Integrating Tobacco Control and Obesity Prevention Initiatives at Retail Outlets

Tobacco products are sold in approximately 375,000 US retail outlets, including convenience stores and pharmacies, which often sell energy-dense, low-nutrient foods and beverages. The Food and Drug Administration's (FDA's) increased authority over tobacco product sales and marketing, combined with declining smoking rates, provides an opportunity to transition tobacco retailers toward healthier retail environments. Unfortunately, research into improving consumer retail environments is often conducted in isolation by researchers working in tobacco control, nutrition, and physical activity. Interdisciplinary efforts are needed to transform tobacco retailers from stores that are dependent on a declining product category, to the sale and promotion of healthful foods and creating environments conducive to active living. The objective of this article is to describe the potential for interdisciplinary efforts to transition retailers away from selling and promoting tobacco products and toward creating retail environments that promote healthful eating and active living

Validity of Secondary Retail Food Outlet Data: A Systematic Review

Improving access to healthy foods is a promising strategy to prevent nutrition-related chronic diseases. To characterize retail food environments and identify areas with limited retail access, researchers, government programs, and community advocates have primarily used secondary retail food outlet data sources (e.g., InfoUSA or government food registries). To advance the state of the science on measuring retail food environments, this systematic review examined the evidence for validity reported for secondary retail food outlet data sources for characterizing retail food environments

Evidence for validity of five secondary data sources for enumerating retail food outlets in seven American Indian Communities in North Carolina

Abstract Background Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data. Methods Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data. Results 699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0.49). Evidence for validity was comparatively lower for Dun & Bradstreet, online Yellow Pages, and the NC Department of Agriculture. Conclusions Secondary data sources both over- and under-represented the food environment; they were particularly problematic for identifying convenience stores and specialty markets. More attention is needed to improve the validity of existing data sources, especially for rural local food environments

Evidence for validity of five secondary data sources for enumerating retail food outlets in seven American Indian Communities in North Carolina

Abstract Background Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data. Methods Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data. Results 699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0.49). Evidence for validity was comparatively lower for Dun & Bradstreet, online Yellow Pages, and the NC Department of Agriculture. Conclusions Secondary data sources both over- and under-represented the food environment; they were particularly problematic for identifying convenience stores and specialty markets. More attention is needed to improve the validity of existing data sources, especially for rural local food environments

Disaggregate Land Uses and Walking

Background: Although researchers have explored associations between mixed-use development and physical activity, few have examined the influence of specific land uses. Purpose: This study analyzes how the accessibility, intensity, and diversity of nonresidential land uses are related to walking for transportation. Methods: Multinomial logistic regression was used to investigate associations between walking for transportation and neighborhood land uses in a choice-based sample of individuals (n=260) in Montgomery County MD. Land uses examined included banks, bus stops, fast-food restaurants, grocery stores, libraries, rail stations, offices, parks, recreation centers, nonfast-food restaurants, retail, schools, sports facilities, night uses, physical activity uses, and social uses. Exposure to these uses was measured as the street distance from participants' homes to the closest instance of each land use (accessibility); the number of instances of each land use (intensity); and the number of different land uses (diversity). Data were collected from 2004-2006 and analyzed in 2009-2010. Results: After adjusting for individual-level characteristics, the distances to banks, bus stops, fast-food restaurants, grocery stores, rail stations, physical activity uses, recreational facilities, restaurants, social uses and sports facilities were associated negatively with transportation walking (ORs [95% CI] range from 0.01 [0.001, 0.11] to 0.91 [0.85, 0.97]). The intensities of bus stops, grocery stores, offices, and retail stores in participants' neighborhoods were associated positively with transportation walking (ORs [95% CI] range from 1.05 [1.01, 1.08] to 5.42 [1.73, 17.01]). Land-use diversity also was associated positively with walking for transportation (ORs [95% CI] range from 1.39 [1.20, 1.59] to 1.69 [1.30, 2.20]). Conclusions: The accessibility and intensity of certain nonresidential land uses, along with land-use diversity, are positively associated with walking for transportation. A careful mix of land uses in a neighborhood can encourage physical activity.close18232