title: Small Food Store Retailers' Willingness to Implement Healthy Store Strategies in Rural North Carolina.
abstract: Access to supermarkets is lacking in many rural areas. Small food stores are often available, but typically lack healthy food items such as fresh produce. We assessed small food store retailer willingness to implement 11 healthy store strategies to increase the availability, display, and promotion of healthy foods and decrease the availability, display, and promotion of tobacco products. Interviews were conducted with 55 small food store retailers in three rural North Carolina counties concurrently with store observations assessing current practices related to the strategies. All stores sold low-calorie beverages, sugar-sweetened beverages, candy and cigarettes. Nearly all sold smokeless tobacco and cigars/cigarillos, and 72 % sold e-cigarettes. Fresh fruits were sold at 30.2 % of stores; only 9.4 % sold fresh vegetables. Retailers reported being most willing to stock skim/low-fat milk, display healthy snacks near the register, and stock whole wheat bread. About 50 % were willing to stock at least three fresh fruits and three fresh vegetables, however only 2 % of stores currently stocked these foods. Nearly all retailers expressed unwillingness to reduce the availability of tobacco products or marketing. Our results show promise for working with retailers in rural settings to increase healthy food availability in small food stores. However, restrictions on retail tobacco sales and marketing may be more feasible through local tobacco control ordinances, or could be included with healthy foods ordinances that require stores to stock a minimum amount of healthy foods.
authors.affiliation: Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. heatherdangelo@westat.com.|, Westat, 1700 Research Boulevard, RB4224, Rockville, MD, 20850, USA. heatherdangelo@westat.com.
authors.forename: Heather
authors.initials: H
authors.lastname: D'Angelo
authors.affiliation: Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|UNC Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Ammerman
authors.affiliation: Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Penny
authors.initials: P
authors.lastname: Gordon-Larsen
authors.affiliation: Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Linnan
authors.affiliation: Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Lytle
authors.affiliation: Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Kurt M
authors.initials: KM
authors.lastname: Ribisl
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D005260:Female; D005523:Food Supply; D015438:Health Behavior; D006801:Humans; D008297:Male; D040541:Marketing / Q000458:organization & administration*; D008875:Middle Aged; D009657:North Carolina; D012424:Rural Population; D055815:Young Adult
keywords: Food environment; Healthy food availability; Rural; Small food stores; Tobacco marketing