cfschcs final5.19.11

Healthy Corner Stores: Innovative Strategies and Implications

for Policy

National Food Policy Conference

May 20, 2011

Erin MacDougall, Public Health – Seattle & King County

Tammy Morales, Urban Food Link

Megan Rowan, Johns Hopkins University

John Weidman, The Food Trust

Overview

• Three sites: Philadelphia, Baltimore, and Seattle/King County

• Site and project descriptions

• Different phases and focus of each project

• Lessons learned

• Unifying themes

The Food Trust www.TheFoodTrust.org

Healthy Corner Store Initiative, Philadelphia

www.TheFoodTrust.org

www.TheFoodTrust.org

The Pennsylvania Fresh Food Financing Initiative

§ Public-private partnership

§ $120 million financing program that provides grants and loans to supermarkets and grocery stores

“Top 15 Innovations in American Government” – Harvard University’s Kennedy School of Government, 2009

www.TheFoodTrust.org

www.TheFoodTrust.org

Healthy Food Identification Campaign

corner store

Percentage of Stores Adding Healthy Products,

by Category*

*out of 358 stores evaluated for inventory additions as of March 7, 2011**refers to healthy snacks, water, and non-sugar-sweetened beverages

www.TheFoodTrust.org

Corner Store Conversions

www.TheFoodTrust.org

Anticipating the Challenges: Best Practices

• Ask, is this store a viable partner?– Understand challenges and

ask, is this store a good fit?

• Select an Experienced Operator– Also consider owner’s time

and level of commitment

• Identify a Project Manager

¨ To support owner throughout

¨ To connect and oversee everyone involved

• Create a plan to address training needs

¨ Consider training for business and financial management, POS system, buying, selling and handling produce

www.TheFoodTrust.org

Anticipating the Challenges: Best Practices

• Changes must be sustainable and replicable– Want a business model for

lasting and profitable changes

• Community must be ENGAGED– More likely to adopt healthy

changes and support the store– Partnerships with community

organizations are important

• Marketing Plan and Community Awareness– Making sure healthy

changes are advertised and community is aware

• Modest Changes go a long way

¨ Small changes to store layout and infrastructure are often all that’s required

www.TheFoodTrust.org

Other Resources:

Healthy Corner Store Network

www.healthycornerstores.org

Public Health Law and Policy

www.phlpnet.org

The Food Trustwww.thefoodtrust.org

Thanks!

Baltimore Healthy Stores Projects

Megan Rowan, MPHJohns Hopkins Bloomberg School of

Public Health

Baltimore City Food Environment

Type of food stores

(n=176)

Healthy Food Availability Index, mean(range 0-27)

Skim Milk, %

Fruit, %1-25≥ 26

Vegetable, %1-25≥ 26

Whole Wheat Bread,

%

Supermarkets

(16)19.0 100

2569

1381

100

Grocery/medium size corner stores

(107)

4.425

433

573

8

“Behind the glass” corner

stores(20)

2.00

00

00

0

Convenience stores (33) 3.8

36330

210 24

Baltimore Healthy Food Availability

Franco et al, 2008

Self Efficacy

Self Efficacy

Diet

-Energy Fat, Food Group Intake (e.g., fruits and

vegetables)

Diet

-Energy Fat, Food Group Intake (e.g., fruits and

vegetables)

Obesity and Diet-related

Chronic Disease

Obesity and Diet-related

Chronic Disease

Household

-Preparation -

Purchasing

Household

-Preparation -

Purchasing

Retail Food Stores

-POP Promotions,

Price, Availability

Retail Food Stores

-POP Promotions,

Price, Availability

Knowledge

Knowledge

Intentions

Intentions

Perceptions

Perceptions

Restaurants

-POP Promotions,

Price, Availability

Restaurants

-POP Promotions,

Price, Availability

Food Supply

-Manufactur

er-

Wholesalers-

Distributors

Food Supply

-Manufactur

er-

Wholesalers-

Distributors

Information

Environment

-Media-

Advertising

Information

Environment

-Media-

AdvertisingCommunit

yNutrition Environm

ent

-#/Types of Food

Sources

Community

Nutrition Environm

ent

-#/Types of Food

Sources

Peer Influences

-Peer diet-Mentoring

Peer Influences

-Peer diet-Mentoring

DHMH/DHHSDHMH/DHHS

Dept. of PlanningDept. of Planning

Food Policy CommitteesFood Policy Committees

Industry/Grassroots Advocacy

Industry/Grassroots Advocacy

PolicyPolicy

Food Retailer Criteria

Food Retailer Criteria

Environment/Institution Family/Household Individual

Conceptual Model

Baltimore City Healthy Store Programs

Baltimore Healthy Stores I & II (BHS)

