Evaluation of a Supermarket Environmental Change Intervention: Findings from a Low-Fat Milk Couponing and Educational Marketing Pilot

The purpose of this study was to evaluate a multifaceted, collaborative approach to supermarket environmental change that included in-store couponing and educational marketing to increase low-fat milk purchasing across a 48-store supermarket chain serving predominately Hispanic customers. Point-of-sale (POS) and process data collected during the 16-week program implementation included in-store radio advertising, in-store signage, and POS coupons. POS data were analyzed by the coupon marketing partner, and a chi-square test was conducted to test for significant differences between groups. POS data indicated that 44,050 low-fat milk coupons were issued to traditional full-fat milk purchasing customers with a redemption rate of 5.3%. Of these, 42% became repeat low-fat milk purchasers (i.e., after initial purchase with coupon, customer re-purchased low-fat milk). Results from the chi-square test revealed significant differences in rates of purchase between those who received a coupon (5.87%) and those who did not (4.00%), (χ2 = 8.61, p = .0033). Findings indicate that collaborative public health efforts between retail and marketing partners to engage supermarket customers in a multifaceted yet targeted intervention are feasible and can shift purchasing behaviors towards a healthy alternative. This study has implications for informing future environmental change supermarket strategies

Understanding Impacts of SNAP Fruit and Vegetable Incentive Program at Farmers’ Markets: Findings from a 13 State RCT

Disparities in healthy food access and consumption are a major public health concern. This study reports the findings from a two-year randomized control trial conducted at 77 farmers’ markets (FMs) in 13 states and the District of Columbia that sought to understand the impact of fruit and vegetable (FV) incentive vouchers, randomly issued at varied incentive levels to Supplemental Nutrition Assistance Program (SNAP) recipients, for use at FMs. Measures included FV and overall household food purchasing; FV consumption; food insecurity; health status; market expenditure; and demographics. A repeated-measures mixed-effects analysis and the Complier Average Causal Effect (CACE) were used to examine outcomes. Despite 82% reporting food insecurity in the prior year, the findings showed that financial incentives at FMs had statistically significant, positive effects on FV consumption; market expenditures increased with added incentives. SNAP recipients receiving an incentive of USD 0.40 for every USD 1.00 in SNAP spent an average of USD 19.03 per transaction, while those receiving USD 2 for every USD 1 (2:1) spent an average of USD 36.28 per transaction. The data showed that the incentive program at the highest level (2:1) maximally increased SNAP FM expenditure and FV consumption, increasing the latter by 0.31 daily cups among those who used their incentive (CACE model)

School technology use and achievement on statewide assessment: Is there a relationship?

As our nation becomes engulfed in the “standards and assessment” movement, school-based technology integration is at a critical juncture. After investing billions of dollars for the incorporation of technology into the classroom, many are interested in understanding the impact of this investment. For some investors, particularly proponents of data-driven decision making, a key indicator for the value of technology integration is student performance on statewide assessments. The present study investigates the relationship between technology and standardized achievement at the school level. First, the latent structure of the components of a statewide technology survey is examined using factor analysis. Resultant factors are then used to investigate technology\u27s relationship with student performance on the Maryland State Performance Assessment, controlling for known predictors including class size, school type, and the percentage of students receiving free or reduced-price meals. Dependent variable measures include 3rd, 5th and 8th grade student achievement in mathematics, science, social studies, reading and writing. Findings from the factor analysis reveal two latent constructs inherent in the school-based technology survey items: student technology use and teacher technology use. Results from the multiple regression analysis using the student and teacher technology use variables in conjunction with the control variables (percentage of students receiving free or reduced meals, pupil teacher ratio, and school location) show that both student technology use in school and teacher technology use in school are positive predictors of achievement for all subject areas and grade levels studied. However, not all of these positive relationships are statistically significant. Variation in the relative importance of student technology or teacher technology use is found across grade level and subject areas

Pandemic-Era WIC Participation in Wilmington, Delaware: Participants’ Experiences and Challenges

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic including financial concerns, a national infant formula shortage, and rising food costs. To mitigate these challenges, the United States Department of Agriculture implemented WIC program waivers and flexibilities aiming to simplify program operations (e.g., remote appointments and food package substitutions). However, little is known about WIC participants’ perceptions of these changes and their impact on in-store benefit redemption. As such, this study aimed to characterize how pandemic-related events impacted Delaware WIC participants’ shopping experiences and program perceptions. The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign, and open-ended questions regarding WIC program participation experiences during the pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that WIC participants benefitted from the pandemic program’s flexibilities. However, they continued to experience burdensome shopping trips as well as concerns about their ability to feed their families due to infant formula shortages and inflation. These findings indicate the importance of extending existing WIC flexibilities and providing continued support for both participants and WIC-authorized retailors

