Healthy Corner Store Initiative Research Articles

Corner Store Retailers' Perspectives on a Discontinued Healthy Corner Store Initiative.

Making fresh fruits and vegetables (FFV) more widely available has been a prominent focus of healthy retail interventions and may have an important role in improving food access and diet quality at the population level. 'Healthy retail' interventions in corner/convenience stores (CS) are increasingly being adopted by public health practitioners to address the diet-related risk factors, improve food access at the community level, and change food retail environments. Private sector retailers are integral to the success of public health retailing interventions, making their perspectives and experiences critical. There is a particular need for greater evidence from retailers in settings where evaluations of these interventions have yielded null or mixed results. Through semi-structured interviews with 8 CS retailers (7 from urban settings and 1 from rural) in Ottawa, Ontario, Canada, this study aimed to describe experiences and critical factors regarding the feasibility and sustainability of a healthy CS program that was not sustained following the pilot testing phase, with a specific focus on the sale of FFV. Thematic analysis was used to analyze the interview data, which indicated that retailers faced two dominant challenges with selling FFV in CS: both relate to how these stores are embedded in the larger local and global food system. We join others in arguing that efforts and support for retail interventions aiming to increase the availability of FFV in CS need to address the structure and relations of the food system, as an upstream determinant of CS retailer interest and motivation.

Community-Based Participatory Approach to Increase African Americans' Access to Healthy Foods in Atlanta, GA.

African Americans in Atlanta, Georgia disproportionately reside in communities with limited access to healthy foods. Collaborations with local corner stores to provide healthy food options have been identified as an evidence-based intervention that could be used to increase food access. This paper describes the community-based participatory approach used to culturally-tailor a Healthy Corner Store Initiative (HCSI) in five Atlanta communities. A mixed method approach (qualitative/quantitative) was utilized. Spatial analysis and an environmental assessment were conducted to locate all corner stores in the partner communities that were listed in a business database. An environmental assessment was conducted at 34 corner stores using a structured log and checklist. Among them, 11 were selected and signed memorandums of understanding to implement the HCSI. A customer intercept survey was administered to 100 African American corner store customers at five of the healthy corner store sites. Descriptive statistics were used to analyze log/checklist and survey data. Corner store customers indicated that they typically purchase snacks, tobacco, and breads, but would purchase certain healthy foods, if offered. They also indicated that freshness of fruits and vegetables and positive relationships with corner store owners would influence healthy food purchases. Findings demonstrate that working collaboratively with community members, researchers and business owners is a critical step in nurturing trust, strengthening credibility, and building partnerships towards increased healthy food access and improved community health.

Evaluating the impact of a healthy corner store initiative on food access domains

Healthy Corner Store Initiatives (HCSIs) are one food access strategy that aims to improve food environments by supporting local food stores in expanding their healthy offerings. This study presents the evaluation results from one such HCSI. Fresh Foods Here evaluated its network of eight stores in Columbus, Ohio between November 2013 and August 2014. Data from invoices, inventories, rapid market assessments, and customers surveys were analyzed for evidence of impact on the service delivery and personal domains of food access. For some indicators, initial gains were concentrated between pre- and interim evaluation periods, followed by either a leveling off or decline between interim and post. However, overall results were promising, with increases noted in the number of healthy items ordered by store owners, in daily foot traffic and transactions, and in consumer confidence for certain healthy behaviors. Lessons learned concerning the operation and evaluation of HCSIs are shared.

P180 - Process Evaluation of a SNAP-Ed Healthy Corner Store Initiative in New York State

