Retail Food Stores Research Articles

Two years of data monitoring of all-CO2 retail stores within the MultiPACK project

This paper presents the results of a 24-month field monitoring of CO2 transcritical units designed to satisfy all the thermal needs of food retail stores, namely refrigeration, heating and cooling. The units, adopting state-of the art technologies, such as two phase ejectors and parallel compression, are developed within the H2020 project MultiPACK. The monitored supermarkets are located in Italy, in two different climatic areas, featuring different heating and cooling demands for indoor comfort, as well as diverse building type and display cabinets mix. Long lasting measurements allow for evaluation of energy and efficiency related KPIs, together with operational indicators. These figures are relevant for benchmarking with traditional solutions.

The retail wellnesscape: conceptualizing consumer wellness in a health food retailing context

PurposeThis paper aims to deepen the knowledge of consumer wellness by conceptualizing this construct in an everyday retail setting, specifically a health food store. With wellness seeking being a central theme in the positioning strategy of many food retail stores, this study aims to investigate the development of an everyday wellness pursuit in a retail setting, identify its underlying dimensions in a health food store setting and establish the key managerial drivers that nurture it in such context, from the consumer standpoint.Design/methodology/approachThe research design uses a qualitative approach. In-depth interviews with 20 customers of six multibranch health food retailers were carried out.FindingsThe findings show the holistic and multidimensional nature of wellness in an everyday consumption setting and highlight the development of physical, emotional, intellectual, social and spiritual consumer wellness in this context. They also bring to light how, in an everyday activity such as a health food retail store visit, retailers can co-create and nurture consumer wellness through their product assortment, store environment and employees’ orientation toward customer wellness.Originality/valueThe main contribution of this study lies in the conceptualization of the retail wellnesscape, defined as a retail space that consumers choose to visit in their daily lives that contribute to their holistic wellness journey. This paper emphasizes both the importance and the feasibility of cultivating consumer wellness on an everyday basis, for both consumers and retailers, while it has traditionally been associated with more occasional and out of the ordinary settings such as wellness tourism.

Factors and Perceptions Associated with Post-Pandemic Food Sourcing and Dietary Patterns among Urban Corner Store Customers in Baltimore, Maryland.

Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality. Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti. This study was set in Baltimore, Maryland, USA. The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store. The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting. This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.

A high density of ultra-processed food, alcohol & tobacco retail stores, and social inequalities are associated with higher mortality rates of non-communicable diseases in Mexican adults: 2005 to 2021.

Non-communicable diseases (NCDs) are the leading causes of mortality in Mexico. Factors contributing to NCDs-related deaths may vary across small geographic areas such as municipalities. We aimed to predict municipal-level factors associated with NCD mortality in Mexican adults from 2005 to 2021 using the small-area analysis (SSA) approach. We gathered data on population sociodemographic, access to healthcare services, and mortality records at the municipal-level from census and public institutions from 2005 to 2021. We identified municipal predictors of NCDs mortality rates (MR) using negative binomial regression models. A total of 584,052 observations of Mexican adults were analyzed. The national expected NCDs MR per 100,000 inhabitants was 210.7 (95%CI: 196.1-226.7) in 2005 and increased to 322.4 (95%CI: 300.3-346.4) by 2021. Predictors of NCDs mortality (quintile 5 vs. quintile 1) included; indigeneity (IRR = 1.15, 95%CI: 1.12-1.19), poverty (IRR = 1.14, 95%CI: 1.13-1.15), affiliation with Mexican Social Security Institute (IRR = 1.11, 95%CI: 1.09-1.14), households with television (IRR = 1.14, 95%CI: 1.11-1.17), and high density of ultra-processed food, alcohol & tobacco retail stores (IRR = 1.15, 95%CI: 1.13-1.17). The greatest increases in MR were observed in municipalities from Oaxaca (>200% increments). There was an overall increase in NCDs MR from 2005 to 2021, with a significant geographic variation among Mexican municipalities. The results of this study highlight the importance of identifying priority areas in the country that urgently require public policies focused on local factors associated with deaths from NCDs, such as the regulation of the ultra-processed food, alcohol & tobacco retail stores, and efforts to reduce social inequalities.

