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

项目摘要/摘要 美国第一项健康检查政策于2021年在加利福尼亚州伯克利实施，并将于#年实施 2022年，为了解政策对饮食质量的影响提供了机会。这项政策禁止高糖 还有结账处的高钠产品，这是一个以冲动购物著称的地区。通过潜在地降低 消费含糖饮料、糖果和咸味零食--结账时最常见的物品--这项政策 可以降低人群肥胖和2型糖尿病的风险。其他国家采用的自愿结账标准 各国成功地减少了对不健康食品和饮料的购买，增加了购买 这表明，强制性的健康检查政策可以有效地改善饮食质量。 然而，由于伯克利的政策是此类政策中的第一项，目前还没有关于一项政策在多大程度上 健康结账政策改变商店食品环境和食品和饮料的健康程度 购买量--人口饮食质量的客观指标。这项研究将评估 美国首个关于商店食品环境和购物健康的健康检查政策。通过 利用一项自然实验，这些结果将在伯克利分店和 三个对照城市采用综合控制法和差异法。第一个目标是评估 策略对结账时和商店中其他地方的商店环境的影响，包括 所有26种不健康和保健品及其添加糖、卡路里和钠的含量 干预商店和81家对照商店的随机抽样。第二个目标是评估政策影响 购买(A)通常在结账时出售的小号休闲食品和饮料，以及(B)所有大小的 这些产品(占替代产品)使用来自16个干预的商店和产品级别的销售数据 以及172家比较店。第三个目标是确定影响政策的执行因素 有效性，例如政策支持、成本、覆盖范围和利益相关者的反应，通过与城市工作人员的访谈， 政策制定者、零售商和对伯克利居民的调查。该评估利用了基准和1- 研究团队使用一种新的基于照片的工具收集了基线后一年的商店环境数据。这个 拟议中的研究有望为强制性健康饮食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 这可以为其他司法管辖区的政策决策提供信息。

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.