Regional Supermarket Research Articles

Marketing Two Immunization Services at a Regional Supermarket Chain Pharmacy.

Background: Personal selling of immunization services includes starting a dialogue with patients, utilizing effective questioning and listening skills to identify their vaccination needs, and recommending appropriate vaccines accordingly. The study objectives were (1) to integrate personal selling into the dispensing workflow to promote pneumococcal polysaccharide vaccine (PPSV23), and (2) to evaluate the impact of personal selling and automated telephone calls to promote herpes zoster vaccine (ZVL). Methods: For the first study objective, a pilot project was conducted at one out of 19 affiliated supermarket pharmacies. Dispensing records were used to target patients with diabetes mellitus for PPSV23, and personal selling was implemented over a 3-month period. For the second study objective, a full study was conducted among the nineteen pharmacies, with five in the study group and 14 in the control group. Personal selling was implemented over a 9-month period, and automated telephone calls were placed and tracked over a 6-week period. Mann-Whitney U tests were used to compare vaccine delivery rates between the study and control groups. Results: In the pilot project, 47 patients needed PPSV23, but none received it from the pharmacy. In the full study, 900 ZVL vaccines were given, with 459 given for 15.5% of the eligible patients in the study group. During the time when 2087 automated telephone calls were placed and tracked, 85 vaccines were given across all pharmacies, with 48 given for 1.6% of the eligible patients in the study group. During both the 9-month and 6-week periods, the mean ranks of vaccine delivery rates in the study group were higher than the control group (p < 0.05). Conclusions: The pilot project incorporated personal selling into the dispensing workflow and, although no vaccines were given, provided valuable lessons. The full study demonstrated that personal selling alone and personal selling combined with automated telephone calls were associated with higher vaccine delivery rates.

Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study

IntroductionFatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. ObjectivesThe objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes. MethodsThe interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1) a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period. ResultsBetween the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings. ConclusionThis small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.

How community pharmacists envision using pharmacogenomic data: A qualitative analysis

BackgroundNearly 300 medications contain pharmacogenomic information in their labeling approved by the U.S. Food and Drug Administration. As this number continues to grow, community pharmacists will be called on to use available pharmacogenomic data at the point of dispensing. ObjectiveThis qualitative study aimed to describe how pharmacists envision the integration of pharmacogenomic data into the current workflows of community pharmacy practice. MethodsCommunity pharmacists from a regional supermarket chain pharmacy in the greater Pittsburgh area were interviewed using a semistructured interview guide. Participating pharmacists were presented with 3 clinical scenarios, followed by questions, to gain insight into how they envisioned the integration of pharmacogenomic data into community pharmacy workflow. The interview transcriptions were transcribed and coded. The content was analyzed to deduce the final themes. Supporting quotes were selected to illustrate each theme. ResultsTen community pharmacists from 3 different pharmacy locations participated in the study. A thematic analysis produced 6 themes: (1) integrating pharmacogenomic data into the dispensing software, (2) receiving an alert for pharmacogenomic information within the dispensing software, (3) accessing pharmacogenomic clinical guidelines to guide drug–decision-making, (4) contacting the prescriber by adding a task to the call queue, (5) placing a mandatory counseling alert on medications that were adjusted using pharmacogenomic data, and (6) counseling the patient on the first refill of a medication that was adjusted using pharmacogenomic data. ConclusionThis study describes how pharmacists envisioned the integration of pharmacogenomic data into community pharmacy workflow. The participants sought the integration of pharmacogenomic data into existing dispensing software, alerts for actionable prescribing changes using patient-specific pharmacogenomic data when available, and access to clinical decision support. In addition, the participants preferred to engage prescribers and receive alerts to counsel patients at prescription pick-up. These findings are key to integrating pharmacogenomic data into community pharmacy practice.

