The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption

Abstract

Background Modifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months. Trial design Clustered randomized controlled trial Methods Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team’s support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees’ capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors. Results The study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects. Conclusions Structural and social change interventions can modify customers’ behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products). Trial registration NCT01475526

Culturally-tailored cookbook for promoting positive dietary change among hypertensive Filipino Americans: a pilot study

“…While this intervention type has been shown to be successful, studies have also highlighted the need for cultural competency in this setting, with findings of higher diet adherence, improvements in disease management, and lower chronic disease burden when cultural elements are incorporated ( 37 ). Similar to other dietary intervention studies found in our review of existing literature ( 23 , 24 , 28 ), culturally-focused culinary medicine studies have predominantly been conducted in Hispanic/Latinx populations and in populations with diabetes (75%) ( 30 , 37 ). Despite its importance, studies have highlighted a gap in culinary medicine interventions focused on Asian populations–despite recognition of this population’s increased cardiovascular disease risks ( 37 ).…”

“…Other interventions which apply a cookbook as part of their dietary intervention include ones that targeted African Americans for healthy dietary change ( 25 ), or Mexican-Americans for decreased sodium consumption and increased fruits and vegetable intake ( 26 ). Similarly, single recipes or cooking demonstrations have been part of multi-component interventions to decrease meat consumption ( 27 ) or increase purchasing of produce, including for Latino/a populations ( 28 ). The positive dietary change results from these dietary interventions, along with specific evidence from the DASH trial ( 29 ) showing diets which emphasize fruits, vegetables, and low sodium foods reduce blood pressure in hypertensive patients, serve as the rationale behind our intervention design to target a unique population and support the promise of culturally-tailored interventions.…”

Encouraging Healthier Food and Beverage Purchasing and Consumption: A Review of Interventions within Grocery Retail Settings

“…A total of 40 studies analyzed the effects of multi-component interventions on healthy food item purchasing and consumption ( Table 3 ) [ 32 , 35 , 39 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ]. Of these, 16 studies were experimental [ 55 , 59 , 60 , 61 , 62 , 63 , 64 , 72 , 73 , 74 , 82 , 83 , 86 , 88 , 89 ,…”

“…A total of 17 multi-component studies collected objective outcomes data [ 32 , 35 , 39 , 55 , 56 , 61 , 62 , 67 , 68 , 69 , 72 , 73 , 75 , 78 , 82 , 84 , 89 ]. Additionally, of the studies evaluating multi-component interventions, 14 were conducted in stores that explicitly served SNAP customers [ 32 , 54 , 58 , 60 , 64 , 67 , 68 , 72 , 73 , 78 , 82 , 85 , 86 , 89 ], 15 were located in a low-income community that likely served SNAP customers [ 39 , 55 , 56 , 57 , 62 , 63 , 69 , 74 , 75 , 76 , 77 , 80 , 83 , 87 , 90 ], 5 were conducted in a corner store or bodega without any neighborhood demographics or income levels disclosed [ 35 , 61 , 66 , 71 , 88 ] and 3 were con...…”

Segmentation of Consumer Preferences for Vegetables Produced in Areas Depressed by Drought

“…In this context, new spaces for analyses of marketing strategies in new contexts such as digital media [79], and mobile markets [80] are understudied in Latin America. Moreover, these are important issues in view of obesity prevention and vegetable consumption promotion in the region [81][82][83].…”