1. Implementation of a Shelf Labeling and Grocery Store Tour Program in a Low-Income Community Value Store of Houston, Texas
Presented by: Brittany Kaczmarek
University of Texas School of Public Health

2. Background
Obesity prevalence highest among those with little education and lowest income
Socioeconomically disadvantaged less likely to buy groceries following dietary guideline recommendations
Low socioeconomic status individuals with limited food budgets usually purchase less expensive, energy-dense foods
Drewnowski et al., 2004; Turrell et al., 2002

3. Background continued
Minorities twice as likely to be aware of and significantly more likely to use shelf labeling program than Caucasians
Seventy-five percent who led grocery store tours reported most participants showed competence of the skills taught
Sixty-nine percent of participants in intervention group reported program was extremely useful and twice as many intervention participants noticed shelf labels compared to control group
Lang et al., 2000; Panichelli et al., 2011; Milliron et al., 2012

4. Public Health Significance
The prevalence of obese adults in the Houston metropolitan area was 27% in 2012
Non-Hispanic Blacks exhibit highest rates of obesity at 48%, followed by Hispanics at 43%
Obesity and type II diabetes occurrence found to be higher among those economically disadvantaged
Study sample will be a high minority population living in a low-income area and has an increased risk for obesity and associated complications
CDC, 2013; Ogden et al., 2014; Drewnowski et al., 2004

5. Objective
To compare the effectiveness of shelf labeling and grocery store tours on pre- and post- purchasing behavior of employees who work for a chosen Houston, TX value store over one year in 2015

6. Methods Non-controlled trial beginning in spring 2015
Implemented for one year at a chosen value store
Participants complete the National Health and Nutrition Examination Survey Food Frequency Questionnaire at baseline and follow-up
Average daily food consumption of each employee at both time points compared to demonstrate efficacy of project
NCI, 2013

7. Methods continued
Shelf Labeling: implement using the M-Fit Supermarket Shelf Labeling Program identifying products low in total fat, saturated fat, cholesterol, sodium and high in total fiber using a color coded system
Grocery Store Tours: employee allowed paid time to participate in twenty minute grocery store tour including nutrition education information about selecting healthy foods and information about shelf labeling program
Study Population: fifty employees working for randomly chosen value store
Lang et al., 2000

8. Methods continued
Collection of Variables: exposure of the study is the shelf labeling program and grocery store tours providing nutrition education and the outcome measured will be healthier food purchasing behaviors
Statistical Analysis: Differences in baseline and follow-up data assessed using paired t-test to determine statistical significance at p < 0.05 using STATA version 13
Limitations: recall bias and small sample size

9. Daily Recommended Number of Servings*
Table 1. Food Group Intake Measured at Baseline and One Year Follow-Up Using NHANES FFQ
Food Groups
Daily Recommended Number of Servings*
Daily Intake at
Baseline
 Daily Intake at
Follow-Up
P-Value
Mean SD
Median
Dairy
3 cups
Fruits
1 ½ -2 cups
Vegetables
2-3 cups
Protein Foods
5-6 ½ ounces
Grains
5-8 ounces
Oils
5-7 teaspoons
SD = Standard Deviation *According to the United States Department of Agriculture (2011); Servings recommended will vary depending on age, gender and amount of physical activity. ** p ≤ 0.05

10. Graph 1. Gender Comparison of Pre- and Post- Daily Intake Percentage Difference