PHILADELPHIA SODA TAX EVALUATION

&

HEALTHY IN-STORE MARKETING

SUMR Scholar: Kehinde OyekanmiMentor: Karen Glanz, PhD, MPH

AGENDA

I. My Objectives

II. Philadelphia Soda Tax Evaluation

III. Healthy In-Store Marketing Project

IV. Learning and Experience

V. Acknowledgements2

MY LEARNING OBJECTIVES

¢Gain knowledge and experience in health research involving diverse ethnic populations, including� Data collection and fieldwork � Data coding and analysis

3

PHILADELPHIA SODA TAX EVALUATION

4

BACKGROUND:

PHILADELPHIA SODA TAX¢ Philadelphia: First major city to enact a soda tax

¢ 1.5 ¢ per ounce on sugar sweetened beverages andartificially sweetened beverages

¢ Applies to beverages sold anywhere in Philadelphia –includes stores, restaurants, vending machines

¢ Includes bottled and fountain beverages, single-serving and multi-serving beverages

¢ Tax is on the distributor; not on consumer5

SODA TAX EVALUATION¢ Question: How will the tax affect the retail price that

consumers will have to pay?

¢ Mission: To gather beverage pricing data in Philadelphia, Montgomery, and Delaware counties before taxing is scheduled to begin in January 2017

¢ Plan: Assess availability and pricing of single-serve, non-single serve and fountain beverages in supermarkets, corner stores, drug and dollar stores, fast-food restaurants, and vending machines

6

MY ROLE: SODA TAX EVALUATION

¢ Participated in fieldwork assessments ¢ Went to 30 stores, restaurants, and vending

machines¢ Data entry and cleaning

My Observations: ¢ More promotions geared towards sweetened

beverages in comparison to water and low-calorie beverages� Kids’ beverages� Soda/Energy drinks

7

HEALTHY IN-STORE MARKETING PROJECT

8

9

I. BackgroundII. SignificanceIII.AimsIV. MethodsV. Findings: Intercept SurveysVI. Intervention Strategies

BACKGROUND- OBESITY

¢ Obesity is the second leading cause of preventable death in the US � 18% of deaths are obesity-related

¢ Obesity can lead to a number of serious health problems� Type II Diabetes� Hypertension� Heart disease (leading cause of death in the US)

¢ Principal Causes of Obesity:� Inactivity� Unhealthy diet and eating habits

10

RACIAL DISPARITIES IN OBESITY

11

SIGNIFICANCE – REDUCING OBESITY

¢ DECREASING THE RISK OF OVERCONSUMPTION AND OBESITY REQUIRES CHANGING THE ENVIRONMENT.....� Retail grocery stores are the primary locations for food

purchases and are therefore an opportune setting to help influence food choices

� Targeting supermarkets in low-income, ethnically diverse neighborhoods provides an opportunity to:¢Evaluate various strategies that promote the purchase

of healthier products ¢Positively influence the diet quality of those at

greatest risk for obesity 12

Kerr J, Frank L, Sallis JF, et al. Predictors of trips to food destinations. Int J Behav Nutr Phys Act. 2012;9:58

PROJECT OVERVIEW

¢ Implementing healthy marketing strategies of key products in 32 supermarkets in low-income, ethnically diverse neighborhoods in the mid-Atlantic region

¢Goal: To test whether the promotion of healthy, lower calorie foods and beverages will increase the sales of these items

13

AIMSAim 1: Evaluate the effect of in-store healthy food marketing strategies on sales and purchases of specific healthier items in six product categories:

� Milk� Cheese� Salty Snacks� Sliced Bread� Frozen entrees � Beverage check-out coolers

Aim 2: Evaluate changes in food marketing environments with changes in sales and purchase of specific healthier items in the same six categories

Aim 3: Examine the relationship between neighborhoods and whether changes in sales and purchase of healthier items vary across different types of neighborhoods

14

RESEARCH DESIGN

¢Cluster randomized control trial

¢32 supermarkets in low income, high minority neighborhoods will be randomly assigned to a 2 year intervention (n=16) versus control (n=16)

¢ Intervention stores will implement placement and promotion strategies

15

STUDY PROCEDURESMeasures Sample Timing

OUTCOME DATA

Sales Data 32 stores Weekly, 1 yr pre-intervention, & 2 yrs during intervention

Grocery Marketing Environment Assessment

32 stores Baseline & every 3 months

PROCESS DATA

Focus Groups 4 groups, n=60 customers Once, pre-intervention

Milk Taste Tests n=25/store @16 intervention stores

Monthly

Intercept surveys (cohort w/receipts also provide outcome data)

n=50/ store in all 32 stores (cohort=20/store w/receipt)

Months 0, 6, 12, 18, 24

Intervention Implementation &Compliance

16 intervention stores 2x/month for 6 months, then monthly

ECOLOGICAL DATA

Neighborhood Characteristics 32 stores Year 2, rechecked in Year 3

SHOPPER INTERCEPT SURVEYS

¢ Surveys are completed by 50 shoppers at each enrolled store at baseline and at 6, 12, 18 and 24 months

