Abstract
BackgroundPurchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases.MethodsIn a cross-sectional design, data collectors assessed store features in a sample of 99 small and non-traditional food stores not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Minneapolis/St. Paul, MN in 2014. Customer intercept interviews (n = 594) collected purchase data from a bag check and demographics from a survey. Store measures included fruit/vegetable and whole grain availability, an overall Healthy Food Supply Score (HFSS), healthy food advertisements and in-store placement, and shelf space of key items. Customer nutritional measures were analyzed using Nutrient Databases System for Research (NDSR), and included the purchase of ≥1 serving of fruits/vegetables; ≥1 serving of whole grains; and overall Healthy Eating Index-2010 (HEI-2010) score for foods/beverages purchased. Associations between store and customer measures were estimated in multilevel linear and logistic regression models, controlling for customer characteristics and store type.ResultsFew customers purchased fruits and vegetables (8%) or whole grains (8%). In fully adjusted models, purchase HEI-2010 scores were associated with fruit/vegetable shelf space (p = 0.002) and the ratio of shelf space devoted to healthy vs. less healthy items (p = 0.0002). Offering ≥14 varieties of fruit/vegetables was associated with produce purchases (OR 3.9, 95% CI 1.2–12.3), as was having produce visible from the store entrance (OR 2.3 95% CI 1.0 to 5.8), but whole grain availability measures were not associated with whole grain purchases.ConclusionsStrategies addressing both customer demand and the availability of healthy food may be necessary to improve customer purchases.Trial registrationClinialTrials.gov: NCT02774330. Registered May 4, 2016 (retrospectively registered).
Highlights
Purchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases
The purpose of this study is to examine whether customers who shop at small and non-traditional food stores with more health-promoting features have healthier purchases, using objective data on store features and customer purchases
We calculated least square means of HEI-2010 for each level for categorical independent variable; for the continuous Healthy Food Supply Score (HFSS) variable, we present the regression coefficients and standard errors
Summary
Purchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases. In the U.S, urban residents purchase food and beverages at an array of businesses besides supermarkets [5, 7,8,9,10,11], including small grocery stores (corner stores, bodegas) [10, 12,13,14,15,16,17,18], as well as other limitedservice businesses, like gas-marts, dollar stores, and pharmacies [19,20,21,22,23,24] Together these have been referred to as “small and non-traditional” urban food retailers [25]. Purchases at small and non-traditional food stores tend to have poor nutritional quality [13,14,15,16,17, 25, 26, 30, 38], and have been associated with poor health outcomes, including increased obesity risk [39,40,41]
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