Merchant Attitudes Toward a Healthy Food Retailer Incentive Program in a Low-Income San Francisco Neighborhood

In low-income urban communities across the United States and globally, small stores frequently offer processed foods, sodas, alcohol, and tobacco but little access to healthy products. To help address this problem, the city of San Francisco created a healthy food retailer incentive program. Its success depends, in part, on retailers’ willingness to participate. Through in-person interviews, we explored attitudes toward the program among store owners or managers of 17 nonparticipating stores. Eleven merchants were uninterested in the program due to negative past experiences trying to sell healthier products, perceived lack of customer demand, and fears that meeting program requirements could hurt profits. Six merchants expressed interest, seeing demand for or opportunity in healthy foods, foreseeing few difficulties in meeting program requirements, and regarding the assistance offered as appealing. Other municipalities considering such interventions should consider merchants’ perspectives, and how best to challenge or capitalize on retailers’ previous experiences with selling healthy foods.

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Change in Food and Beverage Availability and Marketing Following the Introduction of a Healthy Food Financing Initiative–Supported Supermarket

American Journal of Health Promotion ◽

10.1177/0890117118801744 ◽

2018 ◽

Vol 33 (4) ◽

pp. 525-533 ◽

Cited By ~ 2

Author(s):

Chelsea R. Singleton ◽

Yu Li ◽

Angela Odoms-Young ◽

Shannon N. Zenk ◽

Lisa M. Powell

Keyword(s):

Low Income ◽

Regression Models ◽

The United States ◽

Healthy Food ◽

Healthy Foods ◽

Food Stores ◽

Intervention Community ◽

Wide Range ◽

Food And Beverage ◽

Matched Comparison

Purpose: The Healthy Food Financing Initiative (HFFI) aims to expand access to healthy foods in low-resourced communities across the United States. This study examined changes in food and beverage availability and marketing in nearby small food stores after the opening of an HFFI-supported supermarket in a predominately low-income and African American community. Design: Natural experiment. Setting: Rockford, Illinois. Participants: A full audit was conducted of the small grocery and limited service stores located in a 1-mile radius around the new supermarket (N = 22) and a 1-square mile area within a nearby demographically matched comparison community (N = 18). Stores were audited in 2015 (1 month preopening) and 2016 (1 year afterward). Measures: Store characteristics, item availability, and interior and exterior promotions/advertisements were examined. Analysis: Difference-in-difference (DID) regression models assessed pre- and postintervention changes in availability and marketing between small food stores in the intervention and comparison communities. Results: The DID regression models indicated no difference between intervention and comparison communities with respect to changes in availability and marketing of all food items with the exception of frozen vegetables which had higher availability postintervention in the comparison community versus intervention (β for interaction term = .67; standard error: 0.33; P = .04). Conclusion: After the opening of the HFFI-supported supermarket, food and beverage availability and marketing in nearby small food stores did not change significantly. However, the wide range of staple foods offered by the supermarket contributed to the expansion of healthy food retail in the intervention community.

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Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City

Nutrients ◽

10.3390/nu13093055 ◽

2021 ◽

Vol 13 (9) ◽

pp. 3055

Author(s):

Siyao Zhu ◽

Cassandra Mitsinikos ◽

Lisa Poirier ◽

Takeru Igusa ◽

Joel Gittelsohn

Keyword(s):

System Dynamics ◽

Low Income ◽

The United States ◽

Staple Food ◽

Healthy Foods ◽

Web Based ◽

Obesity Epidemic ◽

Policy Interventions ◽

Decision Variables ◽

City Policy

Policy interventions to improve food access and address the obesity epidemic among disadvantaged populations are becoming more common throughout the United States. In Baltimore MD, corner stores are a frequently used source of food for low-income populations, but these stores often do not provide a range of affordable healthy foods. This research study aimed to assist city policy makers as they considered implementing a Staple Food Ordinance (SFO) that would require small stores to provide a range and depth of stock of healthy foods. A System Dynamics (SD) model was built to simulate the complex Baltimore food environment and produce optimal values for key decision variables in SFO planning. A web-based application was created for users to access this model to optimize future SFOs, and to test out different options. Four versions of potential SFOs were simulated using this application and the advantages and drawbacks of each SFO are discussed based on the simulation results. These simulations show that a well-designed SFO has the potential to reduce staple food costs, increase corner store profits, reduce food waste, and expand the market for heathy staple foods.

