Large scale food retailing as an intervention for diet and health: quasi-experimental evaluation of a natural experiment

• Published in: Journal of epidemiology and community health (1979) Vol. 59; no. 12; pp. 1035 - 1040
• Main Authors: Cummins, Steven, Petticrew, Mark, Higgins, Cassie, Findlay, Anne, Sparks, Leigh
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.12.2005; BMJ Publishing Group; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Aged; Analysis of covariance; Biological and medical sciences; Consumer psychology; Diet; Diet Surveys; Diseases of the digestive system; Economic activity; Education; Evidence Based Public Health Policy and Practice; Experimental design; Feeding Behavior; Female; Food; Food access; Food consumption; Food deserts; Food Services - standards; Fruit; Fruits; health; Health Behavior; Health Status; Humans; Intervention; Low income areas; Male; Medical sciences; Mental Health; Middle Aged; Miscellaneous; Natural experiments; neighbourhood; Prospective Studies; Psychoeducational intervention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Response rates; retail intervention; Retail stores; Scotland; Self; Shopping; Socioeconomic Factors; Surveys and Questionnaires; Vegetables; United Kingdom; Scotland; Great Britain; Europe; Evaluation; Sanitary program; Poverty; Fruit vegetable; Experimental study; Feeding; Medicine; Diet therapy; Treatment; Diet; Food intake; Population; Public health; Food; Psychological well being
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.2004.029843

Objectives: To assess the effect on fruit and vegetable consumption, self reported, and psychological health of a “natural experiment”—the introduction of large scale food retailing in a deprived Scottish community. Design: Prospective quasi-experimental design comparing baseline and follow up data in an “intervention” community with a matched “comparison” community in Glasgow, UK. Participants: 412 men and women aged 16 or over for whom follow up data on fruit and vegetable consumption and GHQ-12 were available. Main outcome measures: Fruit and vegetable consumption in portions per day, poor self reported health, and poor psychological health (GHQ-12). Main results: Adjusting for age, sex, educational attainment, and employment status there was no population impact on daily fruit and vegetable consumption, self reported, and psychological health. There was some evidence for a net reduction in the prevalence of poor psychological health for residents who directly engaged with the intervention. Conclusions: Government policy has advocated using large scale food retailing as a social intervention to improve diet and health in poor communities. In contrast with a previous uncontrolled study this study did not find evidence for a net intervention effect on fruit and vegetable consumption, although there was evidence for an improvement in psychological health for those who directly engaged with the intervention. Although definitive conclusions about the effect of large scale retailing on diet and health in deprived communities cannot be drawn from non-randomised controlled study designs, evaluations of the impacts of natural experiments may offer the best opportunity to generate evidence about the health impacts of retail interventions in poor communities.