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Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City.

ABSTRACT: Policy interventions to improve food access and address the obesity epidemic among disadvantaged populations are becoming more common throughout the United States. In Baltimore MD, corner stores are a frequently used source of food for low-income populations, but these stores often do not provide a range of affordable healthy foods. This research study aimed to assist city policy makers as they considered implementing a Staple Food Ordinance (SFO) that would require small stores to provide a range and depth of stock of healthy foods. A System Dynamics (SD) model was built to simulate the complex Baltimore food environment and produce optimal values for key decision variables in SFO planning. A web-based application was created for users to access this model to optimize future SFOs, and to test out different options. Four versions of potential SFOs were simulated using this application and the advantages and drawbacks of each SFO are discussed based on the simulation results. These simulations show that a well-designed SFO has the potential to reduce staple food costs, increase corner store profits, reduce food waste, and expand the market for heathy staple foods.

SUBMITTER: Zhu S

PROVIDER: S-EPMC8465929 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City.

Zhu Siyao S Mitsinikos Cassandra C Poirier Lisa L Igusa Takeru T Gittelsohn Joel J

Nutrients 20210831 9

Policy interventions to improve food access and address the obesity epidemic among disadvantaged populations are becoming more common throughout the United States. In Baltimore MD, corner stores are a frequently used source of food for low-income populations, but these stores often do not provide a range of affordable healthy foods. This research study aimed to assist city policy makers as they considered implementing a Staple Food Ordinance (SFO) that would require small stores to provide a ran ...[more]

PMID: 34578934

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Project description:BackgroundLow-income black residents of Baltimore City have disproportionately higher rates of obesity and chronic disease than other Maryland residents. Increasing the availability and affordability of healthy food are key strategies to improve the food environment and can lead to healthier diets. This paper describes B'More Healthy: Retail Rewards (BHRR), an intervention that tests the effectiveness of performance-based pricing discounts and health communications, separately and combined, on healthy food purchasing and consumption among low-income small store customers.Methods/designBHRR is 2x2 factorial design randomized controlled trial. Fifteen regular customers recruited from each of 24 participating corner stores in Baltimore City were enrolled. Food stores were randomized to 1) pricing intervention, 2) communications intervention, 3) combined intervention, or 4) control. Pricing stores were given a 10-30% price discount on selected healthier food items, such as fresh fruits, frozen vegetables, and baked chips, at the point of purchase from two food wholesale stores during the 6-month trial. Storeowners agreed to pass on the discount to the consumer to increase demand for healthy food. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests, and refrigerators. Primary outcome measures include consumer food purchasing and associated psychosocial variables. Secondary outcome measures include consumer food consumption, store sales, and associated storeowner psychosocial factors. Process evaluation was monitored throughout the trial at wholesaler, small store, and consumer levels.DiscussionThis is the first study to test the impact of performance-based pricing and communications incentives in small food stores, an innovative strategy to encourage local wholesalers and storeowners to share responsibility in creating a healthier food supply by stocking, promoting, and reducing costs of healthier foods in their stores. Local food wholesalers were involved in a top-down, participatory approach to develop and implement an effective and sustainable program. This study will provide evidence on the effectiveness of price incentives and health communications, separately and combined, among a low-income urban U.S.Trial registrationClinicalTrials.gov: NCT02279849 (2/18/2014).

Project description:BackgroundThe consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited.PurposeTo develop a summary score of 'healthfulness' composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation.MethodsA cross-sectional survey of 601 retail food stores, including supermarkets, grocery stores and convenience stores, was completed in Hampshire, United Kingdom between July 2010 and June 2011. The survey measured nine variables (variety, price, quality, promotions, shelf placement, store placement, nutrition information, healthier alternatives and single fruit sale) to assess the healthfulness of retail food stores on seven healthy and five less healthy foods that are markers of diet quality. Four steps were completed to create nine individual variable scores and another three to create an overall score of healthfulness for each store.ResultsAnalysis of variance showed strong evidence of a difference in overall healthfulness by store type (p <?0.001). Large and premium supermarkets offered the most healthful shopping environments for consumers. Discount supermarkets, 'world', convenience and petrol stores offered less healthful environments to consumers however there was variation across the healthfulness spectrum. No relationship between overall healthfulness and neighbourhood deprivation was observed (p =?0.1).ConclusionsA new composite measure of nine variables that can influence food choices was developed to provide an overall assessment of the healthfulness of retail food stores. This composite score could be useful in future research to measure the relationship between main food store and quality of diet, and to evaluate the effects of multi-component food environment interventions.

Project description:BackgroundHealth-promoting strategies targeting the food retail environment can influence consumer purchasing behaviour. Most strategies require the healthiness of available food and beverages to be determined. Healthiness classification systems exist; however, no system is linked to remote food retail point-of-sale systems. The objective of this study was to explore the feasibility and validity of a process to identify healthy food and beverages in food retail store point-of-sale systems, as applied in a discount card study in remote Aboriginal and Torres Strait Islander communities, Australia.MethodsA convergent mixed methods study design was used. Feasibility was explored through semi-structured interviews with project and store team members involved in a process to identify healthy food and beverages in point-of-sale systems across five remote stores. Convergent validity was assessed by comparing alignment of classification of food and beverages via the expert-informed process used, with a technology-driven system underpinned by Australia's Health Star Rating and discretionary classification, the Thumbs Rating system.ResultsAll eight eligible project and store team members involved in the process were interviewed. The expert-informed process, while implemented successfully overall, was not entirely acceptable to participants. Challenges related to the manual classification of products, with participants recommending exploring automated processes to classify products. There was substantial alignment with technology-driven classification (86% of 6281 unique products). Misalignment was largely related to differences in criteria; the expert-informed process was underpinned by a food-based classification system, including selection of the healthier alternatives within food groups, and the Thumbs Rating system is underpinned by food-based classification with nutrient-profiling.ConclusionAlternative methods to the expert-informed process examined in this study should be considered to classify food and beverages in remote food retail point-of-sale systems. The Thumbs Rating provides a valid classification system and would provide an automated means of classification that could be linked to point-of-sale systems. A shift in classification for a small proportion of products, would need to be considered in applying the Thumbs Rating system to remote food retail interventions, or additional criteria overlaying the system could be implemented to meet specific criteria for targeted strategies.

Dataset Information

Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City.

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Development of a System Dynamics Model to Guide Retail Food Store Policies in Baltimore City.

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