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Retail Strategies to Support Healthy Eating

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (5 September 2020) | Viewed by 95504

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Special Issue Editors

Dr. Alyssa Moran

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Guest Editor

Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, US
Interests: chronic disease prevention; food and nutrition policy; food security

Dr. Christina Roberto

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Guest Editor

Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, US
Interests: chronic disease prevention; food and nutrition policy; behavioral economics

Special Issue Information

Dear colleagues,

In January 2020, the Center for Science in the Public Interest (CSPI), The Food Trust, Johns Hopkins Bloomberg School of Public Health, and Healthy Eating Research (HER) met for a Healthy Retail Research Convention in Washington D.C. Attendees included food industry representatives, researchers, and nonprofit organizations. The objective of the convention was to develop a national healthy retail research agenda by: 1) determining the effectiveness of government policies, corporate practices, and in-store pilots in promoting healthy eating; 2) identifying gaps in the healthy food retail literature and generating questions for future research, with an intentional focus on reducing health disparities and improving equity; 3) highlighting best practices for partnering with retailers and food manufacturers on healthy retail research; 4) facilitating relationships between retailers and researchers to implement and evaluate retail interventions; and 5) identifying existing datasets, ongoing work, and new opportunities for retail–research partnerships.

This Special Issue will include a summary of the research convention final report, which will describe the scope of the healthy retail research agenda, the agenda-setting process, and recommendations from expert stakeholders on healthy retail research approaches, data sources, and key areas of future research. The issue will also include several review papers and one original research article, commissioned specifically for the convention, detailing the current state of the retail food environment. These papers will summarize current knowledge on consumer food purchasing trends, the influence of food and beverage companies on the retail food environment, stocking and marketing of sugar-sweetened beverages, in-store food and beverage marketing interventions, and governmental policies to improve the healthfulness of food purchases. Additionally, the issue will include two conceptual frameworks describing the influence of the U.S. retail food environment on food choice—one paper will focus on brick-and-mortar stores, and one will focus on online grocery. Lastly, we will include two commentaries. One will discuss the effects of COVID-19 on the food system and suggest priority areas for future investigation. The other will come from the food retail sector and describe outcomes of interest to industry, challenges to engaging in public health partnerships to support healthy eating, and facilitators of effective retail–research partnerships.

Dr. Alyssa Moran
Dr. Christina Roberto
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

Healthy food retail
Retail food environment
Consumer food purchasing
Marketing

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Published Papers (10 papers)

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Editorial

Jump to: Research, Review

4 pages, 227 KiB

Open AccessEditorial

The Retail Food Environment: Time for a Change

by Alyssa Moran and Christina Roberto

Int. J. Environ. Res. Public Health 2020, 17(23), 8846; https://doi.org/10.3390/ijerph17238846 - 28 Nov 2020

Cited by 3 | Viewed by 2731

Abstract

Food retailers, manufacturers, and distributors exert powerful influence on our food choices through decisions about stocking, pricing, marketing, and promotional practices [...] Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

Research

Jump to: Editorial, Review

15 pages, 886 KiB

Open AccessArticle

Supermarkets in Cyberspace: A Conceptual Framework to Capture the Influence of Online Food Retail Environments on Consumer Behavior

by Neha Khandpur, Laura Y. Zatz, Sara N. Bleich, Lindsey Smith Taillie, Jennifer A. Orr, Eric B. Rimm and Alyssa J. Moran

Int. J. Environ. Res. Public Health 2020, 17(22), 8639; https://doi.org/10.3390/ijerph17228639 - 20 Nov 2020

