nutrition environment assessment methods
TRANSCRIPT
ASSESSING THE PHILADELPHIA NUTRITION ENVIRONMENT: IN-STORE MARKETING AND NEMS Alison Leung and Gabriela Abrishamian-Garcia Mentor: Karen Glanz, PhD., MPH.
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OUTLINE
Overview of nutrition environments
In-Store Marketing Perceived Nutrition
Environment Measurement Survey (NEMS-P)
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NUTRITION ENVIRONMENTS [GLANZ, SALLIS, SAELENS & FRANK 2005]
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IN-STORE MARKETING PROJECT
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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
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AIMS
Design and conduct a pilot study to evaluate the impact of low-cost in-store marketing strategies on their ability to:
1) Decrease the sale of empty calories from energy-dense, 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
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“Simply Inseparable” Cross-promotion of milk and Oreos
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
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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
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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
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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 high-
impact areas Proportion of unhealthy vs. healthy
food Records check out aisle environment
Create composite scores to prompt
and evaluate change
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Example of an “Island” of produce
MY ROLE
Test GMEA tool and begin collecting data
Assist with focus groups Create GMEA data
dictionary
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PRELIMINARY OBSERVATIONS
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LESSONS LEARNED Changes to the grocery store environment are
crucial Complexity of factors that affect food purchases Importance of collaboration between different
stakeholders
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NUTRITION ENVIRONMENT MEASUREMENT SURVEY - PERCEIVED (NEMS-P)
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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
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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
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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
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MAIN MEASUREMENT
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.
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
Measuring the Perceived Nutrition Environment
Measuring the Observed Nutrition Environment
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NUTRITION ENVIRONMENT MEASUREMENT SURVEY-STORES AND CORNER STORE (NEMS-S AND NEMS-CS)
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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
NUTRITION ENVIRONMENT MEASURES SURVEY (NEMS)
Restaurants (NEMS-R) Stores (NEMS-S)
Data collected with paper survey Data collected with PDA survey
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DATA COLLECTION
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CURRENT STATUS NEMS-S data
collection Data cleaning Data analysis
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MY ROLE
Scanned surveys Data collection using NEMS-S Compiled survey comments for
review
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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.
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PRELIMINARY FINDINGS FROM NEMS-P
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NEMS-P SAMPLE
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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
IMPORTANCE OF PUBLIC TRANSPORTATION WHEN SHOPPING FOR FOOD
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IMPORTANCE OF BUYING FOOD NEAR HOME
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IMPORTANCE OF COST WHEN SHOPPING FOR FOOD
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IMPORTANCE OF CONVENIENCE WHEN EATING OUT AT A RESTAURANT
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IMPORTANCE OF WEIGHT CONTROL WHEN EATING OUT AT A RESTAURANT
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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?
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