B’More healthy: retail rewards - design of a multi-level communications and pricing intervention to improve the food environment in Baltimore City

BMC Public Health

Joel Gittelsohn³  Fred A Katz⁶  Lisa Powell⁴  Kevin D Frick⁶  Divya Prasad¹  Jayne K Jeffries²  Alison Cuccia⁵  Nadine Budd³ 

[1] Joseph Stokes, Jr. Research Institute, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA;The Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill 27599, NC, USA;Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore 21205, MD, USA;Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA;Army Institute of Public Health, Health Promotion & Wellness Portfolio, USAPHC, ATTN: MCHB-IP-H, 5158 Blackhawk Road, Aberdeen Proving Ground, Aberdeen 21010, MD, USA;Carey Business School, Johns Hopkins University, 100 International Drive, Baltimore 21202, MD, USA

关键词: Urban;    Low-income;    Intervention;    Pricing;    Food access;    Food stores;    RCT;    Obesity;   

Others  :  1170973
DOI  :  10.1186/s12889-015-1616-6

 received in 2015-02-19, accepted in 2015-03-05,  发布年份 2015

【 摘 要 】

Background

Low-income black residents of Baltimore City have disproportionately higher rates of obesity and chronic disease than other Maryland residents. Increasing the availability and affordability of healthy food are key strategies to improve the food environment and can lead to healthier diets. This paper describes B’More Healthy: Retail Rewards (BHRR), an intervention that tests the effectiveness of performance-based pricing discounts and health communications, separately and combined, on healthy food purchasing and consumption among low-income small store customers.

Methods/design

BHRR is 2x2 factorial design randomized controlled trial. Fifteen regular customers recruited from each of 24 participating corner stores in Baltimore City were enrolled. Food stores were randomized to 1) pricing intervention, 2) communications intervention, 3) combined intervention, or 4) control. Pricing stores were given a 10-30% price discount on selected healthier food items, such as fresh fruits, frozen vegetables, and baked chips, at the point of purchase from two food wholesale stores during the 6-month trial. Storeowners agreed to pass on the discount to the consumer to increase demand for healthy food. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests, and refrigerators. Primary outcome measures include consumer food purchasing and associated psychosocial variables. Secondary outcome measures include consumer food consumption, store sales, and associated storeowner psychosocial factors. Process evaluation was monitored throughout the trial at wholesaler, small store, and consumer levels.

Discussion

This is the first study to test the impact of performance-based pricing and communications incentives in small food stores, an innovative strategy to encourage local wholesalers and storeowners to share responsibility in creating a healthier food supply by stocking, promoting, and reducing costs of healthier foods in their stores. Local food wholesalers were involved in a top-down, participatory approach to develop and implement an effective and sustainable program. This study will provide evidence on the effectiveness of price incentives and health communications, separately and combined, among a low-income urban U.S. population.

Trial registration

ClinicalTrials.gov: NCT02279849 webcite (2/18/2014).

【 授权许可】

   
2015 Budd et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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