A Point-of-Purchase Intervention Featuring In-Person Supermarket Education Affects Healthful Food Purchases

Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Journal of nutrition education and behavior (Impact Factor: 1.36). 11/2011; 44(3):225-32. DOI: 10.1016/j.jneb.2011.05.016
Source: PubMed


This study tested the efficacy of a multicomponent supermarket point-of-purchase intervention featuring in-person nutrition education on the nutrient composition of food purchases.
The design was a randomized trial comparing the intervention with usual care (no treatment).
A supermarket in a socioeconomically diverse region of Phoenix, AZ. One hundred fifty-three adult shoppers were recruited onsite.
The intervention consisted of brief shopping education by a nutrition educator and an explanation and promotion of a supermarket point-of-purchase healthful shopping program that included posted shelf signs identifying healthful foods, sample shopping lists, tips, and signage.
Outcomes included purchases of total, saturated, and trans fat (grams/1,000 kcal), and fruits, vegetables, and dark-green/yellow vegetables (servings/1,000 kcal) derived through nutritional analysis of participant shopping baskets.
Analysis of covariance compared the intervention and control groups on food purchasing patterns while adjusting for household income.
The intervention resulted in greater purchasing of fruit and dark-green/yellow vegetables. No other group differences were observed.
Long-term evaluations of supermarket interventions should be conducted to improve the evidence base and to determine the potential for influence on food choices associated with decreased chronic disease incidence.

Download full-text


Available from: Brandy-Joe Milliron
  • Source
    • "Thirteen studies were undertaken in the USA, one in New Zealand and one in Canada (Additional file 5: Table S5). The studies included from one [15, 21, 45, 46] to 372 [28] supermarkets/stores and from 61 [46] to 2399 participants [40]. Most participants in all studies were female (Additional file 5: Table S5). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Point-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting. Records from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome. The search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions. A range of intervention types have been used at point-of-sale to encourage healthy purchasing and/or intake of healthier food options and to improve health outcomes. There is a need for more well designed studies on the effectiveness of a range of point-of-sale interventions to encourage healthier eating and improve health outcomes, and of the mediating factors that might impact these interventions.
    Full-text · Article · Sep 2014 · BMC Public Health
  • [Show abstract] [Hide abstract]
    ABSTRACT: The relative affordability of energy-dense versus nutrient-rich foods may promote socioeconomic disparities in dietary quality and obesity. Although supermarkets are the largest food source in the American diet, the associations between SES and the cost and nutrient content of freely chosen food purchases have not been described. To investigate relationships of SES with the energy cost ($/1000 kcal) and nutrient content of freely chosen supermarket purchases. Supermarket shoppers (n=69) were recruited at a Phoenix AZ supermarket in 2009. The energy cost and nutrient content of participants' purchases were calculated from photographs of food packaging and nutrition labels using dietary analysis software. Data were analyzed in 2010-2011. Two SES indicators, education and household income as a percentage of the federal poverty guideline (FPG), were associated with the energy cost of purchased foods. Adjusting for covariates, the amount spent on 1000 kcal of food was $0.26 greater for every multiple of the FPG, and those with a baccalaureate or postbaccalaureate degree spent an additional $1.05 for every 1000 kcal of food compared to those with no college education. Lower energy cost was associated with higher total fat and less protein, dietary fiber, and vegetables per 1000 kcal purchased. Low-SES supermarket shoppers purchase calories in inexpensive forms that are higher in fat and less nutrient-rich.
    No preview · Article · Apr 2012 · American journal of preventive medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate reliability and validity of a new tool for assessing the placement and promotional environment in grocery stores. Trained observers used the GroPromo instrument in 40 stores to code the placement of 7 products in 9 locations within a store, along with other promotional characteristics. To test construct validity, customers' receipts were coded for percentage of food purchases in each of the categories. Of the 22 categories tested, 21 demonstrated moderate to high interrater reliability (intraclass correlation ≥ 0.61). When more unhealthy items were placed in prominent locations, a higher percentage of money was spent on less-healthy items, and a lower percentage of food dollars were spent on fruits and vegetables. The prominence of locations was more important than the number of locations. The GroPromo tool can be used to assess promotional practices in stores. Data may help advocates campaign for more healthy food items in key promotional locations.
    No preview · Article · Nov 2012 · Journal of nutrition education and behavior
Show more