Neighborhood Food Environment, Diet & Health: Quasi-Experimental Study
Stephen Matthews, Ph.D.
Reducing the population prevalence of obesity is a current major public health goal. Interventions to reduce the prevalence of obesity have generally focused on individual behavior and lifestyle but have met with limited success. Strategies that focus on the role of the built environment have been neglected. The purpose of this innovative pilot study is to evaluate, using a quasi-experimental design, the impact on diet and psychological health of a three-year $40 million state-government funded program - The Pennsylvania Fresh Food Financing Initiative - that aims to improve the local built food retail environment in Philadelphia. The project has four specific aims. 1) To describe and compare fruit and vegetable consumption patterns and measures of psychological health in an intervention neighborhood against a matched comparison neighborhood. 2) To evaluate whether these patterns change after the opening of a new food supermarket (the intervention) in the intervention neighborhood compared to a matched comparison site. 3) To explore impacts on defined subgroups of residents based on income, education and baseline consumption status. 4) To investigate changes in the retail economy in the intervention neighborhood and compare these with the comparison neighborhood. A telephone survey of residents of two Philadelphia neighborhoods (one intervention and one comparison) with an achieved sample size of four hundred and sixty-six men and women aged 18+ in each neighborhood at follow-up will be undertaken. At baseline, respondents will be contacted with a pre-notification letter which will then be followed by a telephone call designed to elicit responses to questions relating to diet, mental health, perceptions of food access, food shopping behavior, transport and a range of socio-demographic data. Respondents will then be followed-up at eight months in order to assess the effect of the intervention. In addition geographical information systems will be used to assess positive and negative changes in the local food retail economy and relate them to changes in physical access to food. Findings from the project will be used to prepare a proposal to NIH for a larger mixed-method, multi-site experimental study in a range of community settings (urban, small town, rural) throughout the USA.