Healthy Food Retail in Weld County Year Two Final Report
A Research Report
June 2015
Prepared by Spark Policy Institute on behalf of the Colorado Department of Public Health and Environment Lyn Kathlene, PhD and Sophie Oppenheimer, MS, MPH
TABLE OF CONTENTS Background........................................................................................................................................................... 1 Year Two Activities and Results .................................................................................................................... 5 Outreach to Stores from Year One ............................................................................................................................ 5 Tienda Paulin, (Platteville, Census Tract 18) ..................................................................................................................... 5 El Mercado Market (La Salle, Census Tract 17)................................................................................................................. 6 Plains Market (Pierce, Census Tract 25.01) ........................................................................................................................ 7 Other Stores/Tracts ...................................................................................................................................................................... 7 Data Collection at Newly-Recruited Stores ............................................................................................................ 7 Jerry’s Market, (Greeley, Census Tract 5.02) ...................................................................................................................... 8 La Tarahumara (Greeley, Census Tract 1) ......................................................................................................................... 13 Building Relationships ................................................................................................................................................17 Community Partners .................................................................................................................................................................. 17
Challenges and Opportunities ..................................................................................................................... 17 Recommendations for Year 3 Scope of Work ........................................................................................ 18 Conclusion .......................................................................................................................................................... 19 References .......................................................................................................................................................... 21 Appendix A ......................................................................................................................................................... 22 Community Commons Maps for Weld County.....................................................................................................22 Basic Demographics.................................................................................................................................................................... 22 Food Access .................................................................................................................................................................................... 25 Employment ................................................................................................................................................................................... 28
Appendix B ......................................................................................................................................................... 30 Weld County Employment information ................................................................................................................30
Appendix C ......................................................................................................................................................... 32 Store owner Interview Protocol...............................................................................................................................32 In-Store Visual Assessment .......................................................................................................................................39 Customer Survey Protocol .........................................................................................................................................43
Appendix D ......................................................................................................................................................... 45 Storeowner Debriefs ....................................................................................................................................................45 La Tarahumara.............................................................................................................................................................................. 45 Financing ......................................................................................................................................................................................... 47 Jerry’s Market ................................................................................................................................................................................ 50 Financing ......................................................................................................................................................................................... 53
Appendix E ......................................................................................................................................................... 55 Store pictures..................................................................................................................................................................55 Tienda Paulin ................................................................................................................................................................................. 55 El Mercado Market ...................................................................................................................................................................... 55
Appendix F ......................................................................................................................................................... 56 Healthy Food Access Meeting List of Attendees .................................................................................................56
BACKGROUND Year Two of the Healthy Food Retail Store Initiative focused on addressing barriers and identifying potential solutions to increasing healthy food access, including food distribution and transportation. When it comes to healthy food, access can be explored in three levels:
Informational Access refers to education (such as nutritional) presented in a culturally relevant way.
Economic Access refers to affordability along the continuum of food access, from production to distribution, to store owner costs and consumer costs.
Geographic Access refers to the physical location of healthy food – is it near potential customers? Is it accessible by public transportation or other realistic means? Before delving into access, however, target areas need to be identified.
Spark researched census tracts in Weld County to identify target areas using secondary data. We began by reviewing materials created for Year 1 of the project, including a map of food retailers and poverty rates created by CDPHE and results from consumer surveys, storeowner surveys, and store assessments conducted by Weld County Public Health. We then conducted additional research and created visuals for specific census tracts in Greeley. Five census tracts in Greeley, tracts 1, 2, 6, 8, and 10.04, were identified by Weld County Public Health as areas of low healthy food access and low income. The figure below shows census tracts 6 and 2 have the highest rates of low food access, including for low-income and children. Census tract 10.04 is also high compared to census tracts 8 and 1.
Chart 1: Food Access by Census Tract 94%
92%
95%
90%
84%
82% 70%
66%
41%
36% 29%
6
2
23% 12%
7%
6%
5%
24%
10.04
4% 8
8% 2% 1
Census Tract Low access (total population)
Low access, low-income people
Low access, children age 0-17
No vehicle access and low food access, housing units
1
According to the USDA-ERS Food Environment Atlas, four of the five districts are considered food deserts by at least one definition (USDA ERS Food Access Research Atlas, 2015).
