-income neighborhoods in Baltimore City, MD. Process evaluation assesses the implementation of an intervention and monitor progress. To the best of our knowledge, little detailed process data from multi-level obesity prevention trials have been published. Implementation of each intervention component (wholesaler, recreation center, carryout restaurant, corner store, policy and social media/text messaging) was classified as high, medium or low according to set standards. The wholesaler component achieved high implementation for reach, dose delivered and fidelity. Recreation center and carryout restaurant components achieved medium reach, dose delivered and fidelity. Corner stores achieved medium reach and dose delivered and high fidelity. The policy component achieved high reach and medium dose delivered and fidelity. Social media/text messaging achieved medium reach and high dose delivered and fidelity. Overall, study reach and dose delivered achieved a high implementation level, whereas fidelity achieved a medium level. Varying levels of implementation may have balanced the performance of an intervention component for each process evaluation construct. This detailed process evaluation of the B'More Healthy Communities for Kids allowed the assessment of implementation successes, failures and challenges of each intervention component.
Collapse
Affiliation(s)
- C F Ruggiero
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - L Poirier
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A C B Trude
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T Yang
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - T Schwendler
- Peace Corps, Serekunda, The Gambia, Washington, DC, USA
| | - B Gunen
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - I H Loh
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K Perepezko
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - C S Nam
- Joint Learning Initiative on Faith and Local Communities, Washington, DC, USA
| | - P Sato
- University of S�o Paulo, S�o Paulo, SP, Brazil
| | - J Gittelsohn
- Global Obesity Prevention Center, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
28
|
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]
|
29
|
Sadeghzadeh CJ, Soldavini J, Uslan D, De Marco M. Novel Sales Tracking Method to Evaluate a Healthy Corner Store Intervention. Health Promot Pract 2018; 21:401-409. [PMID: 30041554 DOI: 10.1177/1524839918789379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes a Supplemental Nutrition Assistance Program-Education-funded (SNAP-Ed) healthy corner store intervention and novel evaluation method for tracking sales of promoted foods in two corner stores in North Carolina. The healthy corner store intervention was designed to encourage the purchase of healthy foods among SNAP participants. Stickers were placed on eligible foods to highlight healthy options as well as assist with tracking the sales of those products. Store staff removed the sticker and placed it on a tracking sheet that recorded the date, number of healthy foods purchased, whether the purchased item(s) contained a fruit or vegetable, and the type of payment. Storeowners were interested in participating and remained engaged throughout the program; however, there were challenges with fidelity to the intervention and its evaluation using the sticker method to track sales. Additional research on methods for evaluating healthy retail interventions that are simple, low cost, and feasible for retailers that do not have electronic sales data is needed.
Collapse
Affiliation(s)
| | | | - Daniella Uslan
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Molly De Marco
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
30
|
Misyak SA, Hedrick VE, Pudney E, Serrano EL, Farris AR. Reliability of a Market Basket Assessment Tool (MBAT) for Use in SNAP-Ed Healthy Retail Initiatives. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:511-515. [PMID: 29500105 DOI: 10.1016/j.jneb.2018.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the reliability of the Market Basket Assessment Tool (MBAT) for assessing the availability of fruits and vegetables, low-fat or nonfat dairy and eggs, lean meats, whole-grain products, and seeds, beans, and nuts in Supplemental Nutrition Assistance Program-authorized retail environments. METHODS Different trained raters used the MBAT simultaneously at 14 retail environments to measure interrater reliability. Raters returned to 12 retail environments (85.7%) 1 week later to measure test-retest reliability. Data were analyzed using paired-sample t tests and correlations. RESULTS No significant differences were found for interrater reliability or test-retest reliability for individual categories (mean differences, 0.0 to 0.3 ± 0.2 points) or total score (mean difference, 0.5 ± 0.4 points and (mean differences, 0.0 to 0.3 ± 0.3 points) or total score (mean difference, 0.8 ± 0.4 points), respectively. CONCLUSIONS AND IMPLICATIONS Future steps include validation of the MBAT. A low-burden tool can facilitate evaluation of efforts to promote healthful foods in retail environments.
