Healthy Corner Store Toronto Model

Healthy Corner Store Toronto ModelPresentation to Sustain Ontario—webinar, March 4, 2015

The Problem

Food retail in general still dominated by less healthy foods

Many lower income areas of Toronto lack sources of

healthy, affordable, diverse food

“Healthfulness” of Toronto’s Food Retail

Darker red = “less healthy” food

retail environments (1 km radius)

The Problem

Public Health’s mantra:

“making the healthy choice the easiest & most appealing”

must be applied to food retailers too

Currently very little support for independent small retailers

Waterloo, ON study found that females of average height

(5’5) weighed15.2lbs less and had 6.4cm smaller waist

circumference for every km increase in distance from their

home to nearest convenience store (adjusted coefficients).

Source: Minaker, L. (2013). Evaluating food environment assessment methodologies: a multi-level examination of associations

between food environments and individual outcomes. University of Alberta, PhD Thesis.

Compared to infrequent HCS shoppers, residents who visited

our HCS pilot store 2+ times/week consumed on a daily basis:

396 more calories

852mg more sodium, and

69% more added sugar

Frequent Convenience Store Shoppers

Notes: Based on pre-intervention survey, self-reported. Feb 2014, (n=194). No significant differences were found in frequent vs

infrequent supermarket shoppers.

High profit margin

Strong marketing support

Long shelf life

Free new fridge & displays

Attractive product design

Hassle-free distribution

Low risk

High existing customer demand

Financial incentives to sell more

In line with store’s image

No product training required

Some demand for product

Service to community

X Highly perishable

X Lower profit margins

X Distribution?

X Need training in product handling

X Store not branded as F&V seller

X Past failed attempts to stock

X Funds to buy new equipment?

X Change management support?

Choices Facing Convenience Store Owners

Changes Happening, But No Equity Lens

PHAC Funded Food Retail Evaluation

Growing literature on food environments and how they influence diet quality and health status over and above individual knowledge and attitudes

The Context: Food environment research

(Glanz et al. 2005)

Key findings in the literature to date—

Methodological gaps in the literature Inconsistency in how food environments are measured Poor robustness of outcome measures (e.g., diet assessment) Mostly cross-sectional associations Few studies include multiple environmental features in the

same study Few accompanying municipal policy assessments Limited assessments of social context in which interventions are

implemented


(Minaker 2013; Mah, Minaker, Cook 2014 forthcoming)


• ‘Food deserts’ per se• Lack of big supermarkets• Big food retailers ignoring

prime locations in lower income neighbourhoods

• Insufficient food production, importation

For Toronto, the problem is NOT

The problem IS

• Poverty!• Many business model,

infrastructure challenges for small and medium stores … enabling policy, economic viability

• Cities (until recently) don’t see food as their mandate

• And more …

Research in 3 lower income sites to evaluate

healthier food retail models

Healthy Corner Store pilot

Mobile Good Food Market site

Non-intervention control site for comparison

Pre-survey

Iterative pilot interventions

Post-survey

Evaluation of outcomes

PHAC-funded Food Retail Evaluation

Assets and strengths of the evaluation

Pre-post, controlled design

Mixed methods

Use of 24h diet recall (ASA24) vs. food frequency

Objective food environment measurement

Novel mobile data collection tool (NEMS

smartphone app)

Proximal metrics (changes in store, point-of-sale)

Shift purchases toward healthier food & displace junk

food sales revenue

Demonstrate potential for economically viable HCS

model

Create toolkit of solutions to support HCS transition

citywide

Healthy Corner Store Pilot Objectives

Healthy CornerPilot Process

Typical HCS Project Components

Source: Jessie Azrilian, Allison Kwan, Mark Linthicum & Julia Wolfson (2012). Creating Healthy Corner Stores: An analysis of factors necessary for effective corner store conversion programs.

Store Owners

Residents’ Association

Project Partners

HCS Pilot Site #1(Before)

“A-Z Variety”

PHAC-funded pilot research

Challenges: Little Fresh Produce

Challenges: Clutter

Challenges: Floor repairs

Challenges: Not maximizing shelf space

City zoning doesn’t allow door directly to outside from apt building retail(but rules in process of changing)

Padlocked!

Challenges:

Challenges: No natural light inside

City Sign Bylaw doesn’t allow outside sign

Challenges: No outside sign!

74% reported annual income <$30,000

Average daily sodium intake – 3910mg

84% born outside Canada

Residents’ Baseline Data

HCS Pilot Site (mid-conversion)

“Lucy’s Fresh Food Market”

POS System installed (March 2014):Still challenging to get timely accurate data

North wall (pre-intervention)

North wall Step 1

North wall Step 2

North wall Step 3

Window opened up

PriceLabels

Participation at Community events

Community Engagement Work

Nearby community agency support: Links to resident groups Local program connections Community outreach workers to

promote store project

Initiative to link HCS & food entrepreneurs

East Scarb Storefront, Seed to Table

TPH Dietitian & HE support

EcDev & Enterprise Toronto

Unexpected Links

Landlord runs children’s morning snack program

Worked w TPH Dietitians to improve food quality

AND fruit now purchased through HCS pilot store

Marketing Support

Health Canada funding to bring in marketing consultants

Current Challenges

Consistent high quality, affordable fruit & veg distribution

Expansion beyond F&V - how to find full inventory of healthier

fresh, prepared or frozen food distributors

Project currently has limited food retail/marketing expertise

Limited sales data – relying on 3rd party for POS system,

database management & sharing

Comments? Questions?

RESEARCH TEAM

Brian Cook – [email protected] Sommerfreund – [email protected] Minaker – [email protected] Mah – [email protected] de Groh