Process Evaluation of a Comprehensive Supermarket Intervention in a Low-Income Baltimore Community

Area of Science:

• Public Health
• Nutrition Science
• Health Behavior

Background:

• Supermarket interventions can improve food environments and reduce chronic disease risk in underserved communities.
• Environmental barriers often hinder healthy food purchasing among low-income populations.
• The 'Eat Right-Live Well!' program aimed to address these barriers within a specific supermarket.

Purpose of the Study:

• To implement and evaluate a multicomponent intervention in a supermarket to reduce barriers to healthy food purchasing.
• To assess the implementation fidelity, reach, and dose of various intervention components.
• To determine the impact of employee training on staff knowledge and behavioral intentions regarding healthy purchasing.

Main Methods:

• A multicomponent intervention including shelf labels, promotions, taste tests, product expansion, outreach, and employee training was implemented.
• Implementation was evaluated using store environment forms, taste test evaluations, community event forms, and an Employee Impact Questionnaire.
• Fidelity, reach, and dose were assessed for different intervention components.

Main Results:

• Healthy food stocking, labeling, and advertising were implemented with high to moderate fidelity.
• Taste tests achieved moderate reach but low dose, while community outreach had high reach and dose.
• Supermarket employee training did not significantly improve employee knowledge, self-efficacy, or behavioral intentions related to healthy purchasing.

Conclusions:

• Components of the 'Eat Right-Live Well!' intervention showed varying implementation success in a large supermarket setting.
• Effective implementation of healthy eating promotion requires strong management and employee participation.
• Future interventions should focus on enhancing employee engagement and support for healthy food initiatives.