Collapse
Affiliation(s)
- Sarah A Misyak
- Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Ellen Pudney
- Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Elena L Serrano
- Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Alisha R Farris
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| |
Collapse
|
31
|
Ross A, Krishnan N, Ruggiero C, Kerrigan D, Gittelsohn J. A mixed methods assessment of the barriers and readiness for meeting the SNAP depth of stock requirements in Baltimore's small food stores. Ecol Food Nutr 2017; 57:94-108. [PMID: 29283673 DOI: 10.1080/03670244.2017.1416362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We sought to understand Baltimore corner store owners' awareness of and readiness for the then-approved Supplemental Nutrition Assistance Program depth of stock requirements and assess potential barriers and solutions. In-depth interviews and stocking observations were conducted in 17 corner stores in low-income food deserts of Baltimore City. Corner store owners conveyed little to no awareness of the pending depth of stock changes. Only two stores were currently ready for the requirements. Low customer demand, high amounts of potential spoilage, and unfair pricing at the wholesaler were identified by store owners as barriers to stocking required foods.
Collapse
Affiliation(s)
- Alexandra Ross
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA.,b Department of Health, Behavior, and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Nandita Krishnan
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Cara Ruggiero
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Deanna Kerrigan
- b Department of Health, Behavior, and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Joel Gittelsohn
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| |
Collapse
|
32
|
The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111371. [PMID: 29125558 PMCID: PMC5708010 DOI: 10.3390/ijerph14111371] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/18/2017] [Accepted: 11/06/2017] [Indexed: 11/16/2022]
Abstract
The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B’more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler (n = 3), corner store (n = 50), carryout (n = 30), recreation center (n = 28), household (n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
Collapse
|
33
|
Young S, DeNomie M, Sabir J, Gass E, Tobin J. Around the Corner to Better Health: A Milwaukee Corner Store Initiative. Am J Health Promot 2017; 32:1353-1356. [PMID: 29092631 DOI: 10.1177/0890117117736970] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To discuss successes and challenges of a collaborative pilot project to increase healthy food availability in corner stores in Milwaukee, Wisconsin. The Lindsay Heights Healthy Corner Store Initiative aimed to help corner stores sell high-quality produce by increasing supply of healthy foods and funding minor store upgrades to facilitate change. DESIGN Evaluation research. SETTING Milwaukee, Wisconsin. PARTICIPANTS Corner stores; youth and adult community members. INTERVENTION (1) Supporting businesses in purchasing equipment to stock fresh produce, (2) connecting stores with produce sources, and (3) community outreach and marketing. MEASURES Partnership capacity, youth engagement in food justice, and community members' usage of corner stores. ANALYSIS Qualitative analysis; descriptive statistics. RESULTS Storeowners reported more sold produce items per week and increased noticeable fresh produce upon entrance into the store. There was increased or improved store redesign, fresh produce signage, in-store cooking demonstrations, and small business development resources. CONCLUSION Youth learned about new vegetables, increased kitchen skills and proper food storage, and the effects of obesity on overall health. Similar interventions must address infrastructure costs, cooperation with property owners, and local policies and regulations affecting business practices.
Collapse
Affiliation(s)
- Staci Young
- 1 Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Melissa DeNomie
- 1 Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Eric Gass
- 3 School of Health Sciences, Milwaukee Area Technical College, Milwaukee, WI, USA
| | - Jessie Tobin
- 4 Walnut Way Conservation Corp, Milwaukee, WI, USA
| |
Collapse
|
34
|
Asada Y, Lieberman LD, Neubauer LC, Hanneke R, Fagen MC. Evaluating Structural Change Approaches to Health Promotion: An Exploratory Scoping Review of a Decade of U.S. Progress. HEALTH EDUCATION & BEHAVIOR 2017; 45:153-166. [DOI: 10.1177/1090198117721611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Structural change approaches—also known as policy and environmental changes—are becoming increasingly common in health promotion, yet our understanding of how to evaluate them is still limited. An exploratory scoping review of the literature was conducted to understand approaches and methods used to evaluate structural change interventions in health promotion and public health literature. Two analysts—along with health sciences librarian consultation—searched PubMed, Web of Science, and EMBASE for peer-reviewed U.S.-based, English language studies published between 2005 and 2016. Data were extracted on the use of evaluation frameworks, study designs, duration of evaluations, measurement levels, and measurement types. Forty-five articles were included for the review. Notably, the majority (73%) of studies did not report application of a specific evaluation framework. Studies used a wide range of designs, including process evaluations, quasi- or nonexperimental designs, and purely descriptive approaches. In addition, 15.6% of studies only measured outcomes at the individual level. Last, 60% of studies combined more than one measurement type (e.g., site observation + focus groups) to evaluate interventions. Future directions for evaluating structural change approaches to health promotion include more widespread use and reporting of evaluation frameworks, developing validated tools that measure structural change, and shifting the focus to health-directed approaches, including an expanded consideration for evaluation designs that address health inequities.