Relying on their own hands: Examining the causes and consequences of supermarket decentralization in Detroit

ABSTRACT This paper examines the historical evolution of uneven neighborhood food environments in tri-County Detroit, Michigan from 1970 to 2010. It demonstrates how broader economic conditions and business decisions not germane to the region interacted with a landscape marked by economic polarization and racial segregation to create an uneven food environment where Black neighborhoods disproportionately bore the brunt of restrictive food access. It also contextualizes capital-centric accounts of retail decentralization by showing how underlying inequities in the region limited how Detroit’s Black community could respond to store closures in their neighborhoods as well as their ability to relocate closer to suburban stores. This work raises questions about policies that heavily subsidize national and regional supermarket chains to relocate to urban centers as well as policies that solely focus on supply factors rather than the broader inequities remaking the region.

Operationalizing Pandemic Vaccinations at a Regional Supermarket Chain Pharmacy

Community pharmacies were underutilized as vaccination locations during the 2009 H1N1 pandemic. Since that time, community pharmacies are a common location for seasonal influenza vaccinations with approximately one-third of adults now getting vaccinated at a pharmacy. Leveraging community pharmacies to vaccinate during a pandemic such as pandemic influenza or the current coronavirus disease (COVID-19) pandemic will result in a more timely and comprehensive public health response. The purpose of this article is to summarize the results of a strategic planning meeting held in 2017 that focused on operationalizing pandemic influenza vaccinations at a regional supermarket chain pharmacy. Participating in the planning session from the supermarket chain were organizational experts in pharmacy clinical programs, managed care, operations leadership, supply chain, information technology, loss prevention, marketing, and compliance. Additionally, experts from the county and state departments of health and university faculty collaborated in the planning session. Topics addressed included (1) establishing a memorandum of understanding with the state, (2) developing an internal emergency response plan, (3) scaling the pandemic response, (4) considerations for pharmacy locations, (5) staffing for pandemic response, (6) pandemic vaccine-specific training, (7) pharmacy workflow, (8) billing considerations, (9) documentation, (10) supplies and equipment, (11) vaccine supply chain, (12) communications, and (13) security and crowd control. Information from this planning session may be valuable to community pharmacies across the nation that seek to participate in COVID-19 pandemic vaccinations.

Retrospective evaluation of preconception care opportunities in a chain community pharmacy setting

ObjectivesCertain prescription medications should be avoided during pregnancy to reduce the risk of fetal harm. Identification of these medications to minimize exposure may be achieved through the integration of preconception care recommendations into medication therapy management (MTM) services. The primary objective of this study was to identify missed opportunities for pharmacists to provide preconception care support related to medications associated with adverse pregnancy outcomes for reproductive-aged women who received MTM consultations at a regional supermarket pharmacy chain. Secondary objectives examined the concurrent use of prenatal vitamins, folic acid, or hormonal contraception in patients receiving medications associated with adverse pregnancy outcomes. MethodsThe study examined all MTM and prescription drug claims submitted by a regional chain of supermarket pharmacies from January 1, 2018 to June 30, 2019, to identify female patients aged 15-45 years who received MTM services. Prescription claims were cross-referenced to determine which of these patients also received medications associated with adverse pregnancy outcomes. To identify patients with long-term use of opioids and nonsteroidal anti-inflammatory drugs, a restriction based on days supplied was then applied. ResultsOf the 2020 female patients who received MTM services and filled at least 1 prescription during the study period, 731 (36.2%) were found to have received at least 1 medication associated with adverse pregnancy outcomes for the minimal days’ threshold. Of these, 509 (69.6%) lacked evidence of concurrent prescription contraception, and 74 (10.1%) had a concurrent prescription for folic acid or prenatal vitamins. ConclusionThe use of medications associated with adverse pregnancy outcomes was widespread in this sample of reproductive-aged women. The findings of this study indicate the need for additional research to investigate the implementation of targeted MTM interventions to build standard workflow processes and facilitate pharmacists’ management of this critical clinical issue.

