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Small Food Store Retailers’ Willingness to Implement Healthy Store Strategies in Rural North Carolina

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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.

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Funding

Funding for this study was provided by Grant Number U01 CA154281 from the National Cancer Institute’s State and Community Tobacco Control Initiative. The funders had no involvement in the study design, collection, analysis, writing, or interpretation.

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Author notes

  1. Heather D’Angelo

    Present address: , Westat, 1700 Research Boulevard, RB4224, Rockville, MD, 20850, USA

Authors and Affiliations

  1. Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Heather D’Angelo, Laura Linnan, Leslie Lytle & Kurt M. Ribisl

  2. Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Alice Ammerman & Penny Gordon-Larsen

  3. UNC Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA

    Alice Ammerman

  4. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kurt M. Ribisl

Authors
  1. Heather D’Angelo
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  2. Alice Ammerman
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  3. Penny Gordon-Larsen
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  4. Laura Linnan
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  5. Leslie Lytle
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  6. Kurt M. Ribisl
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Corresponding author

Correspondence to Heather D’Angelo.

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Conflict of interest

Dr. D’Angelo serves as an expert consultant in litigation against cigarette manufacturers. Dr. Ribisl has consulted for the Food and Drug Administration Center for Tobacco Products and is a member of the Tobacco Products Scientific Advisory Committee— the views expressed in this paper are his and not those of the FDA. Dr. Ribisl serves as an expert consultant in litigation against cigarette manufacturers. Dr. Ribisl receives royalties from a store audit and mapping system owned by the University of North Carolina at Chapel Hill but the tools and audit mapping system were not used in this study.

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D’Angelo, H., Ammerman, A., Gordon-Larsen, P. et al. Small Food Store Retailers’ Willingness to Implement Healthy Store Strategies in Rural North Carolina. J Community Health 42, 109–115 (2017). https://doi.org/10.1007/s10900-016-0236-0

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  • DOI: https://doi.org/10.1007/s10900-016-0236-0

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