Store Type Research Articles

Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED).

The Nutrition Environment Measures Surveys are valid and reliable measures of community and consumer food environments. This article describes the adaptation and evaluation of the Nutrition Environment Measures Survey in Stores (NEMS-S) for Mediterranean urban contexts (NEMS-S-MED). Trained raters used the adapted NEMS-S-MED tool to observe and rate food outlets in 21 census tracts and 43 food stores across the city of Madrid, Spain. We evaluated inter-rater and intra-rater reliabilities, construct validity, and the tool’s ability to discriminate between store types and between stores by area-level Socio-Economic Status (SES). Overall, the mean NEMS-S-MED score was 20.7 (SD = 9.8), which ranged from 7 to 43. Most food items displayed substantial or almost perfect inter-rater and intra-rater agreements; the percentage agreement across availability items was almost perfect and kappa statistics were also very high (median κ = 1.00 for inter-rater; κ = 0.92 for intra-rater). Furthermore, the NEMS-S-MED tool was able to discriminate between store types and census tracts of different SES. The adapted NEMS-S-MED instrument is a reliable and valid audit tool to assess the consumer food environment in Mediterranean urban contexts. Well-constructed measurement tools, such as the NEMS-S-MED, may facilitate the development of effective policy interventions to increase healthy food access and affordability.

Digital atmosphere of fashion retail stores

This study sheds light on a prominent issue in retailing: how the digital atmosphere can affect the consumer decision-making process in a fashion retail store. Digital devices and services such as digital screens and digital signage are widely employed in fashion retail stores, transforming the way consumers make decisions about purchasing fashion products. This research investigates how the digital atmosphere affects consumers’ purchase behavior patterns based on the attention-interest-desire-search-action-share (AIDSAS) model. The findings show that attention is a key antecedent to interest, desire, and behavioral responses (search, action, and share) triggered by the digital atmosphere. The findings further suggest that attention has significantly positive effects on consumers’ purchasing patterns of utilizing the digital atmosphere in two types of fashion retail stores: sports and luxury stores. However, we find that these positive effects are more pronounced for sports retail stores than luxury retail stores. This research contributes to understanding consumer behavior related to the digital atmosphere of fashion retail stores by applying the AIDSAS model and helps uncover the stepwise relationships between attention to the store atmosphere-interest/desire and the products-behavior response. These findings have practical implications that can be applied in the fashion industry.

The use and misuse of ratio and proportion exposure measures in food environment research

BackgroundThe food stores within residential environments are increasingly investigated as a possible mechanism driving food behaviours and health outcomes. Whilst increased emphasis is being placed on the type of study designs used and how we measure the outcomes, surprisingly little attention gets diverted to the measures of the food environment beyond calls for standardised approaches for food store coding and geographic scales of exposure. Food environments are a challenging concept to measure and model and the use of ratio and proportion measures are becoming more common in food environment research. Whilst these are seemingly an advance on single store type indicators, such as simply counting the number of supermarkets or fast food restaurants present, they have several limitations that do not appear to have been fully considered.Main bodyIn this article we report on five issues related to the use of ratio and proportion food environment measures: 1) binary categorisation of food stores; 2) whether they truly reflect a more or less healthy food environment; 3) issues with these measures not reflecting the quantity of food stores; 4) difficulties when no stores are present; and 5) complications in statistical treatment and interpretation of ratio and proportion measures. Each of these issues are underappreciated in the literature to date and highlight that ratio and proportion measures need to be treated with caution.ConclusionCalls for the broader adoption of relative food environment measures may be misguided. Whilst we should continue to search for better ways to represent the complexity of food environments, ratio and proportion measures are unlikely to be the answer.

