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2.
Int J Behav Nutr Phys Act ; 21(1): 18, 2024 Feb 19.
Article in English | MEDLINE | ID: mdl-38373957

ABSTRACT

Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.


Subject(s)
Food , Marketing , Humans , Canada , Food Industry , Schools
3.
Appl Physiol Nutr Metab ; 49(3): 340-349, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-37931243

ABSTRACT

The potential for healthier consumer food substitutions is an important factor in the study of food environments, dietary choices, and population nutrition promotion. The burden of diet-related non-communicable diseases is unevenly distributed across Canada and variation in the food environment sub-nationally may be an important explanation. We used population-based 24 h dietary recall data from the 2015 Canadian Community Health Survey-Nutrition for Canadian adults (n = 13 919) to examine dietary intakes of two food group pairings (whole grains/refined grains and legumes/red meats) where consumer substitutions have been recognized to be of importance in promoting healthy and sustainable population diet. We used an ANOVA followed by pairwise comparisons with Bonferroni correction to estimate differences in intakes between provinces for daily weight and proportion of total energy consumed. Based on the Global Burden of Disease Study, Canadians consumed below the average daily requirements of legumes and whole grains and well above the required range of red meat, suggesting room for broad improvements to population diet. Findings also demonstrate that there is potential for targeted shifts in dietary intakes among non-consumers of certain foods (e.g., legumes). This study may inform intervention development for the consumer nutrition environment including food accessibility and affordability to reduce non-communicable disease risk.


Subject(s)
Diet , Fabaceae , Red Meat , Adult , Humans , Canada , North American People , Vegetables , Whole Grains
4.
Int J Behav Nutr Phys Act ; 20(1): 56, 2023 05 04.
Article in English | MEDLINE | ID: mdl-37143132

ABSTRACT

BACKGROUND: Pricing policies have been shown to be an effective lever for promoting healthier dietary choices in consumer food environments. It is not yet well understood how pricing can be used to encourage healthier substitute purchases. The aim of the study was to assess the effect of a retailer-led relative pricing intervention on weekly purchases of targeted snack foods and beverages. METHODS: This was an ecological analysis in a real-world large tertiary hospital consumer food environment setting in urban Canada, comprised of four retail outlets: two large cafeterias, one smaller cafeteria, and one grab-and-go café. An interrupted time series analysis was designed to evaluate the effect of Snacking Made Simple, a retailer-led relative pricing intervention applied to 10 popular snack foods and beverages (n = 87 weeks, 66 weeks baseline and 21 weeks intervention, April 2018 to December 2019), on weekly purchase differences between healthier and less healthy targeted items, adjusted for weekly sales volume. Five healthier items were price discounted, alongside a price increase for five less healthy items. The intervention was actively merchandised in keeping with behaviour change theory. RESULTS: Weekly purchases of targeted snacks became healthier during the intervention period (ß = 21.41, p = 0.0024). This followed a baseline period during which weekly purchases of less healthy targeted snacks had outpaced over time those of healthier targeted snacks (ß = -11.02, p = 3.68E-14). We estimated that, all else being equal, a hypothetical 9.43 additional weeks of the intervention would be required to transition to net-healthier targeted snack purchases in this environment. The effects of the intervention varied by retail outlet, and the outcome appears driven by specific food items; further, examining merchandising implementation, we posited whether direct versus indirect substitution may have affected purchasing outcomes. CONCLUSIONS: Relative pricing may be a promising way to incentivize healthier substitute purchasing in the consumer food environment. Added attention to merchandising strategy as well as value-add factors within food categories and their effects on price salience may be an important factor in effective intervention design.