Collapse
Affiliation(s)
- Yuka Asada
- University of Illinois at Chicago, IL, USA
| | | | | | | | | |
Collapse
|
35
|
Schwendler T, Shipley C, Budd N, Trude A, Surkan PJ, Anderson Steeves E, de Morais Sato P, Eckmann T, Loh H, Gittelsohn J. Development and Implementation: B'More Healthy Communities for Kid's Store and Wholesaler Intervention. Health Promot Pract 2017; 18:822-832. [PMID: 28343413 DOI: 10.1177/1524839917696716] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B'More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community's access to healthy food. The objective of this article is to describe the development and implementation of BHCK's corner store and wholesaler interventions through formal process evaluation. Researchers evaluated each level of the intervention to assess reach, dose delivered, and fidelity. Corner store and wholesaler reach, dose delivered, and fidelity were measured by number of interactions, promotional materials distributed, and maintenance of study materials, respectively. Overall, the corner store implementation showed moderate reach, dose delivered, and high fidelity. The wholesaler intervention was implemented with high reach, dose, and fidelity. The program held 355 corner store interactive sessions and had 9,347 community member interactions, 21% of which were with children between the ages of 10 and 14 years. There was a 15% increase in corner store promoted food stocking during Wave 1 and a 17% increase during Wave 2. These findings demonstrate a successfully implemented food retailer intervention in a low-income urban setting.
Collapse
Affiliation(s)
- Teresa Schwendler
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cara Shipley
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nadine Budd
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Angela Trude
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Thomas Eckmann
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hong Loh
- 4 Johns Hopkins University, Baltimore, MD, USA
| | - Joel Gittelsohn
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
36
|
Media Outlet and Consumer Reactions to Promotional Activities of the Choose Health LA Restaurants Program in Los Angeles County. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 22:231-44. [PMID: 26062098 DOI: 10.1097/phh.0000000000000279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options. DESIGN We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey. SETTING The study was conducted in Los Angeles County, home to more than 10 million residents. PARTICIPANTS An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data. INTERVENTION Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign. MAIN OUTCOME MEASURES Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media. RESULTS Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health. CONCLUSIONS Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.
Collapse
|
37
|
Gittelsohn J, Trude A. Diabetes and obesity prevention: changing the food environment in low-income settings. Nutr Rev 2017; 75:62-69. [PMID: 28049750 PMCID: PMC5207007 DOI: 10.1093/nutrit/nuw038] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including interventions at the environmental and policy levels. Such interventions are promising due to their wide reach. This article reports on 10 multilevel community trials that the present authors either led (n = 8) or played a substantial role in developing (n = 2) in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies examined change from pre- to postintervention and included a comparison group. The results show the trials had consistent positive effects on consumer psychosocial factors, food purchasing, food preparation, and diet, and, in some instances, obesity. Recently, a multilevel, multicomponent intervention was implemented in the city of Baltimore that promises to impact obesity in children, and, potentially, diabetes and related chronic diseases among adults. Based on the results of these trials, this article offers a series of recommendations to contribute to the prevention of chronic disease in Mexico. Further work is needed to disseminate, expand, and sustain these initiatives at the city, state, and federal levels.