¢ Surveys provide shoppers’ demographic information, shopping and buying habits and whether they notice targeted placement and promotion, and at follow-up, changes in these strategies in the stores

My Role¢ Data processing, including cleaning and preliminary

data analysis 17

PRELIMINARY FINDINGS FROM INTERCEPT SURVEYS

¢960 participants in 22 stores in Pennsylvania, New Jersey, and Delaware

18

19

InterceptSurveyParticipants'DemographicCharacteristicsCharacteristic Number(n) Percent(%)

GenderMale 303 32%Female 657 68%

RacialEthnicGroupAfricanAmerican 554 58%Caucasian 299 31%Hispanic/Latino 32 3%Other 75 8%

Education8thgradeorless 14 1%SomeHighSchool 44 5%HighSchoolGraduate 314 33%SomeCollegeorTechnicalSchool 310 32%CollegeGraduateorMore 272 28%NotReported 6 1%

Self-ReportedWeightStatusOverweight 429 45%Underweight 40 4%RightWeight 438 46%IDon'tKnow/NoResponse 53 6%

SupplementNutritionParticipation%ReceivingSnapBenefits 289 31%%ReceivingWICBenefits 63 7%

SHOPPING HABITS

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Morethanonceperweek

Onceaweek Onceevery1-2weeks

Onceamonth Lessthanonceamonth

ShoppingTripsPerMonth

20

SHOPPING HABITS

21

0%

5%

10%

15%

20%

25%

30%

Never Rarely Sometimes Usually Always

Use of a Shopping List

0%

5%

10%

15%

20%

25%

30%

35%

Never Really Sometimes Usually Always NotApplicable

Those Buying Items Not on Shopping List

LIKELIHOOD OF PURCHASING DIFFERENT

TYPE OF FOOD

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Zero chance

Some chance

Moderate chance

Good chance

Very high chance

Bread

0%

5%

10%

15%

20%

25%

30%

35%

40%

Zero chance

Some chance

Moderate chance

Good chance

Very high chance

Cheese

22

LIKELIHOOD OF PURCHASING DIFFERENT

TYPE OF FOOD

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Zero Chance

Some Chance

Moderate Chance

Good Chance

Very High Chance

Salty Snacks

0%

5%

10%

15%

20%

25%

30%

35%

40%

Zero chance

Some chance

Moderate chance

Good chance

Very high chance

Frozen Dinners

23

LIKELIHOOD OF PURCHASING DIFFERENT

TYPE OF FOOD

0%

5%

10%

15%

20%

25%

30%

35%

40%

Zero chance

Some chance

Moderate chance

Good chance

Very high

chance

Soda

24

0%

5%

10%

15%

20%

25%

30%

35%

40%

Zero chance

Some chance

Moderate chance

Good chance

Very high chance

Milk

INTERVENTION

25

TARGETED PRODUCTS

¢ Milk¢ Cheese¢ Beverage check-out coolers¢ Salty snacks¢ Frozen dinners¢ Sliced Bread

¢ 2%, 1%, skim¢ Low-fat cheese¢ Unsweetened and Diet Beverages¢ Pretzels¢ Lower calorie options¢ 100% Whole Wheat Bread

Category Recommended products

26

THE 4P’S OF MARKETING

• Primarily focused onplacement& promotion of healthier items

27

PLACEMENT AND PROMOTION STRATEGIES

1) Multiple Facings2) Prime Placement3) Signage4) Taste-Testing

28

MULTIPLE FACINGS

¢ Increase the number of facings of the targeted products

29

PRIME PLACEMENT

¢ Placing recommended products at arm/eye level and in the middle of the category aisle

30

SIGNAGE¢ Call-out signs with the targeted product’s name and price

31

TASTE-TESTING¢ Shoppers are invited to participate in a blinded milk taste

test and asked to distinguish between whole, 2%, 1%, and skim milk

32

MY ROLE:ASSIST WITH INTERVENTION DEVELOPMENT

¢ Participated in product selection “scouting” fieldwork at intervention stores � Assessed availability of targeted product options in

each product category� Confirmed targeted products availability, size, and if

not available, other products in the store that might be alternatives

¢ Processed data gathered in scouting fieldwork and compared what items are in the stores to store sales data in order to narrow down products to include in the intervention 33

LOOKING FORWARD…

¢ So far:

� Baseline sales data and intercept surveys have been completed in 22 of the 32 stores

¢ Immediate project next steps are:

� Recruitment of remaining 10 stores

� Intervention implementation in 11 enrolled intervention stores

� Lots of data coding, entry, processing34

LEARNING AND EXPERIENCE

¢ Introduction to behavioral research by participating in two research projects

¢ Experience in completing fieldwork by collecting data for beverage tax evaluations and product scouting visits

¢ Introduction into data processing and preliminary data analysis using newly learned database and statistical computer programs

35

ACKNOWLEDGEMENTS

¢ Karen Glanz, PhD, MPH¢ Donna Paulhamus Giordano, MS, RDN¢ Sarah Green, MPH¢ Matthew Phillips, MPH¢ Joanne Levy, Safa Browne, Leonard Davis Institute,

and SUMR¢ Funding for Healthy In-Store Marketing Study

(5R01DK101629)--National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

36