Informing the development of a transitions of care program between an emergency department and regional supermarket chain pharmacies

ObjectivesPharmacist collaboration in transitions of care (TOC) programs is integral to increase patient education and adherence after discharge. This study aimed to conduct a qualitative evaluation of stakeholder perspectives to inform the design and implementation of a TOC program between an emergency department (ED) and regional supermarket chain pharmacies. MethodsPharmacies from a regional supermarket chain were identified for inclusion on the basis of geographic proximity to a local community hospital ED. Semistructured, one-on-one interviews with the primary investigator were conducted. Interview questions were based on the Consolidation Framework for Implementation Research (CFIR). The following 5 CFIR domains were used: (1) intervention characteristics, (2) outer setting, (3) inner setting, (4) characteristics of individuals, and (5) process. Interviews were audio-recorded and transcribed. Two investigators coded each transcript independently. A thematic analysis was performed. ResultsA total of 19 interviews were conducted, and the following 7 major themes emerged on analysis: (1) enhance real-time interprofessional communication, (2) establish data sharing between the ED and the community pharmacy, (3) provide timely resolution of prescription insurance issues for new therapies post-ED discharge, (4) use off-site pharmacy resources to support community pharmacy workflow, (5) increase patient education to prevent primary medication nonadherence, (6) reinforce discharge care plans, and (7) focus on community-dwelling older adult patients in an ED care transition program. ConclusionHealth care providers including pharmacists, physicians, nurses, and care managers, view an ED-to-community pharmacy TOC program as a valuable service to increase patient education on new medications and discharge planning. Establishment of data sharing and reimbursement is integral to the development, implementation, and sustainability of such programs. There is an untapped opportunity for community pharmacists to bridge the gap in care after ED discharge.

Comparison of Discounted and Undiscounted Cash Prices for Cardiovascular Medications by Type of US Community Pharmacy.

Cash prices for prescription drugs vary among community pharmacies in the USA. GoodRx is a discount platform that provides coupons for use in community pharmacies without a membership requirement. Analytical pharmacy is a new type of pharmacy that tests drugs before dispensing to verify medication quality. To compare undiscounted and GoodRx-discounted cash prices for common cardiovascular (CV) drugs by pharmacy type. A cross-sectional study. GoodRx-discounted and GoodRx-undiscounted cash price data; analytical pharmacy cash price data (all data collected in July 2020). GoodRx cash price data for 30 units of 41 generic and 16 brand-name common cardiovascular medications at mass merchandiser, regional supermarket, two national chains, and analytical pharmacy (only one of its kind in the USA). The average (SD) undiscounted generic CV medication cash price was $42.41 (44.1). The average GoodRx-discounted generic CV medication cash prices were $11.01 (8.6), $9.88 (6.7), $17.85 (10.5), and $21.73 (14.1) in mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average generic CV medication cash price was $20.84 (25.7) at the analytical pharmacy. The average (SD) undiscounted brand-name CV medication cash price was $368.33 (127.00). The average GoodRx-discounted brand-name CV medication cash prices were $269.16 (118.1), $258.84 (108.6), $270.28 (118.4), and $274.60 (122.50) for mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average (SD) brand-name CV medication cash price was $365.12 (116.20) at the analytical pharmacy. GoodRx-discounted cash prices of generic CV medications were significantly lower than undiscounted cash prices at supermarket, massmerchandiser, and national chain pharmacies. Analytical pharmacy cash prices too were significantly lower than traditional pharmacy undiscounted cash prices. GoodRx-discounted prices for brand-name CV medications did not differ significantly from undiscounted cash prices and between pharmacy types.

