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

Between- and within-Group Differences in Fruit and Vegetable Purchases, Consumption, and BMI among Hispanic Farmers’ Market Shoppers Who Use SNAP

(1) Background: Despite considerable efforts to increase farmers’ market access (FM) and improve household fruit and vegetable (FV) purchasing in low-income communities, little is known about the FV purchasing and consumption characteristics of low-income Hispanic farmers’ market shoppers. (2) Methods: A secondary analysis of baseline data from a farmers’ market study conducted between 2015 and 2017 (n = 2825) was performed. Participants who also received supplemental nutrition assistance program (SNAP) completed a 31-item online survey assessing demographics, health characteristics, and FV purchasing and consumption habits. Descriptive statistics and bivariate analyses were used to assess between- and within-group differences amongst Hispanic and non-Hispanic households. Regression analyses were used to examine associations among BMI, FV purchasing and consumption, and household size for Hispanic and non-Hispanic households as well as for Hispanic subgroups. (3) Results: The sample included 515 Hispanic and 2310 non-Hispanic SNAP-using FM shoppers in 13 states. Despite experiencing significantly higher food insecurity (89% vs. 81%, non-Hispanic), Hispanic shoppers consumed similar amounts of FV (3.04 cups/day) and spent less doing so. Significant subgroup differences were identified for FV purchasing. (4) Conclusions: Findings emphasize the importance of food insecurity and household size in FV interventions and underscore the capacity of Hispanic families to maintain FV consumption

Stigmatizing imagery for substance use disorders: a qualitative exploration

Abstract Background Stigma is a significant barrier to the treatment of individuals with substance use disorders. While prior efforts have been made to change stigmatizing language to refer to individuals with substance use disorders (SUD), little is known about the effects of stigmatizing imagery. There is a need for complementary qualitative research to identify both stigmatizing and non-stigmatizing imagery in the field of SUD. Methods This study used qualitative methods to identify stigmatizing and non-stigmatizing imagery for SUD and explore the reactions of people with lived experience with SUD to SUD-related imagery. We conducted focus groups and brief semi-structured qualitative interviews with 14 individuals in recovery from a range of SUD. Results Participants identified images of substance use and criminal justice contact that are negative or stigmatizing, along with alternative images that were endorsed for use. The unanticipated concept of imagery-induced triggering and cue reactivity emerged in the interviews, along with an emphasis on diversity in race/ethnicity, gender, and age for representations of both patients and clinicians in all imagery. Conclusions The findings can be helpful in informing imagery that can depict addiction, individuals with SUD, and individuals involved in the justice system for various fields from research to media, public health, and community-based programming. Based on qualitative feedback from patients on triggering effects and reactivity to visual cues, it is never appropriate to use drug use and drug paraphernalia imagery to depict substance use or misuse or pictures of people in cages