Agreement between a web collaborative dataset and an administrative dataset to assess the retail food environment in Mexico

BackgroundLatin American countries are often limited in the availability of food outlet data. There is a need to use online search engines that allow the identification of food outlets and assess their agreement with field observations. We aimed to assess the agreement in the density of food outlets provided by a web collaborative data (Google) against the density obtained from an administrative registry. We also determined whether the agreement differed by type of food outlet and by area-level socioeconomic deprivation.MethodsIn this cross-sectional study, we analyzed 1,693 census tracts from the municipalities of Hermosillo, Leon, Oaxaca de Juarez, and Tlalpan. The Google service was used to develop a tool for the automatic acquisition of food outlet data. To assess agreement, we compared food outlet densities obtained with Google against those registered in the National Statistical Directory of Economic Units (DENUE). Continuous densities were assessed using Bland–Altman plots and concordance correlation coefficient (CCC), while agreement across tertiles of density was estimated using weighted kappa.ResultsThe CCC indicated a strong correlation between Google and DENUE in the overall sample (0.75); by food outlet, most of the correlations were from negligible (0.08) to moderate (0.58). The CCC showed a weaker correlation as deprivation increased. Weighted kappa indicated substantial agreement between Google and DENUE across all census tracts (0.64). By type of food outlet, the weighted kappa showed substantial agreement for restaurants (0.69) and specialty food stores (0.68); the agreement was moderate for convenience stores/small food retail stores (0.49) and fair for candy/ice cream stores (0.30). Weighted kappa indicated substantial agreement in low-deprivation areas (0.63); in very high-deprivation areas, the agreement was moderate (0.42).ConclusionsGoogle could be useful in assessing fixed food outlet densities as a categorical indicator, especially for some establishments, like specialty food stores and restaurants. The data could also be informative of the availability of fixed food outlets, particularly in less deprived areas.

Food Safety and Management System Audits in Food Retail Chain Stores in Greece

The present study aimed to assess the performance of food safety management systems in food retail stores via audits to reveal potential areas of improvement and to find out possible corrective actions to suggest to the top management. Two cycles of on-site audits took place in 106 stores to assess the requirements and hygiene conditions. After the first cycle of audits, improvements were suggested to the top management, and a second cycle of audits took place after a reasonable time. In the checklist, we recorded the temperatures of retail refrigerators and the scores from the inspection of hygiene and HACCP documentation. In the A′ audit, the percentage of stores that had higher temperatures than the critical limits was equal to 51%, and those temperatures occurred in the refrigerators for salads, followed by the refrigerators for deli meat, yogurts and desserts. In the B′ audit, only the refrigerators for salads exhibited percentages that were statistically significant lower (p-value < 0.05), and the stores were improved after the audit. High percentages of high-scoring stores were observed in the A′ and B′ audit in the inspection of HACCP documentation, although there was not a statistically significant improvement observed (p-value > 0.05). In the hygiene inspection, statistically significant improvement with 95% confidence appeared for “Refrigerator’s products appearance”, “Storage cleanliness”, and “Grocery shelf cleanliness”. The highest number of non-conformities without statistically significant improvement was found for “Checking temperatures of the receiving products” and “Labeling of fruit store products”, with the percentages being lower than 15% in both of the audit cycles. Many employees of the stores did not check and record the temperatures of receiving products from suppliers. In addition, the storage of spoiled products beneath fresh products for selling in the same refrigerator is not a good practice. Greater efforts must be made by top management and employees to maintain and distribute food products in the best and safest possible hygiene conditions.