A conceptual value-based incentivization model of adult immunization for community pharmacists

ObjectiveTo design a value-based payment model to incentivize pharmacists for increased administration of influenza, herpes zoster, pertussis-containing, and pneumococcal vaccines to adults at community pharmacies. DesignA modified delphi technique was used to create a concept for a value-based payment model through consensus of expert opinion. Settingand participants: Experts were recruited from a regional supermarket pharmacy, a self-insured employer, a managed care organization, and an academic institution to participate in 4 electronic surveys and 1 in-person meeting. Outcome measuresConsensus on model design by means of a modified delphi technique. ResultsA panel of 11 experts participated in a series of electronic surveys and 1 in-person meeting. The final value-based payment model addressed how and when pharmacists would receive an incentive for meeting specific vaccination goals. The final value-based payment model also addressed the following concepts: estimated cost avoidance, vaccine effectiveness, and community protection. A 3-tiered incentive model was agreed on by the participants to tie increased vaccination rates with increased payment. Vaccination goals for each tier were defined as the percent increase in vaccination rates from the year immediately preceding. Incentives were defined as a percentage of estimated direct medical costs avoided to be shared between the payer and pharmacy. ConclusionA conceptual value-based payment model to incentivize pharmacists for increased delivery of adult vaccinations at community pharmacies was designed and agreed on by experts representing a regional supermarket pharmacy, a self-insured employer, a managed care organization, and an academic institution. Consensus was achieved by aligning the interests of both payers and pharmacies. The final model included 3 tiers of bundled incentives to reward percent increases in adult vaccination from historical baselines. This model may be used as an example for community pharmacies and health care payers to design future value-based immunization programs.

Formation of Regional Supermarket Chains in Hokkaido and Their Procurement Channels of Fruit and Vegetables

Formation of Regional Supermarket Chains in Hokkaido and Their Procurement Channels of Fruit and Vegetables

Increasing adult vaccinations at a regional supermarket chain pharmacy: A multi-site demonstration project

BackgroundMillions of American adults do not receive the recommended vaccinations each year. Community pharmacies are well positioned to help fill this gap through easy access and innovative patient-centered interventions. The primary goal of this demonstration project was to implement new notification and motivational interviewing processes at a regional supermarket chain pharmacy to increase the number of influenza, pertussis, pneumococcal, and herpes zoster vaccines provided to adults. MethodsThis prospective, observational project utilized a pre-post design. Algorithms were developed with pharmacy dispensing data to identify vaccine-eligible patients. Pharmacy staff then received automated notifications through one of the following: (1) a vaccine message printed on the prescription receipt or on paper attached to the prescription bag when patients came to the pharmacy; or (2) a patient list generated through commercially-available software listing patient contact information and which vaccine they were eligible to receive. Irrespective of the notification process, pharmacy staff employed motivational interviewing techniques either face-to-face or telephonic to engage patients in conversation about getting vaccinated. Finally, an interface to the statewide vaccination registry was developed and tested to transmit vaccination information from all pharmacy locations. ResultsNinety-nine pharmacies participated in the demonstration project across western Pennsylvania. A 33% increase in vaccinations was recorded over the prior year. Increases in vaccines were demonstrated in three of the four vaccine types: 45% for influenza, 31% for pertussis, and 7% for pneumococcal vaccinations. A decrease of 5% was observed for herpes zoster vaccinations. A successful connection to the statewide vaccine registry was established and 100% of all vaccines administered were transmitted to the registry. ConclusionA combination of face-to-face and telephonic interventions with motivational interviewing were successful at increasing adult vaccinations in a regional supermarket chain pharmacy. Equal and sustained prioritization for all vaccines is necessary to achieve increases across all vaccine types.

Visual quality and waste of leafy vegetable and fresh herbs in a typical retail market

