Placement and promotion strategies to increase sales of healthier products in supermarkets in low-income, ethnically diverse neighborhoods: a randomized controlled trial.
BACKGROUND
The greater presence of supermarkets in low-income, high-minority neighborhoods has the potential to positively affect diet quality among those at greatest risk of obesity. In-store marketing strategies that draw attention to healthier products may be effective, sustainable, and scalable for improving diet quality and health. Few controlled studies of in-store marketing strategies to promote sales of healthier items in low-income, high-minority neighborhoods have been conducted.


OBJECTIVE
The objective of this study was to evaluate the effects of in-store marketing strategies to promote the purchase of specific healthier items in 5 product categories: milk, ready-to-eat cereal, frozen meals, in-aisle beverages, and checkout cooler beverages.


METHODS
The design was a cluster-randomized controlled trial conducted from 2011 to 2012. Eight urban supermarkets in low-income, high-minority neighborhoods were the unit of randomization, intervention, and analysis. Stores were matched on the percentage of sales from government food-assistance programs and store size and randomly assigned to an intervention or control group. The 4 intervention stores received a 6-mo, in-store marketing intervention that promoted the sales of healthier products through placement, signage, and product availability strategies. The 4 control stores received no intervention and were assessment-only controls. The main outcome measure was weekly sales of the targeted products, which was assessed on the basis of the stores' sales data.


RESULTS
Intervention stores showed significantly greater sales of skim and 1% milk, water (in aisle and at checkout), and 2 of 3 types of frozen meals compared with control store sales during the same time period. No differences were found between the stores in sales of cereal, whole or 2% milk, beverages, or diet beverages.


CONCLUSIONS
These data indicate that straightforward placement strategies can significantly enhance the sales of healthier items in several food and beverage categories. Such strategies show promise for significant public health effects in communities with the greatest risk of obesity.
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Gary D
GD
Foster
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Allison
A
Karpyn
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Alexis C
AC
Wojtanowski
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Erica
E
Davis
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Stephanie
S
Weiss
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Colleen
C
Brensinger
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Ann
A
Tierney
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Wensheng
W
Guo
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Jeffery
J
Brown
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Carly
C
Spross
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Donna
D
Leuchten
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Patrick J
PJ
Burns
From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL).
Karen
K
Glanz
D000328:Adult; D001741:Black or African American; D002648:Child; D054626:Consumer Health Information / Q000191:economics; D003691:Delaware / Q000453:epidemiology; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D063427:Food Quality; D005523:Food Supply / Q000191:economics*; D006293:Health Promotion / Q000191:economics; D006801:Humans; D008297:Male; D018673:Nutrition Policy; D009765:Obesity / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D010349:Patient Compliance / Q000208:ethnology; D010414:Pennsylvania / Q000453:epidemiology; D011204:Poverty Areas; D012111:Residence Characteristics; D012306:Risk; D014505:Urban Population