eat right, live well! a supermarket intervention to … annual meeting/2015...4/22/2015 1 eat right,...

4/22/2015

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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

• 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)

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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

• Get students involved to expand my efforts

• Get more vendor support

• Bring Food Play to B’ More Healthy Baltimore

How Can YOU help?

• Help me get the message out to your clients:

– Food Depot carries local produce year round

– We have in-store butcher and fresh fish market

– I’m available for in-store guidance for free

• Handout to give to clients