Evaluation of the Healthy Food, Healthier You Shelf Labeling Program in an Atlanta Grocery Store Open Access

Creasy, Marian (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/h702q695p?locale=en


Background: Obesity disproportionately impacts low-income, minority communities and the local food environment plays an important role. Since the majority of food purchasing decisions are made in grocery-stores, these settings are optimal for interventions aimed at promoting a healthy diet. The Urban Health Initiative implemented the Healthy Food, Healthier You shelf labeling program in an independently-owned grocery-store serving a predominately low-income, African-American community in Atlanta, Georgia.

Objective: This study applied process and outcome evaluation methodology to examine how the Healthy Food, Healthier You program was implemented and customers' reactions to and awareness and use of the shelf-labels.

Methods: The evaluation used a cross-sectional, post-implementation, mixed-methods design to assess the program. Customer intercept surveys (N=72) were used to assess program reach, customers' reactions to the shelf-labels, and awareness and use of the shelf-labels. Interviews with store employees (N=6) were used to assess current experiences with the program and gather feedback on program feasibility, acceptability, and sustainability. In-store observations were conducted at two time-points to monitor fidelity and dose of shelf-labels and program materials.

Results: Sixty-seven percent of participants were female, 96% African-American, 58% received nutritional assistance from Supplemental Nutrition Assistance Program (SNAP) or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and participants had a mean age of 50.2 ± 14.87 SD. Twenty-six percent of participants were aware of the program and of those aware, 68% of participants used the shelf-label. A logistic regression indicated that higher education, considering healthfulness while food shopping, and greater program exposure were significantly associated with program awareness. Older age was significantly associated with shelf-label use. Grocery-store employees reported strong program acceptance, and indicated that this program may be a feasible means of promoting healthy food purchases for customers. Observations indicated that the program was implemented with a high-level of fidelity and reach, and a moderate-level of dose.

Discussion: Results indicate that this intervention may be a viable approach to reduce the complexity of healthy food purchasing. After a period of capacity building and strengthening of current program components, adding a community outreach component and an in-person nutrition education program should be considered.

Table of Contents

Chapter 1. Introduction...1
Chapter 2. Review of the Literature...22
Chapter 3. Method...47
Chapter 4. Results...73
Chapter 5. Discussion...100

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