Because of their high perishability, leafy vegetables and fresh herbs are transported to the market soon after harvest. It is very likely that most of the damage caused in the farm and during transport will result in food discard only later in the retail market or in the household. Inadequate handling and marketing strategies in the store are expected to further contribute to waste. The study was designed to address the following questions: (1) what is the visual quality of leafy vegetables and fresh herbs received in the retail market; (2) what is the volume of discard of these produce in the retail market (3) what are the main causes of discard and (4) how these variables are influenced by the vegetable species, the suppliers and the stores evaluated. The study was conducted in 4 stores of a regional supermarket chain in Distrito Federal – Brazil, for a period of 6 months. It was evaluated: (1) number of produce items received and discarded; (2) visual quality of produce at reception; (3) cause of discard. The operations in each shop were described based on observations and discussion with the store staff. When considering the sum of all produce, the discard (expressed as units per day and corrected for quantity purchased) was influenced by all the factors studied, namely store, supplier and day of the week. Delivery of produce with any signs of wilting and yellowing was negligible but produce with bruised and old leaves which should have been trimmed in the farm were frequent. Visual quality was important to determine shelf life and preference by the consumer but how important it was depended on other factors such as the produce considered and the workflow in the store. The percentage of discard varied from 8.7 % to 97.0 % of the number of units purchased. Smaller waste volume was observed for spring onion, parsley, coriander, collard, leak and green leaf lettuce. Waste volume equal to or above 50 % was observed for vegetables baby romaine lettuce, broad leaved endive, wild chicory and mustard greens and fresh herbs sage and thyme. The vegetable and fresh herbs discard in the Brazilian retail market is in great measure the result of technological constraints and are not intentional. The implications of this situation in the definitions of food waste and food loss are discussed.

Visual quality and waste of fresh vegetables and herbs in a typical retail market in Brazil

ABSTRACT Because of high perishability, leafy vegetables and fresh herbs are transported to the market soon after harvest. It is very likely that most of the damage due to inadequate handling at the farm and during transport will result in food discard only later in the retail market or in the household. Inadequate handling and marketing strategies in the store are expected to further contribute to waste. The study was designed to address the following questions: 1) what is the visual quality of leafy vegetables and fresh herbs received in the retail market; 2) what is the volume of discard of this produce in the retail market 3) what are the main causes of discard and 4) how these variables are influenced by the vegetable species, the suppliers and the stores evaluated. The study was conducted in 4 stores of a regional supermarket chain in Federal District, Brazil, for a period of 6 months. We evaluated: 1) number of produce items received and discarded; 2) visual quality of produce at reception and 3) cause of discard. The operations in each store were described based on observations and discussion with the store staff. When considering the sum of all produce, the discard (expressed as units per day and corrected for quantity purchased) was influenced by all the factors studied, namely store, supplier and day of the week. Delivery of produce with any signs of wilting and yellowing was negligible but produce with bruised and old leaves which should have been trimmed in the farm were frequent. Visual quality was important to determine shelf life and preference by the consumer but how important it was depended on other factors such as the vegetable or herb considered and the workflow in the store. The discard varied from 8.7% to 97.0% of the number of units purchased. Smaller waste volume was observed for spring onion, parsley, coriander, collard, leek and green leaf lettuce. Waste volume equal to or above 50% was observed for baby romaine lettuce, broad-leaved endive, wild chicory, mustard greens, sage and thyme. The vegetables and fresh herbs discard in the Brazilian retail market is in great measure the result of technological constraints together with bad management practices in the store. The implications of this situation for the definitions of food waste and food loss are discussed.

Implementation of comprehensive medication management at supermarket pharmacies in a pharmacy network

ObjectiveTo garner experience with the early implementation of pharmacist-provided comprehensive medication management at a regional supermarket pharmacy during the initial launch of a statewide community pharmacy enhanced services network payer contract. MethodsA series of key informant interviews were conducted with pharmacists at Giant Eagle Pharmacy locations in Pennsylvania. To be eligible to participate, pharmacists must have been trained by the Pennsylvania Pharmacists Care Network to deliver contracted comprehensive medication management services and willing to participate in audio recorded, telephonic interviews every 2 weeks. Interviews concluded when each pharmacist completed a total of 6 interviews or when the project period ended. A semistructured interview guide was developed by the investigators to elicit the pharmacists’ experience providing contracted services. Interviews were transcribed and coded by 2 independent investigators. Coding discrepancies were resolved. The final coded transcripts were presented back to the project team to identify and finalize major themes. Illustrative quotes were selected to represent each theme. ResultsInterviews from 10 pharmacists were included in the analysis. Five themes emerged as keys of successful early implementation: (1) promote commitment of the pharmacy team, (2) use effective whole-team patient engagement strategies, (3) personalize patient encounters by providing patient-centered care and practicing interpersonal skills, (4) make workflow and staffing resources easily accessible, and (5) make clinical patient care tools readily available. ConclusionThese results highlight thematic trends for how pharmacists can successfully engage their patients in contracted comprehensive medication management services. Understanding the success of early implementation at a regional supermarket pharmacy can serve as a framework for other participants in community pharmacy enhanced services networks to replicate and scale contracted patient care services.