Subject(s)
Beverages , Snacks , Humans , Interrupted Time Series Analysis , Food Preferences , Commerce , Hospitals , Costs and Cost Analysis , Consumer Behavior
5.
Prev Med Rep ; 32: 102162, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36910505

ABSTRACT

The aim of this work was to assess the feasibility and effect of applying a nationally representative and highly disaggregated food costing measure across Canada, through the novel application of web-scraping technology to the methods of the National Nutritious Food Basket (NNFB). Further, this study tested the hypothesis that a product-matched digital NNFB (dNNFB) correlates with existing market basket measures and quantified any differences in costs. This was an observational cross-sectional study using web scraped food price data collected in November 2021. Food price data was collected from the majority of Loblaw's banners across Canada, resulting in a final store sample of 751 stores sourced from 11 retail banners. Stores were located across all five Statistics Canada regions, including all provinces and territories with the exception of Nunavut. Store-level dNNFB costs were computed, adjusted by age-sex group, and summarized by geographic region and banner. dNNFB costs were then compared with existing national statistics office estimates (Market Basket Measure thresholds for reference families). dNNFB costs varied widely across the country, with notable differences by regional, store-level, and age-sex group characteristics. When compared to reported national statistics, our estimates exceeded the national market basket measure in every comparison in corresponding sub-national geography across the country, with correlation varying from 0.49 to 0.78 dependent on summary comparator. Digital collection of food price data was a feasible strategy for market basket costing. Our findings suggest we may be routinely underestimating the impact of food inflation for consumers, particularly those restricted to certain food environments.

6.
Article in English | MEDLINE | ID: mdl-36833632

ABSTRACT

Despite long histories of traditional food security, Indigenous peoples globally are disproportionately exposed to food insecurity. Addressing this imbalance must be a partnership led by Indigenous peoples in accordance with the UN Declaration of the Rights of Indigenous Peoples. We report the co-design process and resulting design of a food security research project in remote Australia and examine how the co-design process considered Indigenous peoples' ways of knowing, being, and doing using the CREATE Tool. Informed by the Research for Impact Tool, together Aboriginal Community Controlled Health Organisation staff, Indigenous and non-Indigenous public health researchers designed the project from 2018-2019, over a series of workshops and through the establishment of research advisory groups. The resulting Remote Food Security Project includes two phases. Phase 1 determines the impact of a healthy food price discount strategy on the diet quality of women and children, and the experience of food (in)security in remote communities in Australia. In Phase 2, community members propose solutions to improve food security and develop a translation plan. Examination with the CREATE Tool showed that employing a co-design process guided by a best practice tool has resulted in a research design that responds to calls for food security in remote Indigenous communities in Australia. The design takes a strengths-based approach consistent with a human rights, social justice, and broader empowerment agenda. Trial registration: The trial included in Phase 1 of this project has been registered with Australian New Zealand Clinical Trials Registry: ACTRN12621000640808.


Subject(s)
Australian Aboriginal and Torres Strait Islander Peoples , Health Services, Indigenous , Child , Humans , Female , Australia , Diet , Food , Food Security
7.
Community Health Equity Res Policy ; 43(4): 421-429, 2023 Jul.
Article in English | MEDLINE | ID: mdl-33823687

ABSTRACT

Making fresh fruits and vegetables (FFV) more widely available has been a prominent focus of healthy retail interventions and may have an important role in improving food access and diet quality at the population level. 'Healthy retail' interventions in corner/convenience stores (CS) are increasingly being adopted by public health practitioners to address the diet-related risk factors, improve food access at the community level, and change food retail environments. Private sector retailers are integral to the success of public health retailing interventions, making their perspectives and experiences critical. There is a particular need for greater evidence from retailers in settings where evaluations of these interventions have yielded null or mixed results. Through semi-structured interviews with 8 CS retailers (7 from urban settings and 1 from rural) in Ottawa, Ontario, Canada, this study aimed to describe experiences and critical factors regarding the feasibility and sustainability of a healthy CS program that was not sustained following the pilot testing phase, with a specific focus on the sale of FFV. Thematic analysis was used to analyze the interview data, which indicated that retailers faced two dominant challenges with selling FFV in CS: both relate to how these stores are embedded in the larger local and global food system. We join others in arguing that efforts and support for retail interventions aiming to increase the availability of FFV in CS need to address the structure and relations of the food system, as an upstream determinant of CS retailer interest and motivation.