Background (Background, Rationale, Prior Research, and/or Theory): To address poor access to healthful food, a SNAP-Ed healthy corner store policy, systems, and environment (PSE) initiative in New York State was designed to increase availability of fruits, vegetables, and low-fat dairy in local corner stores using phased changes, beginning with education and marketing strategies and ending with sustained increases in healthful offerings. Process evaluation was an important step in assessing program implementation and determining context for implementing evidence-based best practices. Objective: The purpose of this process evaluation was to determine the extent to which the healthy corner store PSE initiative was implemented as intended and to identify facilitators and barriers to implementation in all seven participating stores during FY 2017. Study Design, Setting, Participants, Intervention: The mixed methods design included review of SNAP-Ed program activity logs, discussion with SNAP-Ed staff and partners, and site visits. Outcome Measures and Analysis: Fidelity was assessed by comparing quantified input, activity, and output data from activity logs with the program logic model and store-specific goals. Field notes were analyzed for themes related to program implementation successes and challenges. Results: Three of the seven corner stores were new to the initiative in 2017, reflecting successful program efforts to build and sustain relationships with store owners. Program staff implemented (or continued to support) early stage goals (e.g. educational events and presentation and promotion practices to highlight healthful foods already available). However, changing store food offerings proved challenging. Staff cited cultural preferences, limited buying power, and limited store size as barriers to increasing fruit, vegetables, and low-fat dairy offerings. Conclusions and Implications: This healthy corner store PSE initiative reflects nationwide evidence that suggests corner store programs can be slow-moving and require consistent effort and community buy-in. Process evaluation results indicated achievement of early program goals and highlighted challenges in creating sustainable changes in store food offerings. Results will immediately inform scheduled interviews with staff, community partners, store owners, and store customers and will inform interpretation of outcome results. Funding: USDA.

Around the Corner to Better Health: A Milwaukee Corner Store Initiative.

To discuss successes and challenges of a collaborative pilot project to increase healthy food availability in corner stores in Milwaukee, Wisconsin. The Lindsay Heights Healthy Corner Store Initiative aimed to help corner stores sell high-quality produce by increasing supply of healthy foods and funding minor store upgrades to facilitate change. Evaluation research. Milwaukee, Wisconsin. Corner stores; youth and adult community members. (1) Supporting businesses in purchasing equipment to stock fresh produce, (2) connecting stores with produce sources, and (3) community outreach and marketing. Partnership capacity, youth engagement in food justice, and community members' usage of corner stores. Qualitative analysis; descriptive statistics. Storeowners reported more sold produce items per week and increased noticeable fresh produce upon entrance into the store. There was increased or improved store redesign, fresh produce signage, in-store cooking demonstrations, and small business development resources. Youth learned about new vegetables, increased kitchen skills and proper food storage, and the effects of obesity on overall health. Similar interventions must address infrastructure costs, cooperation with property owners, and local policies and regulations affecting business practices.

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina.

In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson’s correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m2. There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives.

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina

Perspectives of Urban Corner Store Owners and Managers on Community Health Problems and Solutions.

IntroductionUrban corner store interventions have been implemented to improve access to and promote purchase of healthy foods. However, the perspectives of store owners and managers, who deliver and shape these interventions in collaboration with nonprofit, government, and academic partners, have been largely overlooked. We sought to explore the views of store owners and managers on the role of their stores in the community and their beliefs about health problems and solutions in the community.MethodsDuring 2013 and 2014, we conducted semistructured, in-depth interviews in Philadelphia, Pennsylvania, and Camden, New Jersey, with 23 corner store owners/managers who participated in the Healthy Corner Store Initiative spearheaded by The Food Trust, a nonprofit organization focused on food access in low-income communities. We oversampled high-performing store owners.ResultsStore owners/managers reported that their stores served multiple roles, including providing a convenient source of goods, acting as a community hub, supporting community members, working with neighborhood schools, and improving health. Owners/managers described many challenging aspects of running a small store, including obtaining high-quality produce at a good price and in small quantities. Store owners/managers believed that obesity, diabetes, high cholesterol, and poor diet are major problems in their communities. Some owners/managers engaged with customers to discuss healthy behaviors.ConclusionOur findings suggest that store owners and managers are crucial partners for healthy eating interventions. Corner store owners/managers interact with community members daily, are aware of community health issues, and are community providers of access to food. Corner store initiatives can be used to implement innovative programs to further develop the untapped potential of store owners/managers.