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Feasibility of Utilizing Social Media to Promote HPV Self-Collected Sampling among Medically Underserved Women in a Rural Southern City in the United States (U.S.)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010820 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10820

Author(s):

Matthew Asare ◽

Beth A. Lanning ◽

Sher Isada ◽

Tiffany Rose ◽

Hadii M. Mamudu

Keyword(s):

Social Support ◽

Social Media ◽

Low Income ◽

Pap Smear ◽

Multinomial Logistic Regression ◽

The United States ◽

Medically Underserved ◽

Willingness To Participate ◽

Underserved Women ◽

Support Cost

Background: Social media (Facebook, WhatsApp, Instagram, Twitter) as communication channels have great potential to deliver Human papillomavirus self-test (HPVST) intervention to medically underserved women (MUW) such as women of low income. However, little is known about MUW’s willingness to participate in HPVST intervention delivered through social media. We evaluated factors that contribute to MUW’s intention to participate in the social media-related intervention for HPVST. Methods: A 21-item survey was administered among women receiving food from a local food pantry in a U.S. southern state. Independent variables were social media usage facilitators (including confidentiality, social support, cost, and convenience), and barriers (including misinformation, time-consuming, inefficient, and privacy concerns). Dependent variables included the likelihood of participating in social-driven intervention for HPVST. Both variables were measured on a 5-point scale. We used multinomial logistic regression to analyze the data. Results: A total of 254 women (mean age 48.9 ± 10.7 years) comprising Whites (40%), Hispanics (29%), Blacks (27%), and Other (4%) participated in the study. We found that over 44% of the women were overdue for their pap smears for the past three years, 12% had never had a pap smear, and 34% were not sure if they had had a pap smear. Over 82% reported frequent social media (e.g., Facebook) usage, and 52% reported willingness to participate in social media-driven intervention for HPVST. Women who reported that social media provide privacy (Adjusted Odds Ratio (AOR) = 6.23, 95% CI: 3.56, 10.92), provide social support (AOR = 7.18, 95% CI: 4.03, 12.80), are less costly (AOR = 6.71, 95% CI: 3.80, 11.85), and are convenient (AOR = 6.17, 95% CI: 3.49, 10.92) had significantly increased odds of participating in social media intervention for HPVST. Conclusions: The findings underscore that the majority of the MUW are overdue for cervical cancer screening, regularly use social media, and are willing to participate in social media-driven intervention. Social media could be used to promote HPV self-testing among MUW.

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A modified choice experiment to examine willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents

Renewable Agriculture and Food Systems ◽

10.1017/s1742170518000364 ◽

2018 ◽

Vol 35 (2) ◽

pp. 140-157 ◽

Cited By ~ 5

Author(s):

Jared T. McGuirt ◽

Stephanie B. Jilcott Pitts ◽

Karla L. Hanson ◽

Molly DeMarco ◽

Rebecca A. Seguin ◽

...

Keyword(s):

New York ◽

Low Income ◽

Rural Areas ◽

Choice Experiment ◽

Limited Resource ◽

Community Supported Agriculture ◽

Willingness To Participate ◽

Healthy Foods ◽

Food Quantity ◽

Access To Healthy Foods

AbstractThere is a need to improve geographical and financial access to healthy foods for limited resource populations in rural areas. Community Supported Agriculture (CSA) programs can improve access to healthy foods in rural and limited-resource populations. However, research is needed to discern the most appealing conditions for a CSA (e.g. price, frequency, food quantity) among rural, low-income customers. The goal of this study was to understand low-income consumers' preferences related to participation in a CSA program, considering price, frequency, food quantity and accessibility (e.g. distance) conditions. A modified exploratory choice experiment exercise was embedded within in-depth interviews to examine willingness to participate in CSA under a variety of conditions among 42 low-income adults with at least one child in the household in North Carolina, New York, Vermont and Washington. Willingness to participate in a CSA under each condition was summed and compared across conditions. Results were stratified by race, number of children and household members and McNemar's test and Student's t-test were used to examine differences in willingness between conditions. Salient quotes were extracted to support themes related to each condition. Our analysis suggests that the ideal CSA would be a full-sized share of eight to nine items of mixed variety, distributed every other week, priced at less than US$15, no more than 10 min further than the supermarket (SM) from their home and preferably less expensive but no more than 20% more expensive than SM prices. CSAs interested in reaching rural low-income populations may benefit from considering these consumer-level preferences.

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Association of Home Food Availability with Prediabetes and Diabetes among Adults in the United States

Nutrients ◽

10.3390/nu12051209 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1209

Author(s):

Jennifer R. McAtee ◽

Meng-Hua Tao ◽

Christian King ◽

Weiwen Chai

Keyword(s):

Food Availability ◽

The United States ◽

Healthy Food ◽

Inverse Association ◽

Healthy Foods ◽

Low Fat ◽

Health And Nutrition ◽

Healthy Food Availability ◽

Home Food ◽

Home Food Availability

This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20–70 years) participating in 2007–2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73–0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65–0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.