Collapse
Affiliation(s)
- Joel Gittelsohn
- J. Gittelsohn and A. Trude are with the Department of International Health, Center for Human Nutrition, Global Obesity Prevention Center at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Angela Trude
- J. Gittelsohn and A. Trude are with the Department of International Health, Center for Human Nutrition, Global Obesity Prevention Center at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
38
|
Adam A, Jensen JD. What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets? -a systematic review. BMC Public Health 2016; 16:1247. [PMID: 28031046 PMCID: PMC5192566 DOI: 10.1186/s12889-016-3985-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/22/2016] [Indexed: 11/23/2022] Open
Abstract
Background The Prevalence of obesity and overweight has been increasing in many countries. Many factors have been identified as contributing to obesity including the food environment, especially the access, availability and affordability of healthy foods in grocery stores and supermarkets. Several interventions have been carried out in retail grocery/supermarket settings as part of an effort to understand and influence consumption of healthful foods. The review’s key outcome variable is sale/purchase of healthy foods as a result of the interventions. This systematic review sheds light on the effectiveness of food store interventions intended to promote the consumption of healthy foods and the methodological quality of studies reporting them. Methods Systematic literature search spanning from 2003 to 2015 (inclusive both years), and confined to papers in the English language was conducted. Studies fulfilling search criteria were identified and critically appraised. Studies included in this review report health interventions at physical food stores including supermarkets and corner stores, and with outcome variable of adopting healthier food purchasing/consumption behavior. The methodological quality of all included articles has been determined using a validated 16-item quality assessment tool (QATSDD). Results The literature search identified 1580 publications, of which 42 met the inclusion criteria. Most interventions used a combination of information (e.g. awareness raising through food labeling, promotions, campaigns, etc.) and increasing availability of healthy foods such as fruits and vegetables. Few used price interventions. The average quality score for all papers is 65.0%, or an overall medium methodological quality. Apart from few studies, most studies reported that store interventions were effective in promoting purchase of healthy foods. Conclusion Given the diverse study settings and despite the challenges of methodological quality for some papers, we find efficacy of in-store healthy food interventions in terms of increased purchase of healthy foods. Researchers need to take risk of bias and methodological quality into account when designing future studies that should guide policy makers. Interventions which combine price, information and easy access to and availability of healthy foods with interactive and engaging nutrition information, if carefully designed can help customers of food stores to buy and consume more healthy foods. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3985-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Abdulfatah Adam
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 25, DK-1958, Frederiksberg, Denmark.
| | - Jørgen D Jensen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 25, DK-1958, Frederiksberg, Denmark
| |
Collapse
|
39
|
Winkler LL, Christensen U, Glümer C, Bloch P, Mikkelsen BE, Wansink B, Toft U. Substituting sugar confectionery with fruit and healthy snacks at checkout - a win-win strategy for consumers and food stores? a study on consumer attitudes and sales effects of a healthy supermarket intervention. BMC Public Health 2016; 16:1184. [PMID: 27876025 PMCID: PMC5120526 DOI: 10.1186/s12889-016-3849-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022] Open
Abstract
Background The widespread use of in-store marketing strategies to induce unhealthy impulsive purchases has implications for shopping experience, food choice and possibly adverse health outcomes. The aim of this study was to examine consumer attitudes and evaluate sales effects of a healthy checkout supermarket intervention. The study was part of Project Sundhed & Lokalsamfund (Project SoL); a Danish participatory community-based health promotion intervention. Methods Consumer attitudes towards unhealthy snack exposure in supermarkets were examined in a qualitative pre-intervention study (29 short in-store interviews, 11 semi-structured interviews and three focus group interviews). Findings were presented to food retailers and informed the decision to test a healthy checkout intervention. Sugar confectionery at one checkout counter was substituted with fruit and healthy snacking items in four stores for 4 weeks. The intervention was evaluated by 48 short exit interviews on consumer perceptions of the intervention and by linear mixed model analyses of supermarket sales data from the intervention area and a matched control area. Results The qualitative pre-intervention study identified consumer concern and annoyance with placement and promotion of unhealthy snacks in local stores. Store managers were willing to respond to local consumer concern and a healthy checkout intervention was therefore implemented. Exit interviews found positive attitudes towards the intervention, while intervention awareness was modest. Most participants believed that the intervention could help other consumers make healthier choices, while fewer expected to be influenced by the intervention themselves. Statistical analyses suggested an intervention effect on sales of carrot snack packs when compared with sales before the intervention in Bornholm control stores (P < 0.05). No significant intervention effect on sales of other intervention items or sugar confectionery was found. Conclusions The present study finds that the healthy checkout intervention was positively evaluated by consumers and provided a ‘responsible’ branding opportunity for supermarkets, thus representing a win-win strategy for store managers and consumers in the short term. However, the intervention was too modest to draw conclusions on long-term sales and health implications of this initiative. More research is needed to assess whether retailer-researcher collaborations on health promotion can be a winning strategy for public health.
