Performing Department
Human Environmental Sciences
Non Technical Summary
Online grocery shopping is a growing phenomenon and needs to be further studied, particularly among lower-income consumers, in order to determinethe effectiveness in perhaps increasing the purchases of healthy foods while decreasing the purchases of less healthy food item. However, there are main barriers among rural and smaller grocery store owners in adapting this technology, moreoever there may be other barriers among low income shoppers such as internet access from adopting this type of behavior. If online shopping does lead to healthier food and beverage purchase and consumption, it could be one mechanism to promote healthful purchases among Supplemental Nutrition Assistance Program (SNAP) participants. Online shopping also has implications for the Healthy Food Financing Initiative: Instead of financing traditional "brick and mortar" supermarkets,35 financially supporting online grocery shopping could be an additional strategy for improving access to healthy food among residents of urban and rural food deserts. Finally, if online grocery shopping does indeed promote healthier purchases, there could be financial incentive programs to encourage online shopping among low-income SNAP participants (similar to the double-bucks programs for fruits and vegetables purchased through SNAP at farmers' markets) or tax benefits for supermarkets that offer online shopping to SNAP participants. Therefore, this project will test how simulated online grocery shopping may help to decrease the pester-power of in store shopping to improve shopping habits among SNAP recipients.In addition to this project testing how online shopping may improve shopping behaviors improving the food environment within the store is equally relevant since a large proportion of shoppers will enter the store at some point during the shopping cycle, especially for "grab and go" items. To these ends this project will work with grocery store managers to intiate selected behavioral economic strategies in their store to improve shopping choices among SNAP recipients.
Animal Health Component
50%
Research Effort Categories
Basic
(N/A)
Applied
50%
Developmental
50%
Goals / Objectives
Aim 1. Determine barriers and facilitators to shopping at local grocery stores among 60 low-income caregivers and 8 supermarket owners and managers in four counties in Appalachian Kentucky, using qualitative, in-depth interviews.Aim 2: Examine the effectiveness of a simulated grocery shopping intervention to reduce pester power and ego depletion, and increase habit strength for healthy food purchases among caregivers (n = 150) of children ages 2-12 years, enrolled in the Supplemental Nutrition Assistance Program (SNAP) in four counties in Appalachian Kentucky (Knox, Clinton, Greenup, Letcher n=2 intervention counties and n=2 control counties) relative to controls.
Project Methods
Caregiver qualitative interviews: Alison Gustafson, PhD, MPD, RD Principal Investigator on this project plans to conduct qualitative interviews regarding potential barriers and facilitators to online shopping among WIC and participants with assistance from graduate students in the department. Dr. Gustafson is collaborating on the development of the interview guide with colleagues from the multi-state research project NC-1196. The guide will include questions about grocery shopping habits, the use of grocery lists, impulse purchases, ego depletion and pester-power. We will also ask participants to bring a recent grocery receipt, and mark on the receipt which were planned versus impulse purchases. We will use a simple question to assess ego depletion: "What was your "state of mind" during this shopping trip? Were you happy, sad, stressed, relaxed, or pressured for time?" We will add questions related to whether participants enjoy the social environment inside the supermarket. As unit price is more clearly displayed in the online environment, we will examine whether customers might end up purchasing more calories online versus in-store. We will also demonstrate the online experience for each participant, wherein the interviewer will log on, "shop" and then show participants how to reserve the time slot to pick up/ pay for groceries.We will also conduct qualitative interviews with caregivers after Aims 2 and 3 (below) to learn about their experiences with online shopping. We will ask about grocery shopping habits, the use of grocery lists, impulse purchases online, ego depletion and pester-power: Pester-power could still be a problem even while caregivers are grocery shopping online, as children could approach caregivers when shopping on their computers or smart phones and make food and beverage requests.Supermarket owners/ manager interviews: We will interview 8 supermarket owners/managers (2 in each county*4 counties=8) to determine the barriers and facilitators to stores when considering implementing online shopping and in-store marketing of local and healthy food. We will also ask about how certain items are selected as free offers within the online shopping environment. We will begin to learn how in-store