OVERVIEW/AIMS: To increase access to healthy foods in

Baltimore City

• Stipend

To promote these foods at the point of purchase

• Posters, flyers, shelf labels, giveaways

• Taste testing, health education

To work in collaboration with community partners

BHS Materials Educational Display Flyer

Coupon

BHS Store Owner Training Materials

Nutrition Education Booklet (Korean)

Cultural Guidelines (Korean)

BHS Impact

Significant impact on food preparation methods and frequency of purchase of promoted foods

Positive trend for healthy food intention

Significant impact on healthy food stocking and sales

Song et al, 2009

Baltimore Healthy Eating Zones (BHEZ)

OVERVIEW:

Youth-targeted “healthy eating zones” around 14 rec centers

Increase availability, POPs, interactive sessions

Center, peer, and store staff training

INITIAL FINDINGS:

Significantly reduced BMI percentile in overweight girls

Baltimore Healthy Carryouts (BHC)

OVERVIEW:

Formative research: Availability, pricing and consumption of carryout foods (4 intervention; 4 control)

Develop and test interventions (menu-labeling, portion sizes, etc)

INITIAL FINDINGS:

Significantly increased sales of promoted foods

Baltimore Cornerstore Criteria Program

Literature review of US programs (n=15)

Interviews with key stakeholders

Online Surveys with Expert Panel

Weighted combined scores

Ranked Criteria for “Healthy Stores”

Data Collection and Analysis

BCCP: Findings

Baltimore Cornerstore Criteria Program

Analysis and Dissemination

BCCP Policy Report/Recommendations

• 2010 Zoning Rewrite: New “high” risk zone definition

• Licensing stipulations/fees

• Graded incentivization (licensing, tax, zoning)

Baltimore lessons learned

Healthy Store Programs: Keys Barriers

Risk of profit loss

• Low consumer demand, perishability, high price

Cultural/Linguistic communication barriers

Consumer demand

• Exposure, knowledge, taste preference, cost

Healthy Store Programs: Keys to Success

Address both supply and demand

Employ a evidenced-based strategies

Utilize a community-based approach• Acceptability and sustainability • Taste-preferences, barriers, facilitators,

media channels

Healthy Store Programs: Keys to Success

Work in multiple institutions to achieve high exposure

Simple strategies (≤20 foods, POP, Interactive Sessions)

Cost-neutral food replacements and incentives

Collaboration with policy-makers/

community leaders

www.healthyfoodshere.org

Southwest King County

• Roughly 340 square miles

• Eleven target communities

• 25-90% living 200% below FPL

www.healthyfoodshere.org

Project Goals• Increase availability of healthy food

and beverage products in target communities

• Increase in capacity of businesses to effectively participate in WIC/EBT

• Increase capacity of store owners to profitably sell healthy food

• Increase demand for healthy products in the participating businesses

Criteria for Prioritization• CPPW target communities

• Low access to healthy food retail

• Serving food insecure people

• Local interest

Consulting Services• Merchandising, store layout, inventory management,

distribution/supply chain development, WIC/EBT, etc.

Financial Incentives• Small Grants – up to $700 for baskets, produce scales, shop vac, small shopping carts• Seed Capital – up to $7500 (with 20% owner investment) for equipment• Low cost loans – to make store improvements, purchase equipment, provide working capital

Marketing Materials

Shelf Talkers

Cooler Signs

www.healthyfoodshere.org

“…including a grocery store in the commercial core.”

www.healthyfoodshere.org

www.healthyfoodshere.org

www.healthyfoodshere.org

www.healthyfoodshere.org

Seattle-King CountyLessons Learned

1. Include industry experts on the team2. Urban form affects ability to do this work3. Educational materials for store owners4. CBOs don’t necessarily have capacity to do this kind of

work; be clear about their experience5. Meet the stores where they are with business practices,

support improvements through technical assistance6. Hard to quantify impact- don’t share sales data, don’t

know customer counts and purchase patterns

www.healthyfoodshere.org

Summary

• Data driven

• Community supported

• Business-focused

• Policy supports for systems change

Our contact info:

Erin MacDougall, PhD Megan Rowan, MPHPublic Health – Seattle & King County Johns Hopkins Center for erin.macdougall@kingcounty.gov Human Nutrition206-263-8804mrowan@jhsph.edu

703-400-6513

Tammy Morales, MSCRP John Weidman, MAUrban Food Link The Food Trusttammy@urbanfoodlink.comjweidman@thefoodtrust.org206-396-1276 215-575-0444 x 135