Cited by 27 | Viewed by 7343

Abstract

The rapid increase in online shopping and the extension of online food purchase and delivery services to federal nutrition program participants highlight the need for a conceptual framework capturing the influence of online food retail environments on consumer behaviors. This study aims to develop such a conceptual framework. To achieve this, mixed methods were used, including: (1) a literature review and development of an initial framework; (2) key informant interviews; (3) pilot testing and refinement of the draft framework; and (4) a group discussion with experts to establish content validity. The resulting framework captures both consumer- and retailer-level influences across the entire shopping journey, as well as the broader social, community, and policy context. It identifies important factors such as consumer demographic characteristics, preferences, past behaviors, and retailer policies and practices. The framework also emphasizes the dynamic nature of personalized marketing by retailers and customizable website content, and captures equity and transparency in retailer policies and practices. The framework draws from multiple disciplines, providing a foundation for understanding the impact of online food retail on dietary behaviors. It can be utilized to inform public health interventions, retailer practices, and governmental policies for creating healthy and equitable online food retail environments. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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17 pages, 2113 KiB

Open AccessArticle

Developing a National Research Agenda to Support Healthy Food Retail

by Amelie A. Hecht, Megan M. Lott, Kirsten Arm, Mary T. Story, Emily Snyder, Margo G. Wootan and Alyssa J. Moran

Int. J. Environ. Res. Public Health 2020, 17(21), 8141; https://doi.org/10.3390/ijerph17218141 - 4 Nov 2020

Cited by 8 | Viewed by 4020

Abstract

The food retail environment is an important driver of dietary choices. This article presents a national agenda for research in food retail, with the goal of identifying policies and corporate practices that effectively promote healthy food and beverage purchases and decrease unhealthy purchases. The research agenda was developed through a multi-step process that included (1) convening a scientific advisory committee; (2) commissioned research; (3) in-person expert convening; (4) thematic analysis of meeting notes and refining research questions; (5) follow-up survey of convening participants; and (6) refining the final research agenda. Public health researchers, advocates, food and beverage retailers, and funders participated in the agenda setting process. A total of 37 research questions grouped into ten priority areas emerged. Five priority areas focus on understanding the current food retail environment and consumer behavior and five focus on assessing implementation and effectiveness of interventions and policies to attain healthier retail. Priority topics include how frequency, duration, and impact of retailer promotion practices differ by community characteristics and how to leverage federal nutrition assistance programs to support healthy eating. To improve feasibility, researchers should explore partnerships with retailers and advocacy groups, identify novel data sources, and use a variety of study designs. This agenda can serve as a guide for researchers, food retailers, funders, government agencies, and advocacy organizations. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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17 pages, 659 KiB

Open AccessArticle

Urban vs. Rural Socioeconomic Differences in the Nutritional Quality of Household Packaged Food Purchases by Store Type

by Allison Lacko, Shu Wen Ng and Barry Popkin

Int. J. Environ. Res. Public Health 2020, 17(20), 7637; https://doi.org/10.3390/ijerph17207637 - 20 Oct 2020

Cited by 20 | Viewed by 4257

Abstract

The U.S. food system is rapidly changing, including the growth of mass merchandisers and dollar stores, which may impact the quality of packaged food purchases (PFPs). Furthermore, diet-related disparities exist by socioeconomic status (SES) and rural residence. We use data from the 2010–2018 Nielsen Homescan Panel to describe the nutritional profiles of PFPs by store type and to assess whether these vary by household urbanicity and SES. Store types include grocery stores, mass merchandisers, club stores, online shopping, dollar stores, and convenience/drug stores. Food and beverage groups contributing the most calories at each store type are estimated using survey-weighted means, while the associations of urbanicity and SES with nutritional quality are estimated using multivariate regression. We find that households that are customers at particular store types purchase the same quality of food regardless of urbanicity or SES. However, we find differences in the quality of foods between store types and that the quantity of calories purchased at each store type varies according to household urbanicity and SES. Rural shoppers tend to shop more at mass merchandisers and dollar stores with less healthful PFPs. We discuss implications for the types of store interventions most relevant for improving the quality of PFPs. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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21 pages, 1026 KiB

Open AccessArticle

A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions

by Megan R. Winkler, Shannon N. Zenk, Barbara Baquero, Elizabeth Anderson Steeves, Sheila E. Fleischhacker, Joel Gittelsohn, Lucia A Leone and Elizabeth F. Racine

Int. J. Environ. Res. Public Health 2020, 17(20), 7591; https://doi.org/10.3390/ijerph17207591 - 19 Oct 2020

