The mismatch between observational measures and residents’ perspectives on the retail food environment: a mixed-methods approach in the Heart Healthy Hoods study

Abstract

Objective: To gain a deeper understanding of the retail food environment by investigating similarities and differences between objective measures and residents' perspectives. Design: The study incorporated Geographic Information System (GIS)-based measures, in-store surveys and the results from a larger photovoice project. We combined these data using a convergent parallel mixed-methods approach. Setting: We conducted this study in a low-income neighbourhood in Madrid (Spain) in 2016. Subjects: We assessed healthy food availability, accessibility and affordability using GIS-based measures and in-store audits. We also analysed the photographs and discussions from twelve participants who engaged in a photovoice project on their food environment. Results: Quantitative results depicted a widely served and highly accessible retail food environment, in which supermarkets scored highest in terms of healthy food availability (36·5 out of 39) and 98·9 % of residents could access a healthy food store within a walking travel distance of less than 15 min. Qualitative results showed that participants preferred small local businesses over supermarkets, and revealed built environment obstacles for elderly residents. They also highlighted how the socio-economic context constrained residents' food choices. Conclusions: People's experienced retail food environment is different from the one quantitatively analysed. Results show the potential of using a mixed-methods approach to enrich food environment research and enhance public health interventions.

Food availability and food access in rural agricultural communities: use of mixed methods

“…Qualitative interview results supported this finding, as participants reported having availability and access to fresh food products in chain grocery stores or farming fields. These findings corroborated results from other studies in rural communities in the US and other international setting that grocery stores offer more healthful food selections but are outnumbered by convenience stores [ 23 – 25 ]. Although convenience stores offer fewer varieties of healthful food choices, [ 16 , 24 – 27 ] they are also located in more accessible areas, potentially leading to higher customer traffic of neighborhood residents [ 24 , 27 , 28 ].…”

“…Although convenience stores offer fewer varieties of healthful food choices, [ 16 , 24 – 27 ] they are also located in more accessible areas, potentially leading to higher customer traffic of neighborhood residents [ 24 , 27 , 28 ]. A recent study showed that proximity helps individuals build close social ties with food store owners impacting their preference to shop in smaller food stores [ 25 ].…”

A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention

“…These projects took place between 2015–2017 in Villaverde, a low-income District located in the southeastern part of the city of Madrid (Spain). These Photovoice projects aimed to identify both environmental facilitators and barriers to residents’ food choices and physical activity [ 25 , 35 ].…”

“…Following Wang’s Photovoice methodology [ 28 ], we divided the Photovoice process into several sessions [ 25 , 35 ]. First, in an initial session, we explained the project aims and scope and discussed the group sessions schedule with participants.…”

“…Photovoice methodology draws on the notion that residents are the actual experts on their environment and the ones who should guide the actions needed to foster social and policy change at the community-level [ 25 , 26 , 27 ]. Photovoice is a community-based participatory research methodology, developed by Wang and Burris, that puts cameras into the participants’ hands to help them documenting, reflecting upon, and communicating issues of concern; while stimulating social change and reaching policy-makers [ 26 , 28 , 29 ].…”