Re vie w o f the E vide nc e : He a lth Pro mo tio n Stra te g ie - - PowerPoint PPT Presentation

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Re vie w o f the E vide nc e : He a lth Pro mo tio n Stra te g ie s fo r Re ta il F o o d Sho pping Ve nue s NEOP Research and Evaluation Unit Nutrition Policy Institute University of California Kelly Blondin Dania Orta-Alemn Gail

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SLIDE 1

Re vie w o f the E vide nc e : He a lth Pro mo tio n Stra te g ie s fo r Re ta il F

  • o d Sho pping Ve nue s

NEOP Research and Evaluation Unit Nutrition Policy Institute University of California Kelly Blondin Dania Orta-Alemán Gail Woodward-Lopez May 31

st, 201

7

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SLIDE 2

S hopping Patterns and Potential Reach

Healthy Retail

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SLIDE 3
  • On average SNAP recipients travel 3.8 miles to their

primary grocery store

–Closest SNAP-authorized store is 2.0 miles away

L

  • w-inc o me individua ls tra ve l to

sho p a t full se rvic e ma rke ts

Ver Ploeg M, et al., 2015. Where do Americans usually shop for food and how do they travel to get there? Initial findings from the national household food acquisition and purchase survey.

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SLIDE 4

Whe re do SNAP Pa rtic ipa nts Sho p?

Supermarkets, 42.6% Supercenters, 41.5% Grocery stores, 4.7% Convenience stores, 5.0% Specialty stores, 1.1% Farmers' Markets, 0.5%

Castner L, Henke J. Benefit Redemption Patterns in the S upplemental Nutrition Assistance Program: Mathematica Policy Research; 2011

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SLIDE 5

Co nc lusio ns: Sho pping Pa tte rns

  • Income more predictive than access
  • SNAP households shop at low-cost venues and will travel to

do so

  • But still challenged to purchase a healthful product mix

–Low-income households may stretch limited dollars by purchasing

lower cost, less healthy foods

  • A small proportion of households have extremely limited

access to healthy full service outlets

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SLIDE 6

What works ?

Healthy Retail

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SLIDE 7

Me tho ds

Systematic literature review

  • Interventions implemented via retail food stores that sell unprepared food.
  • Pre/post measures with control group
  • Outcome measures: food purchases, dietary intake, and/or adiposity
  • Upper-Middle or High-Income countries

Databases: PubMed and agency repositories

  • 88 primary papers
  • Published between 1

982 to present, most from later 1 990s on

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SLIDE 8

Ac c e ss inte rve ntio ns

  • Opening new

supermarkets in undeserved areas

  • Free produce delivery

Sto re -b a se d inte rve ntio ns

  • Printed promotional

materials

  • In-store nutrition education
  • Store conversions
  • Product placement,

improved stocking, training to store owners, taste-tests

Pric e inte rve ntio ns

  • Vouchers/Coupons
  • Vouchers+Nut Education
  • Rebates
  • Discounts
  • Taxes
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SLIDE 9
  • 1. Ac c e ss inte rve ntio ns
  • Opening new stores: No

promise

  • Delivering free produce:

shows promise but more evidence is needed

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SLIDE 10

n I

nte rve ntio n:

n

“ Ro lling Sto re " fo o d d e live ry and nutritio n e d uc atio n fo r Afric an Ame ric an w o me n

n Study De sig n:

n

RCT

n

Bato n Ro ug e , L A

n I

mpa c t:

n

Sig nific antly inc re ase d c o nsumptio n o f fruit, fruit juic e and ve g e table s (se rving s/ day)

n

Me an de c re ase in we ig ht o f 0.4kg (SD 3.0kg ), and re duc e d BMI at 6 m o nths.

Ca se in Point: F

  • o d De live ry

(Source: Kennedy et al., 2009)

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SLIDE 11
  • 2. Sto re -Ba se d

inte rve ntio ns

  • Nutrition education and

promotion via print materials or audio-visual mediums: not consistently effective

  • Multicomponent store

interventions: Not consistently

effective

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SLIDE 12

(Source: Payne et al., 201 5)

Ca se in Point: Gro c e ry Cart Plac ards

  • Intervention:

§ Placards on shopping carts with a message about the number of

produce items normally purchased

§ Focus on social norms

  • Study Design:

§ Quasi-experiment § 1

intervention and 1 control supermarket in El Paso, TX

  • Impact

§

Increased produce spending after 2 weeks (p=0.04)

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SLIDE 13

n

Intervention:

n

Increased stocking of healthy foods

n

Shelf labels and signage for promoted healthier foods

n

Taste tests

n

Store staff training.

n

Community outreach events

n

Study Design:

n

Quasi-experiment, 4 months

n

2 supermarkets

n

Baltimore, MD

n

Impact:

n

Increased sales of promoted healthier foods (low-fat, low-sodium, healthier sugar level, 1 00% juice) in the intervention store.

Ca se in Point: E at Rig ht-L ive We ll

(Source: Surkan et al., 201 6)

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SLIDE 14
  • 3. Pric e inte rve ntio ns
  • Monetary incentives, including

vouchers, coupons, rebates and price reductions: Consistently

effective

  • Taxes: Promising approach
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SLIDE 15

Ca se in Point:

SNAP He althy Inc e ntive Pilo t

§Intervention:

  • Incentive of 30 cents for every $1
  • f

fruits and vegetables purchased

  • Up to $60/month, added to EBT card

§Study Design:

  • RCT, 23 months
  • SNAP-authorized retailers in western

MA

§Impact:

  • 26%

increase in consumption of FVs

  • About ¼ cup or ½ serving/day

(Source: Bartlett et al., 2014 (USDA Report))

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SLIDE 16

Co nc lusio ns

  • Promising evidence: Price interventions

(vouchers/coupons, rebates, price reductions, monetary incentives)

  • Inconsistent evidence: Store-based interventions (in-store

print materials, audio-visual education, multicomponent)

  • Insufficient evidence: Access interventions (new

supermarkets, free produce delivery)

  • No evidence: farmers’ markets, food hubs, food coops,

food banks, healthy checkouts, in-store availability of healthy and/or unhealthy products, among others.