Cited by 25 | Viewed by 6181

Abstract

The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and scientific advances in the field suggest the time is ripe to revisit this conceptualization. In this paper, we propose the Retail Food Environment and Customer Interaction Model to convey the evolving variety of factors and relationships that convene to influence food choice at the point of purchase. The model details specific components of the RFE, including business approaches, actors, sources, and the customer retail experience; describes individual, interpersonal, and household characteristics that affect customer purchasing; highlights the macro-level contexts (e.g., communities and nations) in which the RFE and customers behave; and addresses the wide-ranging outcomes produced by RFEs and customers, including: population health, food security, food justice, environmental sustainability, and business sustainability. We believe the proposed conceptualization helps to (1) provide broad implications for future research and (2) further highlight the need for transdisciplinary collaborations to ultimately improve a range of critical population outcomes. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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14 pages, 327 KiB

Open AccessCommunication

Healthy Food Retail during the COVID-19 Pandemic: Challenges and Future Directions

by Lucia A. Leone, Sheila Fleischhacker, Betsy Anderson-Steeves, Kaitlyn Harper, Megan Winkler, Elizabeth Racine, Barbara Baquero and Joel Gittelsohn

Int. J. Environ. Res. Public Health 2020, 17(20), 7397; https://doi.org/10.3390/ijerph17207397 - 11 Oct 2020

Cited by 102 | Viewed by 23594

Abstract

Disparities in dietary behaviors have been directly linked to the food environment, including access to retail food outlets. The Coronavirus Disease of 2019 (COVID-19) pandemic has led to major changes in the distribution, sale, purchase, preparation, and consumption of food in the United States (US). This paper reflects on those changes and provides recommendations for research to understand the impact of the pandemic on the retail food environment (RFE) and consumer behavior. Using the Retail Food Environment and Customer Interaction Model, we describe the impact of COVID-19 in four key areas: (1) community, state, tribal, and federal policy; (2) retail actors, business models, and sources; (3) customer experiences; and (4) dietary intake. We discuss how previously existing vulnerabilities and inequalities based on race, ethnicity, class, and geographic location were worsened by the pandemic. We recommend approaches for building a more just and equitable RFE, including understanding the impacts of changing shopping behaviors and adaptations to federal nutrition assistance as well as how small food business can be made more sustainable. By better understanding the RFE adaptations that have characterized the COVID-19 pandemic, we hope to gain greater insight into how our food system can become more resilient in the future. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

Review

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26 pages, 724 KiB

Open AccessReview

Understanding the Intersection of Race/Ethnicity, Socioeconomic Status, and Geographic Location: A Scoping Review of U.S. Consumer Food Purchasing

by Chelsea R. Singleton, Megan Winkler, Bailey Houghtaling, Oluwafikayo S. Adeyemi, Alexandra M. Roehll, JJ Pionke and Elizabeth Anderson Steeves

Int. J. Environ. Res. Public Health 2020, 17(20), 7677; https://doi.org/10.3390/ijerph17207677 - 21 Oct 2020

Cited by 27 | Viewed by 5925

Abstract

Disparities in diet quality persist in the U.S. Examining consumer food purchasing can provide unique insight into the nutritional inequities documented by race/ethnicity, socioeconomic status (SES), and geographic location (i.e., urban vs. rural). There remains limited understanding of how these three factors intersect to influence consumer food purchasing. This study aimed to summarize peer-reviewed scientific studies that provided an intersectional perspective on U.S. consumer food purchasing. Thirty-four studies were examined that presented objectively measured data on purchasing outcomes of interest (e.g., fruits, vegetables, salty snacks, sugar-sweetened beverages, Healthy Eating Index, etc.). All studies were of acceptable or high quality. Only six studies (17.6%) assessed consumer food purchases at the intersection of race/ethnicity, SES, or geographic location. Other studies evaluated racial/ethnic or SES differences in food purchasing or described the food and/or beverage purchases of a targeted population (example: low-income non-Hispanic Black households). No study assessed geographic differences in food or beverage purchases or examined purchases at the intersection of all three factors. Overall, this scoping review highlights the scarcity of literature on the role of intersectionality in consumer food and beverage purchasing and provides recommendations for future studies to grow this important area of research. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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28 pages, 977 KiB

