A store-based intervention to increase fruit and vegetable consumption: The El Valor de Nuestra Salud cluster randomized controlled trial

Abstract

Introduction Most evidence-based interventions to improve fruit and vegetable (FV) consumption target individual behaviors and family systems; however, these changes are difficult to sustain without environmental support. This paper describes an innovative social and structural food store-based intervention to increase availability and accessibility of FVs in tiendas (small-to medium-sized Latino food stores) and purchasing and consumption of FVs among tienda customers. Methods Using a cluster randomized controlled trial with 16 tiendas pair-matched and randomized to an intervention or wait-list control condition, this study will evaluate a 2-month intervention directed at tiendas, managers, and employees followed by a 4-month customer-directed food marketing campaign. The intervention involves social (e.g., employee trainings) and structural (e.g., infrastructure) environmental changes. Three hundred sixty-nine customers (approximately 23 per tienda) serve on an evaluation cohort and complete assessments (interviews and measurements of weight) at 3 time points: baseline, 6-months post-baseline, and 12-months post-baseline. The primary study outcome is customer-reported daily consumption of FVs. Manager interviews and monthly tienda audits and collection of sales data will provide evidence of tienda-level intervention effects, our secondary outcomes. Process evaluation methods assess dose delivered, dose received, and fidelity. Results Recruitment of tiendas, managers, employees, and customers is complete. Demographic data shows that 30% of the customers are males, thus providing a unique opportunity to examine the effects of a tienda-based intervention on Latino men. Conclusions Determining whether a tienda-based intervention can improve customers’ FV purchasing and consumption will provide key evidence for how to create healthier consumer food environments.

What Happens When Parents and Children Go Grocery Shopping? An Observational Study of Latino Dyads in Southern California, USA

“…Given the number of interactions observed during a single 10-minute shopping trip, a typical 30-minute shopping trip may involve six or more interactions. Thus, it is important to consider the impact that directing these interactions toward healthier food and beverage choices could have on dietary intake given the frequency with which people visit these stores (Ayala et al, 2015; Sanchez-Flack et al, 2016). …”

Exploring sales data during a healthy corner store intervention in Toronto: the Food Retail Environments Shaping Health (FRESH) project

“…directly collected checkout scanner data, commercially available data sets and grocery receipts) have been used to monitor the effectiveness of interventions in a variety of types of retail food stores, [9][10][11][12] including a number of recent small-store studies. [13][14][15][16][17] Together, these studies suggest that sales data can actually be used in the design of retail food interventions. For example, Foster and colleagues 9 found that low-cost strategies focussed on improving product availability and placement enhanced sales of some foods and beverage categories (milk, water, frozen meals) but not others (regular soda, diet soda, cereal).…”

Evaluation of Store Environment Changes of an In-Store Intervention to Promote Fruits and Vegetables in Latino/Hispanic-Focused Food Stores

“…El Valor was a clustered randomized controlled trial that used structural and social intervention strategies to modify the physical and social environments of tiendas to improve FV consumption among Latino/Hispanic customers [30]. The trial included 16-pair matched tiendas in San Diego County, California where approximately 33% of the population is of Latino/Hispanic origin [31].…”