Background Nutrition interventions promoting healthy food choices aim to address health challenges of residents in low-income environments. Research about the effectiveness of nutrition interventions in low-income populations is limited, particularly for those in rural areas. Behavioral economics (BE) strategies demonstrate effectiveness for improving eating behaviors in some settings. However, the efficacy of BE interventions in retail food stores serving low-income populations residing in rural and urban geographies is nascent. Objective This systematic literature review aims to identify and compare nutrition interventions implemented in rural and urban low-income retail food stores, including BE strategies when applied. Methods This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers searched five databases for peer-reviewed publications from October 2010 to October 2019. Included studies implemented a nutrition intervention in low-income retail food stores and provided a quantitative outcome evaluation with results separated by rural and urban geography. BE interventions were analyzed based on the MINDSPACE framework for behavior change. Results Forty-six separate publications (n ¼ 20 rural, n ¼ 26 urban) in the United States, Canada, Europe, New Zealand, and Australia were included. Researchers independently rated publications as low risk of bias (n ¼ 4), moderate (n ¼ 18), or high risk of bias (n ¼ 24) using the Quality Assessment Tool for Quantitative Studies. Studies (n ¼ 18) demonstrated positive outcomes for customer purchases, store sales, or participant intake of targeted healthy foods. Overall, most effective interventions included point-ofpurchase signage (n ¼ 16) and product placement strategies (n ¼ 4 urban). Rural studies included financial incentives combined with participant education (n ¼ 2) and incorporated culturally appropriate messengers and/or symbols (n ¼ 5) to improve healthy food purchases and intake. Conclusions Improved research quality and tailored evidence-based interventions, including BE strategies, are necessary in retail food environments to promote healthy eating behaviors in low-income populations.

High rates of obesity and chronic disease exist in the southeastern United States (US). Knowledge about the attitudes, beliefs, and barriers of the rural low-income Louisiana population regarding healthy eating is limited. Focus Group discussions based on the Theory of Planned Behavior (TPB) were conducted in rural parishes (N = 3) with low-income residents of Louisiana (N = 29). Grounded Theory methods and cross-case analysis were used. The participants were primarily single Black females of age 18–30 years who earned a high school diploma, were employed, and had children. Beliefs included healthy eating was physically beneficial, yet financial impacts and the low palatability of healthy foods were barriers. Professional resources for nutrition education were limited which led to reliance on friends, family, and the internet. Friends and family were positive and negative influences on eating choices. Control beliefs included the high prices and low palatability of healthy foods, the wide availability of Energy Dense Nutrient Poor (EDNP) foods, and low motivation to sustain eating behavior changes. Formative research to optimize campaign distribution channels may improve accessibility to social marketing support and healthy eating resources. Persuasive messages that address control beliefs are needed in social marketing campaigns for rural low-income Louisiana environments.

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Objectives The purpose of this research was to evaluate the effect of Body Quest: Food of the Warrior nutrition curriculum on preferences and willingness to consume fruits and vegetables among third graders. Methods After collecting signed parental and photo consent forms, 326 third grade students received the intervention. Students received the Body Quest education program and participated in a Veggie Tasting of six vegetables (carrots, broccoli, cauliflower, peppers, spinach, and tomatoes). Students were asked if they liked the vegetable before and after tasting it, if they would eat the vegetable in the future, and if they would ask their parents to buy the vegetable for them to eat at home. Assessments of data were completed in four periods, weeks 1, 7, 12, and 17. Alpha was set at 0.05. Results Approximately half of the students were male (n = 163; 50.2%). The largest percentage of students were white (n = 171; 53.1%). Black students comprised the next largest group (n = 112; 34.8%), and Hispanic and American Indian students comprised the remaining 12.1% (n = 39) students. Generalized estimating equations analysis revealed that, over time, statistically significant changes in preference for cauliflower and spinach occurred with students decreasing their liking for cauliflower (P = .04) and increasing their liking for spinach (P = .01). A statistically significant change in students’ interest in eating cauliflower (P = .01) and tomatoes (P = .03) in the future occurred with students initially indicating an increased willingness to eat the two vegetables, but ultimately showing a decreased willingness to eat either vegetable. A similar pattern of willingness to ask their parents to buy spinach (P = .04) occurred with students initially showing an increased willingness to ask their parents to buy spinach but ultimately indicating a decrease in their willingness to make that request. Conclusions This research suggests that Body Quest was effective in improving liking and willingness to try and request some vegetables. Because liking and willingness to request decreased in cauliflower and spinach, respectively more research is warranted to identify the optimal length of food exposure to change preference among this population. Funding Sources Supplemental Nutrition Assistance Program—Education (SNAP-Ed).