Food Policy
Conditions
Brief summary
Improving healthy food availability and decreasing the availability of high calorie, low nutrient products, particularly in underserved communities, has been identified as a leading strategy for local governments to prevent obesity. However, policy action in this area to date has been limited. This R01 will examine the impact of a local policy change that establishes minimum stocking criteria for a wide array of healthy foods as a requirement of food store licensing. To our knowledge, this is the only policy of its kind in the US. As such, if it is successful, it could serve as an important model policy for other local governments seeking to increase healthy food availability and prevent obesity through local policy action.
Detailed description
The aim of this study is to evaluate the impact of a local policy change (i.e., the Minneapolis Staple Foods Ordinance) that establishes minimum stocking criteria for a wide array of healthy foods as a requirement of food store licensing. Recent calls to action from the Institute of Medicine, the Centers for Disease Control and Prevention and other authorities have identified improving access to healthy foods as a primary strategy for local governments to use in advancing obesity prevention efforts, but policy initiatives in this area have been limited. In this study, the impact of the Minneapolis Staple Foods Ordinance will be evaluated by assessing objectively measured changes in: (a) food environments among small- to mid-sized, urban food stores, including availability, promotion, advertising, quality, price, and placement of both healthy and unhealthy foods and beverages, (b) nutritional quality of consumer purchases at small food stores, including assessment of energy density and calories via customer intercept surveys and direct observation of purchases and (c) home food environments, including availability of healthy and unhealthy foods/beverages and an overall home food obesogenicity score, among households that frequently shop at small- to mid-sized stores. These changes will be assessed pre-policy implementation, as well as 4-, 12- and 24-months post-policy implementation, in two Minnesota cities: Minneapolis and St. Paul, (our control community). The proposed scope of work in this study is important because its takes advantage of a unique opportunity to evaluate an innovative local policy addressing a recommended action area for obesity prevention that aligns with key recommendations by leading obesity prevention authorities. To our knowledge, the Minneapolis Staple Food Ordinance is the only policy of its kind in the US, and as such it could serve as an important model policy for other local governments if it is successful.
Interventions
OTHERPolicy
This local policy change (i.e., the Minneapolis Staple Foods Ordinance) establishes minimum stocking criteria for a wide array of healthy foods as a requirement of food store licensing. To our knowledge, it is the first and only policy of its kind in the U.S. This Staple Foods Ordinance requires stores to stock specific types of foods in minimum quantities and varieties, including fruits and vegetables, low-fat dairy, and whole grains. A full list of all requirements can be found online through the City of Minneapolis: http://www.minneapolismn.gov/health/living/eating/staple-foods.
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Centers for Disease Control and Prevention
University of Minnesota
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Must be 18 years of age or older * Must be able to speak and understand English * Must have purchased at least one food or beverage item from a randomly selected store that meets the following criteria: * Outside the central downtown commercial core * Not authorized to accept benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children * Valid licensing address * \>100 square feet of retail floor space * Not small vendors in market areas or specialty stores * Non-supermarket * Permission from store staff to recruit participants
Exclusion criteria
* Not meeting inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healthy Food Supply (store-level) | 24 months post-policy implementation (i.e., 12-months post-policy enforcement) | To assess changes in healthy and unhealthy food availability, we will use a tool developed at the Yale Rudd Center for Food Policy and Obesity to evaluate the impact of 2009 Special Supplemental Nutrition Program for Women, Infants, and Children policy revisions in small stores, with minor adaptations to suit the needs of our study (See Andreyeva et al, J Acad Nutr Diet. 2012;112(6):850-858). As detailed in Andreyeva et al, we will create and use an an adapted Healthy Food Supply (HFS) score that summarizes availability, price, quality, and variety in the stores in our sample.We will examine changes in healthy food supply scores over time in stores in our sample in Minneapolis (where the policy is in place, i.e., our intervention community) versus those in St. Paul (where no such policy exists, i.e., our control community). |
| Calories purchased (customer-level) | 24 months post-policy implementation (i.e., 12-months post-policy enforcement) | Our staff will examine all foods and beverages purchased (via a bag check) by participating customers existing stores in our sample and will record item names, product types and weights/sizes. We will conduct detailed nutrient analyses on these purchases to assess total calories purchased and possible changes in calories purchased over time, comparing relative changes in purchasing among participants recruited outside of stores in Minneapolis (where the policy is in place, i.e., our intervention community) versus those in St. Paul (where no such policy exists, i.e., our control community). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Healthy home food availability/obesogenicity score (customer-level) | 24 months post-policy implementation (i.e., 12-months post-policy enforcement) | Trained staffers will visit the homes of participants who report frequently shopping in small- and non-traditional food stores to complete a home food inventory using a validated assessment tool. (See Fulkerson et al, International Journal of Behavioral Nutrition and Physical Activity 2008;5(55).) Data collected using this tool will be used to create a validated summative obesogenicity score, as detailed in Fulkerson et al 2008. Changes in this score will be examined over time. |
Countries
United States
Outcome results
None listed