4/22/2015 1 Eat Right, Live Well! A supermarket intervention to increase healthy food purchases Sheryl Hoehner, MS, RD, LD, Food Depot Anne Palmer, MA, Johns Hopkins Center for a Livable Future, Bloomberg School of Public Health MAND, April 24, 2015 Why Food, Why Now? • Dramatic increase in diet- related disease, portion sizes • Ubiquity of processed food • Impact on environmental sustainability and climate change • Increasing markets for local and regional food producers • Local economic development in post-industrial urban areas Thriving Local Economies Vibrant Farms Healthy People Healthy Ecosystems Strong Communities Baltimore Food Policy Initiative (BFPI) • Inter-governmental collaboration: – Baltimore Office of Sustainability, Department of Planning, Health Department, Baltimore Development Corporation • Food Policy Advisory Committee (Food PAC) – Provides Advisory Capacity to implement Food Policy Taskforce recommendations – 60 Diverse stakeholders (including anti- hunger community, Extension, city government, nonprofits, schools)
Transcript
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Eat Right, Live Well! A supermarket intervention to
increase healthy food purchases
Sheryl Hoehner, MS, RD, LD, Food Depot
Anne Palmer, MA, Johns Hopkins Center for a Livable Future, Bloomberg School of Public Health
MAND, April 24, 2015
Why Food, Why Now?
• Dramatic increase in diet-related disease, portion sizes • Ubiquity of processed food • Impact on environmental sustainability and climate change • Increasing markets for local and regional food producers • Local economic development in post-industrial urban areas
Thriving
Local
Economies
Vibrant
Farms
Healthy
People
Healthy
Ecosystems
Strong
Communities
Baltimore Food Policy Initiative (BFPI)
• Inter-governmental collaboration: – Baltimore Office of Sustainability,
Department of Planning, Health Department, Baltimore Development Corporation
– 60 Diverse stakeholders (including anti-hunger community, Extension, city government, nonprofits, schools)
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Definition:
• ¼ mile from grocery store
• Low vehicle availability
• At or below 185% federal poverty level
• Low Healthy Food Availability Score based on the Nutrition Environment Measurement Survey
Impact:
• 20% of city residents in food deserts, (120,000 residents)
• 23% of school aged children (31,000) • 26% of African American (105,000) • 82.5% employed • 24.5% receive SNAP benefits,
compared to 12% in non food desert
Food Desert Map
• Healthy Food Challenge Grants – 11 schools
• Let’s Move Salad Bar Initiative – 10 new salad bars
• Fruit and Vegetable Program – 86 schools
Healthy Food in Schools
• Vacant land assessment
• Leasing land to urban farmers
• Updated animal husbandry regulations
• Comprehensive urban agriculture plan
• Updated city building code
Homegrown Baltimore Grow Local, Buy Local, Eat Local
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• Goals – Fruit & vegetable
campaign by youth, for youth
– Food media literacy • 2,000 elementary
students – 250 ads in metro
buses • 5 Public service
announcements • Funded by Kaiser
Permanente
Get Fresh Baltimore
Public Markets • Retail strategies for carryouts to
provide/display healthier choices – Create healthy menu labels & displays
– Change menus to include healthier sides & combo meals
– Pilot healthy carryout certification
• Increase demand for healthy food purchasing
– Cooking demos & nutrition education
– Coupons and incentives for healthy choices
• Local farm stands
– Day stalls for local farmers
The Intervention
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Program Overview
Goal: To increase sales of promoted healthy foods
Activities
• Identify promoted healthy products with shelf labels, posters and signage (475 items)
• Create new healthy product displays
• Offer taste tests and recipe cards for promoted foods
• Reduce prices of promoted healthy foods
• Train employees in promoting healthy eating
Shelf Labeling
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Signage
Signage
Taste Tests and Recipe Cards
• Shoppers try promoted products
• Shoppers sample healthy recipes
– Cucumber salad, three bean salad
• Goals:
– Give shoppers confidence that they won’t waste new healthy foods
– Interact with shoppers, explain Eat Right, Live Well
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Taste Tests
Taste Tests
Sales and Price Reductions
• Sales promoted in circular
• Price matching for healthy alternatives
– Low fat and regular salad dressing
– 1% and Skim milk at lower price
• Sales on products in “Eat Right, Live Well!” displays
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The Circular
• Common to both stores
Community Outreach
• Outreach events include:
– Eat Right Live Well healthy eating workshops
– Tabling at school events & health centers
– Community dinners and discussions
– Healthy grocery shopping tours
• Community partners include:
– Schools, Head Start centers, senior living facilities, churches, abuse recovery centers, other community organizations
Community Workshops
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• Goal:
– Help families make healthy and budget-friendly choices
• Content:
– Reading food labels
– Identifying whole grain foods
– Comparing unit prices
– Practicing buying healthy foods on a budget
“Shopping Matters” Tours
Other Activities
• Store staff orientation and training
• “Eat Right, Live Well!” employee recognition award
• Store employee advisory board meetings (bi-monthly)
• Loudspeaker announcements
• Giveaways – water bottles, bags, buttons, label reading guides
• Healthy shelf at three checkout aisles
Data Collection
• Process evaluation of implementation – Intercept interviews (3 months after start, N=100) – Bi-monthly process evaluation (check on signage, sales,
end of aisle displays) – Documentation of taste tests and community events
• Employee Impact Questionnaire – Pre and post-intervention for Store employees
• Quantitative evaluation – To compare changes in sales on promoted items from this
intervention store to that of a control store • Three months back, one year back
– Calculate net impact on store profits
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Topline Findings
• Measured sales changes for 4 months
• Label fidelity at >75% during this time.
