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Creating healthier retail food environments

By Betsy Johnson, Extension educator in health and nutrition

As we work with our communities to improve access to healthy foods, one important setting is retail foods. Grocery stores, restaurants, and corner or convenience stores comprise the majority of places people in Minnesota get their food. I started working with the Minnesota Department of Health (MDH) and Healthy Northland, our seven-county SHIP initiative in northeastern Minnesota, four years ago on the Community Wellness Grant to improve retail food environments.

Woman in grocery store pushing a cart looking at a list.

Most of our first two years of work on the MDH statewide committee was focused on creating Minnesota-specific assessment tools for each of the retail environments (MN-EATS). There are now four environmental assessments incorporated into the Counter Tools nationwide GIS initiative–grocery stores, convenience stores, restaurants, and the “tiny tool,” a one-page quick assessment that can be used at the same time tobacco store audits are conducted. The tiny tool information is helpful for identifying communities that may be ready for a full assessment and follow-up.

Focusing on convenience stores

Years 2 and 3 were dedicated to creating resources and tools for changing the retail environments to make healthier food more accessible and obvious. The result of this work is MDH’s Good Food Sold Here (GFSH) project pilot where local SHIP coordinators partner with convenience store owners/managers to change the environment within the store.

The GFSH pilot is being implemented at more than 20 convenience stores across the state, including three in northeastern Minnesota. The pilot includes adding more healthy food options, rearranging shelving, displays, checkouts, and refrigerators, and posting signage to guide consumers to healthier choices. In the pilot project, store owners are interviewed to assess readiness and ability to make changes, and customers are surveyed to learn what healthier food items they’d like to see.

Once all of the surveys and assessments have been completed, the SHIP coordinator works with the store to make the changes. These changes are left in place for four months, then the SHIP coordinator goes back and re-assesses the store to determine impact and sustainability. The pilot project ends in December so we’ll have a better idea then what works and what doesn’t. After the pilot, the campaign information and materials will be made available to all SHIP initiatives in the state.

We chose to focus on convenience or corner stores (C-stores) because many rural areas and lower-income neighborhoods have no grocery store so residents can’t buy fresh produce, lower –fat, -sodium, and –sugar items, whole grain items, or fresh meat, eggs, and milk. Many of the behavioral economics principals we use in food shelves and school lunchrooms are also used in the C-stores.

In northeastern Minnesota, we currently have campaigns (at various stages of development) running in Virginia, Deer River, Aurora, Moose Lake, and Hill City. We’re kind of the test-site for remote rural areas to see if these campaigns gain any traction. Many of our stores showed interest to make these changes in time for summer tourist traffic–it will be interesting to compare the summer and winter seasons in terms of customer feedback and sales.

Developing healthier checkout lanes

Teresa Ambroz from MDH and I presented a session on the Good Food Sold Here project and used the creation of a healthier checkout lane as the interactive activity. Here are the guidelines we use for healthier beverages and snack items at the checkout:
  • Beverages
    • Plain or sparkling water
    • Flavored water with no added sugars
    • Skim or 1% plain or flavored milk, including vitamin D fortified soy milk
    • Tea and coffee with no added sugars
    • 100% fruit or vegetable juice in 8 oz. portions or less with no added sugars and <200 mg sodium per container.
  • Snacks
    • The first ingredient must be a whole grain, fruit, vegetable, dairy, or protein food
    • Each product, as packaged (even if the package is 2 or more servings), may contain no more than:
      • 200 calories
      • 2 grams of saturated fat (except nuts, seeds, or trail mix with no added candy)
      • 0 trans fat
      • 10 grams of total sugars (except fruit and vegetable based products with no added sugars, and yogurts with <23 grams total sugars per 6 oz. container)
      • 200 mg of sodium

Try it out–pick your favorite grab and go snack and see if it fits the guidelines!

And check out this infographic on the business case for healthier retail food environments.
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