Scores for StoresA unique approach for communicating & evaluating store quality

Presented by: Alyssa Ghirardelli, MPH, RDValerie Quinn, M.Ed., Sharon Sugerman, MS, RD, FADA, Ellen Feighery, MS, RN

Presenter Disclosures

(1) The following personal financial relationships with commercial interests relevant to this presentation existed

during the past 12 months:

Alyssa Ghirardelli, MPH, RD

No relationships to disclose

Research: Clear connection between neighborhood factors & health outcomes

Neighborhoods Matter

Obesity Poor nutrition

Diabetes Cancer

Stroke

CX3: Project Background

Objectives:1. Collect real-world data that accurately conveys

neighborhood conditions

2. Activate consumers to improve food availability in low-income neighborhoods*

Focused initiative with CA 25 local health depts.• Began 2006 (6 pilot sites)• Collect neighborhood-level data using CX3

standardized tools & methods • Over 100 neighborhoods

* >50% at or below 185% Federal Poverty Level

Neighborhood Nutrition Data

• Look at nutrition in the broadest sense: All about understanding how consumers are influenced in their food choices.

– Are healthy food choices available and accessible to residents of low-income neighborhoods?

– How many fast food outlets are in neighborhood and around schools? What’s the proportion to large grocery stores?

– How much and what are the types of nutrition marketing messages around schools? At stores?

– Safely walk to store? Is it accessible?

– And more!

Data Uses

• Expose disparities

• Resource allocation

• Engage residents in advancing change

• Program planning- tailor interventions

• Real-world data to create healthier neighborhoods– City/Co Planners, Redevelopment

agencies, inform General Plan, health impact, etc.

• Program evaluation

Tier 1: GIS Mapping

Tier 2:

Field

Surveys

Tier 3: Community Assets

• Grocery stores and small markets– Different types of stores (large to small, c-stores, etc)

– Availability and quality of fruits and vegetables, new WIC pkg

– Fruit and vegetable prices

– Marketing of healthy/unhealthy foods

CX3 Data Collection: Field Surveys

• Walkability & Safety

• Fast food– Availability of healthy options– Menu labeling– Marketing

• Outdoor marketing

• Food Banks

• Alternative Healthy Food Sources

Problem: Mountain of data

Need: Descriptive, easy way to compare.

CX3 Store Data Analyses

Store survey

Store tool

• Algorithms constructed to calculate scores from raw data– Automatically generates scores

• Only positive conditions get points!• Levels for maximum and “meets

standards” points per category• Max total: 100 points; 75 points

indicates “quality” store – Emphasis on access & availability, less for marketing &

product placement

• Reliability testing conducted- tested well– Reported in Journal of Nutrition Education & Behavior, July/Aug 2011

Categories and Point Structure

Category Max score

Meeting standards (min)

EBT/SNAP and WIC Access 10 5

Fruit availability & quality 20 18

Veg availability & quality 20 18

F/V Prices w/in county-level reasonable price

10 7

Other healthy foods available 10 8

Nutrition information available and/or promoted

4 3

Limited exterior marketing 8 4

Limited interior marketing 8 5

Walkability/safety around store 10 7

TOTAL: 100 75

• 9 subcategory guides areas of focus w/in retail store

CX3 Store Analyses

Scored only 47 pts!

Looks are deceptive

Food Store Types in CX3 Neighborhoods 2007-2010

Store Scores by Store Type 2008 – 2010

WIC - Store Scores2008-2009

n= 86 stores

5% of non WIC vendors were quality

stores

Retail Improvement Examples• Sonoma: Developed city incentive pilot program in

Santa Rosa city• 75 points + subcategories

• Orange County: Significant improvements in the Mission neighborhood, now 3 healthy grocery stores

• Santa Clara: Designated food desert now has a food bank mobile van with fresh f/v

• Contra Costa: Target by Community-Based Organizations, 3 Latino indep. markets now accept WIC

CX3 Success Stories (cont.)

• San Mateo: YO! Mateo youth interviewed about the Healthy Neighborhood Stores campaign and the Friday Night Live Network on "Beyond the Headlines" with Cheryl Jennings on ABC7 news

http://abclocal.go.com/kgo/video?id=8270974(The segment can be found exactly at the 18:22 mark of the video if you would like to fast forward to the interview.)

Benefits

• Advances local change – Proven!

• Puts local groups at forefront for obesity prevention

• Standardized indicators, methods, tools

• Appealing to funders

JNEBPublication

• Recent July/Aug Publication in Journal of Nutrition Education and Behavior, covering reliability results and store scores

• Supplement covering findings from Network for a Healthy California

Thank you!

This material was produced by the California Department of Public Health’s Network for a Healthy California with funding from USDA SNAP, known in California as CalFresh (formerly Food Stamps). These institutions are equal opportunity providers and employers. CalFresh provides assistance to low-income households and can help buy nutritious foods for better health. For CalFresh information, call 1-877-847-3663. For important nutrition information, visit www.cachampionsforchange.net.

Alyssa Ghirardelli, RD, MPH - Network for a Healthy California Alyssa.Ghirardelli@cdph.ca.gov916.449.5342

Valerie Quinn, M.Ed. - Network for a Healthy CaliforniaValerie.Quinn@cdph.ca.gov916.552.9908

CX3 Website:http://www.cdph.ca.gov/programs/cpns/Pages/CX3_Main_Navgation.aspx