Table 2 Summary of studies
Intervention Category | Country | Program/project name | Settings and Target group | Study Design | Outcome variable and targeted foods | Key Findings | QAT score (%) | Risk of bias |
|---|---|---|---|---|---|---|---|---|
Information | ||||||||
Milliron et al. (2012) [81] | U.S.A. | EatSmart | Urban supermarket; adult participants are targeted in a socioeconomically diverse region of Phoenix | Randomized controlled trial | Purchases of total, saturated, and trans fat (grams/1,000 kcal), and fruit, vegetables, and dark-green/yellow vegetables | The intervention positively affected purchase of fruit and dark-green/yellow vegetables. No other group differences were observed. | 83.3% | medium |
Sutherland et al. (2010) [77] | U.S.A. | Guiding Stars | 168 supermarket stores in both rural and metropolitan areas | “Natural” experimental design | Sales of star-labelled foods before and after intervention | Sustained and significant changes in food purchasing after implementation and at follow-up reported | 57.1% | high |
Ogawa et al. (2011) [56] | Japan | - | Two urban supermarkets in two Japanese cities | pre-post study with control group | Sales of fruit and vegetables before and after intervention | Sales of fruit and vegetables of all types significantly increased during the intervention period at intervention store. | 42.9% | high |
Steenhuis et al. (2004) [63] | The Netherlands | - | Clients in 13 urban supermarkets were targeted | randomized, pre-post, experimental control group design | Fat intake | The education intervention, neither in stand-alone nor when coupled with the labeling had no significant effects | 89.6% | low |
Steenhuis et al. (2004) [62] | The Netherlands | - | Conducted at Supermarkets and worksite cafeterias and target was their clients | Description of program history and phases | Fat intake | The findings suggest that programmes should be promoted intensively. Furthermore, the relevant manufacturers and Wholesalers supplying worksite cafeterias should be encouraged to increase their range of suitable low-fat products | 57.1% | high |
Colapinto and Malaviarachchi (2009) [52] | Canada | Paint Your Plate | 17 grocery stores in the City of Greater Sudbury; adults with diverse socioeconomic status were targeted | Pre-post with a comparison group | Knowledge of fruit serving size | Intervention participants were six times more likely than participants receiving brochures to identify a serving size of fruit and vegetables; however, this difference vanished at follow-up | 54.8% | high |
Freedman and Connors (2010) [69] | U.S.A. | Eat Smart | Multi-ethnic college students shopping at on-campus convenience store | Quasi-experimental study | Sale specific promoted foods | Purchase of tagged food items increased | 42.9% | high |
Salmon et al. (2015) [64] | The Netherlands | Health on Impulse | 127 customers of a Dutch supermarket | Cluster Randomized Controlled Trial | Sale of low calorie cheese | Nudging ego-depleted consumers to purchase low fat cheese with the help of social proof is effective. | 69.0% | medium |
Prices | ||||||||
Phipps et al. (2014) [25] | U.S.A. | - | Urban low-income supermarkets | Mixed-methods (longitudinal quantitative design supplemented with qualitative data) | Weekly purchases of targeted foods | Households sought out products with price discounts. | 56.3% | medium |
Geliebter et al. (2013) [24] | U.S.A. | Supermarket Discounts on Low-Energy Density Foods | Two urban supermarkets; overweight and obese adults with various demographic backgrounds were involved | Randomized controlled trial | Intake of fruit and vegetables (and BMI) | Discounts of low-energy density fruit and vegetables led to increased purchasing and intake of those foods | 83.3% | medium |
Herman et al. (2008) [28] | U.S.A. | Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) | English or Spanish speaking WIC-recipient Women at 3 WIC sites | pre-post study with non-equivalent control-group design | Purchase of fruit and vegetables | Increase of consumption of fruit and vegetables by intervention participants; this increase was sustained at 6 months follow-up. | 70.8% | medium |
Herman et al. (2006) [29] | U.S.A. | Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) | Low-income women, infants and children participating WIC program in suburban Los Angeles | pre-post study with non-equivalent control-group design | Fruit and vegetable purchases | Monetary incentives as a supplement to WIC had positive effect on fruit and vegetable purchase by low-income women participating the intervention. | 50.0% | high |
An et al. (2013) [23] | South Africa | Healthy Foods Benefit | Households that are members of South Africa’s largest private insurance company receive discounts on healthy foods at 800 participating supermarkets | Cohort study | Sale of healthy foods identified by Discovery Insurance Panel | Discounts for program participants increased consumption of healthy foods | 78.6% | medium |
Access and availability | ||||||||
Cummins et al. (2005) [55] | U.K. | - | New Urban superstore in socially underserved area; study participants were men and women aged 16 and above | Quasi-experimental design | Fruit and vegetable consumption in portions per day, psychological health | Positive effect on psychological health for intervention participants. No intervention effect on fruit and vegetable consumption. | 73.8% | medium |
Information and Price | ||||||||