Trends in Store-Level Sales of Sugary Beverages and Water in the U.S., 2006–2015

Previous research on sugar-sweetened beverage trends has focused on self-reported consumption from surveys. Few studies used objective store sales or explored differences by area-level demographics and store type. The average volume of beverages sold per store per 3-digit zoning improvement plan code from 2006 to 2015 was calculated using national Nielsen Retail Scanner point-of-sale data from 24,240 stores. A multilevel regression model analyzed annual trends, with random intercepts for state and separate models for beverage type (regular soda, no/low-calorie soda, other sugary drinks, 100% fruit juice, bottled water). Differences by store type (convenience, supermarkets, drug stores, mass merchandisers) and area-level demographics (categorized as tertiles) were examined. Data were analyzed in 2019. The model-based estimates indicated that sales of regular soda (-11.8%), no/low-calorie soda (-19.8%), and 100% fruit juice (-31.9%) decreased over time, whereas sales of bottled water (+34.4%) increased and sales of other sugary drinks remained stable (+2.4%). Decreases in sugar-sweetened beverage sales were largely concentrated in supermarkets and larger in areas with high income and education levels and a high percentage of black and Hispanic people. There were also relatively larger increases in bottled water sales in states located in the South and Midwest. The finding that sales of sugar-sweetened beverages decreased over time, whereas sales of bottled water increased is encouraging because sugar-sweetened beverage consumption is linked to obesity and other chronic conditions. This study provides a novel, rigorous assessment of U.S. beverage sales trends and differences by community and store characteristics.

Spatial clustering: Influence of urban street networks on retail sales volumes

As is often believed that the more centrally located a shop, the higher its sales volume, this paper analyzed relationships between the spatial clustering of retail stores, their respective transaction volumes, and the urban street networks to determine whether, and to what extent, the accessibility and density of a store’s location was correlated with its transaction volume. While this hypothesis is widely accepted, its veracity is underexplored and rarely validated using large-scale empirical datasets, possibly owing to the lack of access. Therefore, transaction datasets and accessibility indicators were first examined; a clear, positive correlation between density and revenue was found for specialty stores wherein people do “comparison shopping,” and for stores that complemented each other for activities such as “one-trip shopping,” the revenues were positively correlated when the stores were clustered. Generally, daily-use stores’ revenues were more sensitive to local access and those of non-daily-use stores were more sensitive to global access. In conclusion, these findings would not have been found using conventional methodology focused on the retail sector as a whole, because aggregate market mechanisms would have hidden the observed effects on specific store categories. Therefore, upon disaggregating the data, we found a distinct heterogeneity across the different store types for what concerns the relationship between revenue and location.

Occurrence and Distribution of Aflatoxin in Maize from Selected Counties, Eastern Region, Kenya

Purpose: The study aimed to assess the occurrence and distribution of aflatoxin contamination on dry maize in different types of stores in Meru, Embu, Isiolo, Makueni and Machakos Counties of Eastern region of Kenya.Methodology: Automatic spear sampler was used to collect maize samples from each bag at even intervals. 280 maize samples were collected from 29 stores in five Counties. 100 g of each maize sample was ground, resampled into 50g, blended, extracted, centrifuged, filtered and a quantified for Aflatoxin B1, B2, G1 and G2. Samples were prepared and extracted with methanol/water. The bulky of the samples were analyzed with enzyme-linked immunoassay test kits. Confirmation of positive samples was done with high performance liquid chromatography (HPLC) coupled with fluorescence detector. Data analysis was done with SPSS and Microsoft excel.Findings: Maize samples from Counties in eastern region of Kenya had significantly high levels of (93.10%) aflatoxin contamination. The mean values for aflatoxin B1, B2, G1 and G2 were: 50.08± 4.42, 17.26±1.08, 30.17±2.06 and 10.54± 1.52 (ng/g) in that order. Only nine samples had total aflatoxin within the accepted limit for human consumption of 15 ng/g. The highest total aflatoxin contamination recorded was 198.45ng/g in Makueni county and the lowest recorded was 8.76ng/g in Embu county. Makueni and Embu had mean values for aflatoxin B1, B2, G1 and G2 being (83.07±7.53, 22.15± 1.36, 49.38±3.11, 20.52± 0.70 ng/g) and (18.71 ±2.63, 8.07 ±0.64, 17.02 ±1.38, 8.86 ±1.62 ng/g). Makueni NCPB depot had the highest mean contamination with aflatoxin B1 of 92.67± 5.78 ng/g and Embu had the lowest with 6.26 ± 4.14 ng/g. All the county markets recorded high aflatoxin B1 contamination with exception of Embu county which had a mean of 4.0 ±0.84, Makueni (83.67± 10.42 ng/g), Isiolo (51.27± 32.29 ng/g), Meru (46.02± 23.88 ng/g) and Machakos (36.34± 26.27 ng/g). The stores had aflatoxin load varied from on store to the other and county to county.Unique contribution to theory, policy and practice: The counties in the region had high occurrence and distribution of aflatoxin B1, B2, G1 and G2 in maize in all stores where samples were picked. Location for maize stores should be in areas with low levels of carbon dioxide because mycotoxins are produced under aerobic conditions. The design for maize threshing machines should not course shocks, breakage and cracks on maize grains to decrease chances of mycotoxins infestation during their storage.