Conceptualising marketplaces in Anglophone West Africa: a sexpartite framework

Marketplaces in Anglophone West Africa have a long history. However, previous studies have failed to conceptualise the characteristics of these marketplaces in an organised manner. This article demonstrates that the Anglophone West African marketplace is a multidimensional concept characterised by six interrelated features, namely physical, social, economic, cultural, governance, and contestation attributes. With increasing globalisation and penetration of global and regional supermarket chains in Africa, the multifunctional space of the Anglophone West African marketplace, as experienced in Euro-American contexts, risks extinction. More broadly, the article shows that the attributes identified in this framework have relevance beyond Anglophone West Africa, suggesting that the marketplace in other parts of Africa and the Global South face similar threats. The framework lends itself to further research in several disciplines and has applied relevance for Anglophone West African policymakers and municipal authorities as well as the international community.

Positive Impact of Technician-Driven MTM Program on Performance Measures

Objective: To determine the effect of using a technician-driven medication therapy management (MTM) program on quality performance measures for a community pharmacy chain. Methods: A technician-driven MTM program was incorporated in 35 stores of a regional supermarket pharmacy chain. The overall chain percentage score for the 4 quality measures used in Medicare Part D Star Ratings—proportion of days covered (PDC) for cholesterol, diabetes, renin–angiotensin system antagonists (RASA), and high-risk medication use—was compared pre- and postimplementation of the technician-driven MTM program. Data were collected from Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) platform and t tests were used to analyze 1 year pre- and postimplementation. Results: The PDC for RASA, high cholesterol medications, and diabetes medications significantly increased pre- to postimplementation for each drug class (P < .001, P = .011, P = .001, respectively). The combined overall mean PDC score for RASA, cholesterol medications, and diabetes medication classes significantly increased by 5.6% from 2015 to 2016 (74.2% vs 79.8%, P < .001); there was also a nonsignificant decrease in high-risk medication use for the entire chain. Conclusions This technician-driven MTM program can positively affect pharmacy quality performance and potentially improve patient outcomes.

The “price” of health: Fruit and vegetable costs differentially affect purchase volume by gender

The purpose of this study was to extend findings that experimental cost manipulations influence purchasing behavior by examining these effects in a field setting and identify gender differences in purchasing behavior in response to variations in the cost of lower energy dense (ED) and higher ED foods. Using a counterbalanced procedure adapted from experimental economics, low- and median- income male and female grocery shoppers at a regional supermarket were given a debit card and allowed to purchase any foods from 2 tables. Tables were identical, except one had lower ED foods low priced; the other had lower ED foods higher priced. Results showed that when lower ED foods were more expensive, fewer lower ED foods were purchased overall (95% CI -1.0, -.40), with men spending more money (in dollars) when high calorie foods were higher priced (95% CI $0.51, $1.73); however, women, but not men, increased spending when low calorie foods were higher priced (95% CI -$2.85, -$0.73). Overall, the results contribute to an understanding of how perceptions of price impact consumer choice and suggest that efforts aimed to increase the perceived value of health over cost should be tailored towards men.

