Development and Implementation: B'More Healthy Communities for Kid's Store and Wholesaler Intervention

Abstract

Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B'More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community's access to healthy food. The objective of this article is to describe the development and implementation of BHCK's corner store and wholesaler interventions through formal process evaluation. Researchers evaluated each level of the intervention to assess reach, dose delivered, and fidelity. Corner store and wholesaler reach, dose delivered, and fidelity were measured by number of interactions, promotional materials distributed, and maintenance of study materials, respectively. Overall, the corner store implementation showed moderate reach, dose delivered, and high fidelity. The wholesaler intervention was implemented with high reach, dose, and fidelity. The program held 355 corner store interactive sessions and had 9,347 community member interactions, 21% of which were with children between the ages of 10 and 14 years. There was a 15% increase in corner store promoted food stocking during Wave 1 and a 17% increase during Wave 2. These findings demonstrate a successfully implemented food retailer intervention in a low-income urban setting.

Keywords: chronic disease; community intervention; health education; health promotion; nutrition; obesity; process evaluation; program planning and evaluation.

FIGURE 1. Wholesale Process Evaluation Results

NOTE: W = Wave; P = Phase. ^aPercentage of high process evaluation standard achieved. See Supplemental Table S2 (available online with this article) for standards. No dose delivered standards were collected in Wave 1. There were two fidelity process standards evaluated in Wave 1, and three standards were evaluated in Wave 2.

FIGURE 2. Corner Store Process Evaluation Results

NOTE: W = Wave; P = Phase. ^aPercentage of high process evaluation standard achieved. See Supplemental Tables S1 and S2 (available online with this article) for standards. Four fidelity measures were evaluated for Wave 1, and five standards for Wave 2.