Creating user-friendly resources for healthy food retail implementation - a case study.

Research into the co-creation of healthy food retail is in its early stages. One way to advance co-creation research is to explore and understand how co-creation was applied in developing, implementing, and evaluating a heath-enabling initiative in a supermarket in regional Victoria, Australia. A case study design was used to explore and understand how co-creation was applied in the Eat Well, Feel Good Ballarat project. Six documents and reports related to the Eat Well, Feel Good Ballarat project were analyzed with findings from the focus groups and interviews. Motivations to develop or implement health-enabling supermarket initiatives differed among the participants. Participants considered that initial negotiations were insufficient to keep the momentum going and to propose the value to the retailers to scale up the project. Presenting community-identified needs to the supermarket helped gain the retailer’s attention, whilst the co-design process helped the implementation. Showcasing the project to the community through media exposure kept the supermarket interested. Retailers’ time constraints and staff turnover were considered significant barriers to partnership building. This case study contributes insights into applying co-creation to health-enabling strategies in food retail outlets using two co-creation frameworks.

ObjectiveTo explore the associations of absolute and relative measures of exposure to food retailers with dietary patterns, using simpler and more complex measures.DesignCross-sectional survey.SettingUrban regions in Belgium, France, Hungary, the Netherlands and the UK.ParticipantsEuropean adults (n 4942). Supermarkets and local food shops were classified as ‘food retailers providing healthier options’; fast-food/takeaway restaurants, cafés/bars and convenience/liquor stores as ‘food retailers providing less healthy options’. Simpler exposure measures used were density of healthy and density of less healthy food retailers. More complex exposure measures used were: spatial access (combination of density and proximity) to healthy and less healthy food retailers; density of healthier food retailers relative to all food retailers; and a ratio of spatial access scores to healthier and less healthy food retailers. Outcome measures were a healthy or less healthy dietary pattern derived from a principal component analysis (based on consumption of fruits, vegetables, fish, fast foods, sweets and sweetened beverages).ResultsOnly the highest density of less healthy food retailers was significantly associated with the less healthy dietary pattern (β = −129·6; 95 % CI −224·3, −34·8). None of the other absolute density measures nor any of the relative measures of exposures were associated with dietary patterns.ConclusionsMore complex measures of exposure to food retailers did not produce stronger associations with dietary patterns. We had some indication that absolute and relative measures of exposure assess different aspects of the food environment. However, given the lack of significant findings, this needs to be further explored.

We examined whether access to retail sources of healthy and unhealthy food varies according to level of neighbourhood material deprivation in three Ontario regions and whether urban form characteristics help to explain any such variations. Food retail (FR) outlets were identified from a commercial database for 804 urban neighbourhoods in Toronto, Brampton/Mississauga and Hamilton, Ontario. The median number of healthy and unhealthy FR outlets and percentage of outlets that were unhealthy were derived using 720-metre network buffers based on dissemination blocks and aggregated up to neighbourhood level (census tract). The 2006 Canadian Census was used to derive a composite index of material deprivation and three urban form measures related to zoning and urbanization. Multivariate regression models assessed the association between material deprivation, urban form and each measure of FR access. Compared with the least deprived areas, the most materially deprived neighbourhoods had 2 to 4 times more healthy and unhealthy FR outlets within 720 metres (~ a 10-minute walk) of where most people lived, with the exception of Toronto, where unhealthy FR was more plentiful in less deprived areas. Urban form measures attenuated these associations for Brampton/Mississauga and Hamilton more so than for Toronto. The percentage of unhealthy outlets was generally unrelated to level of neighbourhood deprivation or urban form characteristics. More deprived neighbourhoods had greater access to both healthy and unhealthy FR outlets, with some variation across study regions. Plentiful access to local retail sources of unhealthy food suggests a possible point of intervention for healthy public policy.

Access to food retail outlets in County Durham, UK: a pragmatic cross-sectional study

