Assessing availability of healthy options in food stores to guide community transformation grant activities in Massachusetts

Availability of healthy options in food stores is important to preventing obesity. The Mass in Motion Initiative and two Community Transformation Grant (CTG) projects are conducting statewide longitudinal surveys on availability of major healthy and unhealthy food items in foods stores in Massachusetts (MA). The Community Nutrition Environment Evaluation Data System (C-NEEDS) was developed for food environment surveillance. C-NEEDS takes into account seasonal and geographic variations in food supplies, cultural relevance, and USDA dietary recommendations. Between summer 2012 and winter 2013, 182 food stores in 52 municipalities were surveyed and analyzed. Healthy food availability index (HFAI) was calculated. HFAI has a possible range of 0 to 37, with a higher score indicating a greater availability. Community-level variations in HFAI were analyzed in relation to median household income and housing density. The HFAI scores had good to excellent inter- and intra-rater reliabilities. Store-level HFAI scores had a bimodal distribution, with over 60% of the stores having a score <15, and approximately 15% having a near perfect score of >30. Higher scores were more likely to be seen in stores located in affluent, low density communities. The majority of the surveyed stores were low in healthy food availability. Analysis of store- and community-level variations in availability is useful for CTG programs to formulate and prioritize interventions. The public health importance of evaluating healthy food availibility within food stores, and not just the food stores presence in the community will help evaluate the effectiveness of CTG interventions.