Collapse
Affiliation(s)
- Lise L Winkler
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark.
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
| | - Paul Bloch
- Steno Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 8, 2820, Gentofte, Denmark
| | - Bent E Mikkelsen
- Department of Clinical Medicine, Aalborg University, Frederikskaj 10, Building B, B2,, 2450, Copenhagen, SV, Denmark
| | - Brian Wansink
- Marketing in the Department of Applied Economics, Management at Cornell University, 114 Warren Hall, Ithaca, NY, 14853, USA
| | - Ulla Toft
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
| |
Collapse
|
40
|
Kim M, Budd N, Batorsky B, Krubiner C, Manchikanti S, Waldrop G, Trude A, Gittelsohn J. Barriers to and Facilitators of Stocking Healthy Food Options: Viewpoints of Baltimore City Small Storeowners. Ecol Food Nutr 2016; 56:17-30. [PMID: 27841664 DOI: 10.1080/03670244.2016.1246361] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Receptivity to strategies to improve the food environment by increasing access to healthier foods in small food stores is underexplored. We conducted 20 in-depth interviews with small storeowners of different ethnic backgrounds as part of a small-store intervention trial. Store owners perceived barriers and facilitators to purchase, stock, and promote healthy foods. Barriers mentioned included customer preferences for higher fat and sweeter taste and for lower prices; lower wholesaler availability of healthy food; and customers' lack of interest in health. Most store owners thought positively of taste tests, free samples, and communication interventions. However, they varied in terms of their expectations of the effect of these strategies on customers' healthy food purchases. The findings reported add to the limited data on motivating and working with small-store owners in low-income urban settings.
Collapse
Affiliation(s)
- Mhinjine Kim
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Nadine Budd
- b Division of Nutrition, Physical Activity, and Obesity , Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - Benjamin Batorsky
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Carleigh Krubiner
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Swathi Manchikanti
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Greer Waldrop
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Angela Trude
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Joel Gittelsohn
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| |
Collapse
|
41
|
Obesity-Related Dietary Behaviors among Racially and Ethnically Diverse Pregnant and Postpartum Women. J Pregnancy 2016; 2016:9832167. [PMID: 27298738 PMCID: PMC4889831 DOI: 10.1155/2016/9832167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/12/2016] [Indexed: 01/15/2023] Open
Abstract
Introduction. Obesity is common among reproductive age women and disproportionately impacts racial/ethnic minorities. Our objective was to assess racial/ethnic differences in obesity-related dietary behaviors among pregnant and postpartum women, to inform peripartum weight management interventions that target diverse populations. Methods. We conducted a cross-sectional survey of 212 Black (44%), Hispanic (31%), and White (25%) women, aged ≥ 18, pregnant or within one year postpartum, in hospital-based clinics in Baltimore, Maryland, in 2013. Outcomes were fast food or sugar-sweetened beverage intake once or more weekly. We used logistic regression to evaluate the association between race/ethnicity and obesity-related dietary behaviors, adjusting for sociodemographic factors. Results. In adjusted analyses, Black women had 2.4 increased odds of fast food intake once or more weekly compared to White women (CI = 1.08, 5.23). There were no racial/ethnic differences in the odds of sugar-sweetened beverage intake. Discussion. Compared with White or Hispanic women, Black women had 2-fold higher odds of fast food intake once or more weekly. Black women might benefit from targeted counseling and intervention to reduce fast food intake during and after pregnancy.