Types of grocery stores and demographic and household factors in Japanese provincial area

Abstract Background Neighborhood grocery stores, such as supermarkets (SM) and convenience stores (CVS), have received attention as a determinant of a food purchase behavior. Previous studies reported that grocery store entry or closure was associated with regional populations. This study examines the association of types of SM (i.e. cross-regional, local, or small chain stores), CVS, and household demographics in the cities, towns and villages (having its own incorporated government) in Hiroshima and Okayama Prefectures, Japan. Methods We hypothesized that the entry and closure of SM, CVS are associated with the regional population and type of family household from interview surveys with supermarket and wholesale operators. We collected data on SM and CVS from Large-Scale Retail Store Data in Japan, while data on demographics and households were collected from the census. Data sets from 59 municipalities (city, town, ward, and village) and 49 SM chains (498 stores) and 8 CVS chains (1235 stores) were analyzed using multiple regression analysis. Results Some household factors showed significant associations with the number of SM and CVS at the municipality level. Those municipalities with a greater number of extended families and single households had significantly more “cross-regional” as well as “local chain SM” stores. Those municipalities with more nuclear families had significantly more “small chain SM” and fewer “local chain SM” stores. Those municipalities with more single households had significantly fewer SM stores. Conclusions In these prefectures, population declining and single household increasing are expected over the coming decades. If no political interventions are allowed on this issue, some of “food desert” may emerge for the hundreds of thousands people living in these areas; elderly people may not get fresh vegetables in their neighborhood, and young parents will have to drive for hours to “cross-regional SM” to buy fresh milk for their children. Key messages Supermarkets and convenience stores are determinant of a food purchase behavior. The association of the number of types of SM, CVS, and demographic and household factors.

The food environment in school’s vicinities of Sao Paulo, Brazil

Abstract The school environment plays an important role in the eating patterns of students. The quality of food available in the school vicinities can influence the health and diet outcomes of this population. The study aims to analyze the food environment in the school vicinity of the city of Sao Paulo, focusing on stores selling ultra-processed products. The association between presence and characteristics of schools and density of stores will be investigated. Schools information was obtained from the 2016 School Census, provided by the National Institute of Educational Studies and Research Anísio Teixeira (INEP). The 2016 Annual Social Information List (RAIS) database was used to characterize the school vicinity. Eleven types of stores selling ultra-processed products were identified through the National Classification of Economic Activities (CNAE). Initially, schools and stores were georeferenced by the Postal Address Code in the city street map; this information was attached to the Human Development Units (UDH). Descriptive analyzes (absolute numbers and density per 10.000 inhabitants) were carried out to investigate the distribution of food stores by each category of Municipal Human Development Index (IDHM) present in the city. The influence of the schools on the presence of stores was verified by comparing stores densities in areas with and without schools, considering IDHM categories. The results show that food stores densities are smaller in areas with lower IDHM (8.79/10.000 inhabitants) and bigger in areas with higher IDHM (79.19/10.000 inhabitants). Comparing areas with and without schools, areas with schools present higher food stores densities in every category of IDHM. Furthermore, the study results are relevant and necessary to fill gaps in current literature and may support the formulation of recommendations and intervention proposals for promoting healthy food environments for children and adolescents. Key messages The results assist in the understanding of how different determinants can modulate food choices and practices of children and adolescents. Food environments investigations and monitoring provide important subsidies for designing and directing accurate public policies that promote healthier food environments and choices.

Frequent pattern growth algorithm for maximizing display items

Products are goods that are available and provided in stores for sale. Products provided in stores must be arranged properly to order to attract the attention of consumers to buy. Products arranged in a store will depend on the type of store. The product arrangement at a retail store will be different from the product arrangement at a clothing store. Store display will reflect a picture that is in the store so consumers know the types of products sold by product arrangement. An attractive arrangement will stimulate the desire of consumers to buy. In data mining there are several types of methods by use including prediction, association, classification and estimation. In the prediction method there are several techniques including the frequent pattern growth (FP-growth) method. FP-growth algorithm is the development of the apriori algorithm. So, the shortcomings of the apriori algorithm are corrected by the FP-growth algorithm. FP-growth is one alternative algorithm that can be used to determine the set of data that most often appears (frequent itemset) in a data set. Results of research on the application of the FP-growth algorithm to maximizing the display of goods. It is hoped that this research can be used to adjust the product layout according to the level of frequency the product is sought by the customer so that the customer has no difficulty finding the product they want.

