P20 Effectiveness of Nutrition Interventions in Low-Income Rural and Urban Retail Environments: A Systematic Literature Review

Abstract

<h3>Background</h3> Retail interventions targeting food access and promoting healthy food choices are implemented to address the unique nutrition challenges of residents in low-income rural and urban environments. Research about the effectiveness of interventions in rural environments is limited. <h3>Objective</h3> The purpose of this systematic literature review is to identify successful retail interventions used in stores located in low-income rural and urban environments. <h3>Study Design, Setting, Participants</h3> This review is reported in accordance with PRISMA guidelines. Five databases were searched for peer-reviewed articles, and additional publications were hand-searched or provided by experts in the field. Studies were sought from October 1, 2010, until December 31, 2018. <h3>Measurable Outcome/Analysis</h3> Studies which included a nutrition promotion in retail stores located in a low-income rural or urban community were included if they provided a quantitative outcome evaluation regarding the impact of the intervention(s). Intervention data was extracted and classified based on the MINDSPACE framework. Store level approaches including manager and staff training, store incentives, and/or store modifications were extracted. Two reviewers independently assessed the methodological quality of the studies using the EPHPP's Quality Assessment for Quantitative Studies. <h3>Results</h3> Peer-reviewed data from 43 publications (19 rural and 24 urban) was extracted representing 38 healthy retail programs in the US, Canada, Europe, New Zealand, and Australia. Preliminary results show 192 (82 rural and 110 urban) MINDSPACE interventions were implemented. Excluding norms, interventions were implemented in descending frequency as follows: salience, priming, commitment, incentives, ego, messenger, affect, and defaults. Rural interventions included a messenger that was unique to the community and appealed to the consumer's emotions more often than urban interventions. Of the 17 programs which reported staff and storeowner training, 12 were in low-income urban areas. <h3>Conclusions</h3> More research is needed to identify interventions, essential equipment, and training needs of managers and staff in low-income rural stores.