Healthier stores in the context of a broader community intervention improved purchasing behaviors in 3 low income communities

Introduction– Healthy store interventions have been gaining popularity, however, findings about the effectiveness of this approach are limited and inconclusive. As part of the Kaiser Permanente’s Northern California Healthy Eating Active Living initiative, we evaluated the impact of healthy store conversions on consumer purchases at 9 corner stores/small markets across 3 low-income communities.

Methods – Between 2011 and 2014, changes to store environments were assessed using standardized observation tools and purchase data were collected via consumer intercept survey (n=1438).  At endpoint, store managers were interviewed regarding financial and other outcomes.  Significance of change in purchases was determined by logistic regression.

Results –The extent of store redesign, changes in product mix and use of marketing strategies varied widely. Significant reductions in purchases of sweets and chips were seen in several stores; 2 stores experienced increases in produce purchases.  Soda--but not overall sugar-sweetened beverage-- purchases decreased significantly. Changes in purchases were consistent with the changes made in the stores.  Store managers were unanimously enthusiastic about the program.

Discussion – Small store conversions in the context of a larger community effort had modest positive impacts on consumer purchases. Reduction in purchases of unhealthy foods were more common than increases in healthy food purchases. Changes in beverage purchases suggest that interventions should not focus exclusively on soda.  Results indicate that the type of store, the extent to which there is room for improvement, types of changes made to the store environment, and community involvement are important factors to consider when planning these interventions.