Mhurchu et al. (2007) [61] | New Zealand | The Supermarket Healthy Options Project (SHOP) | Target was main household shoppers at an urban supermarket in New Zealand | Randomized controlled trial | Purchase of fruit and vegetables. | Collection of electronic purchase data is a feasible way to assess effect of nutrition intervention on purchase behavior. | 66.7% | medium |
Mhurchu et al. (2010) [60] | New Zealand | The Supermarket Healthy Options Project (SHOP) | Supermarkets in urban Wellington; target group were Maori, Pacific, and non-Maori/ Non-Pacific ethnic groups | Randomized controlled trial | Change from baseline in percentage energy from saturated fat contained in supermarket food purchases at the completion of the 6-month trial intervention phase | The intervention reported no significant discounts nor tailored nutrition education on nutrients purchased. | 92.9% | low |
Blakely et al. (2011) [59] | New Zealand | The Supermarket Healthy Options Project (SHOP) | Maori, Pacific, and European customers of a Supermarket in New Zealand who had handheld scanner system were targeted | Randomized controlled trial | Purchase of fruit and vegetables. | Price discounts were associated with healthy food purchasing. | 81.0% | low |
Bihan et al. (2012) [57] | France | - | Low-income adults undergoing health examinations at centers affiliated with French Social Security, and 22 compliant supermarkets | Randomized controlled trial | Fruit and vegetable intake | Both stand-alone advice and advice combined with fruit and vegetable (FV) vouchers increased FV servings/day, with the latter leading to slightly higher FV servings/day | 81.0% | low |
Waterlander et al. (2013) [26] | The Netherlands | - | 4 Dutch supermarkets in rural areas and their adult customers with low socioeconomic status are targeted | Randomized controlled trial | Purchase of fruit and vegetables (in grams) by households | Price discounts combined with education significantly increases purchase of fruit and vegetable | 83.3% | low |
Ball et al. (2015) [27] | Australia | Supermarket Healthy Eating for Life (SHELf) | 574 women customers of an Australian supermarket | Randomized Controlled Trial | Sale of F&V and beverages | Price reductions had a partial effect (i.e., on some of the targeted foods) | 90.5% | low |
Information AND Access/ availability | ||||||||
Foster et al. (2014) [73] | U.S.A. | - | Urban low-income supermarkets | Cluster-randomised controlled trial | Weekly sales of targeted products | Placement strategies can significantly enhance the sales of healthier items in several food and beverage categories | 76.2% | medium |
Sigurdsson et al. (2014) [58] | Norway | - | A convenience store and a discount store; and healthy foods | Alternating treatment design | Sale of targeted healthy foods | Placing healthy food items at the store checkout can lead to a substantial impact on sales of these products. | 47.6% | high |
Kennedy et al. 2009 [50] | U.S.A. | Rolling Store | A flexible store in Louisiana targeting African American Women | Randomized controlled trial | Increase consumption of fruit and vegetables, and to prevent weight gain | Intervention participants showed a weight loss of 2.0 kg, whereas the control group gained 1.1 kg. But change in energy intake was not significant. | 56.3% | high |
Gittelsohn et al. (2006) [65] | The Republic of Marshall Islands | The Republic of Marshall Islands (RMI) Healthy Stores project | Stores in a developing country (RMI); target were nutritionally deprived communities in RMI | Pre-post pilot study | Fruit and vegetables, and other healthy foods such as foods with lower fat alternatives. | High levels of exposure to the intervention were achieved during the 10-week period of implementation. | 56.3% | high |
Curran et al. (2005) [71] | U.S.A. | Apache Health Stores | Ethnic minority (American Indians) facing healthy food access problems | Process evaluation: assess fidelity, dose, reach and context | Number of healthy foods stocked; and number in-store promotion activities | Intervention was implemented with a high level of dose and reach, and a moderate to high level of fidelity | 52.4% | high |
Gittelsohn et al. (2010) [75] | U.S.A. | Health Foods Hawaii | Five stores in two Low-income ethnic minority communities; children and mothers were particularly targeted | Pre-post randomized trial | HEI score, HEI grain score, and water consumption | Intervention increased consumption of targeted healthy foods by children; also improved healthy food knowledge among caregivers. | 66.7% | medium |
Novotny et al. (2011) [82] | U.S.A. | Health Foods Hawaii | Low-income ethnic minority in rural Hawai’i; children and mothers were particularly targeted | Randomized Controlled Trial | Exposure (Dose, reach, fidelity) | Relatively high fidelity, dose and reach of store intervention was achieved. Availability was a challenge. Stocking decisions are not always controlled by storeowners/managers. | 66.7% | low |
Gittelsohn et al. (2013) [78] | U.S.A. | Navajo Healthy Stores | Stores in Low-income ethnic minority with poor food environment | Custer randomized controlled trial | Consumption intention and purchase of targeted healthy foods, BMI | Intervention was associated with reduced overweight/obesity and improved obesity-related psychosocial and behavioral factors among those persons most exposed to the intervention | 58.3% | medium |
Bains et al. (2013) [51] | Canada | Healthy Foods North | Low-income ethnic minority in Arctic Canada; focus was on women of childbearing age | Cluster randomized controlled trial | Energy and selected nutrient intakes, nutrient density and dietary adequacy | The intervention had a positive effect on vitamin A and D intake by intervention participants. No significant impact on calorie, sugar, or fat consumption | 64.3% | medium |
