This document summarizes a study assessing the nutrition environment in Philadelphia through in-store marketing and perceived nutrition environment measurement surveys. The study aims to evaluate the impact of in-store marketing strategies on decreasing unhealthy food sales and increasing healthy food sales. Researchers developed tools to measure the grocery marketing environment and perceived nutrition environment. Preliminary findings from surveys suggest the importance of factors like public transportation, cost, and convenience when shopping and eating out.

1. ASSESSING THE PHILADELPHIA
NUTRITION ENVIRONMENT:
IN-STORE MARKETING AND
NEMS
1 Alison Leung and Gabriela Abrishamian-Garcia
Mentor: Karen Glanz, PhD., MPH.

2. OUTLINE
 Overview of nutrition
environments
 In-Store Marketing
 Perceived Nutrition
Environment Measurement
Survey (NEMS-P)
2

3. NUTRITION ENVIRONMENTS
[GLANZ, SALLIS, SAELENS & FRANK 2005]
3

4. IN-STORE MARKETING PROJECT
4
Funded by the Robert Wood Johnson Foundation

5. 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
5

6. AIMS
 Design and conduct a pilot study
to evaluate the impact of low-cost “Simply Inseparable”
Cross-promotion of milk and Oreos
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 6

7. 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
7

8. 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
8

9. 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 9
 Frozen Dinners
 Beverages

10. 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 Example of an “Island” of produce
 Create composite scores to prompt 10
and evaluate change

11. MY ROLE
 Test GMEA tool and begin
collecting data
 Assist with focus groups
 Create GMEA data
dictionary
11
Collecting data in a corner store

12. PRELIMINARY OBSERVATIONS
12

13. LESSONS LEARNED
 Changes to the grocery store environment are
crucial
 Complexity of factors that affect food purchases
 Importance of collaboration between different
stakeholders
13

14. NUTRITION ENVIRONMENT
MEASUREMENT SURVEY -
PERCEIVED (NEMS-P)
14
Funded by Abramson Cancer Center
PA Tobacco Settlement Fund

15. 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
15

16. 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
16

17. 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
17

18. MAIN MEASUREMENT
Measuring the Perceived Measuring the Observed
Nutrition Environment Nutrition Environment
 Recruitment began in  Evaluated using the
November 2010 Nutrition Environment
Measures Survey
 Participants were
(NEMS)
asked to complete the
survey 2 different  Trained staff are
collecting NEMS for a
times, 2-3 weeks sample of the
apart. restaurants and stores
 Surveys could be  A portion of the
completed in-person restaurants and stores
or through the mail. are being double rated
for inter-rater reliability 18

19. NUTRITION ENVIRONMENT MEASUREMENT
SURVEY-STORES AND CORNER STORE
(NEMS-S AND NEMS-CS)
 11 measures  Measures…
 Milk  Price
 Fruit  Availability
 Frozen and Canned  Quality
Fruit
 Vegetables
 Frozen and Canned
Vegetables
 Ground Beef
 Hot Dogs
 Frozen Dinners
 Baked Goods
 Beverages
 Bread
 Chips and Snacks Produce section of convenience store in
 Cereal West Philadelphia
19

20. NUTRITION ENVIRONMENT MEASURES
SURVEY (NEMS)
Restaurants (NEMS-R) Stores (NEMS-S)
 Data collected with paper survey  Data collected with PDA survey
20

21. DATA COLLECTION
21

22. CURRENT STATUS
 NEMS-S data
collection
 Data cleaning
 Data analysis
22

23. MY ROLE
 Scanned surveys
 Data collection using NEMS-S
 Compiled survey comments for
review
Collecting data in a corner store
23

24. 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.
24

25. 25
PRELIMINARY FINDINGS FROM
NEMS-P

26. NEMS-P SAMPLE
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
26

27. IMPORTANCE OF PUBLIC TRANSPORTATION
WHEN SHOPPING FOR FOOD
27

28. IMPORTANCE OF BUYING FOOD NEAR
HOME
28

29. IMPORTANCE OF COST WHEN SHOPPING
FOR FOOD
29

30. IMPORTANCE OF CONVENIENCE WHEN
EATING OUT AT A RESTAURANT
30

31. IMPORTANCE OF WEIGHT CONTROL WHEN
EATING OUT AT A RESTAURANT
31

32. 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

33. QUESTIONS/COMMENTS?
33