Sugar-Sweetened Beverage Demand and Tax Simulation for Federal Food Assistance Participants: A Case of Two New England States

Excessive consumption of sugar-sweetened beverages is a major concern in the efforts to improve diet and reduce obesity in USA, particularly among low-income populations. One of the most commonly proposed strategies to reduce sugar-sweetened beverage consumption is increasing beverage prices through taxation. The objective of this study was to evaluate whether and how price-based policies could reduce sugar-sweetened beverage consumption among participants in the federal Supplemental Nutrition Assistance Program. Using point-of-sale data from a regional supermarket chain (58 stores), we estimated the responsiveness of demand to sugar-sweetened beverage price changes among Supplemental Nutrition Assistance Program-participating families with young children. Own-price and cross-price elasticities for non-alcoholic beverages were estimated using a Quadratic Almost Ideal Demand System model. The study found evidence that a tax-induced sugar-sweetened beverage price increase would reduce total sugar-sweetened beverage purchases among Supplemental Nutrition Assistance Program participants, who were driven by purchase shifts away from taxed sodas and sports drinks to non-taxed beverages (bottled water, juice, milk). The substitution of non-taxed caloric beverages decreases the marginal effects of the sugar-sweetened beverage tax, yet the direct tax effects are large enough to reduce the overall caloric intake, with the average net reduction in monthly calories from sugar-sweetened beverages estimated at around 8% for a half-cent per ounce tax and 16% for a one cent per ounce tax. A beverage price increase in the form of an excise tax would reduce sugar-sweetened beverage consumption and increase healthier beverage purchases among low-income families.

The origin and expansion of regional value chains: the case of Kenyan horticulture

AbstractRegional value chains (RVCs), involving regional lead firms that trade within a single world region, are increasingly prominent within the Global South. Yet, emerging analyses of RVCs have not adequately interrogated how the expansion of RVCs relates to global value chains (GVCs), how actors in RVCs interact with overlapping chains, or the implications for development. Through a case study of horticulture value chains in Kenya, two main types of RVC–GVC interactions are identified. First, opportunistic RVCs emerged when suppliers found their produce rejected from GVCs for lack of standards compliance and began selling spillover produce in regional markets. Second, a more independent targeted RVC has evolved since suppliers began selling produce directly to regional supermarkets that had established their own regional procurement strategies and private standards. Some suppliers are also involved in hybrid interactions – participating in both opportunistic spillovers and targeted RVCs. The analysis concludes that the expansion of RVCs must be considered in the context of GVCs, leading to more nuanced understandings of the characteristics and development implications of RVCs.

Assessment of the construct validity of the Australian Health Star Rating: a nutrient profiling diagnostic accuracy study.

Nutrient profiling models classify the healthiness of foods based on their nutritional composition and provide the science that underlies nutrition signposting schemes. The two objectives were to examine the construct validity of the Health Star Rating (HSR) system by determining its diagnostic accuracy and to detect the optimal HSR cutoff points to define healthiness in packaged dairy foods. We hypothesised that ultra-processed dairy, defined by NOVA, would have less stars (less healthy) and non-ultra-processed dairy would have more stars (more healthy). The diagnostic accuracy of the HSR system used for 621 dairy foods for sale in an Australian regional supermarket was investigated. The healthiness of packaged dairy was measured using the NOVA food classification system. The dairy beverages model was found to discriminate between healthy and less healthy dairy beverages as classified by NOVA (AUC: 0.653; 95% CI: 0.556-0.750; P=0.005). A receiver operating characteristic curve analysis for dairy beverages demonstrated that the optimal cutoff point corresponded to a rating of four stars. There was no discrimination power when using the HSR for predicting the health value of yoghurt and other dairy, or cheeses. At the optimal cutoff point of four stars the HSR has a high sensitivity but a low specificity to correctly classify healthy packaged dairy beverages, as defined by NOVA. We provide evidence to support the construct validity of the HSR model for dairy beverages, but not for the models used for yoghurts and other dairy products, or cheeses.