Nashville’s CPPW Corner Store Initiative: Methods and Measurement

Celia Larson, PhDDirector of Evaluation Alisa Haushalter, DNP, RNProject Director

Bill Paul, MPH, MDDirector of Health

Annual Meeting of the American Public Health Association

October 31, 2012

The ChallengesGeographic areas that lack full service grocery stores are known as food deserts.

These areas have been shown to have:higher rates of obesity, chronic diseases, as well as, lower rates of fruit and vegetable

availability and consumption.

Primarily populated with low-income and racial and ethnic minority individuals and families.

Three food deserts were identified in the service area.

The Strengths

Strong Partnerships in each food desert Leaders of religious institutions Community organizations Community leaders

Food Advocacy (organizations and individuals) 501c3 – Community Food Advocates Mobile Market Metro Farmers Market

Preliminary work prior to grant achieved:Emerging community awareness of the problem. Broad identification of population areas in need. Establishment of a mobile food supplier.

CPPW Corner Store Objective:

Access to healthy foods and beverages will be

improved among low income residents by

increasing shelf space by 20% for selling healthy

foods and beverages in corner stores located

in 3 geographic areas that are defined as food

deserts in low-income neighborhoods.

MethodsRefinement of Food Desert

Definition & Geography

Store Selection for Intervention

Strategy Development & Implementation

Assessment Tools & Process

Refinement of Food Desert Definition & Geography Four food deserts establishedCorner/Convenience stores were

mapped.

Data Sources: Census Data and Metro Planning & Transit Departments Data

Store Selection for Intervention

Criteria developed to select stores to receive intervention Presence of assets and resources in neighborhoods

5 stores selected

Presence of Assets and Resources for each Store

 

Store

 

Sidewal

ks

Schools/Childcare Facilities

Public Housing/Residential

Religious Institutions

Business

es

Parks/Community Centers

Store

A

Store

B

Store

C  

Store

D   

Store

E  

Strategy Development and Implementation

Listening sessions held in each neighborhood

Interviews conducted with store proprietors

Community Sensitive Strategies

Strategy Development and Implementation Technical Assistance

Structural support items such as displays and coolers

Procurement of products not currently retailed

How to promote and direct consumers to items

Neighborhood PartnershipsFaith CommunityBusiness Community

Communications Campaign Corner Store Logo NashVitality CampaignBillboards & Print Ads

Assessment Tools & Process

Baseline Assessment to Inform StrategiesProprietor Interviews Neighborhood Listening Sessions

Pre-Post Measures: Store AuditsStore Audits: Nutrition Environment

Measures Survey-Corner Stores (NEMS-CS) Tool

Pre-Post Measures: Customer Intercepts Store Customer Intercepts: Standardized

NEMS protocol and training materials

Evaluation Results Qualitative Analysis Results – Proprietor Perceptions  

Store

A

Store

B

Store

C

Store

D

Store

E

Barriers          

Neighborhood Crime / Shoplifting Structural support for selling items (coolers/displays)        

Strengths          

Dense residential area  

High foot traffic      

Families - primary customer      

Only store in area/great location      

Role of Store          Supports community as a sponsor of sports or events      Customers proud of or like having store in neighborhood  

Evaluation Results Qualitative Analysis Results – Neighborhood Listening Sessions

Themes identifiedConsumer Education (Clergy & Residents)

Poor Quality Produce (Clergy & Residents)

Mistrust of Store Owners (Clergy & Residents)

Mistrust of Government (Clergy & Residents)

Evaluation Results: Store Outcomes

Audit results (3 stores)

Fruit – Availability & variety increased in all stores

Vegetables – Availability & variety increased in all stores

Milk – Low fat availability increased in 2 of 3 stores

Whole Wheat Bread – Availability & variety increased in all stores

Evaluation Results: Store Outcomes Increase in Variety and Space Available

Fruit Va-riety

Vegetable Variety

Whole Wheat Bread Brands

Columns for Low Fat

Milk

3

10

1 1

15

35

2

29

PrePost

Evaluation Results: Consumer Purchases

Fruit

Vegetables

2% Milk

Whole Wheat Bread

Chips

Beverages

Refrigerated Food

Pastry

Dry Family Products

Prepared Food

Candy

Nuts, Seeds,Granola

1.3%

0.0%

0.0%

0.0%

30.3%

26.5%

16.4%

11.3%

1.3%

10.1%

1.2%

1.2%

5.5%

11.9%

0.0%

0.0%

20.1%

22.0%

17.4%

9.1%

12.8%

0.9%

0.0%

0.0%

PostPren = 89

n = 103

Lessons Learned to Date

Start Small Community Engagement Expertise in Food Retail &

Marketing Utilize National Expertise Standardized Evaluation Communication Coordination of Efforts

Disclosures

This project was supported in part by a contract through Metro Public Health Department , Nashville , TN with a cooperative agreement (1U58DP002447-01) with the Centers for Disease Control and Prevention. Portions of this project’s work involve the Communities Putting Prevention to Work initiative supported by CDC funding. However the findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.