Figure 1: Food Deserts by Census Tract
Another approach to measuring food access, recently developed by the CDC, is the Modified Retail Food Environment Index (mRFEI), which measures the number of healthy and unhealthy food retailers, with scores ranging from 0 (no food retailers that typically sell healthier foods) to 100 (only food retailers that typically sell healthier foods). Figure 2 shows RFEI score in Weld County, with the targeted census tracts denoted by the grey bubbles.
Figure 2: mRFEI for Weld County Census Tracts
2
Although both methods show similar trends for some census tracts, they also show different trends for others. For example, census tract 6 has a relatively high mRFEI score, but also has the highest rate of low access according to USDA-ERS measures. These measures are slightly different: one measures distance to healthy food stores and one measures relative density of healthy to unhealthy food stores. These measures are useful when comparing counties on a population level. However, they are limited in their ability to give an accurate account of a current local situation and even more limited in their ability to represent the unique barriers each community faces. Spark conducted outreach to thirteen of the sixteen stores identified in Table 1* to gauge interest in participating in the pilot program. Three of the stores did not have working number and we were unable to find an alternative phone number. The majority of stores responded that a manager was not present. Only two managers answered after multiple attempts and said they were too busy and did not have time to answer any questions. One storeowner agreed to speak with Spark. He said there was already a grocery store close to his and then said he was busy and had to hang up.
Table 1: Stores Identified in the Target Area Census Name of Store Tract 1 East African Store 1 Dollar General Store 1 Sahiro Grocery Store 1 Doof Market 1 Loyan Shop 1 La Tarahumara Market 1 Everyday Store #5710 1 Everyday Store #5711 1 Conoco Food and Gas 6 Panaderia La Mexicana 6 C-Stop Food Market 6 Carniceria San Luis 8 City Food and Gas 8 Save-A-Lot 8 Everyday Store #5709 8 King Soopers #32
Given the difficulties in engaging storeowners in the predefined target area by phone and the possibility that other census tracts in Weld County have higher needs, we re-evaluated our approach. To begin, we created additional maps using Community Commons to give a rough overview of the entire county (Appendix A). These include food access maps, population density, poverty rates, gross employment job density, and commuting time, among others. Indicator choice was based in part on a broad body of research indicating rural food access differs from urban access in terms of commuting and shopping patterns. For example, because rural residents often live far from grocery stores, they often consolidate errands into one trip. This behavior implies that focusing on food stores closer to schools or major employers might have more impact. Additionally, we dove deeper into the landscape in Weld County by gathering details about major employers. Between 2010 and 2012, the top three growing industries were: Support Activities for Oil and Gas, General Medical and Surgical Hospitals, and Animal Production (Upstate Colorado, 2014). The top three declining industries were: Crop Production, Photo Film, Paper, Plate and Chemical Manufacturing, and Specialty Hospitals. The largest industry by sector was Manufacturing (employing 11,835 people or 9.9% of total Weld County employment in 2011). The key manufacturers were JBS, Vestas Blades & Nacelles, Carestream Health, Leprino Foods, Sparton Medical Systems, and PTI Group. The next largest industry was Health and Wellness sector, which accounted for 8.2% of total Weld employment (9,864 people) in 2011, largely due to the 378-bed North Colorado Medical Center (NCMC) in Greeley. Other significant industries in Weld County include Energy (fossil and renewable), Business Services (company management, administrative/back office support), and Agriculture (mostly livestock production). Further
*
King Soopers and Save-A-Lot were excluded because they are grocery stores and the Dollar Store was excluded because the corporate office said they were not interested during Year 1 outreach.
3
details on Weld County labor sheds, commuter patterns, and employer information can be found in Appendix B. Given that Weld County is a rural area with a diverse population, we conducted additional research to determine the best strategies to address food system changes in this area. The little existing research on the success of corner stores in rural areas suggests the best strategy is to involve community members in the process from the beginning and throughout the entire project (ChangeLab Solutions, 2015). Similarly, research regarding changing food systems in urban areas with diverse populations has also found community engagement to be essential in ensuring program sustainability. Efforts to improve healthy food access across the United States have used varied approaches because each community is unique, but they have found that having community input allows programs to develop organically and meet the real needs of the community. Overall, research suggests that community engagement is important because it:
Helps clarify community needs. Engaging the community allows developers to identify factors not available in easily accessible data such as cultural preferences, dietary restrictions, and social norms around food.