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Healthy Food Environments in Food Pantries: Lessons Learned from a Sodium Reduction Intervention

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413206 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13206

Author(s):

Emilee L. Quinn ◽

Kate Ortiz ◽

Laura Titzer ◽

Barb Houston-Shimizu ◽

Jessica Jones-Smith

Keyword(s):

Low Income ◽

Environmental Changes ◽

The United States ◽

Sodium Content ◽

Lessons Learned ◽

Food Sources ◽

Healthy Foods ◽

Customer Choice ◽

Food Pantries ◽

United States Food

In the United States, food pantries increasingly serve as regular food sources for low income households experiencing high rates of chronic disease, including hypertension. Sodium consumption is a modifiable risk factor for hypertension, so pantry customers would benefit from access to low-sodium foods. Pantry customers often experience difficulty acquiring healthy foods, however; little is known about pantry foods’ sodium content specifically. This study assesses the sodium content of pantry foods and lessons learned from an adaptable intervention to support pantries in adopting policies and environmental changes to make healthy, lower-sodium foods appealing and accessible. We conducted sodium assessments of food at 13 food pantries, tracked implementation of intervention strategies, and interviewed 10 pantry directors. More than half of food items in 11 categories met sodium standards for foods to be chosen “often”. Pantry directors reported valuing the intervention approach and implemented six of nine behavioral economics strategies, especially those targeting the visibility and convenience of foods, along with layout changes and expanded customer choice. One pantry adopted an agency-specific nutrition policy and 12 adopted a coalition-level policy. Results can inform intervention efforts to make available healthy options appealing and easy to select while also improving the customer experience in food pantries.

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Corner Store Inventories, Purchases, and Strategies for Intervention

Californian Journal of Health Promotion ◽

10.32398/cjhp.v11i3.1537 ◽

2013 ◽

Vol 11 (3) ◽

pp. 01-13 ◽

Cited By ~ 38

Author(s):

Brent A Langellier ◽

Jeremiah R. Garza ◽

Michael L. Prelip ◽

Deborah Glik ◽

Ron Brookmeyer ◽

...

Keyword(s):

Nutrition Education ◽

Healthy Eating ◽

Low Income ◽

The United States ◽

Intervention Strategies ◽

Marshall Islands ◽

Healthy Foods ◽

Food Stores ◽

Corner Store ◽

Food Retail Environment

Introduction: An increasingly popular strategy to improve the food retail environment and promote healthy eating in low-income and minority communities is the corner store conversion. This approach involves partnering with small ‘corner’ food stores to expand access to high-quality fruits, vegetables, and other healthy foods. Methods: We conducted a structured review of the literature to assess inventories and sales in corner stores, as well as to identify intervention strategies employed by corner store conversions. Results: Our review returned eight descriptive studies that discussed corner store inventories and sales, as well as ten intervention studies discussing six unique corner store conversion interventions in the United States, the Marshall Islands, and Canada. Common intervention strategies included: 1) partnering with an existing store, 2) stocking healthy foods, and 3) social marketing and nutrition education. We summarize each strategy and review the effectiveness of overall corner store conversions at changing peoples’ food purchasing, preparation, and consumption behaviors. Conclusions: Consumption of fresh, healthy, affordable foods could be improved by supporting existing retailers to expand their selection of healthy foods and promoting healthy eating at the neighborhood level. Additional corner store conversions should be conducted to determine the effectiveness and importance of specific intervention strategies.

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Using Ethnography to Explore HIV Risk Among Transgender Sex Workers in Washington, DC

Practicing Anthropology ◽

10.17730/praa.27.2.m02551529362765w ◽

2005 ◽

Vol 27 (2) ◽

pp. 18-22

Author(s):

Amy Hardt

Keyword(s):

