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      An evaluation of the impact of a restrictive retail food environment intervention in a rural community pharmacy setting

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          Abstract

          Background

          Sugar-sweetened beverage consumption is associated with morbidity and mortality. The retail food environment influences food and beverage purchasing and consumption. This study assesses the impact of a community pharmacy’s removal of sweet beverages on overall community sales of carbonated soft drinks (CSD) in a rural setting. We also examined whether the pharmacy intervention affected CSD sales in the town’s other food stores.

          Methods

          Weekly CSD sales data were acquired from the three food retailers in the town of Baddeck, Nova Scotia (January 1, 2013 to May 8, 2015, n = 123 weeks). Autoregressive integrated moving average (ARIMA) analysis was used to analyse the interrupted time series data and estimate the impact of the pharmacy intervention (September 11, 2014) on overall CSD sales at the community level. Data were analysed in 2015.

          Results

          Before the intervention, the pharmacy accounted for approximately 6 % of CSD sales in the community. After the intervention, declines in total weekly average community CSD sales were not statistically significantly. CSD sales at the other food stores did not increase after the pharmacy intervention.

          Conclusions

          This study was among the first to examine the impact of a restrictive retail food environment intervention, and found a non-significant decline in CSD sales at the community level. It is the first study to examine a retail food environment intervention in a community pharmacy. Pharmacies may have an important role to play in creating healthy retail food environments.

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          Most cited references18

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          New neighborhood grocery store increased awareness of food access but did not alter dietary habits or obesity.

          National and local policies to improve diet in low-income US populations include increasing physical access to grocery stores and supermarkets in underserved neighborhoods. In a pilot study that evaluated the impacts of opening a new supermarket in a Philadelphia community considered a "food desert"-part of the Pennsylvania Fresh Food Financing Initiative-we found that the intervention moderately improved residents' perceptions of food accessibility. However, it did not lead to changes in reported fruit and vegetable intake or body mass index. The effectiveness of interventions to improve physical access to food and reduce obesity by encouraging supermarkets to locate in underserved areas therefore remains unclear. Nevertheless, the present findings suggest that simply improving a community's retail food infrastructure may not produce desired changes in food purchasing and consumption patterns. Complementary policy changes and interventions may be needed to help consumers bridge the gap between perception and action. The replication of our findings in other settings and research into the factors that influence community residents' receptivity to improved food access are urgently required.
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            Interventions in Small Food Stores to Change the Food Environment, Improve Diet, and Reduce Risk of Chronic Disease

            Introduction Many small-store intervention trials have been conducted in the United States and other countries to improve the food environment and dietary behaviors associated with chronic disease risk. However, no systematic reviews of the methods and outcomes of these trials have been published. The objective of this study was to identify small-store interventions and to determine their impact on food availability, dietary behaviors, and psychosocial factors that influence chronic disease risk. Methods From May 2009 through September 2010, we used PubMed, web-based searches, and listservs to identify small-store interventions that met the following criteria: 1) a focus on small food stores, 2) a completed impact evaluation, and 3) English-written documentation (peer-reviewed articles or other trial documents). We initially identified 28 trials; 16 met inclusion criteria and were used for analysis. We conducted interviews with project staff to obtain additional information. Reviewers extracted and reported data in a table format to ensure comparability between data. Results Reviewed trials were implemented in rural and urban settings in 6 countries and primarily targeted low-income racial/ethnic minority populations. Common intervention strategies included increasing the availability of healthier foods (particularly produce), point-of-purchase promotions (shelf labels, posters), and community engagement. Less common strategies included business training and nutrition education. We found significant effects for increased availability of healthy foods, improved sales of healthy foods, and improved consumer knowledge and dietary behaviors. Conclusion Trial impact appeared to be linked to the increased provision of both healthy foods (supply) and health communications designed to increase consumption (demand).
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              Theory and practice in the study of influences on energy balance-related behaviors.

              This paper aims to provide an overview of different theoretical approaches in the study of determinants of energy balance-related behaviors (EBRBs). The Environmental Research framework for weight Gain prevention (EnRG) is used as a general framework to guide the overview. Theoretical approaches in the integrated study of EBRBs are discussed, as well as theories addressing environmental factors, mediating factors, moderating factors and automatic environment-behavior links. Five distinct topics should be deliberated when researchers conceptualize their research model: (1) to apply a theory-based approach in their determinants study within the broader perspective of systematic obesity prevention, (2) to incorporate the notion of potential clustering of (motives to engage in) EBRBs, (3) to accompany research towards environmental determinants of EBRBs with the operationalization of factors that may mediate the environmental influence, (4) to hypothesize both mediated and unmediated paths in environment-behavior relations, and (5) to incorporate potential moderators of the studied influences on EBRBs in the research design. The choice for change objectives and subsequent obesity prevention intervention strategies may be optimized when relevant determinants are interpreted as either primary (direct) causal factors, mediated determinants, mediating determinants or as moderators of causal factors. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                519-888-4567 , lminaker@uwaterloo.ca
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                16 July 2016
                16 July 2016
                2016
                : 16
                : 586
                Affiliations
                [ ]Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
                [ ]Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
                [ ]Atlantic Pharmasave, 491 Chebucto St, Baddeck, NS B0E 1B0 Canada
                [ ]Toronto Public Health, 277 Victoria Street, 5th Floor, Toronto, ON M5B 1W2 Canada
                [ ]Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 230 Elizabeth Ave, St. John’s, NL A1B 3X9 Canada
                Article
                3281
                10.1186/s12889-016-3281-9
                4947263
                27423902
                be3e6532-0712-45bc-8204-01ae42bf4b70
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 October 2015
                : 7 July 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000015, Canadian Cancer Society Research Institute (CA);
                Award ID: Major Program Grant #701019
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research (CA);
                Award ID: Research Fellowship
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                Public health

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