Abstract

BackgroundModifying a household’s food environment by targeting a single retailer type, like supermarkets, has a limited impact on dietary outcomes. This may be because the food environment has a limited impact on shopping behaviors, or because households are not as reliant on supermarkets as we assume. However, our understanding of how households shop for food, especially when considering the use of both food at home (FAH) retailers, such as supermarkets, and away from home retailers (FAFH), such as restaurants, is limited. Thus, understanding how households shop for food is a necessary first step when developing programs to modify food purchasing behavior.MethodsK-means cluster analysis was used to identify weekly food shopping trip patterns based on the percentage of trips to FAH and FAFH retailers in the 2013 Food Acquisition and Purchase Survey (FoodAPS) dataset (n = 4665 households). Multinomial logistic regression was used to examine the relationship between shopping trip patterns, household and food environment characteristics.ResultsThree patterns emerged: primarily supermarket, primarily supercenter, or mix (i.e. no dominant retailer type, but high FAFH use). Households with incomes below 185% of the federal poverty line were evenly divided between patterns that rely primarily on FAH retailers, and the mix pattern. While nearly 70% of households with incomes above 185% of the federal poverty line are in the mix cluster. Supermarket and superstore availability significantly influenced the likelihood of belonging to those clusters respectively, while having a child, higher income, and attitudes towards healthy meal preparation time or taste significantly influenced the likelihood of belonging to the mix cluster.ConclusionAlthough lower-income households are more likely to rely primarily on FAH retailers, household’s, regardless of income, that primarily utilize FAH retailers show a strong preference for either superstores or supermarkets suggesting a need for interventions to reach both retailer types. However, altering the food environment alone may not be sufficient to discourage use of FAFH retailers as households relying on FAFH retailers are significantly influenced by meal preparation time and healthy food taste.

Highlights

  • Modifying a household’s food environment by targeting a single retailer type, like supermarkets, has a limited impact on dietary outcomes

  • K-means clustering analysis Analyses using either food at home (FAH) or food away from home (FAFH)+FAFH trips identified three clusters that were named after the predominant retailer category: superstore (SS), supermarket (SM), and mix (M)

  • Because the Food Acquisition and Purchase Survey (FoodAPS) dataset defines FAH events by “food and drinks that are brought home and used to prepare meals for consumption at home or elsewhere”, rather than store type, it is possible that a trip to a store type typically associated with FAFH, such as a restaurant, may be included in FAH only analysis

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Summary

Introduction

Modifying a household’s food environment by targeting a single retailer type, like supermarkets, has a limited impact on dietary outcomes. Where individuals purchase food is believed to influence the quality of their diet and health outcomes [1, 2] Previous studies investigating this hypothesis have focused primarily on the influence of living within close proximity of or utilizing a specific retailer type (i.e. supermarkets, fast food restaurants), and have produced mixed conclusions regarding the relationship between retailer type and health outcomes [3]. The consequences of overemphasizing retailer type are exemplified in programs like the Healthy Food Financing Initiative (HFFI) This program subsidizes the cost of building new supermarkets in areas identified as having low access to healthy food options, but evaluations of such interventions have shown little effect on consumer behavior and dietary outcomes [6,7,8]

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