Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments?

Developing and Testing a User-Focused, Web GIS-Based Food Asset Map for an Under-Resourced Community in Northeastern Connecticut

Background/Objectives: Access to healthy and affordable food remains a challenge for under-resourced communities due to uneven food distribution and the need for reliable transportation. This study developed and evaluated an interactive Geographic Information System (GIS)-based food asset map for a low-income community in Windham, Connecticut to improve awareness of food resources and expand opportunities for fresh food access. Methods: Using the human-centered design (HCD) framework and the Asset-Based Community Development (ABCD) model, the map integrates food locations, transportation routes, and assistance eligibility. Internal pilot testing (n = 8) identified usability issues, leading to updates such as mobile compatibility and user guides. Usability testing (n = 74) assessed navigation performance and user feedback through task-based evaluations and surveys. Categorical map usability, sociodemographic, diet, and health characteristics were tested for participants with food security (yes/no) or digital literacy (passed/failed). Results: Food-secure participants showed higher usability success than food-insecure individuals (p < 0.05), while those relying on food assistance faced greater challenges (p < 0.05). Individuals rating their diet as "very good/excellent" were most likely to pass the map usability testing (p < 0.05), whereas younger, college-educated, employed participants and those with vehicles trended toward passing (p < 0.1). Participants generally reported the map easy to navigate, especially those with food security. Conclusions: The asset map promotes food resource awareness and addresses barriers such as limited public transportation information. Additional efforts are needed to support food-insecure users in utilizing digital food access resources. This study contributes to initiatives to improve food access, digital inclusion, and community engagement in under-resourced communities.

Multi-Method Formative Evaluation of a Digital Online Grocery Shopping Assistant Among Special Supplemental Nutrition Program for Women, Infants, and Children Participants

OBJECTIVE

Assess the acceptability of a digital grocery shopping assistant among rural women with low income.

DESIGN

Simulated shopping experience, semistructured interviews, and a choice experiment.

SETTING

Rural central North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children clinic.

PARTICIPANTS

Thirty adults (aged ≥18 years) recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children clinic.

PHENOMENON OF INTEREST

A simulated grocery shopping experience with the Retail Online Shopping Assistant (ROSA) and mixed-methods feedback on the experience.

ANALYSIS

Deductive and inductive qualitative content analysis to independently code and identify themes and patterns among interview responses and quantitative analysis of simulated shopping experience and choice experiment.

RESULTS

Most participants liked ROSA (28/30, 93%) and found it helpful and likely to change their purchase across various food categories and at checkout. Retail Online Shopping Assistant's reminders and suggestions could reduce less healthy shopping habits and diversify food options. Participants desired dynamic suggestions and help with various health conditions. Participants preferred a racially inclusive, approachable, cartoon-like, and clinically dressed character.

CONCLUSIONS AND IMPLICATIONS

This formative study suggests ROSA could be a beneficial tool for facilitating healthy online grocery shopping among rural shoppers. Future research should investigate the impact of ROSA on dietary behaviors further.

Food Resource Management and Healthy Eating Focus Associates with Diet Quality and Health Behaviors in Low-Income Adults

Nutrition education and food resource management (FRM) can assist food-insecure individuals in acquiring healthy and affordable food. We aimed to assess the relationships between FRM skills and healthy eating focus with diet quality and health-related behaviors in low-income adults during the COVID-19 pandemic. This cross-sectional study was conducted using an online survey of 276 low-income adults living in a low-food-access community in Northeast Connecticut. Through analysis of covariance, adults who usually or always had a meal plan, considered reading nutrition labels important, made a grocery list, were concerned about their food healthiness, and rated their diet quality as very good/excellent reported higher diet quality (frequency-based and liking-based scores) (p < 0.05 for all). Individuals who considered reading food labels very important and reported having a good diet reported less frequent pandemic-related unhealthy behaviors (consumption of candy and snack chips, soda or sugary drinks, weight gain, smoking) (p < 0.001). Furthermore, higher-frequency-based diet quality was associated with lower risk of overweight or obesity (OR: 0.37; 95% CI: 0.18, 0.76; p-trend < 0.01). Thus, FRM skills and healthy eating focus were associated with higher diet quality and healthier self-reported changes in diet, weight, and smoking behaviors during the pandemic.

The potential influence of the digital food retail environment on health: A systematic scoping review of the literature

INTRODUCTION

The digital food retail environment (defined in this study as a digital platform, app or website where food can be purchased by individuals for personal consumption) is an emerging component of the wider food system. We aimed to systematically search and review the literature to understand the potential influence of the digital food retail environment on population diets and health.

METHODS

Four databases (across health, business, and marketing) and grey literature were searched using terms relating to "food and beverages," "digital," and "purchasing." Identified studies were included if they examined any aspect of the digital food retail environment where outcomes were examined with a health-related focus and were published before September 2023. All study designs were included (quantitative, qualitative, observational, and experimental). Reviews and conference abstracts were excluded.

RESULTS

We identified 21,382 studies, of which 57 articles were eligible for inclusion. Of the 57 included studies, 30 studies examined online grocery retail, 22 examined online food delivery platforms, and five examined meal kit subscription services. Of the 30 studies examining online grocery retail, six studies reported that customers believed they purchased fewer unhealthy food and beverages when shopping online, compared with shopping in-store. Nevertheless, customers also reported that their ability to choose healthy foods and beverages was reduced when shopping online due to difficulty in product comparison. Studies that examined online food delivery platforms primarily found that they promoted unhealthy foods and beverages more often than healthy options, through extensive use of marketing practices such as price discounts and images, and that unhealthy food offerings on these platforms dominate. Meal kit subscription services offered mostly healthy meals, with studies suggesting that these types of services may help individuals alleviate some of their "mental load" and stress related to cooking meals for their families.

CONCLUSIONS

The literature describing the digital food retail environment was found to be diverse, with different aspects having potential to impact health in different ways. Some evidence suggests that online grocery retail and meal kit subscription services may have positive population dietary impacts, whereas online food delivery platforms appear likely to promote unhealthy food purchasing. However, the current evidence base is fragmented, with many knowledge gaps. Further research is required to understand the influence of the digital food retail environment on population diets and how these environments can be designed to support healthy food choices.