Collapse
|
42
|
Khojasteh M, Raja S. Agents of Change: How Immigrant-Run Ethnic Food Retailers Improve Food Environments. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1112759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Maryam Khojasteh
- University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Samina Raja
- University at Buffalo, The State University of New York, Buffalo, New York, USA
| |
Collapse
|
43
|
Pinard CA, Byker Shanks C, Harden SM, Yaroch AL. An integrative literature review of small food store research across urban and rural communities in the U.S. Prev Med Rep 2016; 3:324-32. [PMID: 27419032 PMCID: PMC4929238 DOI: 10.1016/j.pmedr.2016.03.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 03/07/2016] [Accepted: 03/11/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The purpose of this review was to identify how rural and urban food access differs across small food stores as well as the types of research strategies and methodologies that have been applied in each setting in the U.S. METHODS Manuscripts were included in the review if they were published in English over the past ten years, with a clear delineation between urban and/or rural, conducted in the U.S., and reported data from small food store research. RESULTS After elimination, 19 manuscripts representing rural (n = 5) and urban (n = 14) settings were included in the final review. The review was conducted in Nebraska between January 2015 and May 2015. Findings from the reviewed manuscripts revealed that rural communities might face different challenges with healthy food access in small food stores when compared to urban settings. In particular, small food stores in rural areas lacked healthy food options largely because storeowners perceived that their customers would not purchase healthier items and due to challenges with distribution. Conversely, studies reporting on small food stores in urban areas suggest challenges with transportation and safety concerns. CONCLUSION Research on small food stores is nascent and further research, especially intervention studies, is needed. Further, less evidence exists on healthy food access, in particular intervention testing on small food store research in rural areas.
Collapse
Affiliation(s)
- C A Pinard
- Gretchen Swanson Center for Nutrition, 8401 West Dodge Road, Suite 100, Omaha, NE 68114, United States
| | - C Byker Shanks
- Montana State University, Food and Health Lab, 960 Technology Blvd, Room 215, Bozeman MT 59718, United States
| | - S M Harden
- Virginia Tech, Integrated Life Sciences Building, 1981 Kraft Dr., Room 1009, Blacksburg, VA 24060, United States
| | - A L Yaroch
- Gretchen Swanson Center for Nutrition, 8401 West Dodge Road, Suite 100, Omaha, NE 68114, United States
| |
Collapse
|
44
|
Sato PM, Steeves EA, Carnell S, Cheskin LJ, Trude AC, Shipley C, Mejía Ruiz MJ, Gittelsohn J. A youth mentor-led nutritional intervention in urban recreation centers: a promising strategy for childhood obesity prevention in low-income neighborhoods. HEALTH EDUCATION RESEARCH 2016; 31:195-206. [PMID: 26936480 PMCID: PMC5007578 DOI: 10.1093/her/cyw011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/03/2016] [Indexed: 05/25/2023]
Abstract
B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers within interventions targeting youth. This article evaluates the implementation of the BHCK intervention in recreation centers, and describes lessons learned. Sixteen youth leaders delivered bi-weekly, interactive sessions to 10- to 14-y olds. Dose, fidelity and reach are assessed, as is qualitative information regarding what worked well during sessions. Dose is operationalized as the number of interactive sessions, and taste tests, giveaways and handouts per session; fidelity as the number of youth leaders participating in the entire intervention and per session and reach as the number of interactions with the target population. Based on a priori set values, number of interactive sessions was high, and number of taste tests, giveaways and handouts was moderate to high (dose). The number of participating youth leaders was also high (fidelity). Of the 14 planned sessions, the intervention was implemented with high/moderate reach. Data suggest that working with cross-age peers is a promising nutritional intervention for recreation centers.
