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by Christian Maino Vieytes, Graduate Student, The University of Illinois at Urbana-Champaign

Can the retail environment be harnessed to affect positive change? Can retail be used as a means to advocate for public health?

One example of how retail has affected public health is cigarette smoking. Public health organizations and government have partnered to curb retail marketing of cigarette products. Restricting cigarette advertisements from the public eye has led to significant decreases in smoking rates1. Although we may not realize it, public policy plays a major role in the development of a “healthy retail environment” and the health of a nation. Creating an environment that makes healthy choices easy to make is a crucial strategy for promoting healthful behavior. Another example we will discuss will shed light on this idea. Nevertheless, although these are all large scale changes, they can be applied to smaller settings, such as your local commissary. In this discussion, we will focus our attention on two specific methods that involve choice architecture and store tours. 

Sodas in School and Visibility 

 Studies have shown that soda machines in schools are directly related to overall caloric intake and obesity in young students 2. Some states and their governing institutions have experimented with limiting the sale of soda and other sugar-sweetened beverages. In California, the ban on the sale of sugar-sweetened beverages in public schools resulted in a substantial decline in the overall consumption of sugar-sweetened beverages (mainly sodas)3. Research has also shed light on how changing the landscape of food access in schools can influence how much “junk” food is consumed by students 4. This example highlights the concept of making certain some items are more visible than others and the power that this can have for consumption behavior. There is an entire field of study that is devoted to understanding how the arrangement of items in grocery stores influences our eating patterns! It is called “choice architecture”5. Reorganizing a store so that the healthier items are more visible than other, less-healthful, products is one effective strategy for promoting healthier consumption. Locating produce visible in the front of the store and providing greater than 14 different types of fruits and vegetables have been demonstrated to result in healthier eating patterns by the store patrons6. Choice architecture can also take the form of rearranging shelf space so that more of it is reserved for healthier food options7. 

Nutrition Education in Your Grocery Store! 

Another ingenious way of harnessing the potential is to offer free grocery store tours that emphasize healthy eating. Research done in this area has demonstrated that grocery store patrons receiving the tour are more motivated to consume more fruits and vegetables and healthier options in general8,9. A grocery store tour is one way of educating the general public about nutritional concepts. Effective grocery store themes can include: 

  • Eating healthy on a budget
  • Making more healthful choices
  • Avoiding the traps of unhealthful products
  • Increasing the stability of healthful foods by choosing frozen options and other methods
  • Reading and interpreting nutrition labels

Many people feel motivated to change their eating patterns and live a more healthful life. However, they may feel helpless in finding the measures to promote this healthy lifestyle because of an entire list of self-perceived barriers10. Grocery store tours can be the bridge by providing hands-on experience and information directly to and empowering consumers. They can be reinforced by providing an incentive, such as a gift card for purchasing a healthy item, or two, from the commissary. 

Nutrition education can also be provided more delicately. Shelf tags or labels, such as that labeling high-sodium and high-calorie foods or healthful nutrients such as fiber, can be used to orient store customers towards healthier options11. Results from the research on the use of shelf labels is exciting given, that it has been shown that consumers are more likely to consume products tagged as having beneficial nutrients! 

The local grocery store is being redefined as a center for nutrition education. The growing body of evidence shows that promoting nutrition education in grocery stores can be effective for reducing the burden of diseases such as high blood pressure.12. The methods we have discussed here can also be harnessed for growing bonds within the community.

What have you seen in your grocery store to promote nutrition?

 References:

1. Levy DT, Lindblom EN, Fleischer NL, et al. Public Health Effects of Restricting Retail Tobacco Product Displays and Ads. Tob Regul Sci. 2015;1(1):61-75.

2. Rovner AJ, Nansel TR, Wang J, Iannotti RJ. Food Sold in School Vending Machines Is Associated With Overall Student Dietary Intake. J Adolesc Health. 2011;48(1):13-19. doi:10.1016/j.jadohealth.2010.08.021

3. Shi L, van Meijgaard J. Substantial decline in sugar-sweetened beverage consumption among California’s children and adolescents. Int J Gen Med. 2010;3:221-224.

4. Briefel RR, Crepinsek MK, Cabili C, Wilson A, Gleason PM. School Food Environments and Practices Affect Dietary Behaviors of US Public School Children. J Am Diet Assoc. 2009;109(2):S91-S107. doi:10.1016/j.jada.2008.10.059

5. Johnson EJ, Shu SB, Dellaert BGC, et al. Beyond nudges: Tools of a choice architecture. Mark Lett. 2012;23(2):487-504. doi:10.1007/s11002-012-9186-1

6. Caspi CE, Lenk K, Pelletier JE, et al. Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies and dollar stores. Int J Behav Nutr Phys Act. 2017;14(1):76. doi:10.1186/s12966-017-0531-x

7. Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy Nutrition Environments: Concepts and Measures. Am J Health Promot. 2005;19(5):330-333. doi:10.4278/0890-1171-19.5.330

8. Nikolaus CJ, Muzaffar H, Nickols-Richardson SM. Grocery Store (or Supermarket) Tours as an Effective Nutrition Education Medium: A Systematic Review. J Nutr Educ Behav. 2016;48(8):544-554.e1. doi:10.1016/j.jneb.2016.05.016

9. Thompson KL, Silver C, Pivonka E, Gutschall M, McAnulty L. Fruit- and Vegetable-Focused Grocery Store Tour Training Kit to Promote Peer-on-Peer Nutrition Education Utilizing Nutrition and Dietetics Students. J Nutr Educ Behav. 2015;47(5):472-476.e1. doi:10.1016/j.jneb.2015.04.329

10. Sproesser G, Klusmann V, Schupp HT, Renner B. Comparative optimism about healthy eating. Appetite. 2015;90:212-218. doi:10.1016/j.appet.2015.03.008

11. Pennington JAT, Wisniowski LA, Logan GB. In-store nutrition information programs. J Nutr Educ. 1988;20(1):5-10. doi:10.1016/S0022-3182(88)80287-5

12. Watowicz RP, Wexler RK, Weiss R, Anderson SE, Darragh AR, Taylor CA. Nutrition Counseling for Hypertension Within a Grocery Store: An Example of the Patient-Centered Medical Neighborhood Model. J Nutr Educ Behav. 2019;51(2):129-137.e1. doi:10.1016/j.jneb.2018.11.011