title: Supermarket and grocery store-based interventions to promote healthful food choices and eating practices: a systematic review.
abstract: BACKGROUND
  Increasingly high rates of obesity have heightened interest among researchers and practitioners in identifying evidence-based interventions to increase access to healthful foods and beverages. Because most food purchasing decisions are made in food stores, such settings are optimal for interventions aimed at influencing these decisions. The objective of this review was to synthesize the evidence on supermarket and grocery store interventions to promote healthful food choices.
  
  
  METHODS
  We searched PubMed through July 2012 to identify original research articles evaluating supermarket and grocery store interventions that promoted healthful food choices. We categorized each intervention by type of intervention strategy and extracted and summarized data on each intervention. We developed a scoring system for evaluating each intervention and assigned points for study design, effectiveness, reach, and availability of evidence. We averaged points for each intervention category and compared the strength of the evidence for each category.
  
  
  RESULTS
  We identified 58 articles and characterized 33 interventions. We found 7 strategies used alone or in combination. The most frequently used strategy was the combination of point-of-purchase and promotion and advertising (15 interventions); evidence for this category was scored as sufficient. On average, of 3 points possible, the intervention categories scored 2.6 for study design, 1.1 for effectiveness, 0.3 for reach, and 2 for availability of evidence. Three categories showed sufficient evidence; 4 showed insufficient evidence; none showed strong evidence.
  
  
  CONCLUSIONS
  More rigorous testing of interventions aimed at improving food and beverage choices in food stores, including their effect on diet and health outcomes, is needed.
authors.affiliation: Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726-2397, USA. aescaron@gmail.com
authors.forename: Anne L
authors.initials: AL
authors.lastname: Escaron
authors.forename: Amy M
authors.initials: AM
authors.lastname: Meinen
authors.forename: Susan A
authors.initials: SA
authors.lastname: Nitzke
authors.forename: Ana P
authors.initials: AP
authors.lastname: Martinez-Donate
mesh_terms: D002755:Choice Behavior; D003132:Commerce; D005247:Feeding Behavior; D006801:Humans