This review identifies the most promising intervention strategies for promoting the purchase and consumption of healthier items within U.S. grocery retail settings, with a particular focus on those strategies that may be most effective when implemented within SNAP-authorized retail settings. Searches of nine electronic databases, as well as forward and backward searches, yielded 1942 studies. After being screened, 73 peer-reviewed academic articles were identified for inclusion. Of these, 33 analyzed single-component interventions, while 40 assessed multi-component interventions. The following unique intervention types were considered as evaluated in these studies for their ability to increase healthy item purchasing and consumption: (1) nutrition scoring, (2) nutritional messaging, (3) non-nutritional messaging, (4) endcaps and secondary placement, (5) point-of-sale interventions, (6) increased stocking, (7) food tasting and demonstrations, (8) nutrition education, and (9) placement on shelf interventions. Nutritional scoring and nutritional messaging emerged as the most rigorously tested and effective intervention strategies. Other strategies warrant more research attention. Simple intervention strategies, as opposed to complex ones, yield the most successful results and minimize shopper burden. Therefore, these strategies should be reviewed for policy implementation within SNAP-authorized grocery retailers.
The consumption of sugar-sweetened beverages (SSBs) has been linked to obesity, diabetes, and other negative health outcomes among children. In response, many government entities have enacted healthy default beverage policies that require restaurants offering bundled kids’ meals—food and drink items combined and sold as a single unit—to include only healthier drinks. Despite growing interest in these policies, little is known about their potential reach, restaurant management perceptions, and possible implementation challenges. This study evaluated restaurant managers’ knowledge and support of a policy in Delaware that had passed, but not yet gone into effect. We conducted structured in-person interviews with managers (n = 50) from full-service and quick-service chain and non-chain restaurants (QSRs) using a stratified random sample. Managers were interviewed about the number of bundled meals sold, beverage sales with those meals, and awareness and perceptions of the policy. On average, QSRs sold significantly more bundled kids’ meals per week (281) compared to full-service restaurants (111), and managers from chain restaurants reported selling significantly more bundled kids’ meals per week (233) compared to non-chain restaurants (91). Managers reported 72.5% of those meals were sold with a healthier beverage (water, milk, or 100% juice), consistent with the forthcoming policy, while 28% were sold with SSBs. Furthermore, although only three managers (6%) reported knowing about the policy, the majority supported it when it was explained. Our findings indicate general support for the intent of the policy, but suggest the need for tailored implementation approaches and additional education for restaurant manager’s and staff.
Background: Despite United Nations’ recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for the Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation.Objectives: This paper aims to examine 1) the validity of the FIES for use in the Bahamas, 2) moderate and severe food insecurity prevalence, and 3) the socio-demographic factors which contribute to increased food insecurity.Methods: The FIES was administered via randomized and weighted landline telephone survey in Nassau, Bahamas to 1,000 participants in June and July of 2017. The Rasch modelling procedure was applied to examine tool validity, and outcomes used to report prevalence. A regression analysis informed the relationship between household variables and food security.Results: The FIES met acceptable ranges for fit statistics for all eight items and the overall Rasch reliability is 0.7. The prevalence of moderate and severe food insecurity is 21%, and the prevalence of severe food insecurity is 10%. Statistically significant variables that contribute to food insecurity include education, age, gender, and presence of diabetes, high blood pressure, or heart disease.Conclusions: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in SIDS. Further, this study provides a baseline for future research which may seek to understand the impacts of Hurricane Dorian. Post-disaster food security data is needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following such catastrophic events.
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