Does a New Supermarket Improve Dietary Behaviors of Low-income African Americans?

描述（由申请人提供）：一个新的超市是否改善了低收入非洲裔美国人的饮食行为？肥胖对我们国民的健康构成严重威胁。在美国，三分之二的成年人超重或肥胖，低收入和少数种族/民族受到不成比例的影响。不良的饮食质量和模式是肥胖的关键风险因素，饮食和肥胖都是癌症和其他慢性病的既定风险因素。越来越多的证据表明，改变食物环境以支持健康饮食可能对饮食和肥胖产生可持续的人口影响。然而，对环境方法的研究不足。 2010年，一家价值850万美元的全方位服务杂货店，由公共和私人资金资助，将改变宾夕法尼亚州匹兹堡邻近社区希尔区的食品零售格局。这种公私联合的奋进提供了一个独特的和关键的时机，以研究如何改变健康食品的可用性影响食品购买和饮食摄入的居民在美国社区。这家提供全方位服务的杂货店将是近30年来这个低收入、主要是非洲裔美国人社区的第一家。这项拟议中的研究将利用这一自然实验。我们的具体目标是（1）描述在引入全方位服务杂货店之前和之后，食品零售场所内健康和不太健康的选择的可用性、价格和货架空间;（2）确定引入全方位服务杂货店对食品购买行为和饮食摄入的影响;以及（3）确定这些关联被接入因素修改的程度（例如，交通工具和与杂货店的空间接近程度）和社会文化因素（例如，对健康饮食的态度，对健康饮食的感知障碍，以及对健康饮食的社会支持）。我们建议使用一个匹配的准实验设计，包括一个前和两个“干预”后的1,000个家庭在山区和650个家庭在匹配的比较附近的评估。我们会进行逐户调查，收集参与者的家庭食物购买情况和个人膳食摄入量。我们还将对干预和比较社区的食品环境进行前后评估。食品环境评估将记录食品购买场所的数量和类型，并评估这些场所健康食品的可用性、质量和价格。总的来说，这些数据将使我们能够研究在低收入，主要是非洲裔美国人社区开设一家提供全方位服务的杂货店如何影响人们的饮食和食品购买行为。我们的研究将填补有关饮食和肥胖的环境决定因素文献中的重大空白，并将有助于解决有关物理环境对这些结果影响的关键政策问题。

DESCRIPTION (provided by applicant): Does a new supermarket improve dietary behaviors of low-income African Americans? Obesity poses a serious threat to the health of our nation. Two thirds of adults in the United States are either overweight or obese, and low-income and racial/ethnic minorities are disproportionately affected. Poor dietary quality and patterns are key risk factors for obesity, and both diet and obesity are established risk factors for cancer and other chronic diseases. Increasing evidence suggests that modifying the food environment to support healthy eating may have a sustainable population impact on diet and obesity. Yet, environmental approaches are understudied. In 2010, an 8.5 million dollar full-service grocery store, financed with public and private funds, will change the food retail landscape of the Hill District, a collection of contiguous neighborhoods of Pittsburgh, Pennsylvania. This joint public-private endeavor provides a unique and critically timed opportunity to examine how change in the availability of healthy foods affects food purchasing and dietary intake of residents in a US community. This full-service grocery store will be the first in nearly 30 years for this low-income, predominantly African-American community. The proposed study will capitalize on this natural experiment. Our specific aims are (1) to describe the availability, price, and shelf-space of healthy and less healthy options within food retail venues before and after the introduction of a full-service grocery store; (2) to determine the impact of the introduction of a full-service grocery store on food purchasing behaviors and dietary intake; and (3) to determine the extent to which these associations are modified by access factors (e.g., means of transportation and degree of spatial proximity to the grocery store) and socio-cultural factors (e.g., attitudes toward eating a healthy diet, perceived barriers to eating a healthy diet, and social support for healthy eating). We propose to use a matched quasi-experimental design involving one pre- and two post-"intervention" assessments of 1,000 households in the Hill District and 650 households in matched comparison neighborhood. Using door-to-door surveys, we will collect information on participants' household food purchasing and individual dietary intake. We will also conduct pre- and post- assessments of the food environment in the intervention and comparison neighborhoods. The food environment assessments will document the number and type of food purchasing venues and assess availability, quality, and price of healthy foods in these venues. Collectively, these data will allow us to examine how opening a full-service grocery store in a low-income, predominantly African American neighborhood, affects peoples' diet and food purchasing behaviors in both the short and long term. Our study will fill significant gaps in the literature on environmental determinants of diet and obesity and will help address key policy questions about the effects of the physical environment on these outcomes.