Reflects community values. When stores reflect the values and preferences of community members, they are more likely to attract business, which is good for sustainability.
Helps identify key community stakeholders who can strengthen the program. For example, in areas where farming is a major industry, programs can address issues with distribution while building local farmers’ capacity, further strengthening the program.
Helps identify community partners that might not be obvious. For example, two organizations in California have engaged liquor store owners to sell fresh foods in their stores and allow coalitions to use their parking lots for weekend pop-up produce markets.
Builds community capacity. Community engagement not only helps make these programs successful, it can also be a great tool to build community capacity, which can further address some of the social issues often faced by underserved communities. For example, vendors can network with each other, learn about business practices, and even agree to buy products together, which can reduce productpurchasing costs and allow them to sell products at a price that is accessible to their customers.
Considering what we know about Weld County from the research conducted over the past two years and a close examination of unique factors in the county (e.g. ethnic and racial diversity and the presence of large employers), it is important to take the time to ensure all potential community partners are brought together so any adopted strategy will meet the needs of the community. For example, since many people work in large companies, it might make sense to focus on choosing stores close to those employment centers rather than in neighborhoods, since the former will target a larger population. Similarly, large companies might have an interest in the health of their workers and can therefore become key community partners to help sustainability beyond the pilot project timeline. Additional research has presented new possibilities for addressing food access in rural areas like Weld County. In some cases, healthy convenient store models might not have as much impact as other, more innovative models for addressing healthy food access. Mobile markets, for example, are a new model focused on bringing healthy food retail closer to where people work or gather on a regular basis. Examples of mobile markets include produce markets at train stations in Atlanta, fresh food on Green Carts in New York City, a mobile grocery truck in Portland, Oregon, and a converted horse trailer in Tulsa (Averill, 2014; Edmundson, 2015; McColl, 2015). Other models use pop-up produce stands at strategic locations, such as low-income residential facilities, senior centers, and health centers, including Mandela Marketplace and Country Fresh Stops.
4
YEAR TWO ACTIVITIES AND RESULTS In light of the findings from the research-to-date, we determined immediate action items:
Follow up with stores from Year One to determine progress on recommendations;
Broaden the geographic focus to different census tracts and continue outreaching to convenient stores, including those near major employers or public transit locations;
Conduct storeowner interviews, in-store visual assessments, and customer interviews at newly recruited stores (Appendix C);
Debrief findings with storeowners of newly recruited stores (Appendix D);
Form partnerships with community organizations with similar or related interests;
Identify community leaders and engage unlikely partners (e.g. liquor stores, churches, major employers, farmers, distributors, etc.); and
Conduct a needs assessment with community members to determine how the community defines the problem, which includes key informant interviews with community organizations, storeowners, and community members.
To complete these action items, Spark conducted a full day site-visit to Weld County. This visit included conducting follow-up visits to stores from Year One, investigating additional stores to recruit, meeting with community partners, and disseminating surveys at community health centers.†
OUTREACH TO STORES FROM YEAR ONE Spark visited the five stores from Year One (Tienda Paulin, El Mercado Market, Plains Market, Kersey Super Market, and Platteville Grocery Store) to assess if they adopted any recommendations from Year One.
Tienda Paulin, (Platteville, Census Tract 18) Although the storeowner was not there when we visited, we did call her from the store and ask her if she has made any progress on recommendations from Year One. She informed us that she has not been able to make changes to the store layout due to family issues, but intends to make changes when possible. In addition to items previously sold in Year One, the store added dried lentils, lima beans, garbanzo beans, celery, carrots, and whole wheat tortillas. While the addition of whole wheat options is an improvement, the tortillas were very high in salt. Moving forward, stores should be aware of the full nutritional profile of added “healthy” food items such as fruits, vegetables, or whole grains to ensure they do not inadvertently increase access to additives such as sugar and salt.