Subject(s)
Commerce , Food Supply , Humans , Marketing , Vegetables , Ontario
8.
BMJ Open ; 12(4): e061660, 2022 04 27.
Article in English | MEDLINE | ID: mdl-35477873

ABSTRACT

INTRODUCTION: Poor diet is a leading preventable risk for the global burden of non-communicable disease. Robust measurement is needed to determine the effect of COVID-19 on dietary intakes and consumer purchasing, given the widespread changes to consumer food environments and economic precarity. The research objectives are as follows: (1) describe dietary intakes of foods, beverages and nutrients of concern during the COVID-19 pandemic; (2) quantify change in diet during COVID-19 as compared with prepandemic, previously captured in the provincial samples of the population-representative 2015 Canadian Community Health Survey-Nutrition and (3) examine how household purchasing practices predict dietary intakes during COVID-19. METHODS AND ANALYSES: Observational study of diet, using a population-based stratified probability sampling strategy allocated via dual-frame (landline and cellphone) calls to random-digit dialled numbers, followed by age-sex group quotas. The base population comprises the four provinces of the Atlantic region of Canada, jurisdictions with an excess burden of pre-existing dietary risk, compared with the rest of Canada. Our aim is n=1000 to obtain reliable estimates at a regional level to describe intakes and compare with prepandemic baseline. Data collection entails 12 weeks participation: (1) enrolment with sociodemographics (key dietary risk predictors such as age, sex, gender, pre-COVID-19 income, employment, household composition, receipt of economic relief, rural residence); (2) two 24hour diet recalls using the online ASA-24 Canada 2018 tool; and (3) online uploads of household food purchase receipts over the 12 weeks enrolled. Participation incentives will be offered. ETHICS AND DISSEMINATION: This research protocol received funding from the Canadian Institutes of Health Research (FRN VR5 172691) and ethics review approval from the Dalhousie University Research Ethics Board. Study protocol and instruments and a de-identified dataset will be made publicly available. We will submit the findings to peer-reviewed journals, as well as conferences geared towards scientific and decision-maker audiences.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Canada/epidemiology , Diet , Eating , Female , Humans , Male , Observational Studies as Topic , Pandemics
9.
Public Health Nutr ; : 1-33, 2022 Mar 09.
Article in English | MEDLINE | ID: mdl-35260223

ABSTRACT

OBJECTIVE: The cost of food is a key influence on diet. The majority of diet cost studies match intake data from population-based surveys to a single source of food supply prices. Our aim was to examine the methodological significance of using food supply data to price dietary intakes. METHODS: Nationally representative 24-hour dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) was matched to the 2015 Canadian Consumer Price Index (CPI) food price list. Proportions and means of reported intakes covered by the 2015 CPI price list were used to compare reported intakes of food groups and food components of interest and concern overall, and by quartile of CPI coverage. SETTING: Canada. PARTICIPANTS: 20,487 Canadians ages one and older. RESULTS: The CPI covered on average 76.3% of total dietary intake (g) without water. Staple food groups that were more commonly consumed had better CPI price coverage than those less commonly consumed. Yet some food groups (vegetables, additions, sweets) that were also commonly consumed by Canadians were not well covered by price data. Individuals in the poorest CPI coverage quartile reported consuming significantly greater fibre (g), gram weight (g), dietary fibre (g), and energy (kcal) as compared to those with the best coverage. CONCLUSIONS: Differential CPI price coverage exists among food components and commonly consumed food groups; additionally dietary intake differs significantly in the population by CPI coverage. Methodological refinements are needed to better account for error when using prices from food supply data to estimate diet costs.