Perceptions and determinants of healthy eating for people with HIV in the Dominican Republic who experience food insecurity.

The current study aimed to understand how moderate and severe food-insecure people living with HIV (PLHIV) in the Dominican Republic perceive a healthy diet and explore facilitators and barriers to engaging in healthy dietary behaviours as a means of HIV self-management. We conducted semi-structured interviews with PLHIV. We generated codes on food insecurity among PLHIV and used content analysis to organise codes for constant comparison between and within participants. Two urban HIV clinics in the Dominican Republic. Thirty-two PLHIV participated in the interviews. Factors that contributed to dietary behaviours include individual factors, such as knowledge of nutrition, views and attitudes on healthy dietary behaviours, beliefs about dietary needs for PLHIV and diet functionality. Interpersonal factors, including assistance from family and peers in providing food or funds, were deemed critical along with community and organisational factors, such as food assistance from HIV clinics, accessibility to a variety of food store types and the availability of diverse food options at food stores. Policy-level factors that influenced dietary behaviours were contingent on respondents' participation in the labour market (i.e. whether they were employed) and consistent access to government assistance. Food insecurity influenced these factors through unpredictability and a lack of control. PLHIV who experience food insecurity face various barriers to engaging in healthy dietary behaviours. Their diets are influenced at multiple levels of influence ranging from individual to structural, requiring multi-level interventions that can address these factors concurrently.

Mexican households' food shopping patterns in 2015: analysis following nonessential food and sugary beverage taxes.

To examine patterns of taxed and untaxed food and beverage shopping across store types after Mexico's sugary drink and non-essential food taxes, the nutritional quality of these patterns and the socio-economic characteristics associated with them. We performed k-means cluster analyses using households' percentage of food and beverage purchases from each store type (i.e. convenience stores, traditional shops (e.g. bodegas, tiendas, mom-and-pop shops), supermarkets, wholesalers and others). We calculated adjusted mean proportions of taxed and untaxed products (ml or g/capita per d) purchased in each pattern. We studied the associations between households' SES and shopping patterns using multinomial logistic regressions. Within shopping patterns, we obtained mean volumes and proportions of taxed and untaxed food and beverage subgroups and calculated the proportion of products purchased at each store type. Mexico. Urban Mexican households (n 5493) from the Nielsen Mexico Consumer Panel Survey 2015. We found four beverage shopping patterns and three food shopping patterns, driven by the store type where most purchases were made. For beverages, 48 % of households were clustered in the Traditional pattern and purchased the highest proportion of taxed beverages. Low-SES households had the highest probability of clustering in the Traditional beverage shopping pattern. For foods, 35 % of households were clustered into the Supermarket pattern. High-SES households had the highest probability of clustering in the Supermarket food shopping pattern. The combination of store types where Mexican households purchase packaged foods and beverages varies. However, households in all shopping patterns and SES purchase taxed beverages mainly at traditional stores. Store-level strategies should be developed to intervene on traditional stores to improve the healthfulness of purchases.

Blowing in the wind: Bacteria and fungi are spreading from public restroom hand dryers

This study aimed to identify and quantify fungi and bacteria in the airflow of restroom hand dryers in public areas. Airflow from restroom hand dryers in 8 retail locations was tested using three types of culture media, followed by PCR and sequence analysis to identify microbial species. Both bacterial and fungal colonies were detected in all locations. The number of colonies did not vary significantly across different locations, suggesting a similar level of microbial spread by hand dryers between different types of commercial stores. Molecular analysis revealed 24 bacterial species and 40 fungal species. Of these species, 48% (31/64) have been reported to be implicated in various infections in humans, primarily those with underlying medical conditions. This study is the first to demonstrate the spread of fungi by the airflow of restroom hand dryers, and the first to show the prevalence of different fungal and bacterial species spread by restroom hand dryers in common public areas.

