Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
PLoS One. 2012;7(6):e39431. doi: 10.1371/journal.pone.0039431. Epub 2012 Jun 27.
Consumption of fruit and vegetables is important for health, but is often lower than recommended and tends to be socio-economically patterned with lower consumption in more deprived groups. In 2008, the English Department of Health introduced the Change4Life convenience store programme. This aimed to increase retail access to fresh fruit and vegetables in deprived, urban areas by providing existing convenience stores with a range of support and branded point-of-sale materials and equipment.
We undertook a mixed-methods study of the Change4Life convenience store programme in the North East of England around two years after initial implementation. Store mapping (n = 87; 100% stores) and systematic in-store observations (n = 74; 85% stores) provided information on intervention fidelity; the variety, purchase price and quality of fresh fruit and vegetables on sale; and purchase price compared to a major supermarket. Ten qualitative interviews with a purposive sample of retailers and other professionals explored experiences of the intervention and provided further insight on quantitative results.
Intervention stores were primarily located in socio-economically disadvantaged areas. Fidelity, in terms of presence of branded materials and equipment, was low and much was not being used as intended. Fresh fruit and vegetables on sale were of high quality and had a purchase price around 10% more than comparable products at a major supermarket. Interviewees were supportive of the health improvement aim of the intervention. Retailers were appreciative of part-funding for chill cabinets and free point-of-sale materials. The intervention suffered from: poor initial and on-going communication between the intervention delivery team and retailers; poor availability of replacement point-of-sale materials; and failure to cement intended links with health workers and community organisations.
Overall, intervention fidelity was low and the intervention is unlikely to have had a substantial or long-term effect on customers' consumption of fruit and vegetables.
食用水果和蔬菜对健康很重要，但摄入量往往低于推荐量，而且往往存在社会经济模式，贫困人群的摄入量较低。2008 年，英国卫生部推出了 Change4Life 便利店计划。该计划旨在通过为现有便利店提供一系列支持以及品牌销售点材料和设备，增加贫困城市地区零售水果和蔬菜的供应。
在 Change4Life 便利店计划最初实施大约两年后，我们在英格兰东北部地区开展了一项混合方法研究。通过商店地图绘制（n=87；100%的商店）和系统的店内观察（n=74；85%的商店），我们获得了干预措施的忠实程度、销售的新鲜水果和蔬菜的种类、购买价格和质量以及与一家大型超市的购买价格等信息。对零售商和其他专业人员的有目的样本进行了 10 次定性访谈，探讨了干预措施的经验，并对定量结果提供了进一步的见解。
参与干预的商店主要位于社会经济处于不利地位的地区。从品牌材料和设备的存在来看，忠实程度较低，很多材料和设备没有按照预期使用。销售的新鲜水果和蔬菜质量很高，购买价格比主要超市的同类产品高出约 10%。受访者支持干预措施改善健康的目标。零售商对冷藏柜的部分资金支持和免费销售点材料表示赞赏。该干预措施存在以下问题：干预实施团队与零售商之间的初始和持续沟通不佳；替换销售点材料的可用性差；未能巩固与卫生工作者和社区组织的预期联系。
总体而言，干预措施的忠实程度较低，该干预措施不太可能对顾客食用水果和蔬菜的行为产生重大或长期影响。