†
Though we did administer surveys at community centers, only five were completed. Due to the low response rate, we chose not to report survey results.
5
As part of North Colorado Health Alliance’s Make TODAY Count! Campaign, a community group got together and painted a mural on the side of the building (pictured right). Although the mural does not incorporate agriculture or promote fruits and vegetables as recommended in Year One, it does represent the community’s heritage, including views of plains and the Rocky Mountains. The mural also includes a “Make TODAY Count” emblem, which is a healthy community initiative inspiring healthy eating and active living. The mural is also colorful and attracts the attention of passersby. Lastly, it was designed and painted by the community, fostering community support and involvement with the store. Inside the store there were several posters promoting healthy items, including fruits and chia seeds (Appendix E).
El Mercado Market (La Salle, Census Tract 17) El Mercado did not make any changes to the store layout. However, they increased signage outside the store. One sign was placed above the entrance with the name of the market and pictures of fruits and vegetables (left). The second sign was placed out near the street to attract nearby drivers to the store. It includes the name of the market and pictures of various items, including fruits and vegetables as well as junk food (right). The storeowner, Gloria, believes the sign has increased customer visits. We conducted a brief informal interview with Gloria and learned that she is very interested in selling more fruits and vegetables, and her customers (many of whom live in the neighborhood) have requested fresh produce. Most of the fresh produce is currently stored in a refrigerator (Appendix E), but the amount she offers is limited by lack of refrigerated storage space. She is interested in obtaining additional refrigerated storage space, as well as misters for produce to keep it fresh. Some of the produce is stored in produce baskets provided by the Public Health Department (left and in Appendix E). However, the produce spoils more quickly without refrigeration. There were more unused produce baskets in the back of the store, as well as unused signs advertising fruits and vegetables provided by the Public Health Department (right).
6
In addition to selling more produce, Gloria is interested in installing a meat counter so that she can provide meat to her customers (many of whom have requested she sell meat). She is also interested in adding a commercial kitchen to sell value-added goods such as chopped fruits and vegetables. Gloria is interested in applying for grants to reach these goals, but indicated she would need help with the paperwork. As a result, Spark investigated grant opportunities and loan programs that may be appropriate for Gloria and other small corner stores. The most promising opportunity is a loan program through the Colorado Enterprise Fund (CEF). Through follow-up with Gloria, we learned that she and her husband are interested in financing options, but have not had any luck finding loan rates that work for them. In fact, Gloria is considering taking another job to pay for the changes she wants to make to the store. Spark provided Gloria with information about CEF and put her in touch with the Healthy Food Program Manager at CEF, who will follow up with her about appropriate opportunities available‡.
Plains Market (Pierce, Census Tract 25.01) The storeowner, Connie, was not in the store when we conducted our visit. Despite follow-up calls, we have not been able to reach her. There have been no significant changes to the store layout. A few additional healthy items such as nonfat yogurt, almond milk, and locally sourced beef were present, but these items were limited. The lack of consistency in products offered is a result of the store’s business model, which relies mostly on buying sale items at larger stores and re-selling them. The downside of this model is that customers cannot rely on a consistent products and it likely prevents the storeowner from sourcing products based on customer needs. Many smaller rural stores face issues sourcing healthier foods at a reasonable price. Potential solutions include partnering with other stores in the area to access distributors at a cheaper price and building relationships with local food producers who may be willing to sell to smaller stores at a reasonable price.
Other Stores/Tracts
Kersey Super Market (Kersey, Census Tract 16): The Kersey Super Market was closed when we conducted our site visit. As we were sitting in the parking space, the storeowner closed the store for the day. After reviewing the report from Year One that indicated the owners were not interested in offering healthy foods, as well as observing the location of the store, we decided it is not worth pursuing a partnership with this store at this time.
Platteville Grocery Store (Platteville, Census Tract 18): This store has gone out of business.