Hiv Infection ◽

Ethnic Minority ◽

San Francisco ◽

Sex Work ◽

Low Income ◽

Sex Workers ◽

Health Workers ◽

The United States ◽

Washington Dc ◽

Income Status

In the United States, HIV/AIDS is a health issue that we tend to associate with developing countries in Africa, Asia and Eastern Europe. The quiet truth is that American HIV infections have remained steady over the past decade, with sex, gender, and race/ethnic minority populations disproportionately affected by AIDS in the 21st century. A subgroup that appears to have one of the highest rates of HIV infection is characterized by a confluence of sex/gender/race/ethnic minority attributes, as well as low-income status. This subgroup comprises male-to-female transgender individuals (MTFs) who engage in street-based commercial sex work (prostitution) in urban centers such as Washington, DC. MTF as a gender and sex work as an employment are not standard categories on the US census, so we do not have the kind of nationwide population data that would be necessary to generate a representative epidemiological profile for this sub-group. However, CDC surveillance does tell us that men of color who sleep with men (MSM) have a growing rate of HIV infection around the country, and the MSM category is understood to include most MTFs who reveal their status to health workers. Also, studies in several cities suggest that HIV among MTF transgenders, and MTF sex workers in particular, may be at epidemic levels. In a 1999-2000 study of 188 MTF transgenders living in the Washington, DC area, thirty-two percent (32%) reported their positive HIV status (Xavier 2000). In a similar study in San Francisco, thirty-five percent (35%) of 392 MTF transgenders actually tested seropositive (Clements-Nolle et al. 2001). Studies with MTF sex workers, such as one with 55 participants conducted in Atlanta, have found over fifty percent (50%) of samples infected with HIV (Boles and Elifson 1994).

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CATTLE PRODUCERS’ WILLINGNESS TO ADOPT OR EXPAND PRESCRIBED GRAZING IN THE UNITED STATES

Journal of Agricultural and Applied Economics ◽

10.1017/aae.2015.6 ◽

2015 ◽

Vol 47 (2) ◽

pp. 213-242 ◽

Cited By ~ 7

Author(s):

KIMBERLY L. JENSEN ◽

DAYTON M. LAMBERT ◽

CHRISTOPHER D. CLARK ◽

CAROLINE HOLT ◽

BURTON C. ENGLISH ◽

...

Keyword(s):

United States ◽

Management Practices ◽

The United States ◽

Farm Management ◽

Hurdle Model ◽

Willingness To Participate ◽

Incentive Program ◽

Willingness To Adopt ◽

Prescribed Grazing ◽

Cattle Farmer

AbstractA triple hurdle model estimates cattle farmer willingness to adopt or expand prescribed grazing on pasture in the United States in response to a hypothetical incentive program. Interest in adoption/expansion is estimated first, then willingness to participate in the program, followed by intensity of participation measured as additional acres enrolled. The supply elasticity of enrolled acres with respect to the incentive is 0.13. Nonpecuniary factors inter alia farmer sentiment about stewardship, current farm management practices, farm location, and education are associated with farmer willingness to participate and with participation intensity.

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Healthy food access for urban food desert residents: examination of the food environment, food purchasing practices, diet and BMI

Public Health Nutrition ◽

10.1017/s1368980014002742 ◽

2014 ◽

Vol 18 (12) ◽

pp. 2220-2230 ◽

Cited By ~ 66

Author(s):

Tamara Dubowitz ◽

Shannon N Zenk ◽

Bonnie Ghosh-Dastidar ◽

Deborah A Cohen ◽

Robin Beckman ◽

...

Keyword(s):

Low Income ◽

Food Access ◽

Physical Distance ◽

Healthy Food ◽

Food Desert ◽

Dietary Quality ◽

Healthy Foods ◽

Food Stores ◽

Food Purchasing ◽

Food Shopping

AbstractObjectiveTo provide a richer understanding of food access and purchasing practices among US urban food desert residents and their association with diet and BMI.DesignData on food purchasing practices, dietary intake, height and weight from the primary food shopper in randomly selected households (n 1372) were collected. Audits of all neighbourhood food stores (n 24) and the most-frequented stores outside the neighbourhood (n 16) were conducted. Aspects of food access and purchasing practices and relationships among them were examined and tests of their associations with dietary quality and BMI were conducted.SettingTwo low-income, predominantly African-American neighbourhoods with limited access to healthy food in Pittsburgh, PA, USA.SubjectsHousehold food shoppers.ResultsOnly one neighbourhood outlet sold fresh produce; nearly all respondents did major food shopping outside the neighbourhood. Although the nearest full-service supermarket was an average of 2·6 km from their home, respondents shopped an average of 6·0 km from home. The average trip was by car, took approximately 2 h for the round trip, and occurred two to four times per month. Respondents spent approximately $US 37 per person per week on food. Those who made longer trips had access to cars, shopped less often and spent less money per person. Those who travelled further when they shopped had higher BMI, but most residents already shopped where healthy foods were available, and physical distance from full-service supermarkets was unrelated to weight or dietary quality.ConclusionsImproved access to healthy foods is the target of current policies meant to improve health. However, distance to the closest supermarket might not be as important as previously thought, and thus policy and interventions that focus merely on improving access may not be effective.

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