Collapse
Affiliation(s)
- Priscila M Sato
- Department of Health, Clinics and Institutions, Institute of Health and Society, Federal University of São Paulo, Santos, SP 11015-020, Brazil,
| | | | | | - Lawrence J Cheskin
- Department of Medicine, Global Obesity Prevention Center, Johns Hopkins Hospital, Baltimore, MD 21205-2179, USA and
| | - Angela C Trude
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - Cara Shipley
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - M J Mejía Ruiz
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - Joel Gittelsohn
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| |
Collapse
|
45
|
Shin A, Surkan PJ, Coutinho AJ, Suratkar SR, Campbell RK, Rowan M, Sharma S, Dennisuk LA, Karlsen M, Gass A, Gittelsohn J. Impact of Baltimore Healthy Eating Zones: an environmental intervention to improve diet among African American youth. HEALTH EDUCATION & BEHAVIOR 2016; 42:97S-105S. [PMID: 25829124 DOI: 10.1177/1090198115571362] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study assessed the impact of a youth-targeted multilevel nutrition intervention in Baltimore City. The study used a clustered randomized design in which 7 recreation centers and 21 corner stores received interventions and 7 additional recreation centers served as comparison. The 8-month intervention aimed to increase availability and selection of healthful foods through nutrition promotion and education using point-of purchase materials such as posters and flyers in stores and interactive sessions such as taste test and cooking demonstrations. Two hundred forty-two youth-caregiver dyads residing in low-income areas of Baltimore City recruited from recreation centers were surveyed at baseline using detailed instruments that contained questions about food-related psychosocial indicators (behavioral intentions, self-efficacy, outcome expectancies, and knowledge), healthful food purchasing and preparation methods, and anthropometric measures (height and weight). The Baltimore Healthy Eating Zones intervention was associated with reductions in youth body mass index percentile (p = .04). In subgroup analyses among overweight and obese girls, body mass index for age percentile decreased significantly in girls assigned to the intervention group (p = .03) and in girls with high exposure to the intervention (p = .013), as opposed to those in comparison or lower exposure groups. Intervention youth significantly improved food-related outcome expectancies (p = .02) and knowledge (p < .001). The study results suggest that the Baltimore Healthy Eating Zones multilevel intervention had a modest impact in reducing overweight or obesity among already overweight low-income African American youth living in an environment where healthful foods are less available. Additional studies are needed to determine the relative impact of health communications and environmental interventions in this population, both alone and in combination.
Collapse
Affiliation(s)
- Ahyoung Shin
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Sonali R Suratkar
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca K Campbell
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Megan Rowan
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lauren A Dennisuk
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Micaela Karlsen
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anthony Gass
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joel Gittelsohn
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
46
|
Taillie LS, Ng SW, Popkin BM. Global growth of "big box" stores and the potential impact on human health and nutrition. Nutr Rev 2015; 74:83-97. [PMID: 26714934 DOI: 10.1093/nutrit/nuv062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 08/03/2015] [Indexed: 01/09/2023] Open
Abstract
Despite a large body of literature on the food environment, little is known about the role of supercenters in human nutrition and health. The objectives of this review are to examine what is currently known about the association between supercenters, nutrition, and obesity, to identify how supercenters may affect disparities in food access and nutritional quality of food purchases, and to document the rapid rise of supercenters as a source of food purchases in the United States. A case study of Wal-Mart, the largest food retailer in the United States, is presented that demonstrates the major and increasing role of supercenters as a source of packaged food purchases in the United States, particularly among low-income households, as well as the role of supercenters in supplying key nutrients. Taken together, this review and case study highlight the dominant role of supercenters in the US diet and the need to better understand how supercenters can be leveraged to improve the nutritional quality of what consumers buy and eat.
Collapse
Affiliation(s)
- Lindsey Smith Taillie
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Shu Wen Ng
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Barry M Popkin
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA.
| |
Collapse
|
47
|
Sharif MZ, Garza JR, Langellier BA, Kuo AA, Glik DC, Prelip ML, Ortega AN. Mobilizing Young People in Community Efforts to Improve the Food Environment: Corner Store Conversions in East Los Angeles. Public Health Rep 2015; 130:406-15. [PMID: 26347230 DOI: 10.1177/003335491513000421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mienah Z Sharif
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Jeremiah R Garza
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Brent A Langellier
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Alice A Kuo
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Deborah C Glik
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Michael L Prelip
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Alexander N Ortega
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| |
Collapse
|
48
|
Healthy versus Unhealthy Suppliers in Food Desert Neighborhoods: A Network Analysis of Corner Stores' Food Supplier Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15058-74. [PMID: 26633434 PMCID: PMC4690901 DOI: 10.3390/ijerph121214965] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 01/22/2023]
Abstract
Background: Products in corner stores may be affected by the network of suppliers from which storeowners procure food and beverages. To date, this supplier network has not been well characterized. Methods: Using network analysis, we examined the connections between corner stores (n = 24) in food deserts of Baltimore City (MD, USA) and their food/beverage suppliers (n = 42), to determine how different store and supplier characteristics correlated. Results: Food and beverage suppliers fell into two categories: Those providing primarily healthy foods/beverages (n = 15) in the healthy supplier network (HSN) and those providing primarily unhealthy food/beverages (n = 41) in the unhealthy supplier network (UHSN). Corner store connections to suppliers in the UHSN were nearly two times greater (t = 5.23, p < 0.001), and key suppliers in the UHSN core were more diverse, compared to the HSN. The UHSN was significantly more cohesive and densely connected, with corner stores sharing a greater number of the same unhealthy suppliers, compared to HSN, which was less cohesive and sparsely connected (t = 5.82; p < 0.001). Compared to African Americans, Asian and Hispanic corner storeowners had on average −1.53 (p < 0.001) fewer connections to suppliers in the HSN (p < 0.001). Conclusions: Our findings indicate clear differences between corner stores’ HSN and UHSN. Addressing ethnic/cultural differences of storeowners may also be important to consider.