Print E-mail Dissolved: Lessons Learned from the Portland Multnomah Food Policy Council

The city of Portland, Oregon, is often hailed in news and popular media as the capital of the U.S. alternative food movement. In 2002, the Portland Multnomah Food Policy Council (PMFPC) was established to address the region's growing interest in cultivating a sustainable local food system. Council members contributed to many notable achievements, including a healthy corner store initiative, a beginning farmer training program, and changes to zoning codes to expand urban agriculture. However, the PMFPC was dissolved in the summer of 2012 after local government agencies expressed that the council was losing relevancy. After a decade of conducting food policy and advocacy work in a region praised for fostering both citizen engagement and sustainable food systems, what can we learn from the story of the PMFPC? In this reflective case study, we explore the challenges associated with citizen engagement in local food policy. Through semistructured interviews and analysis of PMFPC documents, we provide insight into how particular obstacles might have been avoided or overcome. Our research speaks to the broad arena of public participation and highlights the importance of negotiating and clearly articulating the roles and responsibilities of council members, government staff liaisons, and elected officials; regularly evaluating the usefulness of established roles, structures, and processes; and making the changes necessary to maintain the relevance of the council throughout its life. We conclude with lessons learned and recommendations for both citizens and government agencies hoping to foster productive public engagement and to advance local food systems policy.

A randomized controlled study of a healthy corner store initiative on the purchases of urban, low-income youth.

ObjectiveAlthough many initiatives exist to improve the availability of healthy foods in corner stores, few randomized trials have assessed their effects. This study evaluated, in a randomized, controlled trial, the effects of a first-generation healthy corner store intervention on students’ food and beverage purchases over a two-year period.Design and MethodsParticipants (n=767) were 4th-6th grade students. Ten schools and their nearby corner stores (n=24) were randomly assigned to the healthy corner store intervention or an assessment-only control. Intercept surveys directly assessed the nutritional characteristics of students’ corner store purchases at baseline, 1 and 2 years. Students’ weight and heights were measured at baseline, 1 and 2 years.ResultsThere were no differences in energy content per intercept purchased from control or intervention schools at year 1 (p=0.12) or 2 (p=0.58). There were no differences between control and intervention students in BMI-z score (year 1, p=0.83; year 2, p=0. 98) or obesity prevalence (year 1, p=0.96; year 2, p=0.58).ConclusionsA healthy corner store initiative did not result in significant changes in the energy content of corner store purchases or in continuous or categorical measures of obesity. These data will help to inform future interventions.

Purchasing behaviors of individuals who shop at corner stores (1019.6)

Background. The Jackson County MO Healthy Corner Store Initiative is designed to work with small retail establishments to increase healthy food availability where residents have limited access to full line grocery stores. As part of this initiative, we assessed the purchasing habits of individuals who frequent one of four neighborhood corner stores. Method. Intercept surveys were administered during 28 two‐hour sessions and 2 four‐hour sessions. Survey sessions were held early morning, mid‐day and late afternoon over a 2‐week period. Participants were asked to indicate age, gender, transportation mode, food purchase frequency, typical items purchased, perceived healthiness of food items available, what influenced purchase decisions, and what items they purchased that day. Results. 446 surveys were completed. Most participants were greater than 18 years old (88%), male (61%) and drove a car or truck to the store. About 36% reported visiting corner stores daily. Most participants purchased snack items (59%) and felt that available food items were somewhat healthy (38%). Chips (17%), regular soda (25%), alcohol (15%) and tobacco (14%) were common items purchased. Almost 50% of participants reported to be very interested in healthier food options while about 23% felt that prices of healthy food items were comparable to other stores. 44% indicated variety would be the most important factor when deciding to purchase healthy foods. Discussion. Intercept survey results provided insight about buying habits and what changes might be possible to increase healthier food purchases. Education about healthy food choices will be an important factor when implementing the Healthy Corner Store Initiative.Grant Funding Source: Supported by CDC

Food habits of residents who live near corner stores (132.3)