marketing can help the store owner as well recipe promotions, change in end-cap products, and other marketing tools. We will also ask (among participants from stores where online grocery shopping is offered) why SNAP Electronic Benefit Transfer cards are not accepted outside the stores, and how they might be made available.Qualitative data management and analysis: For caregiver and supermarket owner/manager interviews, participants will sign informed consent, and all interviews will be audio-recorded and transcribed verbatim. Interviewers will also take hand-written notes on the interview guides, and this information will be used to provide further context for the data analysis. Caregiver and owner/manager interview participants will be compensated $50 for their time. Two qualitative analysts will read through 3-5 data rich transcripts and come up with two independent codebooks that include codes and operational definitions, based upon repeated themes and the interview guide questions. The analysts will meet to compare codebooks and decide upon a consensus codebook. They will then independently apply the codes to segments of text for 2-4 transcripts, meet to discuss and resolve discrepancies, revise the codebook, and will continue coding in this sequence. NVivo (version 10,QSR NVivo Software, QSR International Pty Ltd, Melbourne, Australia, 2013) will be used to manage and analyze transcripts deductively for themes explained above, as well as inductively for unanticipated themes. Deductive themes for the caregiver interviews will likely include shopping habits, impulse purchases, pester-power, ego depletion, potential for reduced stigma related to participation in WIC and/or SNAP, as well as barriers to and benefits of online grocery shopping. Potential themes for the owner/ manager interviews will include barriers to and facilitators of online grocery shopping, decisions about marketing of items within the online shopping environment, identification of WIC-approved items online, and barriers to offering SNAP/EBT on a card-reader outside the store.For Aims 2 and 3: Study team will conduct a four week randomized pilot study among 150 caregivers of children ages 2-12 years receiving SNAP benefits (n=75 intervention participants and n=75 control participants). Eligibility criteria are as follows: Over 18 years, enrolled in SNAP, not currently an online shopper, but a weekly grocery shopper at Sav-A-Lot or IGA (there are both Sav-A-Lot and IGA stores in all 4 counties), regular internet access, ability and willingness to pay for groceries purchased online with cash or debit/credit card, English Speaker. We will recruit 150 current grocery shoppers at local stores (Sav-A-Lot and IGA) and randomize them to (1) a traditional "brick-and-mortar" which is the control or (2) a simulated online shopping group for 4-weeks plus traditional shopping. We hypothesize that through online pre-commitment, shoppers randomized to simulated shopping plus traditional shopping will have practiced how to resist temptation within the store and thus lead to less unhealthy pester power by children and less exposure to impulse marketing, increasing cognitive reserves, increasing habit strength for healthy food and beverage purchases, leading to fewer unhealthy purchases. We selected an four-week experiment because we expect that four weeks will be enough time to build and solidify purchasing habits. We will also have stores conduct Cooperative Extension Plate It Up Kentucky Proud (PIUKP) programming during the intervention cycle. Each store will be given a small stipend to move fruits and vegetables in prominent display, to encourage purchasing of local produce when appropriate, to display marketing materials promoting produce, and to allow Cooperative Extension agents to conduct recipe demonstrations. ($500 per store).The development of the online shopping will be developed in year 1 of the study when the qualitative data collection is taking place. Currently USDA is offering small grants to stores to install online shopping in their stores. For those stores that do not want to participate in the online shopping technology the study team will use a web-based application "app" which simulates grocery shopping in their store. This app has been developed from a previously funded CDC grant of which Dr. Gustafson is a Co-PI on.Recruitment and enrollment: We will recruit and enroll participants from WIC and SNAP through Cooperative Extension and local health departments. We will approach potentially eligible individuals, and use the eligibility screener and assess initial interest. We will explain the study and the participant timeline and incentives provided, and explain that participation includes potentially being randomized to either traditional or simulated shopping for 8 weeks, turning in weekly grocery receipts for 2 weeks before, 2 weeks after, and during the 8 weeks of grocery shopping, and completing three sets of dietary measures (pre, post, and during the 8-week intervention). The budget includes incentives for participating in the program ($100 per participant in the intervention and $50 in the control).