Limitations of traditional geospatial measures, like the modified Retail Food Environment Index (mRFEI), are well documented. In response, we aimed to: (1) extend existing food environment measures by inductively developing subcategories to increase the granularity of healthy v. less healthy food retailers; (2) establish replicable coding processes and procedures; and (3) demonstrate how a food retailer codebook and database can be used in healthy public policy advocacy. We expanded the mRFEI measure such that 'healthy' food retailers included grocery stores, supermarkets, hypermarkets, wholesalers, bulk food stores, produce outlets, butchers, delis, fish and seafood shops, juice/smoothie bars, and fresh and healthy quick-service retailers; and 'less healthy' food retailers included fast-food restaurants, convenience stores, coffee shops, dollar stores, pharmacies, bubble tea restaurants, candy stores, frozen dessert restaurants, bakeries, and food trucks. Based on 2021 government food premise licences, we used geographic information systems software to evaluate spatial accessibility of healthy and less healthy food retailers across census tracts and in proximity to schools, calculating differences between the traditional v. expanded mRFEI. Calgary and Edmonton, Canada. N/A. Of the 10 828 food retailers geocoded, 26 % were included using traditional mRFEI measures, while 53 % were included using our expanded categorisation. Changes in mean mRFEI across census tracts were minimal, but the healthfulness of food environments surrounding schools significantly decreased. Overall, we show how our mRFEI adaptation, and transparent reporting on its use, can promote more nuanced and comprehensive food environment assessments to better support local research, policy and practice innovations.

IntroductionCo-creation of healthy food retail comprises the systematic collaboration between retailers, academics and other stakeholders to improve the healthiness of food retail environments. Research into the co-creation of healthy food retail is in its early stages. Knowledge of the roles and motivations of stakeholders in intervention design, implementation and evaluation can inform successful co-creation initiatives. This study presents academic experiences of stakeholder roles and motivations in the co-creation of healthy food retail environments.MethodsPurposive sampling of academics with research experience in the co-creation of healthy food retail initiatives. Semi-structured interviews conducted between October and December 2021 gathered participants’ experiences of multi-stakeholder collaborative research. Thematic analysis identified enablers, barriers, motivations, lessons and considerations for future co-creation of healthy food retail.ResultsNine interviewees provided diverse views and applications of co-creation research in food retail environments. Ten themes were grouped into three overarching areas: (i) identification of stakeholders required for changes to healthier food retail; (ii) motivations and interactions, which included the intrinsic desire to build healthier communities along with recognition of their work; and (iii) barriers and enablers included adequate resourcing, effective and trusting working relationships and open communications.ConclusionThis study provides insights that could help future co-creation in healthy food retail environments. Trusting and respectful relationships and reciprocal acknowledgement between stakeholders are key practices in the co-creation process. These constructs should be considered in developing and testing a model that helps to systematically co-create healthy food retail initiatives that ensure all parties meet their needs while also delivering research outcomes.

Healthy food retail (HFR) interventions are a recommended strategy to improve the dietary behaviors of low-income residents with limited access to healthy food; however, tools are needed to assess, tailor, and implement HFR plans to local contexts. The present study identifies factors influ­encing HFR implementation and presents findings related to identifying, operationalizing, and priori­tizing facilitators of and barriers to implementing HFR interventions within low-resource rural and urban contexts. Practitioners and community resi­dents, recruited from nine counties in Ohio, par­ticipated in semistructured interviews and focus groups. Grounded theory methodology was used to develop themes and indicators of readiness and capacity for successful HFR implementation. Con­sensus conference feedback from an expert panel prioritized themes and indicators based on their perceived relevance and importance for successful­ly implementing HFR interventions. Five themes were identified as influential factors: (1) corner store awareness and perception, (2) organizational and practitioner capacity, (3) community attitudes and perceptions, (4) logistical factors, and (5) net­works and relationships. Additionally, 18 indicators within the five themes were identified to further illustrate influential factors to HFR implementa­tion. The themes and indicators presented in this research have been synthesized into the PSE READI tool[1] (developed outside of this research). The PSE READI tool uniquely provides an oppor­tunity to assess, tailor, and implement HFR plans to the local contexts by considering the key themes and influential factors that emerged from this community-level, qualitative research.

ObjectivesWe investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market...

BackgroundExcess calorie consumption and poor diet are major contributors to the obesity epidemic. Food retailers, in particular at supermarkets, are key shapers of the food environment which influences consumers’ diets. This study seeks to understand the decision-making processes of supermarket retailers—including motivators for and barriers to promoting more healthy products—and to catalogue elements of the complex relationships between customers, suppliers, and, supermarket retailers.MethodsWe recruited 20 supermarket retailers from a convenience sample of full service supermarkets and national supermarket chain headquarters serving low- and high-income consumers in urban and non-urban areas of New York. Individuals responsible for making in-store decisions about retail practices engaged in online surveys and semi-structured interviews. We employed thematic analysis to analyze the transcripts.ResultsSupermarket retailers, mostly representing independent stores, perceived customer demand and suppliers’ product availability and deals as key factors influencing their in-store practices around product selection, placement, pricing, and promotion. Unexpectedly, retailers expressed a high level of autonomy when making decisions about food retail strategies. Overall, retailers described a willingness to engage in healthy food retail and a desire for greater support from healthy food retail initiatives.ConclusionsUnderstanding retailers’ in-store decision making will allow development of targeted healthy food retail policy approaches and interventions, and provide important insights into how to improve the food environment.