DATA COLLECTION AT NEWLY-RECRUITED STORES Two additional stores, Jerry’s Market and La Tarauhmara, were selected as pilot sites for Year Two. While not originally located in census tracts considered food deserts, the recent closing of the downtown Safeway grocery store greatly affected food access in the area. In addition, both stores are located in census tracts with large low income and immigrant populations. Once stores agreed to join the project, we conducted a second site visit and collected data for each individual store. Data collection consisted of telephone interviews with storeowners, an in-store food assessment, and in-person interviews with store customers. ‡
Spark Policy Institute is in the process of writing a case study about El Mercado and the barriers that small stores face in accessing financial support to provide healthy food to their communities.
7
Jerry’s Market, (Greeley, Census Tract 5.02) Storeowner Interview We conducted a telephone interview with the store manager from Jerry’s Market, Steve, to gauge interest in the project and gather baseline data. Jerry’s Market is a small independent grocery store established in 1964. The store’s main competitors are Safeway and King Soopers, which are the closest and largest grocery stores in town. Steve shared that Safeway closing positively impacted business because his store is the next closest store and people don’t travel far, either because they don’t want to take the time or because they lack access to transportation. Steve believes more people come into the store now, and he has increased store offerings. He is currently remodeling the front end of the store, including making physical changes, purchasing new equipment (e.g. cash registers) and installing a new operating system. The store serves between 600-800 people per day, many of whom live nearby and either walk, bike, or drive to the store, with few using the bus. Steve estimated 20% of his customers use Jerry’s as their main grocery store, but acknowledged many shop for groceries at multiple stores. Steve sees himself as a member of the community and believes the store helps support the community by providing access to wire transfers, cashing checks, bill pay, and western union – all services requested by community members. Additionally, 90% of the store’s employees are members of the community, which helps him learn about and meet the needs of local residents. Jerry’s accepts SNAP and other cash benefits, but not WIC. Steve estimates that more than 75% of his customers participate in the SNAP program at some point in time. The store sells a wide variety of fruits and vegetables in a 60-foot section near the front of the store and they currently have an adequate refrigeration system. Steve estimated that approximately 10% of total food sales are fresh fruits and vegetables. He does not have any challenges or barriers to carrying fresh produce, but did mention price and spoilage are always important to keep in mind when making purchasing decisions. He feels that, although the warehouse he buys from gets good deals, price is largely dictated by environmental causes affecting supply and quality. Jerry’s Market relies on 25 vendors to maintain inventory, many of whom are local distributors. However, their main vendor is Affiliated Foods, a large distributor out of Nebraska serving over 800 stores across the country with two warehouses over 1 million square feet. Affiliated Foods is a cooperative, where stores buy in and own a piece of the warehouse. As a consequence, stores are financially invested in the success of the company, which incentivizes stores to buy from it. Affiliated Foods does not source foods locally. Instead, they source foods from the east and make deliveries within a 500 miles radius of their warehouses. Jerry’s receives deliveries twice a week, but Steve mentioned that Affiliated Foods has a truck somewhere in the area every day. All of the produce sold at Jerry’s Market is sourced through Affiliated Foods. Steve relies on the principles of supply and demand and the good relationships he has with his customers when deciding what to sell at his store. He said: We have the opportunity to know what customers would like and that’s what we bring in… we can speak to them easily, face to face, and we get a lot of the same customers.
8
If they want something, we try to get it – and they’re aware of that, so we get lots of requests. When asked about specific healthy items, Steve mentioned that many of his customers do not follow a strictly healthy diet because, in his view, the store is located in a low-income area and people living there are not looking for healthy items. He believes people don’t buy healthier foods due to lack of education: they either don’t know why they should eat healthier or they don’t care. Steve is interested in selling more “[It would be] great [to get people to] eat healthier; education healthy foods only if the demand is is at least 80% of that. It’s sad when we have to do this for there, because he might have trouble communities because we feel that we’re too obese as a society selling healthier items before the and that someone needs to intervene to teach people… it’s sad expiration date if the demand is low. He when we get to that place. I have mixed emotions about the said people who want healthier foods whole thing. We should all eat better; most of us know that, like sugar-free or gluten-free items some don’t. I recently had a heart attack, and when I had to already shop somewhere else. In other eat better, I didn’t know how. Like me, I was a heavy salt user; words, Jerry’s sells fill-ins for people if I didn’t know how bad it was until I got educated.” they forgot things from other stores, and consequently he does not sell many – Steve, store owner healthy items other than the basics. Steve’s customers dictate what he sells: if consumption of healthier foods goes up and demand increases, he would gladly sell healthier foods. He believes education is the biggest driver of healthy food consumption.