Assessing the Impact of A Product-Harm Crisis on Brand Trust And Brand Image: A Focus on the Listeriosis Crisis

Brand crises endanger companies, and no organisation is immune from them; each has an equal risk of experiencing one. Existing research on crisis brands lists detrimental consequences on the focus brand and experiments with coping mechanisms. Research on the impact of the brand crisis on brand trust and brand image is sparse. This study examines the impact of a product-harm crisis on brand trust and image. A descriptive quantitative research method was used to collect data from 384 randomly selected food retail store shoppers. The findings revealed that consumers continue to trust open and honest brands during a crisis. The research was limited to uMhlathuze municipality; thus, it cannot be generalised. The brand crisis was limited to the Listeriosis case. The study contributes to the current body of knowledge on brand management by providing insight into how organisations can respond after a crisis to regain their consumers' trust. The research concludes that taking responsibility after a crisis outbreak and being open and honest about the crisis can result in consumers' forgiveness, and they end up overlooking the crisis and its negative impacts.

Propuesta de una escala de medida de innovación en el comercio orientada a la sostenibilidad

This study aimed to propose a scale for assessing the concept of innovation in commerce oriented toward sustainability focusing on consumer perspectives. To achieve this objective, an exploratory-descriptive quantitative research was conducted on a sample of 510 customers of general food retail stores. Based on a principal component analysis, a multidimensional measure emerges, comprising six factors: three referring to innovation and three linked to sustainability, affirming the validity of the concept. This highlights the significance of selecting the appropriate elements of innovation and sustainability that retailers should collectively consider to achieve the multiplicative effects suggested by this concept.

Food access narratives as told by consumers and retailers engaging in a COVID-19-stricken urban food system: A brief report.

Small food retail ("corner") stores in many underserved urban settings face challenges to stocking healthy, affordable foods. The food supply chain is considered one of the most important sectors of the economy and has suffered recent negative impacts due to the Coronavirus disease 2019 (COVID-19) pandemic, from farm to consumer. As part of the larger Baltimore Urban food Distribution (BUD) Study, we examine corner store owner and consumer perceptions of the impact of COVID-19 on navigating an urban food environment using a brief, reflective, semi-structured oral interview framed as "storytelling." Open-ended responses are documented, transcribed, and analyzed for key themes. Presently, we discuss initial key findings in hopes of helping to ensure sufficient value added for corner store owners and consumers who will interact with the BUD mobile application as part of a full-scale trial being implemented in Baltimore, Maryland.

Employment Trends and Relative Influence of U.S. Retail Subsector Employments on GDP

This paper studies employment trends of the U.S. retail industry and its twelve subsectors for the period 1998 through 2021. The retail subsectors are: motor vehicle and parts dealers (NAICS 441), furniture and home furnishing stores (NAICS 442), electronics retail stores (NAICS 443), building material retail stores (NAICS 444), food and beverage stores (NAICS 445), health and personal care retail stores (NAICS 446), gasoline stations (NAICS 447), clothing and accessories retail stores (NAICS 448), sporting goods, hobby goods, books, and music retail stores (NAICS 451), general merchandise stores (NAICS 452), miscellaneous retail stores (NAICS 453), and nonstore retail stores (NAICS 454). Comparing the pre-pandemic (2017-19) and post-pandemic (2019-21) employment growth rates, this study finds nonstore retailers (NAICS 454) and Food and beverages stores (NAICS 445) to be the most pandemic-proof subsectors in terms of retail employment. Besides multi-jurisdictional employment trends of this industry, this paper also explores the state-level influence of retail sub-sectoral employments on U.S. GDP using a fixed panel regression model. The retail subsectors that displayed statistically significant positive correlation with GDP are motor vehicle dealerships, health and personal care stores, clothing stores, and nonstore retailers such as electronic shopping and mail order businesses. Among the control variables, state-level total patent counts had statistically significant positive correlation with GDP.