10.
Appetite ; 168: 105695, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34534591

ABSTRACT

This study explored the important attributes of the local food retail environments that residents from Ottawa, Ontario, Canada, used in recommending where to purchase fresh produce, including fruits and vegetables, in the Ottawa area. Drawing upon an approach originating in marketing and consumer research, qualitative thematic analysis was used to analyze 79 discussions from three social media platforms that occurred between 2015 and 2018. We identified three patterns of conversations about food shopping, characterized by participants describing important factors of their local retail food environments that shaped their recommendations for different retail food establishments: 1) Pleasant represented discussions where having a pleasurable food shopping experience was the main discussion point. 2) Thrifty discussions were marked primarily by economical management and discussed food shopping in pragmatic terms. 3) Compromise represented a group where discussions described needing to find a middle ground between affordability and quality. While not without limitations, our study was the first exploration of whether social media data could be useful for qualitatively evaluating local retail food environments. Our findings add to the conclusions of other researchers that social media data does not compromise on the breadth of views captured and can parallel findings from traditional methods. These findings have implications for nutrition researchers and practitioners who we encourage to consider social media discussion data in their work.


Subject(s)
Social Media , Commerce , Consumer Behavior , Food Preferences , Food Supply , Humans , Ontario , Vegetables
11.
Health Promot Pract ; 22(2): 170-173, 2021 03.
Article in English | MEDLINE | ID: mdl-32174186

ABSTRACT

Retail food environments are an important setting for promoting healthier diets and reducing the global burden of diet-related disease. The purpose of this 2-year community-university partnership was to develop a health promotion intervention for stores in a rural and remote region of British Columbia, Canada. This article reports on the qualitative interviews that were conducted with retail operators as part of an intervention planning process. Seven in-depth, semistructured interviews were conducted with store owners and managers of small- and medium-sized stores in a rural and remote region. Interviews were analyzed using thematic analysis to identify business operations and practices relevant to intervention planning and implementation. Relevant considerations for health promotion planners included the unique business models of rural stores; the prominence of regional travel and "outshopping" in rural and remote regions; challenges balancing between choice, value, and profitability; relationships with suppliers; and using local products to attract and retain customers. Involving retailers in settings-based approaches to improve population nutrition may help to mobilize existing practices and ensure that interventions are responsive to local context.


Subject(s)
Food Supply , Food , British Columbia , Commerce , Diet, Healthy , Health Promotion , Humans , Rural Population
12.
Healthc Manage Forum ; 34(1): 49-55, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33307827

ABSTRACT

Healthcare organizations engage in continuous quality improvement to improve performance and value-for-performance, but the pathway to change is often rooted in challenging the way things are "normally" done. In an effort to propel system-wide change to support healthy eating, Nova Scotia Health developed and implemented a healthy eating policy as a benchmark to create a food environment supportive of health. This article describes the healthy eating policy and its role as a benchmark in the quality improvement process. The policy, rooted in health promotion, sets a standard for healthy eating and applies to stakeholders both inside and outside of health. We explain how the policy offers nutrition but also cultural benchmarks around healthy eating, bringing practitioners throughout Nova Scotia Health together and sustaining collaborative efforts to improve upon the status quo.


Subject(s)
Diet, Healthy , Health Promotion/standards , Quality Improvement , Total Quality Management , Benchmarking , Health Promotion/economics , Humans , Nova Scotia , Nutrition Policy , Surveys and Questionnaires
13.
Lancet Planet Health ; 4(10): e463-e473, 2020 10.
Article in English | MEDLINE | ID: mdl-33038320

