Increasing Healthy Food Access for Low-Income Communities: Protocol of the Healthy Community Stores Case Study Project

Abstract

Improving healthy food access in low-income communities continues to be a public health challenge. One strategy for improving healthy food access has been to introduce community food stores, with the mission of increasing healthy food access; however, no study has explored the experiences of different initiatives and models in opening and sustaining healthy food stores. This study used a case study approach to understand the experiences of healthy food stores in low-income communities. The purpose of this paper is to describe the methodology used and protocol followed. A case study approach was used to describe seven healthy food stores across urban settings in the U.S. Each site individually coded their cases, and meetings were held to discuss emerging and cross-cutting themes. A cross-case analysis approach was used to produce a series of papers detailing the results of each theme. Most case studies were on for-profit, full-service grocery stores, with store sizes ranging from 900 to 65,000 square feet. Healthy Food Availability scores across sites ranged from 11.6 (low) to 26.5 (high). The papers resulting from this study will detail the key findings of the case studies and will focus on the challenges, strategies, and experiences of retail food stores attempting to improve healthy food access for disadvantaged communities. The work presented in this special issue will help to advance research in the area of community food stores, and the recommendations can be used by aspiring, new, and current community food store owners.

Forms of Community Engagement in Neighborhood Food Retail: Healthy Community Stores Case Study Project

“…This study derives from a larger case study project [ 21 ] conducted in partnership with members of the Healthy Food Retail working group of the Robert Wood Johnson Foundation’s Healthy Eating Research (HER) program and the CDC Nutrition and Obesity Policy Research and Evaluation Network (NOPREN). The larger case study aimed to examine the experiences of community food stores in providing healthy food in low-income neighborhoods as well as challenges the stores faced during the COVID-19 pandemic.…”

“…For the project, a multiple case study methodology was employed because it provided in-depth information on selected cases utilizing a mixed-methods approach (i.e., both qualitative and quantitative data collection methods) and permitted the use of multiple data sources to highlight the distinct context within each case. Additional details regarding the study protocol are available elsewhere [ 21 ].…”

“…A total of seven community food stores in different cities across the U.S. were selected by the NOPREN Healthy Food Retail workgroup using a maximum variation sampling approach [ 22 ]. Additional information regarding selection of stores has been previously published [ 21 ]. To maintain anonymity of each store (also known as case in this study), we refer to each case by the city in which the store is located.…”

“…To collect information around community engagement, the stakeholder’s guide had questions around the history of the partnership between stores and stakeholders, and the retailer’s guide asked leadership how they engaged with their community and got community members to visit their store. As described elsewhere [ 21 ], these data were analyzed and combined with other data sources to produce a highly descriptive narrative known as a case report for each site. These reports served as the unit of analysis for this study.…”

“…We applied Stake’s multiple case study analysis approach [ 23 ], moving from within- to cross-case analysis. Analysis began by each site analyzing their multiple data sources to create a within-case report, as described above (additional details are provided elsewhere [ 21 ]). These reports were then used in the cross-case analysis, which aimed to maintain the contextual uniqueness of each case while examining for similarities and differences across cases.…”