This study aims to examine children’s fruit, vegetable, and added sugar consumption relative to the Dietary Guidelines for Americans and the American Heart Association’s recommendations, as well as to compare children’s reported consumption with parental perception of the child’s overall diet quality. Data were drawn from 2 independent, cross sectional panels (2009–10 and 2014–15) of the New Jersey Child Health Study. The analytical sample included 2229 households located in five New Jersey cities. Daily consumption of fruit (cups), vegetables (cups), and added sugars (teaspoons) for all children (3–18 years old) were based on parent reports. Multivariate linear regression analyses estimated children’s adjusted fruit, vegetable, and added sugar consumption across parents’ perception categories (Disagree; Somewhat Agree; and Strongly Agree that their child eats healthy). Although only a small proportion of children meet recommendations, the majority of parents strongly agreed that their child ate healthy. Nonetheless, significant differences, in the expected direction, were observed in vegetable and fruit consumption (but not sugar) across parental perceptional categories for most age/sex groups. Dietary interventions tailored to parents should include specific quantity and serving-size information for fruit and vegetable recommendations, based on their child’s age/sex, and highlight sources of added sugar and their sugar content.

Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009–2017). Outlets were classified as supermarkets, small grocery stores, convenience stores, and pharmacies using multiple sources of data and a rigorous protocol. Census tracts were categorized by median household income and race/ethnicity of the population each year. Significant declines were observed in convenience store prevalence in lower- and medium-income and majority black tracts (p for trend: 0.004, 0.031, and 0.006 respectively), while a slight increase was observed in the prevalence of supermarkets in medium-income tracts (p for trend: 0.059). The decline in prevalence of convenience stores in lower-income and minority neighborhoods is likely attributable to declining incomes in these already poor communities. Compared to non-Hispanic neighborhoods, Hispanic communities had a higher prevalence of small groceries and convenience stores. This higher prevalence of smaller stores, coupled with shopping practices of Hispanic consumers, suggests that efforts to upgrade smaller stores in Hispanic communities may be more sustainable.

Objective

In response to recent national efforts to increase the availability of healthy food in small stores, we sought to understand the extent to which small food stores could implement the newly published Healthy Small Store Minimum Stocking Recommendations and reflect on the new US Department of Agriculture Food and Nutrition Service's final rule for stocking of staple foods for Supplemental Nutrition Assistance Program–approved retailers.

Design

We collected qualitative and quantitative data from 57 small stores in four states (Arizona, Delaware, Minnesota, and North Carolina) that accepted Supplemental Nutrition Assistance Program but not Special Supplemental Nutrition Assistance Program for Women, Infants, and Children benefits. Data from semistructured, in-depth interviews with managers/owners were transcribed, coded, and analyzed. We collected quantitative store inventory data onsite and later performed descriptive analyses.

Results

Store interviews revealed a reluctant willingness to stock healthy food and meet new recommendations. No stores met recommended fruit and vegetable stocking, although 79% carried at least one qualifying fruit and 74% carried at least one qualifying vegetable. Few stores met requirements for other food categories (ie, whole grains and low-fat dairy) with the exception of lean proteins, where stores carrying nuts or nut butter were more likely to meet the protein recommendation. Water and 100% juice were widely available and 68% met basic healthy beverage criteria.

Conclusions

In contrast to the inventory observed, most owners believed store stock met basic recommendations. Further, findings indicate that small stores are capable of stocking healthy products; however, technical and infrastructure support, as well as incentives, would facilitate shifts from staple to healthier staple foods. Retailers may need support to understand healthier product criteria and to drive consumer demand for new products.

In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores.

Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments.

Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65–3.71; non-upgraded: M = 2.52, 95% CI 2.32–2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6–14.1; non-upgraded: M = 12.5, 95% CI 12.0–13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores.

WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.

Objective: Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them.

Design: Eight focus groups were conducted to explore attitudes and behaviors related to CVV use.

Setting: Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ.

Participants: Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households.

Phenomenon of interest: Perceived barriers to CVV use and strategies used to maximize their purchasing value.

Analysis: Transcripts were analyzed using a general inductive approach to identify emergent themes.

Results: Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power.

Conclusions and implications: Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.

Introduction: Healthy Kids, Healthy Communities (HKHC) is an initiative of the Robert Wood Johnson Foundation to prevent obesity among high-risk children by changing local policies, systems, and environments. In 2009, 105 community partnerships applied for funding from HKHC. Later that year, the Centers for Disease Control and Prevention (CDC) released recommended community strategies to prevent obesity by changing environments and policies. The objective of this analysis was to describe the strategies proposed by the 41 HKHC partnerships that received funding and compare them to the CDC recommendations.

Methods: We analyzed the funded proposals to assess the types and prevalence of the strategies proposed and mapped them onto the CDC recommendations.

Results: The most prevalent strategies proposed by HKHC-funded partnerships were providing incentives to retailers to locate and serve healthier foods in underserved areas, improving mechanisms for purchasing food from farms, enhancing infrastructure that supports walking and cycling, and improving access to outdoor recreational facilities.

Conclusion: The strategies proposed by HKHC partnerships were well aligned with the CDC recommendations. The popular strategies proposed by HKHC partnerships were those for which there were existing examples of successful implementation. Our analysis provides an example of how information from communities, obtained through grant-writing efforts, can be used to assess the status of the field, guide future research, and provide direction for future investments.