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Introduction: In-store promotion of food products leads to more frequent purchases. Product promotion can vary by store characteristics. We compared marketing strategies used by grocery stores to promote fruit and vegetables (FV) in neighborhoods with varying socio-economic and racial/ethnic characteristics.<br/><br/>Methods: Data was collected from a random sample of 12 large grocery stores from the same national chain located within a 15-mile radius of Downtown Phoenix. Store zip-code level median household income was used to classify stores as located in lower (<$50,000) or higher (>$50,000) income areas. Stores located in neighborhoods with more than 50% Hispanic population were classified as majority Hispanic serving. The ProPromo tool was adapted to document the presence and promotion of FV at 8 distinct locations throughout each store. Types of promotion strategies documented included displays, price promotions, size, or themes.<br/><br/>Results: FV were present at the entrance, islands, checkouts, and produce section; while fruits were promoted in all of these locations, vegetables were promotion in fewer locations. All stores used size and price promotion to promote FV; display was used to promote vegetables in 2 stores and fruits in all stores. On average stores promoted 32 fruits and 38 vegetables. Stores serving higher and lower income areas promoted similar numbers of FV. However, stores in Hispanic majority neighborhoods promoted fewer FV (66) in comparison to those in Hispanic minority areas (73).<br/><br/>Conclusion: Fruit and vegetable promotion disparity associated with neighborhood demographics may contribute to disparities in fruit and vegetable consumption.
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Hispanic youth have the highest risk for obesity, making this population a key priority for early childhood interventions to prevent the development of adult obesity and its consequences. Involving parents in these interventions is essential to support positive long-term physical activity and nutrition habits. Interventions in the past have engaged parents by providing information about nutrition and fruit and vegetable intake through written materials or text such as newsletters and text messages. The Sustainability via Active Garden Education (SAGE) intervention used gardening and interactive activities to teach preschool children ages 3-5 about healthy eating and physical activity. It aimed to increase physical activity and fruit and vegetable intake in preschool children as well as improve related parenting practices. The intervention utilized newsletters to engage parents by promoting opportunities to increase physical activity and fruit and vegetable intake for their children at home. The newsletters also encouraged parents to discuss what was learned during the SAGE lessons with their children. The purpose of this paper is to describe the content of the newsletters and determine the parent perception of the newsletters through parent survey responses. This can help inform future childhood obesity interventions and parent engagement.
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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.
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Introduction
The US Preventive Services Task Force recommends that all patients be screened for obesity and, if needed, be provided weight-loss advice. However, the prevalence of such advice is low and varies by patient demographics. This study aimed to describe the determinants of receiving weight-loss advice among a sample with a high proportion of low-income, racial/ethnic minority individuals.
Methods
Data were collected from a telephone survey of 1,708 households in 2009 and 2010 in 5 cities in New Jersey. Analyses were limited to 1,109 overweight or obese adults. Multivariate logistic regression determined the association of participants’ characteristics with receiving weight-loss advice from their health care provider. Two models were used to determine differences by income and insurance status.
Results
Of all overweight or obese respondents, 35% reported receiving advice to lose weight. Receiving advice was significantly associated with income in multivariate analysis. Compared with those with an income at or below 100% of the federal poverty level (FPL), those within 200% to 399% of the FPL had 1.60 higher odds of receiving advice (P = .02), and those with an income of 400% or more of the FPL had 1.73 higher odds of receiving advice (P = .03). The strength of the association did not change after adjusting for health insurance.
Conclusion
Income is a significant predictor of whether or not overweight or obese adults receive weight-loss advice after adjustment for demographic variables, health status, and insurance status. Further work is needed to examine why disparities exist in who receives weight-loss advice. Health care providers should provide weight-loss advice to all patients, regardless of income.
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Introduction
Children consume much of their daily energy intake at school. School district policies, state laws, and national policies, such as revisions to the US Department of Agriculture’s school meals standards, may affect the types of foods and beverages offered in school lunches over time.
Methods
This study evaluated changes and disparities in school lunch characteristics from 2006–2007 to 2013–2014. Data were obtained from annual cross-sectional surveys at 4,630 public elementary schools participating in the National School Lunch Program. Multivariate logistic regressions were conducted to examine lunch characteristics.
Results
The percentage of schools regularly offering healthful items such as vegetables (other than potatoes), fresh fruit, salad bars, whole grains, and more healthful pizzas increased significantly from 2006–2007 to 2013–2014, and the percentage of schools offering less healthful items such as fried potatoes, regular pizza, and high-fat milks decreased significantly. Nevertheless, disparities were evident in 2013–2014. Schools in the West were significantly more likely to offer salad bars than were schools in the Northeast, Midwest, or South (adjusted prevalence: West, 66.3%; Northeast, 22.3%; Midwest, 20.8%; South, 18.3%). Majority-black or majority-Latino schools were significantly less likely to offer fresh fruit than were predominantly white schools (adjusted prevalence: majority black, 61.3%; majority Latino, 73.0%; predominantly white, 87.8%). Schools with low socioeconomic status were significantly less likely to offer salads regularly than were schools with middle or high socioeconomic status (adjusted prevalence: low, 38.5%; middle, 47.4%; high, 59.3%).
Conclusion
Much progress has been made in improving the quality of school lunches in US public elementary schools, but additional opportunities for improvement remain.