1. Scores for Stores A unique approach for communicating & evaluating store quality Presented by: Alyssa Ghirardelli, MPH, RD Valerie Quinn, M.Ed., Sharon Sugerman, MS, RD, FADA, Ellen Feighery, MS, RN

2. Presenter Disclosures (1)The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Alyssa Ghirardelli, MPH, RD No relationships to disclose

3. Research: Clear connection between neighborhood factors & health outcomes

4. Neighborhoods Matter

5. You are what you eat where you live Obesity Poor nutrition Diabetes Cancer Stroke

6. CX 3 : Project Background Objectives: 1.Collect real-world data that accurately conveys neighborhood conditions 2. Activate consumers to improve food availability in low-income neighborhoods* Focused initiative with CA 25 local health depts. Began 2006 (6 pilot sites) Collect neighborhood-level data using CX 3 standardized tools & methods Over 100 neighborhoods * >50% at or below 185% Federal Poverty Level

7. Neighborhood Nutrition Data Look at nutrition in the broadest sense: All about understanding how consumers are influenced in their food choices. –Are healthy food choices available and accessible to residents of low-income neighborhoods? –How many fast food outlets are in neighborhood and around schools? What’s the proportion to large grocery stores? –How much and what are the types of nutrition marketing messages around schools? At stores? –Safely walk to store? Is it accessible? –And more!

8. Data Uses Expose disparities Resource allocation Engage residents in advancing change Program planning- tailor interventions Real-world data to create healthier neighborhoods –City/Co Planners, Redevelopment agencies, inform General Plan, health impact, etc. Program evaluation

9. Tier 1: GIS Mapping Tier 2: Field Surveys Tier 3: Community Assets

10. Grocery stores and small markets –Different types of stores (large to small, c-stores, etc) –Availability and quality of fruits and vegetables, new WIC pkg –Fruit and vegetable prices –Marketing of healthy/unhealthy foods CX 3 Data Collection: Field Surveys Walkability & Safety Fast food –Availability of healthy options –Menu labeling –Marketing Outdoor marketing Food Banks Alternative Healthy Food Sources

11. Problem: Mountain of data Need: Descriptive, easy way to compare.

12. CX 3 Store Data Analyses

13. Store survey

14. Store tool Algorithms constructed to calculate scores from raw data –Automatically generates scores Only positive conditions get points! Levels for maximum and “meets standards” points per category Max total: 100 points; 75 points indicates “quality” store –Emphasis on access & availability, less for marketing & product placement Reliability testing conducted- tested well –Reported in Journal of Nutrition Education & Behavior, July/Aug 2011

15. Categories and Point Structure CategoryMax score Meeting standards (min) EBT/SNAP and WIC Access105 Fruit availability & quality2018 Veg availability & quality2018 F/V Prices w/in county-level reasonable price 107 Other healthy foods available108 Nutrition information available and/or promoted 43 Limited exterior marketing84 Limited interior marketing85 Walkability/safety around store107 TOTAL:10075

16. 9 subcategory guides areas of focus w/in retail store

17. CX 3 Store Analyses Scored only 47 pts! Looks are deceptive

18. Food Store Types in CX 3 Neighborhoods 2007-2010

19. Store Scores by Store Type 2008 – 2010

20. WIC - Store Scores 2008-2009 n= 86 stores 5% of non WIC vendors were quality stores

21. Retail Improvement Examples Sonoma: Developed city incentive pilot program in Santa Rosa city 75 points + subcategories Orange County: Significant improvements in the Mission neighborhood, now 3 healthy grocery stores Santa Clara: Designated food desert now has a food bank mobile van with fresh f/v Contra Costa: Target by Community-Based Organizations, 3 Latino indep. markets now accept WIC

22. CX 3 Success Stories (cont.) San Mateo: YO! Mateo youth interviewed about the Healthy Neighborhood Stores campaign and the Friday Night Live Network on "Beyond the Headlines" with Cheryl Jennings on ABC7 news http://abclocal.go.com/kgo/video?id=8270974 (The segment can be found exactly at the 18:22 mark of the video if you would like to fast forward to the interview.)

23. Benefits Advances local change – Proven! Puts local groups at forefront for obesity prevention Standardized indicators, methods, tools Appealing to funders

24. JNEB Publication Recent July/Aug Publication in Journal of Nutrition Education and Behavior, covering reliability results and store scores Supplement covering findings from Network for a Healthy California

25. Thank you! This material was produced by the California Department of Public Health’s Network for a Healthy California with funding from USDA SNAP, known in California as CalFresh (formerly Food Stamps). These institutions are equal opportunity providers and employers. CalFresh provides assistance to low-income households and can help buy nutritious foods for better health. For CalFresh information, call 1-877-847-3663. For important nutrition information, visit www.cachampionsforchange.net. Alyssa Ghirardelli, RD, MPH - Network for a Healthy California Alyssa.Ghirardelli@cdph.ca.gov 916.449.5342 Valerie Quinn, M.Ed. - Network for a Healthy California Valerie.Quinn@cdph.ca.gov 916.552.9908 CX 3 Website: http://www.cdph.ca.gov/programs/cpns/Pages/CX3_Main_Navgation.aspx