Abstract
BackgroundAccess to healthy food is considered a key determinant of dietary behavior, and there is mixed evidence that living near a supermarket is associated with a healthier diet. In Africa, supermarkets may contribute to the nutrition transition by offering both healthy and unhealthy foods and by replacing traditional food sellers. In Kisumu, Kenya, a planned hypermarket (ie, a supermarket combined with a department store) will form the basis for a natural experimental evaluation.ObjectiveThe aim of this study is to explore the impacts of a new hypermarket on food shopping practices, dietary behaviors, physical activity patterns, and body composition among local residents and to identify concurrent changes in the local foodscape. We also aim to explore how impacts and associations vary by socioeconomic status.MethodsWe employ a mixed methods, longitudinal study design. Two study areas were defined: the hypermarket intervention area (ie, Kisumu) and a comparison area with no hypermarket (ie, Homabay). The study is comprised of 4 pieces of primary data collection: a quantitative household survey with local residents, a qualitative study consisting of focus group discussions with local residents and semistructured interviews with government and private sector stakeholders, an audit of the local foodscape using on-the-ground data collection, and an intercept survey of shoppers in the hypermarket. Assessments will be undertaken at baseline and approximately 1 year after the hypermarket opens.ResultsBaseline assessments were conducted from March 2019 to June 2019. From a total sampling frame of 400 households, we recruited 376 of these households, giving an overall response rate of 94.0%. The household survey was completed by 516 individuals within these households. Across the two study areas, 8 focus groups and 44 stakeholder interviews were conducted, and 1920 food outlets were geocoded.ConclusionsThis study aims to further the understanding of the relationship between food retail and dietary behaviors in Kenya. Baseline assessments for the study have been completed.International Registered Report Identifier (IRRID)DERR1-10.2196/17814
Highlights
Dietary behavior is complex and shaped by multiple interacting factors, including policy, built, and social environments [1]
Access to healthy food is considered a key determinant of dietary behavior, and some evidence suggests, albeit inconsistently, that residential proximity to a supermarket is associated with a healthier diet [2]
How has the local foodscape changed, do these changes relate to the new hypermarket at Lake Basin Mall, and how are they experienced by local residents?. This is a protocol for a mixed methods, natural experimental study [20] that will use a combination of quantitative and qualitative research methods to evaluate changes in dietary and health behavior coupled with furthering an understanding of the drivers and impacts of these changes
Summary
Dietary behavior is complex and shaped by multiple interacting factors, including policy, built, and social environments [1]. It is important to understand dietary behaviors in these settings because of the ongoing nutrition transition that is typified by a movement away from traditional staples toward the consumption of cheap and highly processed food [8]. This is responsible, in part, for the emerging “triple burden of malnutrition,” whereby undernutrition and micronutrient deficiency coexist with obesity at population, household, and individual levels [9]. Access to healthy food is considered a key determinant of dietary behavior, and there is mixed evidence that living near a supermarket is associated with a healthier diet.
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