WIC Participants’ Perceptions of the Cash-Value Benefit Increase during the COVID-19 Pandemic

Recent changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash-Value Benefit (CVB), which provides participants with money to spend on fruits and vegetables, have the potential to reduce disparities in healthy food access and food insecurity that were exacerbated by the COVID-19 pandemic. However, few studies have examined how the changes to the CVB allotment that occurred during the pandemic influenced WIC participants’ perceptions of the benefit or their fruit and vegetable purchasing and consumption. To address this gap, we conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign food insecurity screener, and open-ended questions regarding perceptions of the CVB increase and its influence on participants’ fruit and vegetable purchasing and consumption. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that higher CVB allotments increased WIC participants’ purchasing and consumption of fruits and vegetables, increased the frequency of their shopping occasions, and enhanced their dietary variety. Our findings also suggest that WIC participants highly value the increased CVB. Consequently, maintaining the increased CVB allotment could improve the nutritional outcomes of low-income mothers, infants, and children participating in WIC

Reestablishing Healthy Food Retail: Changing the Landscape of Food Deserts

Abstract available at publisher's website.http://dx.doi.org/10.1089/chi.2011.011

Rethinking Research: Creating a Practice-Based Agenda for Sustainable Small-Scale Healthy Food Retail

An emerging body of research examines the health and economic impacts of healthy corner store interventions, although implementing valid mechanisms to capture changes in diet remains a challenge. Healthy corner store interventions employ strategies to help corner stores procure, maintain and market healthier foods such as fruits and vegetables, whole grains and low-fat dairy items like skim milk. A recent national convening of partners yielded a series of research and evaluation questions that need answers in order for the field to progress. Participants in the Healthy Corner Stores Symposium identified several challenges to developing a sustainable business model for small-scale healthy food retail. This group of practitioners, funders, lenders, academics, and other leaders ranked what they saw as the most promising opportunities for maximizing the positive impact these businesses have on the community. Unique to this forum, the agenda was born from a program-operation perspective and not from the more common approach where an independent researcher evaluates the efficacy of a program or intervention. As efforts to improve food systems emerge, such an approach to research is critical. The central challenges and a prioritized list of research questions are discussed.

Improving Consumption and Purchases of Healthier Foods in Retail Environments: A Systematic Review

This review examines current research on manipulations of U.S. food retail environments to promote healthier food purchasing and consumption. Studies reviewed use marketing strategies defined as the 4Ps (product, price, placement, promotion) to examine results based on single- and multi-component interventions by study design, outcome, and which of the “Ps” was targeted. Nine electronic databases were searched for publications from 2010 to 2019, followed by forward and backward searches. Studies were included if the intervention was initiated by a researcher or retailer, conducted in-store, and manipulated the retail environment. Of the unique 596 studies initially identified, 64 studies met inclusion criteria. Findings show that 56 studies had at least one positive effect related to healthier food consumption or purchasing. Thirty studies used single-component interventions, while 34 were multi-component. Promotion was the most commonly utilized marketing strategy, while manipulating promotion, placement, and product was the most common for multi-component interventions. Only 14 of the 64 studies were experimental and included objective outcome data. Future research should emphasize rigorous designs and objective outcomes. Research is also needed to understand individual and additive effects of multi-component interventions on sales outcomes, substitution effects of healthy food purchases, and sustainability of impacts

Correlates of Healthy Eating in Urban Food Desert Communities

The food environment is well documented as an important emphasis for public health intervention. While theoretical models of the relationship between the food environment and dietary outcomes have been proposed, empirical testing of conceptual models has been limited. The purpose of this study was to explore which factors in nutrition environments are significantly associated with dietary outcomes in two urban, low-income, and minority food desert communities. This study analyzed cross-sectional data based on 796 participants from the Food in Our Neighborhood Study. Participants were recruited based on a random sample of addresses in neighborhood study areas, Philadelphia, PA (n = 393) and Trenton, NJ (n = 403). Main dietary outcomes were Healthy Eating Index (HEI) scores and fruit and vegetable consumption subscores computed from ASA24® assessments. Exploratory factor analysis was conducted and yielded a model of four factors with 22 items. Among four factors that emerged, three factors (Perceptions of Neighborhood Food Availability; and Household Food Challenges) were significantly correlated with dietary outcomes. My Store’s Quality and Perceptions of Neighborhood Food Availability were positively correlated with vegetable consumption subscore. The Household Food Challenges factor was negatively correlated with both vegetable subscore and overall HEI score (i.e., more household challenges were associated with lower dietary scores). These findings confirmed the importance of perceived nutrition environments and household food challenges in predicting dietary outcomes among residents of two urban, low-income, and minority food desert communities