Impact of a sweetened beverage tax on beverage prices in Seattle, WA

Seattle’s Sweetened Beverage Tax is an excise tax of 1.75 cents per ounce on sugar-sweetened beverages and is one of the highest beverage taxes in the U.S. This study examined the impact of Seattle’s tax on the prices of beverages. We conducted audits of 407 retail food stores and eating places (quick service restaurants and coffee shops) before and 6 months after the tax was implemented in Seattle and in a comparison area. Ordinary least squares difference-in-differences models with store fixed effects were used to estimate the effect of the tax on prices, stratified by beverage type and store type. In secondary analyses, we assessed the effect of the tax on the price of non-taxed beverages and foods. Results from the adjusted difference-in-differences models indicated the tax was associated with an average increase of 1.58 cents per ounce among Seattle retailers, representing 90 % of the price of the tax. By store type, price increases were highest in smaller grocery stores and drug stores. By beverage type, price increases were highest for energy beverages and soda and lowest for bottled coffee and juice drinks. Prices of some non-taxed beverages also increased while the prices of select healthy foods generally did not. The sweetened beverage tax in Seattle is higher than beverage taxes in most other cities, and nearly the full cost of the tax is being passed through to consumers for many beverage types and stores types.

A Mobile App to Rapidly Appraise the In-Store Food Environment: Reliability, Utility, and Construct Validity Study.

BackgroundConsumer food environments are increasingly being recognized as influential determinants of food purchasing and subsequent intake and health. We developed a tool to enable efficient, but relatively comprehensive, appraisal of the in-store food environment. The Store Scout mobile app facilitates the evaluation of product (availability and range), placement (visibility, accessibility, proximity to high-traffic areas, and location relative to other products), price (price promotion), and promotion (displays and advertising) across 7 categories of food products, with appraisal given immediately as scores (0-100, where a higher score is more in line with best practice). Primary end users are public health nutritionists and nutritionists employed by store organizations; however, store managers and staff are also potential end users.ObjectiveThis study aims to evaluate the reliability (interrater reliability and internal consistency), utility (distribution of scores), and construct validity (score by store type) of measurements using the Store Scout mobile app.MethodsThe Store Scout mobile app was used independently by 2 surveyors to evaluate the store environment in 54 stores: 34 metropolitan stores (9 small and 11 large supermarkets, 10 convenience stores, and 4 petrol stations) in Brisbane, Australia, and 20 remote stores (19 small supermarkets and 1 petrol station) in Indigenous Australian communities in Northern Australia. The agreement between surveyors in the overall and category scores was evaluated using intraclass correlation coefficients (ICCs). Interrater reliability of measurement items was assessed using percentage agreement and the Gwet agreement coefficient (AC). Internal consistency was assessed by comparing the responses of items measuring similar aspects of the store environment. We examined the distribution of score values using boxplots and differences by store type using the Kruskal-Wallis test.ResultsThe median difference in the overall score between surveyors was 4.4 (range 0.0-11.1), with an ICC of 0.954 (95% CI 0.914-0.975). Most measurement items had very good (n=74/196, 37.8%) or good (n=81/196, 41.3%) interrater reliability using the Gwet AC. A minimal inconsistency of measurement was found. Overall scores ranged from 19.2 to 81.6. There was a significant difference in score by store type (P<.001). Large Brisbane supermarkets scored highest (median 77.4, range 53.2-81.6), whereas small Brisbane supermarkets (median 63.9, range 41.0-71.3) and small remote supermarkets (median 63.8, range 56.5-74.9) scored significantly higher than Brisbane petrol stations (median 33.1, range 19.2-37.8) and convenience stores (median 39.0, range 22.4-63.8).ConclusionsThese findings suggest good reliability and internal consistency of food environment measurements using the Store Scout mobile app. We identified specific aspects that can be improved to further increase the reliability of this tool. We found a good distribution of score values and evidence that scoring could capture differences by store type in line with previous evidence, which gives an indication of construct validity. The Store Scout mobile app shows promise in its capability to measure and track the health-enabling characteristics of store environments.

