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

描述(由申请人提供)：一家新的超市是否改善了低收入非裔美国人的饮食行为？肥胖对我们国家的健康构成了严重威胁。美国三分之二的成年人超重或肥胖，低收入和种族/少数民族受到的影响不成比例。不良的饮食质量和饮食模式是肥胖的关键风险因素，而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会对饮食和肥胖产生可持续的人口影响。然而，对环境方法的研究还不够深入。2010年，一家耗资850万美元、提供全方位服务的杂货店将改变希尔区的食品零售格局。希尔区是宾夕法尼亚州匹兹堡的一个毗邻社区。这一公私联合努力提供了一个独特且时机紧迫的机会，来研究健康食品供应的变化如何影响美国社区居民的食品购买和饮食摄入量。这家提供全方位服务的杂货店将是近30年来这个以非裔美国人为主的低收入社区的第一家杂货店。这项拟议的研究将利用这一自然实验。我们的具体目标是(1)描述在引入全套服务杂货店之前和之后食品零售场所内健康和不健康选择的可用性、价格和货架空间；(2)确定引入全套服务杂货店对食品购买行为和饮食摄入量的影响；以及(3)确定这些关联被访问因素(例如，交通工具和距离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)改变的程度。我们建议使用配对的准实验设计，包括对山区的1000户家庭和配对的对照社区的650户家庭进行一次干预前和两次干预后的评估。我们将采用逐户调查的方式，收集参与者的家庭食品购买和个人饮食摄入量的信息。我们还将对干预和对照社区的食物环境进行事前和事后评估。食品环境评估将记录食品购买场所的数量和类型，并评估这些场所的健康食品的供应、质量和价格。总而言之，这些数据将使我们能够研究在一个以非裔美国人为主的低收入社区开设一家提供全方位服务的杂货店，在短期和长期内如何影响人们的饮食和食品购买行为。我们的研究将填补关于饮食和肥胖的环境决定因素的文献中的重大空白，并将有助于解决有关物理环境对这些结果的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.