title: Buying food on sale: a mixed methods study with shoppers at an urban supermarket, Philadelphia, Pennsylvania, 2010-2012.
abstract: BACKGROUND
  The obesity epidemic has drawn attention to food marketing practices that may increase the likelihood of caloric overconsumption and weight gain. We explored the associations of discounted prices on supermarket purchases of selected high-calorie foods (HCF) and more healthful, low-calorie foods (LCF) by a demographic group at high risk of obesity.
  
  
  METHODS
  Our mixed methods design used electronic supermarket purchase data from 82 low-income (primarily African American female) shoppers for households with children and qualitative data from focus groups with demographically similar shoppers.
  
  
  RESULTS
  In analyses of 6,493 food purchase transactions over 65 weeks, the odds of buying foods on sale versus at full price were higher for grain-based snacks, sweet snacks, and sugar-sweetened beverages (odds ratios: 6.6, 5.9, and 2.6, respectively; all P < .001) but not for savory snacks. The odds of buying foods on sale versus full price were not higher for any of any of the LCF (P ≥ .07). Without controlling for quantities purchased, we found that spending increased as percentage saved from the full price increased for all HCF and for fruits and vegetables (P ≤ .002). Focus group participants emphasized the lure of sale items and took advantage of sales to stock up.
  
  
  CONCLUSIONS
  Strategies that shift supermarket sales promotions from price reductions for HCF to price reductions for LCF might help prevent obesity by decreasing purchases of HCF.
authors.affiliation: Einstein Healthcare Network, Director, Center for Urban Health Policy and Research, 5501 Old York Rd, Philadelphia, PA 19141. Telephone: 215-456-1122. E-mail: phippst@einstein.edu.
authors.forename: Etienne J
authors.initials: EJ
authors.lastname: Phipps
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Shiriki K
authors.initials: SK
authors.lastname: Kumanyika
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Shana D
authors.initials: SD
authors.lastname: Stites
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: S Brook
authors.initials: SB
authors.lastname: Singletary
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Cooblall
authors.affiliation: Arcadia University, Glenside, Pennsylvania.
authors.forename: Katherine Isselmann
authors.initials: KI
authors.lastname: DiSantis
mesh_terms: D000328:Adult; D001628:Beverages; D044383:Black People / Q000706:statistics & numerical data; D003132:Commerce / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D005523:Food Supply / Q000191:economics* / Q000592:standards; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015143:Philadelphia; D011632:Public Assistance / Q000706:statistics & numerical data*; D013549:Sweetening Agents; D014504:Urban Health / Q000191:economics*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D013549:Sweetening Agents