ASSESSING THE PHILADELPHIA NUTRITION ENVIRONMENT: IN-STORE MARKETING AND NEMS 1 Alison Leung and Gabriela Abrishamian-Garcia Mentor: Karen Glanz, PhD., MPH.
OUTLINE Overview of nutrition environments In-Store Marketing Perceived Nutrition Environment Measurement Survey (NEMS-P) 2
NUTRITION ENVIRONMENTS [GLANZ, SALLIS, SAELENS & FRANK 2005] 3
IN-STORE MARKETING PROJECT 4 Funded by the Robert Wood Johnson Foundation
PROJECT OVERVIEW Led by Penn, Temple and the Food Trust Assess promotion and placement of healthy versus unhealthy foods Promotion: signage, shopper marketing Placement: location of products in the store, placement on shelves, store layout, etc Collaborate with supermarkets 5
AIMS Design and conduct a pilot study to evaluate the impact of low-cost in-store marketing strategies on their ability to: Simply Inseparable Cross-promotion of milk and Oreos 1) Decrease the sale of empty calories from energydense, low-nutrient child-relevant foods 2) Increase the sale of healthy children s foods 3) Be profitable, or at minimum cost neutral, to retailers and manufacturers 6
SIGNIFICANCE Address the childhood obesity epidemic Change healthy food marketing at grocery stores Fill gaps in research Lack of in-store marketing research on children Lack of representation of diverse population groups (race/ethnicity, income, education) Limited research on consumer behavior/health in real-life settings 7
METHODS Phase 1: Formative research and measurement development Winter 2010: Secure cooperation of grocery chains Spring 2011: Analyze sales data June 2011: Conduct focus groups Fall 2010-Summer 2011: Develop Grocery Marketing Environment Assessment tool (GMEA) Phase 2: Pilot intervention studies Begin September 2011: Implement intervention (4-6 months) Throughout intervention: Intercept surveys 8
PHASE 1 INTERVENTIONS: HEALTHY RETAIL SOLUTIONS Results of focus group and sales data Fresh Grocer and Shop Rite Change signage Change product placement Place call-out signs on shelves Conduct taste-testing Target products Milk Cereal Frozen Dinners Beverages 9
GROCERY MARKETING ENVIRONMENT ASSESSMENT (GMEA) Need a feasible measure of 4 P s for in-store retail environments Measures 8 product categories Notes available products in highimpact areas Proportion of unhealthy vs. healthy food Records check out aisle environment Create composite scores to prompt and evaluate change Example of an Island of produce 10
MY ROLE Test GMEA tool and begin collecting data Assist with focus groups Create GMEA data dictionary Collecting data in a corner store 11
PRELIMINARY OBSERVATIONS 12
LESSONS LEARNED Changes to the grocery store environment are crucial Complexity of factors that affect food purchases Importance of collaboration between different stakeholders 13
NUTRITION ENVIRONMENT MEASUREMENT SURVEY - PERCEIVED (NEMS-P) 14 Funded by Abramson Cancer Center PA Tobacco Settlement Fund
OBJECTIVES Primary Objective Develop and validate a standardized measure of perceived nutrition environment Secondary Objectives Evaluate whether observed nutrition environment and perceived nutrition environment are independent Evaluate the additive mediators of the relationship between self-reported nutrition environments and eating behaviors 15
METHODS Phase 1: Measure Development and Pilot Study Draft Measure Internal Review External Review to Assess Face & Content Validity Pilot Testing Phase 2: Main Measurement Study Ascertainment of measure reliability Ascertainment of measure validity Phase 3: Dissemination of Results 16
STUDY LOCATIONS Target Area 1: Low Socioeconomic Status Area North Philadelphia Predominantly small corner stores & poor access to supermarkets West Philadelphia Main food outlets are small corner stores & fast food restaurants Target Area 2: Higher Socioeconomic Status Area Chestnut Hill Area Characterized by produce markets, small gourmet food shops and moderate access to larger supermarkets Wynnewood Area Characterized by access to produce markets and large supermarkets 17
MAIN MEASUREMENT Measuring the Perceived Nutrition Environment Recruitment began in November 2010 Participants were asked to complete the survey 2 different times, 2-3 weeks apart. Surveys could be completed in-person or through the mail. Measuring the Observed Nutrition Environment Evaluated using the Nutrition Environment Measures Survey (NEMS) Trained staff are collecting NEMS for a sample of the restaurants and stores A portion of the restaurants and stores are being double rated for inter-rater reliability 18
NUTRITION ENVIRONMENT MEASUREMENT SURVEY-STORES AND CORNER STORE (NEMS-S AND NEMS-CS) 11 measures Milk Fruit Frozen and Canned Fruit Vegetables Frozen and Canned Vegetables Ground Beef Hot Dogs Frozen Dinners Baked Goods Beverages Bread Chips and Snacks Cereal Measures Price Availability Quality Produce section of convenience store in West Philadelphia 19
NUTRITION ENVIRONMENT MEASURES SURVEY (NEMS) Restaurants (NEMS-R) Stores (NEMS-S) Data collected with paper survey Data collected with PDA survey 20
DATA COLLECTION 21
CURRENT STATUS NEMS-S data collection Data cleaning Data analysis 22
MY ROLE Scanned surveys Data collection using NEMS-S Compiled survey comments for review Collecting data in a corner store 23
LESSONS LEARNED Process of data management Creating a tool to assess nutrition environments is difficult given the wide variation in store types. Research is a continuous process in which changes and improvements are made along the way. 24
25 PRELIMINARY FINDINGS FROM NEMS-P
NEMS-P SAMPLE Gender Frequency Percent Female 153 69.2 Male 64 29.0 Missing 4 1.8 Total 221 100.0 Age N Minimum Maximum Mean Std. Deviation Age 216 20 65 45.11 11.067 26
IMPORTANCE OF PUBLIC TRANSPORTATION WHEN SHOPPING FOR FOOD 27
IMPORTANCE OF BUYING FOOD NEAR HOME 28
IMPORTANCE OF COST WHEN SHOPPING FOR FOOD 29
IMPORTANCE OF CONVENIENCE WHEN EATING OUT AT A RESTAURANT 30
IMPORTANCE OF WEIGHT CONTROL WHEN EATING OUT AT A RESTAURANT 31
SPECIAL THANKS Dr. Karen Glanz Erica Cavanaugh Erica Davis Sarah Green Olivia Hamilton Marcia Commins Diana Chan Kate Volpicelli Luke Bingaman Bryan Kim Lissy Madden Joanne Levy 32
QUESTIONS/COMMENTS? 33