• Overall sales of all promoted items:
– Downward trend before the intervention
– Slowed in the control store and reversed in intervention store.
– Sales of promoted items increased 23% in the intervention store vs 6% in the control store.
Categories of Food
• Greatest changes were found in sales of produce, soda (diet), healthy snacks & desserts
• Labeling correctly consistently associated with higher sales of item.
• Lower sales of dairy may be related to lack of labeling fidelity.
Study Limitations
• 4 month measurement
• Store renovation started while intervention was happening.
• Shoppers shop 1x/month, less exposure.
• Number of items difficult to track
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Implications for Food Retail
• Labeling matters
• Incentivize stores to label? Promotion of those stores that participate
• Incentives for SNAP users to purchase produce
• Current USDA funding just announced for Food Insecurity Nutrition Incentives (FINI)
Creation of In-Store Program
• Met with students and researchers
– Interview to find out what they had done
– Gather information to find out what was successful and what was not
– Observe grad student’s child friendly demos
• Also met with leaders at WIC and SNAP to gain their perspective and learn more about programs
Create my Brand
• Short time frame with big expectations!
• Red cart and establish Sheryl’s Corner
• Buttons for employees and postcard
• Purchase lab coat with credentials
• In store each week (Frederick Ave and Belair)
• Poster on a stand near my “corner”with my photo and credentials
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Sheryl’s Corner
Goals for Program
• Monthly theme for in-store and circular:
– Decide most important ideas to teach
– Examples of recent themes: April: Whole Grains- Offering tastings of whole wheat bread, Essential Everyday Wheat Waffles, EE Instant Brown Rice and pastas, May: Dairy month with yogurt parfait for Mother’s day
Goals for Program
• Sheryl’s Corner in the Sales Flyer each week
– Keep it simple and build on message
– 8 page ad during SNAP benefit time and 4 page ads the other weeks of the month
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Goals for Program • Other advertising
• Overhead announcements
• Chalkboard signs by my cart
• Painted advertising on the windows
Goals for Program
• Displays and committed shelf for featured foods. Changed on monthly basis
– Work to make sure right food is on shelf with recipe (brown rice not white)
– Work with the buyer to have on sale
– Work to have item on shelf when featured
Sheryl’s Shelf
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Establish community relationships
• Health fairs
• Church events
• Forums (B’More Healthy Communities for Kids)
• Senior Center Programming
• B’More Healthy Baltimore convention
– Booth- Ask the Rd
– Demo on Cooking stage (Let’s Talk Chicken)
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Students
• JHU grad students have come to have “class” in the store
• High school students – store as classroom
• JHU Master’s in Dietetics have spent day
• JMU dietetic student spent two summers with me
What has and has not worked
• Traditional way of offering classes and tours has not worked ( having customers sign up)
• Has worked: Shoppers stopping to try food in demo( average 70-100 conversations in 2 hours!)
• Offering short tours on the spot
• Customers reading information in sales flyer and then coming in to see me
• Associates wanting to learn more and change behaviors ( 1 lost weight to give a kidney, HTN)
Weight Loss Challenge
• Ten weeks (Feb 2015-April 11, 2015)
• 500 employees (84 signed up) – Both Food Depots, Both Cash and Carry locations as
well as Corporate Office and Howard County store
– Only 6 dropped out
– 21 no weight loss but many changed some habits
– 57 have lost weight ( better than 2/3)
– 21 lost 2-3.9% of weight
– 21 lost 4-4.9% of weight
– 17 lost 5-12% of weight
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ERLW Employee Weight Loss Contest
• 10 weeks Feb 2-April 11 2015)
• 84 signed up (76 finished contest)
– 30% (23 employees) lost 10+ pounds
– 21% (16 employees) lost 5-10 pounds
– 21% (16 employees) lost 1-4 pounds
– Grand prize winner lost 42 pounds
– Runners up each lost 29 pounds
Our “Champ”
Customers
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Oldways and Whole Grain Council
• Supportive network
• Resources available (handouts and demo ideas)
• Have met vendors who have come along side
National Retailer’s Award
• B. Green won “Best of Show” February 2014 for the Eat Right Live Well program in our store!
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Ongoing ideas • Monthly tours based on theme of month
