Abstract
Rural communities in Appalachia are displaying increased obesity prevalence, yet traditional interventions have not provided a broad enough impact to improve dietary consumption patterns. Therefore, expanding efforts that address the food environment and incorporate behavioral nudges through community-developed marketing strategies may be a viable mechanism to improve food and beverage choices within this unique population. This study installed shelf-wobblers across n = 5 gas stations in one rural Appalachian county in Kentucky. Smart Snacks were identified from store inventory lists utilizing the CDC Food Service Guideline for Federal Facilities calculator and were categorized into high-protein snacks, low-fat carbohydrate snacks, meal replacement snacks, and no-calorie beverages. NEMS-CS audits were conducted, and monthly sales data was collected at baseline and for six months thereafter for each store location. A difference-in-difference model was used, adjusting for total sales or total mean sales for each Smart Snack model to assess the percentage change within and between stores. Overall, percent change in mean sales and total sales across all stores resulted in a percentage increase of sales of Smart Snack items following wobbler installment. This study provides unique insight into how a community-driven approach to marketing can influence the sale of healthier food and beverage items.
Highlights
Research suggests that the food environment, including access and availability, influences dietary behaviors among individuals in rural communities [1]
This study keenly reveals the bleak food environment within one rural Appalachian county
This study adds to the body of research assessing the efficacy of specific marketing strategies within rural communities aimed to improve food and beverage purchases
Summary
Research suggests that the food environment, including access and availability, influences dietary behaviors among individuals in rural communities [1]. Healthy food and drink options may be scarce within food outlets, while calorically dense foods and sugarsweetened beverages are abundantly available [2]. Consumption of these calorically dense items can lead to increased prevalence of obesity and other diet-related chronic diseases, such as diabetes and heart disease [5]. For this reason, there is great interest in exploring mechanisms to enhance the food environment and improve access to affordable healthy options, improving diet choice and health outcomes in rural communities
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