O7 Fresh Fruit and Vegetable Availability and Cost in SNAP-participating Retail Stores in Mississippi: Differences by Rurality

Background Access to healthy, affordable food is an environmental factor that can influence food security. Research suggests healthy food availability varies by store type, rurality/urbanicity, Supplemental Nutrition Assistance Program (SNAP) participation, and sociodemographic characteristics. Objective The purpose of this study was to investigate differences in variety and cost of fresh fruits and vegetables in convenience stores, grocery stores, and supermarkets in Mississippi across Rural Urban Continuum Codes (RUCCs). Study Design, Setting, Participants A survey design was used to collect data in 461 convenience stores, grocery stores, and supermarkets. Trained surveyors (Extension county agents, Extension nutrition educators, and research team members) selected an assigned number of SNAP-participating stores by county to represent food availability across Mississippi. Measurable Outcome/Analysis Availability and cost data were collected using an adapted version of the Nutrition Environment Measures Survey-Corner Store (NEMS-CS). Metro areas were defined as those with RUCCs of 1 to 3, while non-metro areas were defined as those with RUCCs of 4 to 9. Independent samples t-tests and Mann-Whitney U tests were used to compare means in metro vs non-metro areas within store types. Results Variety of fresh fruits and fresh vegetables was greater in non-metro vs metro areas in convenience and grocery stores but not supermarkets. Cost of 6 most commonly available fruits and vegetables was similar within store types when comparing metro vs non-metro areas. Conclusion Elucidation of food availability patterns in retailers serving SNAP clients is important for planning outreach efforts. Smaller retailers may be important partners and could be a setting for SNAP-Education social marketing messages encouraging healthy food selection behaviors. Involving agents and educators in data collection and in building shared goals with local food retailers may be a promising strategy for improving purchase and consumption of healthy foods in Mississippi. Funding Mississippi State University Extension.

P1 Assessing Food Offerings Among Emerging Food Outlets in Northern Arkansas

<h3>Background</h3> Limited study of the availability of food in nontraditional food stores (Pharmacy and convenience stores) has left a gap in the understanding of the food environment in Arkansas. Recent corporate action among nontraditional food stores suggests that consumers are looking to these stores as sources of healthier food. <h3>Objective</h3> The question that guided this work asked, "Are there differences in food offerings among non-traditional food outlets, such as CVS and Walgreens, and how do those offerings compare to the offerings of convenience stores, in Arkansas?" Understanding differences among these food store types may be useful for subsequent efforts to improve equitable access to healthy food across Arkansas. <h3>Study Design, Setting, Participants</h3> This study used an observational design to assess offerings in non-traditional food outlets. The Nutrition Environment Measures Survey (NEMS) assessment tool was used to document and score the availability of food products in 54 stores in the northern half of Arkansas, including 27 pharmacy stores and 27 convenience stores within a 2.5 mile radius. <h3>Measurable Outcome/Analysis</h3> The NEMS tool gathered availability data across 13 measures, including: fruit, vegetables, dairy products, meat products, frozen dinners, baked goods, bread, beverages, chips and snacks, and cereal. <h3>Results</h3> Pharmacy stores had a higher mean availability score (x̅ = 19.0) than convenience stores (x̅ = 7.2). A paired sample t test indicated that the difference in mean availability score between the store types was not likely due to chance [t(26) = 16.01, <i>P</i> < .001]. <h3>Conclusions</h3> These findings suggest that pharmacy stores offer a healthier supply of foods as compared to convenience stores. Nontraditional food stores may be important intervention sites as consumers look to these stores for an increasing proportion of their food purchases. Further study may help to uncover differences in rural and urban food supply in Arkansas, and may have positive consequences for better understanding best practices for increasing access to food across the state.

Disparities in Access to Healthy Diets: How Food Security and Food Shopping Behaviors Relate to Fruit and Vegetable Intake