ABSTRACT

BACKGROUND: The effectiveness of healthy food promotion on food and beverage sales in real-world food retail settings has been shown in randomised trials. The effectiveness of restrictions on the promotion of unhealthy food is, however, less clear. We aimed to assess the effect of restricted unhealthy food promotion, specifically those items contributing most to free sugar sales, on food and beverage sales. METHODS: In this community-level pragmatic, partially randomised, parallel group trial, stores were randomly assigned by a statistician using a single sequence of random assignments to the intervention group, in which a co-designed strategy restricted merchandising of unhealthy food, or to a control group of usual retail practice. The trial was done in partnership with an organisation operating 25 stores in remote Australia. The primary analysis was based on difference in weekly sales with the strategy compared with no strategy in free sugar from all foods and beverages (g/total MJ; primary outcome), targeted food or beverages (weight and free sugars; g/total MJ), and gross profit (AU$) using mixed models. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12618001588280. FINDINGS: Between June 13 and Aug 15, 2018, 20 stores were recruited; ten stores were randomly assigned to the intervention group and ten stores to the control group. The trial was done between Sept 2 and Dec 2, 2018. The Healthy Stores 2020 strategy resulted in a reduction in sales of free sugar of 2·8% (95% CI -4·9 to -0·7). Targeted beverages were reduced by 8·4% (-12·3 to -4·3) and associated free sugar by 6·8% (-10·9 to -2·6), sugar-sweetened soft drinks by 13·2% (-18·5 to -7·6), and associated free sugar by 13·4% (-18·7 to -7·7). Reductions in sales of free sugar from confectionery of 7·5% (-14·3 to -0·2) and in weight sold (-4·6%, -11·1 to 2·3) resulted; however, the reduction in weight was not statistically significant. No differences in sales of table sugar and sweet biscuits were observed. Gross profit was not impacted adversely; a small increase resulted (5·3%, 0·3 to 10·5). INTERPRETATION: Restricted merchandising of unhealthy foods and beverages, while allowing for complementary merchandising of healthier foods and beverages in a real-world store setting and co-designed with retailers, can achieve both public health and business relevant gains. FUNDING: Australian National Health and Medical Research Council.


Subject(s)
Diet , Food Supply/economics , Health Promotion/economics , Australia , Commerce/economics , Humans , Public Health
14.
Curr Obes Rep ; 9(3): 288-306, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32780322

ABSTRACT

PURPOSE OF THE REVIEW: Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS: Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.


Subject(s)
Consumer Behavior , Diet, Healthy/ethnology , Feeding Behavior/ethnology , Food Supply/statistics & numerical data , Population Groups/psychology , Australia/ethnology , Canada/ethnology , Food Industry , Health Status , Humans , United States/ethnology
15.
Public Health Nutr ; 23(11): 1889-1895, 2020 08.
Article in English | MEDLINE | ID: mdl-32295655

ABSTRACT

OBJECTIVE: Commercially available business (CAB) datasets for food environments have been investigated for error in large urban contexts and some rural areas, but there is a relative dearth of literature that reports error across regions of variable rurality. The objective of the current study was to assess the validity of a CAB dataset using a government dataset at the provincial scale. DESIGN: A ground-truthed dataset provided by the government of Newfoundland and Labrador (NL) was used to assess a popular commercial dataset. Concordance, sensitivity, positive-predictive value (PPV) and geocoding errors were calculated. Measures were stratified by store types and rurality to investigate any association between these variables and database accuracy. SETTING: NL, Canada. PARTICIPANTS: The current analysis used store-level (ecological) data. RESULTS: Of 1125 stores, there were 380 stores that existed in both datasets and were considered true-positive stores. The mean positional error between a ground-truthed and test point was 17·72 km. When compared with the provincial dataset of businesses, grocery stores had the greatest agreement, sensitivity = 0·64, PPV = 0·60 and concordance = 0·45. Gas stations had the least agreement, sensitivity = 0·26, PPV = 0·32 and concordance = 0·17. Only 4 % of commercial data points in rural areas matched every criterion examined. CONCLUSIONS: The commercial dataset exhibits a low level of agreement with the ground-truthed provincial data. Particularly retailers in rural areas or belonging to the gas station category suffered from misclassification and/or geocoding errors. Taken together, the commercial dataset is differentially representative of the ground-truthed reality based on store-type and rurality/urbanity.