Consumer responses to firm-owned devices in self-service technologies: Insights from a data privacy perspective

While self-service technologies (SSTs) enable customers to produce services such as food ordering, hotel check-in, and retail store checkout on their own, they involve the use of devices that are either firm-owned (e.g., the retailer provides a handheld device for self-checkout) or customer-owned (e.g., a customer uses a personal smartphone for self-checkout). With the increasing relevance of customer-owned devices, the role of firm-owned devices is an open question. Therefore, this study examines the role of devices in SSTs. In a series of six empirical studies and drawing on data privacy theory, we explore consumer responses to firm-owned (vs. customer-owned) devices. The findings reveal that consumers prefer firm-owned devices in SSTs and that their general need for data privacy guides these preferences. The findings also show that the interaction with firm-owned (vs. customer-owned) devices is associated with increasing perceptions of data privacy because consumers feel less vulnerable when interacting with firm-owned devices. However, this effect changes depending on the service firm’s practices of customer data usage (data sensitivity and transparency). These findings add to knowledge about consumer response to SSTs and devices, and thereby unfold how devices are interwoven with consumer data privacy. Practitioners learn how consumers respond to device ownership in SSTs and when firm-owned (vs. customer-owned) devices induce favorable customer responses.

Associations between food and beverage purchases and skin carotenoids among diverse small food retail store customers.

To determine if customer purchases at small food stores are associated with healthfulness of the diet as approximated by skin carotenoids. Cross-sectional survey of customers in small food stores regarding demographics and food purchases. Food and beverage purchases were classified as "healthy" or "non-healthy" and "carotenoid" versus "non-carotenoid" using a systematic classification scheme. Fruit and vegetable intake was objectively assessed using a non-invasive device to measure skin carotenoids. Associations between variables of interest were examined using Pearson's correlation coefficients, t-tests, and multiple linear regression analyses. Twenty-two small food retail stores in rural (n = 7 stores) and urban (n = 15) areas of North Carolina. Customers of small food stores. Of study participants (n = 1,086), 55.1% were male, 60.0% were African American/Black, 4.2% were Hispanic, with a mean age of 43.5 years. Overall, 36% purchased at least one healthy item, and 7.6% of participants purchased a carotenoid-containing food/beverage. Healthy foods and beverages purchased included produce, lean meats, 100% juices, plain popcorn, plain nuts, milk, and yogurt. Unhealthy items included non-100% juices, crackers, chips, candy, cakes, and donuts. Purchase of a healthy or carotenoid-containing item was positively associated with skin carotenoid scores (p=0.002 and 0.006, respectively). A relatively small proportion of customers purchased any healthy or carotenoid-containing foods and beverages, and those who did purchase healthy options had higher skin carotenoid scores. Future research should confirm these findings in different populations.

Packaging-free practices in food retail: the impact on customer loyalty

PurposeThis study analyzes the impact of packaging-free practices in food retail stores, particularly supermarkets, on customer loyalty.Design/methodology/approachBased on the literature on the impacts of sustainable practices and corporate social responsibility (CSR) policies on consumer behavior, this study defined a set of seven hypotheses that were tested using data collected from 447 consumers that regularly buy food products at supermarkets. The data were subjected to structural equation modeling using SmartPLS.FindingsThis study confirmed that packaging-free practices positively influence brand image, brand trust, satisfaction and customer loyalty. The expected positive impacts of brand image and satisfaction on customer loyalty were also confirmed. However, the expected impact of brand trust on customer loyalty was not confirmed.Practical implicationsThis article demonstrates how a competitive sector can reap benefits from implementing sustainable practices in the operational domain, particularly by offering packaging-free products at the point of purchase. Thus, as recommended, general retail stores (e.g. supermarkets) gradually increase the stores' offering of packaging-free food products, as this practice has been shown to have positive impacts not only on brand image, but also on customer satisfaction and loyalty.Originality/valueThis study extends the literature on the effects of sustainable practices on customer loyalty, by focusing on a specific practice. Furthermore, this study contributes to the advancement of research on packaging-free practices in retail by developing a research framework and providing evidence on the direct and indirect effects of this specific practice on customer loyalty.

The role of marketing stimuli and attitude in determining post-COVID buying decisions toward organic food products: evidence from retail consumers in Beijing, China

Customers are diverse, and their preferences have changed tremendously, especially post-pandemic, as many business organizations are facing major challenges in meeting those needs. Therefore, an in-depth understanding of consumer buying decisions plays a vital role to develop effective strategies. The aim of this study is to determine whether the marketing mix (4Ps) elements and their attitude have a significant effect on organic food product buying decisions among retail consumers in Beijing, China. A quantitative method was used in this study, whereby 334 questionnaires were physically collected randomly from walk-in customers at Walmart, Darunfa, and Yonghui supermarkets in Beijing, China. Based on the results of the hypothesis test using PLS-SEM, it was confirmed that product, place and promotional strategies had a significant positive relationship with attitude and consumer buying decisions. Interestingly, price had no effect and income was not a moderator. The results of this study provided relevant suggestions to marketing practitioners, especially organic food producers and retail stores on developing and implementing marketing strategies effectively to address changing consumer preferences.

