To enhance access to healthier foods, the U.S. Department of Agriculture (USDA) recently proposed new stocking standards for stores eligible to accept Supplemental Nutrition Assistance Program (SNAP) benefits. It is unknown how many stores are currently in compliance with the proposed enhanced retailer standards; what support rural stores need to successfully stock and engage families in purchasing and consuming the newly stocked healthier items; and how the standards will impact child dietary intake. This quasi-experimental, multi-level community-based research trial will focus on small retail food outlets in low-income, Appalachian counties in Tennessee and consist of three intervention arms: 1) using storeowner-focused strategies (S-only) to increase access to healthier food; 2) using storeowner and family-focused strategies (S+F) to increase access to and demand for healthier items; and 3) a delayed-intervention comparison. The aims of the study are to: 1) assess compliance of SNAP-eligible stores with the proposed SNAP enhance retailer standards in low-income, Appalachian counties in Tennessee; 2) determine the impact of S-only and S+F intervention strategies compares to delayed-intervention on: a) achieving and sustaining stocking levels that meet the SNAP enhanced retailer standards; b) sales of healthier items; c) parental perceptions of community and home food availability; and d) child dietary intake; and 3) determine the most cost-effective intervention (S-only or S+F) to help storeowners stock and sell healthier items.
Testing Strategies to Reduce Obesity by Increasing Access to and Demand for Affordable, Healthier Food in Retail Groceries in Rural Appalachia
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