Collapse
|
49
|
Lee RM, Rothstein JD, Gergen J, Zachary DA, Smith JC, Palmer AM, Gittelsohn J, Surkan PJ. Process Evaluation of a Comprehensive Supermarket Intervention in a Low-Income Baltimore Community. Health Promot Pract 2015; 16:849-58. [PMID: 26296352 DOI: 10.1177/1524839915599359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supermarket-based interventions are one approach to improving the local food environment and reducing obesity and chronic disease in low-income populations. We implemented a multicomponent intervention that aimed to reduce environmental barriers to healthy food purchasing in a supermarket in Southwest Baltimore. The intervention, Eat Right-Live Well! used: shelf labels and in-store displays promoting healthy foods, sales and promotions on healthy foods, in-store taste tests, increasing healthy food products, community outreach events to promote the intervention, and employee training. We evaluated program implementation through store environment, taste test session, and community event evaluation forms as well as an Employee Impact Questionnaire. The stocking, labeling, and advertising of promoted foods were implemented with high and moderate fidelity. Taste test sessions were implemented with moderate reach and low dose. Community outreach events were implemented with high reach and dose. Supermarket employee training had no significant impact on employees' knowledge, self-efficacy, or behavioral intention for helping customers with healthy purchasing or related topics of nutrition and food safety. In summary, components of this intervention to promote healthy eating were implemented with varying success within a large supermarket. Greater participation from management and employees could improve implementation.
Collapse
Affiliation(s)
- Ryan M Lee
- Johns Hopkins University, Baltimore, MD, USA Johns Hopkins Center for a Livable Future, Baltimore, MD, USA
| | | | | | | | - Joyce C Smith
- Johns Hopkins Center for a Livable Future, Baltimore, MD, USA Operation Reachout Southwest, Baltimore, MD, USA
| | - Anne M Palmer
- Johns Hopkins University, Baltimore, MD, USA Johns Hopkins Center for a Livable Future, Baltimore, MD, USA
| | | | | |
Collapse
|
50
|
Gittelsohn J, Mui Y, Adam A, Lin S, Kharmats A, Igusa T, Lee BY. Incorporating Systems Science Principles into the Development of Obesity Prevention Interventions: Principles, Benefits, and Challenges. Curr Obes Rep 2015; 4:174-81. [PMID: 26069864 PMCID: PMC4452216 DOI: 10.1007/s13679-015-0147-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Systems modeling represents an innovative approach for addressing the obesity epidemic at the community level. We developed an agent-based model of the Baltimore City food environment that permits us to assess the relative impact of different programs and policies, alone and in combination, and potential unexpected consequences. Based on this experience, and a review of literature, we have identified a set of principles, potential benefits, and challenges. Some of the key principles include the importance of early and multilevel engagement with the community prior to initiating model development and continued engagement and testing with community stakeholders. Important benefits include improving community stakeholder understanding of the system, testing of interventions before implementation, and identification of unexpected consequences. Challenges in these models include deciding on the most important, yet parsimonious factors to consider, how to model food source and food selection behavior in a realistic yet transferable manner, and identifying the appropriate outcomes and limitations of the model.
Collapse
Affiliation(s)
- Joel Gittelsohn
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Yeeli Mui
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Atif Adam
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Sen Lin
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Anna Kharmats
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Takeru Igusa
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| | - Bruce Y. Lee
- Global Obesity Prevention Center (GOPC), Johns Hopkins University, Room 2041A, 615 North Wolfe St, Baltimore, MD 21205-2179 USA
| |
Collapse
|