Abstract

To examine associations between geographic information systems (GIS)-assessed accessibility to small food stores, shopping patterns and dietary behaviours among small food store customers. Residential addresses and customer shopping patterns (frequency of shopping, and previous purchase of fruits and vegetables) were gathered through customer intercept surveys. Addresses were geocoded, and GIS-assessed distance and driving time from the participants' residence to the store were calculated. Dietary status and behaviours were assessed using an objective non-invasive measure of skin carotenoids, the National Cancer Institute Fruit and Vegetable Screener, and items to assess sugary beverage intake. Associations between distance and driving time, demographics, shopping frequency, prior reported purchase of fruits and vegetables at the store and dietary behaviours were examined. Small food stores (n 22) across North Carolina. Cross-sectional convenience samples of English-speaking customers aged 18 years or older (n 692). Participants living closer to the small store had lower income and formal education, were more likely to be Black, more likely to have previously bought fruits and vegetables at the store and more frequently shopped at the store. In adjusted models, skin carotenoids (n 644) were positively associated with distance to the store from home in miles (P = 0·01). Customers who lived closer to the stores were more frequent shoppers and more likely to have previously purchased fruits and vegetables at the store yet had lower skin carotenoids. These results support continued efforts to examine how to increase the availability and promotion of healthful foods at small food retail stores.

Highlights

  • MethodsStudy settings and participants This analysis was conducted as part of a larger study evaluating the impact of the North Carolina Healthy Food Small Retailer Program (HFSRP) on healthy food availability, purchases and consumption[23]

  • In a previous study of skin carotenoid status and distance to and frequency of shopping among supermarket customers, we found no statistically significant difference in skin carotenoids by frequency of shopping or by distance to the store, though we did find that proximity to less healthy stores such as convenience stores and small grocery stores was associated with lower skin carotenoid levels[18]

  • This study contributes to our understanding of food accessibility, shopping patterns and dietary outcomes among small food store customers using objectively measured distance and dietary outcomes

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Summary

Methods

Study settings and participants This analysis was conducted as part of a larger study evaluating the impact of the North Carolina Healthy Food Small Retailer Program (HFSRP) on healthy food availability, purchases and consumption[23]. The study team first matched the stores on a variety of store-level factors including North American Industry Code Standards (NAICS), store type (small grocery or convenience store), store size, and whether the store was located in a census tract that was designated as a USDA food desert (at least 500 persons and/or at least 33 per cent of the population lives more than 1 mile from a supermarket or large grocery store (10 miles, in the case of rural census tracts)(25). The study team matched on area demographics, including per cent of the census tract that received Supplemental Nutrition Assistance Program benefits and the per cent African American residents in the census tract. Participants were provided a $10 gift card for their time

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