Ho et al. (2008) [53] | Canada | The Zhiiwapenewin Akino’maagewin: Teaching to Prevent Diabetes (ZATPD) | Grocery stores in Remote communities in Canada and their low-income ethnic minority customers | Quasi-experimental pretest/posttest evaluation | Food-related behavioral and psychosocial outcomes | Reported significant change in knowledge among intervention participants. There was also a significant increase in frequency of healthy food acquisition among respondents in the intervention communities. | 50.0% | high |
Rosecrans et al.(2008) [54] | Canada | The Zhiiwapenewin Akino’maagewin: Teaching to Prevent Diabetes (ZATPD) | Grocery stores in Remote communities in Canada and their low-income ethnic minority customers | Assess fidelity, dose, reach and context | Number of foods promoted, number and content of promotion materials, etc. | Program implemented in- and out-of-store activities with moderate fidelity. | 60.4% | high |
Dannefer et al. (2012) [72] | U.S.A. | Healthy Bodegas | 55 corner stores in underserved urban neighborhoods | Pre-post design | Number and type of foods stocked, etc. | Participating stores significantly improved healthy food inventory; also moderate increase customer purchase of healthy foods. | 52.4% | high |
Holmes et al. (2012) [80] | U.S.A. | Healthy Kids Campaign | Urban grocery store intervention targeting children and their parents | Observational time-series without comparison | Sale of fruit and vegetables | Sale of targeted foods including fruits and vegetables increased. | 52.1% | high |
Ayala et al. (2013) [66] | U.S.A. | Vida Sana Hoy y Mañana (Healthy Life Today and Tomorrow) | Tiendas in central North Carolina and targeted mainly Hispanic customers of the tiendas. | Cluster Randomized controlled trial | sale of fruit and vegetables | Moderate intervention effect in reported fruit and vegetable intake | 70.8% | medium |
Caldwell et al. (2008) [67] | U.S.A. | Colorado Healthy People 2010 Obesity Prevention Initiative. | Stores in Colorado and various target groups including, older adults, high-risk individuals, and general community members | Pre-post study design | Fruit and vegetable intake | Significant increase in consumption of fruit and vegetables by intervention participants | 61.9% | high |
Martínez-Donate et al. (2015) [79] | U.S.A. | Waupaca Eat Smart (WES) | 601 customers at intervention & control supermarkets | Randomized Community trial | Reach, fidelity; availability and sale of healthy foods such as F&V | significant, but small improvements in the reported healthiness of target group purchases | 60.4% | high |
Price AND Access/ availability | ||||||||
Andreyeva et al. (2012) [70] | U.S.A. | Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) | Urban grocery store and supermarket intervention targeting women and infants | Pre-post study | Fruit and vegetables and variety of healthy foods in WIC-authorized convenience and grocery stores | Revised WIC food packages had a significant positive effect on availability and variety of healthy foods in WIC-authorized and (to a smaller degree) non-WIC convenience and grocery stores. | 71.4% | medium |
Freedman et al. (2011) [68] | U.S.A. | The Veggie Project | Farmers’ markets intervention targeting Boys and Girls Clubs in ethnically minority low-income areas in Nashville with limited healthy food retail outlet | Pre-post Study | Sales of targeted healthy foods | Intervention led to purchase of fresh fruit and vegetables by participants | 64.6% | high |
Access/availability AND Information AND Price | ||||||||
Gittelsohn et al. (2010) [74] | U.S.A. | Baltimore Healthy Stores; BHS | Urban corner stores in low-income area in Baltimore City | Quasi- experimental design | Food-related behavioral and psychosocial outcomes | Overall healthy food purchasing scores, food knowledge, and self-efficacy did not show significant improvements associated with intervention status. But, intervention had a positive effect on healthiness of food preparation methods and showed a trend toward improved intentions to make healthy food choices | 66.7% | high |
Gittelsohn et al. (2010) [97] | U.S.A. | Baltimore Healthy Stores; BHS | Urban corner stores in low-income area in Baltimore City | Assess Reach, dose and fidelity | Number of foods promoted, number and content of promotion materials, number of discount coupons handed, etc. | Program implemented successfully in small and large stores in a low-income area of Baltimore City. Many lessons learned. The most important being that successful implementation of such a store-based program is feasible | 61.9% | high |
Song et al. (2011) [83] | U.S.A. | Baltimore Healthy Stores; BHS | Urban corner stores in low-income area in Baltimore City | Process evaluation (focus of storeowners perception) | storeowners’ perception of Baltimore Healthy Stores Intervention | The storeowners varied significantly in their level of acceptance and participation in the program. Strong and moderate support storeowners had a more positive attitude toward the community and the program. | 54.8% | high |
Song et al. (2009) [76] | U.S.A. | Baltimore Healthy Stores; BHS | Urban corner stores in low-income area in Baltimore City | Quasi- experimental design | Sale of targeted healthy foods | Significant intervention increase in sales of some promoted healthy foods, compared to comparison group. | 60.4% | high |