Open AccessReview

Improving Consumption and Purchases of Healthier Foods in Retail Environments: A Systematic Review

by Allison Karpyn, Kathleen McCallops, Henry Wolgast and Karen Glanz

Int. J. Environ. Res. Public Health 2020, 17(20), 7524; https://doi.org/10.3390/ijerph17207524 - 16 Oct 2020

Cited by 54 | Viewed by 9251

Abstract

This review examines current research on manipulations of U.S. food retail environments to promote healthier food purchasing and consumption. Studies reviewed use marketing strategies defined as the 4Ps (product, price, placement, promotion) to examine results based on single- and multi-component interventions by study design, outcome, and which of the “Ps” was targeted. Nine electronic databases were searched for publications from 2010 to 2019, followed by forward and backward searches. Studies were included if the intervention was initiated by a researcher or retailer, conducted in-store, and manipulated the retail environment. Of the unique 596 studies initially identified, 64 studies met inclusion criteria. Findings show that 56 studies had at least one positive effect related to healthier food consumption or purchasing. Thirty studies used single-component interventions, while 34 were multi-component. Promotion was the most commonly utilized marketing strategy, while manipulating promotion, placement, and product was the most common for multi-component interventions. Only 14 of the 64 studies were experimental and included objective outcome data. Future research should emphasize rigorous designs and objective outcomes. Research is also needed to understand individual and additive effects of multi-component interventions on sales outcomes, substitution effects of healthy food purchases, and sustainability of impacts. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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23 pages, 816 KiB

Open AccessReview

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review

by Alyssa J. Moran, Yuxuan Gu, Sasha Clynes, Attia Goheer, Christina A. Roberto and Anne Palmer

Int. J. Environ. Res. Public Health 2020, 17(20), 7493; https://doi.org/10.3390/ijerph17207493 - 15 Oct 2020

Cited by 21 | Viewed by 6716

Abstract

Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing. Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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34 pages, 1370 KiB

Open AccessReview

Influence of Food and Beverage Companies on Retailer Marketing Strategies and Consumer Behavior

by Amelie A. Hecht, Crystal L. Perez, Michele Polascek, Anne N. Thorndike, Rebecca L. Franckle and Alyssa J. Moran

Int. J. Environ. Res. Public Health 2020, 17(20), 7381; https://doi.org/10.3390/ijerph17207381 - 10 Oct 2020

Cited by 31 | Viewed by 22828

Abstract

The retail food environment plays an important role in shaping dietary habits that contribute to obesity and other chronic diseases. Food and beverage manufacturers use trade promotion—incentives paid to retailers—to influence how products are placed, priced, and promoted in stores. This review aims to: (1) catalogue trade promotion practices that manufacturers use to influence retailer marketing strategies, and (2) describe how these retailer marketing strategies affect consumer purchasing behavior and attitudes. Researchers searched five databases, Academic Search Ultimate, Business Source Ultimate, PsycINFO, PubMed, and Web of Science, to identify literature from industry and academic sources published in English through November 2019. Twenty articles describing manufacturer trade promotion practices were synthesized and provided insight into four types of trade promotion practices: category management, slotting allowances, price discounts, and cooperative advertising. Fifty-four articles describing the impact of retailer marketing on consumers were synthesized and graded for quality of evidence. While comparison across studies is challenging, findings suggest that retailer marketing strategies, such as price promotions and prominent placement, lead to increased sales. Results can guide efforts by policymakers, public health practitioners, and food retailers to design retail environments that improve healthy eating while maintaining retailer financial interests. Additional research should measure the impact of retailer marketing strategies on consumer diet quality and retailer outcomes (e.g., return-on-investment). Full article

(This article belongs to the Special Issue Retail Strategies to Support Healthy Eating)

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