Towards healthy food retail: An assessment of public health nutrition workforce capacity to work with stores

ObjectiveThis article aims to investigate the capacity of nutrition professionals to engage in food retail practice change to improve population diet. MethodsConvergent mixed method design was used that includes pre-interview surveys, in-depth interviews, and retrospective mapping of service provision. The study was conducted in organisations that provide a nutrition professional service to food retail stores in remote Australia. The study participants include 11 nutrition professionals and eight organisation representatives, including managers, organisation directors and policy officers. Systems-mapping and thematic analysis of the in-depth interviews were conducted using a capacity development framework. Descriptive analysis was applied to pre-interview survey and mapping data. ResultsA gap between the aspirational work and current capacity of nutrition professionals to engage effectively with stores was identified. Engagement with stores to improve population health was valued by organisations. Dominance of the medical health model limited organisation strategic support for store work and created barriers. Key barriers included the limited access to training, decision-support tools, information, financial resources and organisational structures that directed store work. ConclusionsProvision of adequate store-specific training, resources and organisational support may empower the nutrition professional workforce to be powerful leaders in co-design for healthy food retail. Implications for Public HealthBuilding capacity for this critical workforce to engage in food retail practice change must consider the influence of the broader health system and employer organisations and need for access to evidence-based decision-support tools.

Retail food environment and household food waste: An empirical study

We examine the relationship between the retail food environment for individual households and household food waste. Conceptually the relationship is ambiguous and depends on how store access interacts with frequency, size, and the composition of food purchases. We use FoodAPS data to estimate the relationship between store proximity and household food waste. We measure this relationship for different retail food store formats and also investigate heterogeneity and mediating factors. We find that a 1% increase in the distance to the nearest small food store is associated with 0.02% more food waste among all households. A 1% increase in the distance to the nearest large food store – such as supermarkets and grocery stores – is associated with 0.05% more food waste among households in poverty, with larger associations among households without cars. We find that shopping frequency and size do not mediate the relationship between large food store proximity and food waste, but we find differences over the amount of fresh foods purchased on the average shopping trip. Among households that purchase large amounts of fresh foods per trip, greater distance to a large food store is substantially associated with more food waste. Our results contribute to policy discussions surrounding food waste as well as food access.

Pantry direct: A transformative supply chain for reducing food insecurity

AbstractThe food bank, a nonprofit, humanitarian organization, recovers charitable food donations from retail stores via collaborative relationships. We demonstrate that decentralized supply chains enable local partnerships and drive value creation via increased exchange of products and services that also better align with community needs. Our supply chain intervention resulted in a reduction in waste disposal costs for the retailer and a greater supply of food for the food bank. We study the private–public partnership (PPP) in retail food recovery in two successive phases. The first exploratory phase incorporates qualitative data from key informants at multiple Feeding America partners across the United States. The second phase was a researcher‐led supply chain intervention involving multiple stakeholders and executed with our partner food bank. Our intervention, Pantry Direct, represents a transition in the PPP to a decentralized, community network. It shifts the pickup responsibility for retail food recovery to a purely volunteer workforce at the pantry. Retail store management noticed lower pickup service reliability; however, more frequent interactions between food pantry volunteers and retail store employees improved communication, which overshadowed the limitations of the volunteer workforce. Owing to several factors, the gain in PPP performance was not universal. Among the five retail stores that participated in the supply chain intervention, two increased food donations and two others decreased food waste. The Pantry Direct model is transformative in the fight against food insecurity, as increased volume (and quality) of retail food donations enabled downstream pantries to provide end clients with more adequate, consistent, or appropriate access to food.