Background and objectivesIncreasing the availability of healthy foods within food retail outlets can improve consumers' food environments. Such actions or inactions by food retailers may affect people's food purchasing and consumption behavior. This study explored Accra-based food retailers' perceptions and appreciation of “healthiness of food” as a concept. It also documented measures that food retailers adopt to encourage healthy food choices.MethodsIn-person semi-structured interviews were conducted with owners and managers of Accra-based supermarkets (n = 7) and corner stores (n = 13) in March 2021. The interviews were recorded, transcribed, coded, and analyzed thematically.ResultsThe retailers' understanding of healthy food, or lack thereof, is exemplified by such expressions as “health, absence of disease, longevity, balanced diet, diversity, sanitation, and certification.” A handful of retailers described what they sell as “products that meet consumer needs,” “harmless,” or “generally good.” Very few retailers described the food they sell as “junk,” high in sugar, fat, and salt, or energy-dense but nutrient poor foods, or as food that could pose some health risk to consumers. However, some retailers indicated that they advise their customers against the overconsumption of some foods.ConclusionOverall, Accra-based retailers have a fair understanding of what constitutes healthy food – exhibiting limited knowledge of the connection between very salty, very sugary, and very fatty foods and health outcomes. Retailers in Accra require interventions that improve their food, health, and nutrition literacy. Improving retailers' food and nutrition literacy may improve the availability of healthier options in food retail outlets in Accra.

ObjectiveTo assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1–3 of the UK National...

BackgroundFood retail and food service outlets can be part of a chain, or independently operated. Chain food outlets are likely to have the most influence over community food environments but have not been routinely identified in studies which map and monitor access to food, highlighting an important knowledge gap. This study aimed to identify the food retail and food service outlets present within metropolitan Perth, including presence of chain and independent food outlets; and examine differences across local governments.MethodsA nutrition-focused classification framework was applied to all food businesses registered by 32 local governments in Perth, Western Australia, in 2022. All food retail and food service outlets (n = 9069) were identified and classified as part of a chain or independently operated. Chain food outlets were further classified as major or minor. Descriptive statistics summarised access to major and minor chain food outlets within metropolitan Perth and across local governments.ResultsA total of 9069 food outlets (food retail = 2908; food service = 6161) provided access to food in metropolitan Perth. Convenience stores (n = 498, 17.1%) and supermarkets (n = 441, 15.2%) were the most common food retail categories. Fast food outlets (n = 2494, 40.5%) were the most common food service category. Chains (n = 205) represented 28.5% of all food outlets present and were more prevalent in some categories (e.g., 79.6% of all supermarkets present). Across local governments the proportion of food outlets that were chains ranged from 4.9% to 43.1%. The mean density of chain food outlets was 11.62 per 10,000 population (range 2.41, 49.89).ConclusionsThis study of the community food environment in an Australian capital city is the first to examine all food retail and food service outlets present and identify chains, using high quality data provided by local governments. The findings can be used to support evidence-based policies to improve population diets. Government policy which focuses on action within chain food outlets has potential to positively influence public health.

The influence of access to healthy food retail on BMI: Implications for obesity prevention policy at the local government level.

Validity of secondary retail food outlet data: a systematic review.

Retail food environments influence dietary health, yet efforts to improve them have had limited success. Recruiting informants from the food and beverage retail industry for insider information has been challenging due to the sensitivity of inquiries and proprietary protections. Moreover, which recruitment approaches are successful are seldom disseminated. This paper aimed to bridge this gap by detailing the complexities of recruiting and interviewing four food industry insider groups-independent store owners, corporate chain managers, food and beverage distributors, and sales representatives of major companies-to provide insights and specific guidance for future research. From October 2021 to November 2022, we interviewed 49 industry informants to explore business and commercial practices used in the US food retail sector. Recruitment methods were tailored to each group, and qualitative data were collected through in-person or virtual 'walk-along' interviews with customized interview guides. Across the study, we experienced distinct challenges around participant inaccessibility, hierarchy within corporate chains, skepticism, mistrust and variation in knowledge across industry groups. We detail our response to these challenges through four lessons learned, including persistence and flexibility, the importance of vetting, the value of trust-building measures and adapting the study protocol to new information. Given our success in reaching industry groups and accessing insider information, we provide key recommendations that future researchers can use to engage diverse industry groups and advance efforts to promote healthy food retail.