Can Measures of the Grocery Store Environment Be Used to Track Community-Level Dietary Changes?

Background. This article examines whether an in-store unobtrusive survey of grocery store product displays can be used to track community-level dietary behavior. Methods. The survey was conducted in 12 western communities two different times to measure two aspects of the grocery store environment: (a) the relative availability of low-fat and high-fiber products and (b) the amount of store-provided health-education information. Self-reported dietary intake of residents was obtained in the same 12 communities using a telephone survey. We compared the individual and store-level measures both cross-sectionally and over time. Results. We found positive and statistically significant correlations between the availability of healthful products in stores and the reported healthfulness of individual diets in cross-sectional analyses, but correlations between changes over time in the two measures were weaker and not statistically significant. The variance of the grocery store measures was nonetheless sufficiently small that a grocery store survey of 15 stores in each of 8 communities (n = 120 surveys) had power comparable to that of a telephone survey of 200 individuals/community (n = 1,600) surveys, at a fraction of the cost. Conclusion. Although the results provide further validation of cross-sectional measures of the grocery store environment, additional efforts are required to establish the validity of the grocery store survey as a method of measuring dietary change.