Understanding Pathways to Health: Walking Interviews in a New Food Desert Supermarket

Despite efforts to improve food access through supermarket development, little evidence exists to support positive health impacts of these efforts.  Existing studies have focused on resident perceptions of the food environment, produce consumption, and obesity as primary outcome measures.  This study examines more proximal outcomes - shopper behavior and perceptions - in a supermarket developed through the Pennsylvania Fresh Food Financing Initiative (FFFI) to understand how consumers experience the store in ways that could influence health outcomes.

Public health researchers have used go-along interviews as a participatory, in-depth field method, including studies of food shopping behavior.  Go-along interviews allow the participant to guide the interviewer through their shopping trip as it happens.  32 participants were recruited by intercept, equipped with a voice recorder, and asked to narrate their shopping trip to the interviewer, who asked follow-up questions as necessary.  A brief survey was administered to document demographic information, health perceptions and attitudes.  Qualitative coding was applied to interview transcripts and triangulated between multiple researchers and survey responses.  To my knowledge, this method has never been used to evaluate supermarket development in a food desert.

Findings contribute to our understanding of new stores in food deserts: supermarket proximity can broaden trip opportunities and allow the store to function as familiar neighborhood institution.  Most important, this is the first study to document shoppers managing diet-related diseases in a food desert supermarket, identifying more intermediate health behaviors than previous evaluations, and raising critical etiological questions for future interventions in food deserts.