BackgroundFood shopping behaviors may help determine how local food environments influence fruit and vegetable (F/V) intake, especially among food insecure households. ObjectiveTo examine whether household food security, food access, and food shopping behaviors are associated with F/V intake among residents of a low-income neighborhood. DesignStudy design is cross-sectional. Participants/settingA simple random sample of 451 adults from a low-income neighborhood in Montreal (Canada) were recruited through telephone interviews in 2014. Final analyses included 417 participants. Main outcome measuresValidated assessment tools were applied to measure F/V intake and to distinguish food secure (FS) from food insecure (FI) participants. Neighborhood food access was calculated according to number of food stores within 0.5 miles of road network buffer of participants’ homes. Self-reported food shopping behaviors included trip frequency, store types, and transport used to reach the 3 most frequented stores. Participants also reported on mobility constraints, use of F/V markets, gardening, and perceived access to healthy food. Statistical analysesF/V intake was modeled using multivariable linear regression. ResultsA sample of adults, of whom 21.3% were living in FI households, reported consuming F/V an average of 4.1 times daily. FI participants had a lower intake of F/V (b = −0.69, P = .04), independent of sociodemographics, food access, resource constraints, perceived access to healthy food, and food shopping behaviors. Participants with mobility constraints had lower F/V intake (b = −0.68, P = .02), while gardening was associated with higher F/V intake (b = 0.59, P = .01). Number of supermarkets (b = −0.06, P = .03) and specialty stores (b = 0.10, P = .04) were associated with F/V intake, although the strength of the association was weak. ConclusionsFor FI households, barriers to food access linked to financial challenges are associated with lower intake of F/V. Studies on food environment should include people’s experience of food access to better understand the numerous barriers to F/V consumption faced by FI households.

Availability and affordability of healthy and less healthy food in Nova Scotia: where you shop may affect the availability and price of healthy food.

The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia. A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16. Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada. A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample. Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively). The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.

Dynamic healthy food accessibility in a rapidly urbanizing metropolitan area: Socioeconomic inequality and relative contribution of local factors

The socioeconomic status (SES) related disparities in healthy food accessibility have been heatedly debated. Theoretically, a gap remains in the literature about how healthy food accessibility changes over time and the relative contribution of local factors to the change. Methodologically, one main obstacle to this issue emerges on how to address the nested structural interactions among SESs across different levels. This paper first proposes a novel theoretical framework on healthy food accessibility from a spatiotemporally dynamic perspective. Guided by this framework, we employ the enhanced two-step floating catchment area model to examine the dynamic accessibility to four types of healthy food stores (i.e., vegetable markets, supermarkets, seafood markets, and fruit stores) from 2016 to 2018 across communities within the Hangzhou metropolitan area, China. The chain substitution method is further utilized to quantify the relative contributions of local factors, including population demand, healthy food supply, and transportation linkage. Multilevel regression is finally applied to analyze the associations between healthy food accessibility and the nested SESs across community and subdistrict levels. Results reveal that the dynamics of healthy food accessibility and the contributions of the local factors substantially vary depending on the type of healthy food stores and over time. Social inequality in accessibility to supermarkets and fruit stores is much greater than that to vegetable markets. The impact of the SES at the subdistrict level is greater than that at the community level. This study demonstrates a new methodological procedure and can offer new insights into healthy food accessibility in rapidly urbanizing metropolitan areas.

Frequency of Food Shopping and Fruit and Vegetable Consumption: A Systematic Review

Abstract Objectives To examine the relationship between frequency of food shopping and fruit and vegetable (FV) intake in adults. Methods A systematic review, guided by the Cochrane handbook, was conducted across four online databases: PudMed, CINAHL, Web of Science and the Cochrane Library. Studies were included if published in a peer reviewed journal through March 2019, included adults (³ 18 years of age), and were conducted in the United States. Any study using a cross-sectional, longitudinal cohort, or randomized study design that examined the relationship between the exposure variable of frequency of food shopping (defined as purchasing foods at a grocery store, farmer's market, corner store, convenience store, specialty store, mobile produce van) and outcome variable, FV intake was selected. Study quality was reviewed using the Quality Control Checklist. Due to heterogeneity across study designs and variable measurement, the systematic review findings were qualitatively summarized. Results A total of 1021 records were reviewed after 488 duplicates were removed and 69 were selected for full review. Twenty met inclusion criteria and were included in the systematic review. The majority of studies (75%) found evidence of a positive association between the frequency of food shopping and FV intake, such that as frequency increased so did FV intake. The majority of studies received a neutral rating for study quality as most studies (85%) had a cross-sectional or longitudinal design and lacked a consistent definition of frequency of food shopping. FV intake was assessed using self-report measures with only one study using 24-hour recalls. Conclusions There is evidence to show a positive relationship between frequency of food shopping and increased FV intake. More frequent shopping may be an important strategy to incorporate as part of nutrition education, especially within food assistance programs as it may promote FV intake. Given food shopping frequency was broadly defined across food store types that were variable, future research should consider examining if store type influences FV intake. Funding Sources None.