Subject(s)
Commerce/statistics & numerical data , Datasets as Topic/standards , Food Supply/statistics & numerical data , Rural Population/statistics & numerical data , Social Environment , Databases, Factual , Government , Humans , Newfoundland and Labrador , Predictive Value of Tests , Reproducibility of Results , Sensitivity and Specificity , Urban Population/statistics & numerical data
16.
Can J Public Health ; 111(2): 247-256, 2020 04.
Article in English | MEDLINE | ID: mdl-31667780

ABSTRACT

OBJECTIVES: Rural populations bear a disproportionate burden of diet-related risk, and one important explanation is retail food access disparities. Much existing literature has focused on subjective measures of the rural retail food environment, as well as urban-rural differences. The purpose of this paper is to examine how objectively measured food availability and prices vary within a rural region, and to explore how store features predict rural food availability and prices. METHODS: We conducted an observational audit of a census of rural food stores (n = 78) using a modified Nutrition Environment Measures Survey instrument. The study was conducted on the Avalon Peninsula in Newfoundland and Labrador. Observed prices in-store were matched to nutrient composition data and converted to three units of measure for all analyses: unit price ($/kg), serving price ($/serving), and energy price ($/kcal). We examined average availability and prices across the region, and how store features were associated with prices. RESULTS: Healthy food options were generally less available across the stores than regular items. However, with few exceptions, there were no clear or consistent patterns of difference in availability or pricing between stores of different types. No single product category stood out in terms of a clear price pattern. Store characteristics (including store type, size, ownership, or rurality) did not predict food prices. CONCLUSIONS: Food availability and prices varied in this rural region, but with limited differences between stores of different types. More research is needed on measuring rural environmental determinants of diet in Canada.


Subject(s)
Beverages/economics , Beverages/supply & distribution , Commerce , Food Supply/economics , Rural Population , Humans , Newfoundland and Labrador , Nutrition Surveys
17.
Curr Nutr Rep ; 8(4): 411-428, 2019 12.
Article in English | MEDLINE | ID: mdl-31797233

ABSTRACT

PURPOSE OF REVIEW: Update the state of evidence on the effectiveness of retail food environment interventions in influencing diet and explore the underlying role of public policy, through a systematic review of population-level interventions to promote health in the retail food environment, including community and consumer environments. Diet-related outcomes included purchasing, dietary intakes, diet quality, and health including weight. We coded studies for enabling public policy levers underpinning the intervention, using two widely used conceptual frameworks. RECENT FINDINGS: Of 86 articles (1974-2018), the majority (58 articles, 67%) showed at least one positive effect on diet. Thirteen articles (15%) discussed natural experiments, 27 articles (31%) used a design involving comparison groups including 23 articles (27%) specifically describing randomized controlled trials, and 46 (53%) were quasi-experimental (cross-sectional) evaluations. Across the "4Ps" of marketing (product, promotion, placement, and price), promotion comprised the greatest proportion of intervention strategies, especially in earlier literature (pre-2008). Few studies combined geographic access interventions with 4P strategies, and few used robust dietary intake assessments. Behavior change communication remains an intervention mainstay, but recent work has also incorporated environmental and social planning, and fiscal strategies. More recent interventions were multi-component. The retail food environment intervention literature continues to grow and has become more robust overall, with clearer evidence of the effect of interventions on diet-related outcomes, including consumer purchasing, dietary intakes, and health. There is still much scope for development in the field. Attention to enabling public policy could help to strengthen intervention implementation and evaluation in the retail food environment.