Background. Working alongside small retail establishments, the Jackson County MO Healthy Corner Store Initiative aims to increase availability of healthy food items in communities with limited healthy food access. Food habit surveys were conducted in neighborhoods surrounding 4 targeted corner stores. Methods. Several strategies were used to distribute the food habit survey within the targeted areas, including mailed surveys, door‐to‐door canvassing, at focus group discussions, and online. Sample size estimates were calculated utilizing census data with consideration of abandoned and vacant households. Survey items included 24 questions about demographic characteristics and food behaviors. Results. A total of 423 food habit surveys were collected. The most important factors participants indicated when deciding where to purchase food were price (32%) and quality of food (26%). About one‐third of participants reported that they consumed only one serving of fruit and two servings of vegetables a day. Major barriers to fruit and vegetable consumption included price (40%) and spoilage time (41%). More than 60% of participants reported purchasing fruit and vegetables at least once a week, with 40% having to travel only 5 to 10 minutes to purchase items. Discussion. Overall, responses to the food habit surveys indicate that individuals are not eating adequate amounts of fruits and vegetables, although the vast majority reported not having to travel far to purchase items. Changing the perception of corner stores by offering a wider variety of low‐cost and high quality foods may enhance healthy food intake among residents.Grant Funding Source: Supported by CDC

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

IntroductionObesity prevalence in the rural United States is higher than in urban or suburban areas, perhaps as a result of the food environment. Because rural residents live farther from supermarkets than their urban- and suburban-dwelling counterparts, they may be more reliant on smaller corner stores that offer fewer healthful food items.MethodsAs part of a Communities Putting Prevention to Work (CPPW) healthy corner store initiative, we reviewed audit tools in the fall of 2010 to measure the consumer food environment in eastern North Carolina and chose the NEMS-S-Rev (Nutrition Environment Measures Survey-Stores-Revised) to assess 42 food stores. During the spring and summer of 2011, 2 trained graduate assistants audited stores, achieving interrater reliability of at least 80%. NEMS-S-Rev scores of stores in rural versus urban areas were compared.ResultsOverall, healthful foods were less available and of lower quality in rural areas than in urban areas. NEMS-S-Rev scores indicated that healthful foods were more likely to be available and had similar pricing and quality in rural corner stores than in urban corner stores.ConclusionFood store audit data provided a baseline to implement and evaluate a CPPW healthy corner store initiative in Pitt County. This work serves as a case study, providing lessons learned for engaging community partners when conducting rural food store audits.

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Engaging Stakeholders for a Healthy Corner Store Initiative, Part 2

IntroductionWe examined the feasibility of increasing access to healthful food in corner stores to inform a Communities Putting Prevention to Work (CPPW) initiative by engaging stakeholders (corner store owners and customers) in a formative evaluation.MethodsQualitative interviews were conducted with corner store owners and managers (n = 11). Customer intercept surveys (n = 179) were also conducted with customers of 9 stores. Corner stores were located in rural food deserts (municipalities without a chain supermarket) and in low-income, urban municipalities in eastern North Carolina. Interviews were transcribed verbatim and double-coded. Qualitative themes related to feasibility of increasing access to healthful foods were extracted. Shopping patterns of rural and urban customers were compared by using t tests.ResultsCorner store owners were willing to stock more healthful foods, but they perceived that customer demand for these foods was low. Rural customers reported more frequently shopping at corner stores than urban customers and more frequently stated that the reason they do not eat more fruits and vegetables is that the stores in which they shop do not sell them. Most customers reported they would be very or somewhat likely to purchase fresh produce at a corner store.ConclusionCorner stores may be an important source of food for rural and low-income residents and thus a good place in which to intervene. The results of this formative evaluation were used to plan and evaluate a CPPW healthy corner store initiative.

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

Nutrition environments in corner stores in Philadelphia

ObjectiveTo examine the availability, quality, and price of key types of healthy and less-healthy foods found in corner stores in low-income urban neighborhoods and the associations between store characteristics and store food environments. MethodA sample of 246 corner stores was selected from all corner stores participating in the Philadelphia Healthy Corner Store Initiative (HCSI). The Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to assess the availability, quality, and price of foods and beverages in 11 common categories between February and May, 2011. ResultsNEMS-CS measures were completed in 233 stores, 94.7% of the 246 stores approached. The healthier options were significantly less available in all food categories and often more expensive. Baked goods, bread, chips and cereals were sold at nearly all stores, with significantly fewer offering low-fat baked goods (5.7%, p<0.0001), whole grain bread (56.2%, p<0.0001), or baked chips (35.2%, p<0.0001). Number of aisles was positively associated with availability score (p<0.05). ConclusionFindings from this study point toward potential targets for intervention to improve the corner store food environment and dietary choices among low-income urban populations. Availability of certain healthier foods could be improved.