Impact of a Healthy Checkout Policy on Healthfulness of Grocery Environments and Sales

健康结账政策对杂货店环境和销售健康的影响

• 批准号: 10587200
• 负责人: Jennifer Falbe
• 金额: $ 70.96万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10587200
• 关键词: Adopted; Advocate; Affect; Area; Authorization documentation; Behavior; Beverages; Calories; Candy; Cities; Code; Consolidated Framework for Implementation Research; Consumption; Country; Dairying; Data; Diet; Dietary Fiber; Disease; Effectiveness; Environment; Ethnic Origin; Evaluation; Fabaceae; Food; Fruit; Income; Influentials; Intervention; Interview; Knowledge; Laws; Licensing; Methods; Natural experiment; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Nuts; Outcome; Policies; Policy Maker; Population; Prevalence; Proxy; Public Health; Race; Reaction; Research; Sales; Sampling; Sodium; Surveys; Vegetables; authority; cost; experience; food environment; implementation barriers; implementation determinants; implementation evaluation; improved; innovation; novel; obesity risk; post implementation; soft drink; sugar; sweetened beverage; tool

PROJECT SUMMARY/ABSTRACT The nation’s first healthy checkout policy was implemented in Berkeley, CA in 2021 and will be enforced in 2022, presenting an opportunity to understand policy effects on diet quality. This policy prohibits high-sugar and high-sodium products from checkouts, an area known for impulse purchasing. By potentially lowering consumption of sugary beverages, sweets, and salty snacks—the most common items at checkout—this policy could reduce population risk of obesity and types 2 diabetes. Voluntary checkout standards adopted in other countries have successfully decreased purchases of unhealthy foods and beverages and increased purchases of healthy ones, indicating that a mandatory healthy checkout policy could meaningfully improve diet quality. However, because Berkeley’s policy is the first of its kind, there are no studies on the degree to which a healthy checkout policy changes store food environments and the healthfulness of food and beverage purchases—an objective proxy for population diet quality. This research will evaluate the long-term impact of the nation’s first healthy checkout policy on the healthfulness of store food environments and purchases. By leveraging a natural experiment, these outcomes will be compared between Berkeley stores and stores in three comparison cities using synthetic control and difference-in-differences methods. The first aim is to assess the impact of the policy on store environments at checkout and elsewhere in the store, including the prevalence of unhealthy and healthy products and their contents of added sugar, calorie, and sodium in all 26 intervention stores and a random sample of 81 comparison stores. The second aim is to assess policy impact on purchases of (a) small sizes of snack foods and beverages commonly sold at checkout and (b) all sizes of these products (which accounts for substitution) using store- and product- level sales data from 16 intervention and 172 comparison stores. The third aim is to identify implementation factors that influence policy effectiveness, such as policy support, costs, reach, and stakeholder reactions using interviews with city staff, policymakers, and retailers and surveys of Berkeley residents. This evaluation leverages the baseline and 1- year post-baseline store environment data collected by the research team using a novel photo-based tool. The proposed research is expected to provide the first evidence on the effectiveness of a mandatory healthy checkout policy for improving food environments and store sales and the factors that facilitate or pose barriers to implementation, which can inform policy decisions in other jurisdictions.

项目概要/摘要 美国首个健康结账政策于 2021 年在加利福尼亚州伯克利实施，并将于 2021 年强制执行。 2022 年，提供了了解政策对饮食质量影响的机会。该政策禁止高糖 以及来自收银台的高钠产品，这是一个以冲动购买而闻名的区域。通过潜在地降低 消费含糖饮料、糖果和咸味零食——结账时最常见的商品——本政策 可以降低人群患肥胖症和 2 型糖尿病的风险。其他采用的自愿结账标准 各国成功减少了不健康食品和饮料的购买量并增加了购买量 健康食品的数量，表明强制健康检查政策可以有效改善饮食质量。 然而，由于伯克利的政策是同类政策中的首创，因此还没有关于该政策的影响程度的研究。 健康的结账政策改变了商店的食品环境和食品和饮料的健康性 购买量——人口饮食质量的客观指标。这项研究将评估长期影响 全国首个关于商店食品环境和购买健康的健康结账政策。经过 利用自然实验，这些结果将在伯克利商店和美国商店之间进行比较 使用综合控制和双重差分法对三个比较城市进行比较。第一个目标是评估 该政策对结账处和商店其他地方的商店环境的影响，包括 所有 26 种食品中不健康和健康产品的流行情况及其添加糖、热量和钠的含量 干预商店和 81 家比较商店的随机样本。第二个目标是评估政策影响 购买 (a) 通常在结帐处出售的小尺寸零食和饮料以及 (b) 所有尺寸的零食和饮料 这些产品（占替代品）使用来自 16 次干预的商店和产品级销售数据 以及 172 家比价店。第三个目标是确定影响政策的实施因素 有效性，例如政策支持、成本、影响范围以及利益相关者的反应（通过与城市工作人员的访谈）， 政策制定者、零售商以及伯克利居民的调查。该评估利用了基线和 1- 研究团队使用一种新颖的基于照片的工具收集了基线后一年的商店环境数据。这 拟议的研究预计将为强制健康的有效性提供第一个证据 改善食品环境和商店销售的结账政策以及促进或构成障碍的因素 实施，这可以为其他司法管辖区的政策决定提供信息。