Subject(s)
Diet , Environment , Food , Health Promotion , Marketing , Public Policy , Body Weight , Commerce , Consumer Behavior , Databases, Factual , Feeding Behavior , Humans , Public Health
18.
Soc Sci Med ; 220: 176-183, 2019 01.
Article in English | MEDLINE | ID: mdl-30448630

ABSTRACT

Household food insecurity (HFI), lack of access to adequate food due to financial constraint, has been studied extensively in Canada and is well-recognized for its negative impacts on population health. Despite considerable high-level political recognition, the issue has evoked little substantive policy deliberation. We suggest that Béland and Cox's recently articulated construct of 'valence' may be useful in examining why the idea of HFI has motivated little policy response. Valence is defined as the emotional quality of an idea. According to valence theory, ideas with a high emotional intensity, positive valence acquire importance in policy debate, and those with high intensity, negative valence are 'unthinkable' as a policy idea. We compiled four datasets in which HFI was discussed (verbatim legislative excerpts, parliamentary committee proceedings, government reports, interviews with HFI policy entrepreneurs), representing different kinds of political forums for debate. We analyzed what was said with respect to the valence of the idea of HFI. We found that discussions about HFI were on the whole generally subdued and of low emotional intensity. High intensity negative valence pronouncements were found among legislators' statements and parliamentary committee evidence. Regardless of emotional intensity level, speakers usually talked about the idea of HFI in ways that elicited a negative valence. Positive valence in discussion of the idea of HFI was limited and invoked comments about individual aspiration, prosperity, and community spirit. Our findings suggest that the negative valence of HFI is an inherent trait of the idea that makes it unattractive to policy makers. We suggest that HFI may be a better metric than a policy problem and that aspirational goals with positive valence related to poverty alleviation might better use HFI as an outcome rather than the focus of action.


Subject(s)
Emotions , Family Characteristics , Food Supply , Politics , Canada , Humans , Population Health , Qualitative Research
19.
Can J Diet Pract Res ; 79(2): 60-66, 2018 06 01.
Article in English | MEDLINE | ID: mdl-29384696

ABSTRACT

PURPOSE: This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) identify potential food insecurity policy entrepreneurs (i.e., individuals with voice, connections, and persistence) within these networks, and (iii) examine the political landscape for action on food insecurity as revealed by social network analysis. METHODS: A survey was administered to 93 Canadian food insecurity policy actors. They were each asked to nominate 3 individuals whom they believed to be policy entrepreneurs. Ego-centred social network maps (sociograms) were generated based on data on nominees and nominators. RESULTS: Seventy-two percent of the actors completed the survey; 117 unique nominations ensued. Eleven actors obtained 3 or more nominations and thus were considered policy entrepreneurs. The majority of actors nominated actors from the same province (71.5%) and with a similar approach to theirs to addressing food insecurity (54.8%). Most nominees worked in research, charitable, and other nongovernmental organizations. CONCLUSIONS: Networks of Canadian food insecurity policy actors exist but are limited in scope and reach, with a paucity of policy entrepreneurs from political, private, or governmental jurisdictions. The networks are divided between food-based solution actors and income-based solution actors, which might impede collaboration among those with differing approaches to addressing food insecurity.


Subject(s)
Food Supply , Nutrition Policy , Social Networking , Canada , Charities , Food Supply/economics , Food Supply/statistics & numerical data , Humans , Income , Policy Making , Poverty
20.
Can J Public Health ; 108(5-6): e636-e638, 2018 01 22.
Article in English | MEDLINE | ID: mdl-29356676

ABSTRACT

Public engagement is an essential component of public health research, practice, knowledge exchange processes, and decision making. Citizen science was first documented in the early 1900s as an approach to public engagement and there is growing interest in how it can be used in health research. This commentary describes how citizen science approaches were incorporated into a public engagement activity as part of a population health intervention research project on the retail food environment, a workshop we hosted called The Food In This Place in St. John's, Newfoundland and Labrador. We used citizen science methods and approaches to train and support participants to critically analyze a sample of everyday local retail food environments.


Subject(s)
Community Participation , Population Health , Research Design , Commerce , Environment , Food , Humans , Public Health Practice
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