Proximity to High/Moderate vs Low Diversity Selection Food Stores and Patient Weight loss through 24 Months.

Explorations into the neighborhood food environment have not adequately extended to adults with obesity who undergo bariatric surgery. The objective of this study is to determine how diversity of food selection at food retail stores within proximities of 5- and 10-min walks associate with patient postoperative weight loss over 24months. Eight hundred eleven patients (82.1% female; 60.0% White) who had primary bariatric surgery (48.6% gastric bypass) from 2015 to 2019 at The Ohio State University were included. EHR variables included race, insurance, procedure, and percent total weight loss (%TWL) at 2, 3, 6, 12, and 24months. Proximity from patients' home addresses to food stores within a 5- (0.25 mile)- and 10-min (0.50 mile) walk were totaled for low (LD) and moderate/high (M/HD) diversity food selections. Bivariate analyses were conducted with %TWL at all visits and LD and M/HD selections within 5- (0, ≥ 1) and 10-min (0, 1, ≥ 2) walk proximities. Four mixed multilevel models were conducted with dependent variable %TWL over 24months with visits as the between subjects factor and covariates: race, insurance, procedure, and interaction between proximity to type of food store selections with visits to determine association with %TWL over 24months. There were no significant differences for patients living within a 5- (p = 0.523) and 10-min (p = 0.580) walk in proximity to M/HD food selection stores and weight loss through 24months. However, patients living in proximity to at least 1 LD selection store within a 5- (p = 0.027) and 1 or 2 LD stores within a 10-min (p = 0.015) walk had less weight loss through 24months. Overall, living in proximity to LD selection stores was a better predictor of postoperative weight loss over 24months than living within proximity of M/HD selection stores.

An empirical analysis of evaluating the operational and economic efficiency of retail stores under an adverse operating environment

AbstractThis paper evaluates the relative efficiency of 83 food retail stores of a major Greek Supermarket network using monthly panel data that relates to an extended period of deep economic recession (2012–2013). We highlight the importance of the comparative analysis of operational and economic perspectives of the retail stores' efficiency, as they fully capture the real conditions in very competitive and dynamic recessionary environments given that retail stores are interested in minimizing costs while maximizing sales and profits. Efficiency measurements and comparisons led to the identification of benchmark stores and problematic ones thus leading to a series of management actions.

Longitudinal association between density of retail food stores and body mass index in Mexican school children and adolescents

BackgroundObesity is rapidly increasing in Mexican children and adolescents, while food environments are rapidly changing. We evaluated the association between changes in retail food stores and change in body mass index (BMI) in Mexican children and adolescents.MethodsData on 7507 participants aged 5–19 years old came from the Mexican Family Life Survey 2002–2012. Density of food stores at the municipal-level (number of food stores/area in km2) came from the Economic Censuses of 1999, 2004 and 2009. We categorized food stores as small food retail (small neighborhood stores, tiendas de abarrotes in Mexico), specialty foods, fruit/vegetables, convenience foods, and supermarkets. Associations between change in food stores and change in BMI were estimated using five longitudinal linear fixed-effects regression models (one per type of food store) adjusted for age, parental education, municipal-level socioeconomic deprivation and population density. Density of each food store type was operationalized as quartiles. Analyses were stratified by urbanization.ResultsThere was an inverse dose-response association between increases in fruit/vegetable store density and BMI (β = −0.455 kg/m2, β = −0.733 kg/m2, and β = −0.838 kg/m2 in the second, third, and fourth quartile). In non-urban areas, children living in municipalities with the highest density of small food retail stores experienced a reduction in BMI (β = −0.840 kg/m2). In urban areas, there was an inverse association between specialty food stores with BMI (β = −0.789 kg/m2 in third quartile, and β = −1.204 kg/m2 in fourth quartile). We observed dynamic associations with age; results suggested stronger associations in adolescents.ConclusionsThe availability of fruit/vegetable stores may influence a reduction in children and adolescents BMI. These results indicate that policy approaches could be tailored by type of food store – with some consideration for level of urbanization and children’s age.