In-Store Assessment In addition to the storeowner interview, we conducted an in-store food assessment. Jerry’s Market is a small, independent market selling a wide variety of food and non-food products. There are no advertisements for healthy or unhealthy food outside (pictured right), but there are four vending machines with large pictures of soda to the left of the entrance. There is also no healthpromoting signage inside the store. Jerry’s sells a variety of staple items, including bread, cereal, canned goods, vegetables, fruits, fresh meats, juice, water, milk and other dairy products. It also sells junk food like candy, chips, donuts/pastries, and soda. Additionally, the store sells hot beverages, prepared food items, tobacco, and lottery tickets. The produce section is large and located near the front of the store to the right – a common layout seen in many larger grocery stores. Still, items in the main checkout area include sugar sweetened beverages, candy, and chips; no healthier options are displayed near the checkout area. The store offers a wide variety of fresh whole fruits, most of which appeared to be good quality. There are also canned fruit options; however, canned fruit was in syrup (added sugar), with the exception of peaches and pineapples which were in 100% juice. The store also offers a wide variety of fresh whole vegetables, most of which appeared to be good quality. Jerry’s appeared to have fewer culturally-relevant vegetables and fruits compared to other stores in the area. Though they sell canned vegetables, there were no reduced, low, or no-sodium options available. For other canned food items, such as meats, broths, and beans, there
9
were very few fat-free or low-fat options. The store offers only whole and 2% milk, with no options for 1% or fat-free milk. They also offer whole grain cereal and brown rice, as well as many dried beans, peas, and lentils. There were fewer options for 100% juice compared to juice drinks or other sugar-sweetened beverages.
Customer Surveys
Chart 2: Customer Age
Surveys were administered in-person at the store in both English and Spanish. Twenty customers participated in the survey. Chart 2 shows the age distribution of participants, with a slight majority (55%) ages 46 or older. The majority of participants were female (71%). For self-reported race/ethnicity, 88% selected Hispanic/Latino/ and/or Spanish origin, 12% selected White/Caucasian, and 1% selected Other.
15% 30% 20%
10%
25% 19-25
Most customers do not buy most of their groceries at Jerry’s Market (Chart 3); they come to Jerry’s Market for the financial services offered, including money transfers or bill pay, and only occasionally pick up additional items while they are there. Other customers mentioned that they come to Jerry’s when they need to quickly pick up an item they ran out of at home. Most respondents buy their food from larger stores such as King Soopers, Sam’s Club, Save A Lot and Lowes.
26-35
36-45
46-55
55+
Chart 3: Do you buy most of your groceries at Jerry's Market? Yes, 10%
No, 90%
Most respondents live less than ten minutes from Jerry’s Market (by their preferred method of transportation). The majority drive to the store (90%), while some walk (20%) and a few bike (5%). Some participants use multiple methods of transportation.
Chart 4: Shopping 0% Frequency 15% 30% 15%
Chart 4 shows self-reported shopping frequency among customers surveyed. Half of respondents shop at Jerry’s one to three times per month and a few shop there four or more times per week (15%).
20% About once per month 2-3 times per week 4 or more times per week
10
20% About one time per week 2-3 times per month
Participants were also asked which types of items they buy at Jerry’s Market. Chart 5 shows that the top three items customers buy are fruits, vegetables and breads.
Chart 5: Products commonly bought at Jerry's Market Fruits
78%
Vegetables
78% 61%
Breads Beans
50%
Meat Protein
50%
Milk
50% 44%
Cheese 33%
Yogurt Rice
28%
Customers were asked to elaborate on the types of items they buy in each category below to determine the extent to which they were buying healthier options.
Fruits: Most reported buying whole or chopped fresh fruit; very few buy canned.
Vegetables: Most reported buying whole fresh vegetables; very few buy canned.
Breads: Slightly more than half reported buying whole wheat; almost half buy white bread. Some buy both options.
Meat/Protein: Customers reported buying mostly beef, followed by pork and chicken.
Milk: About two-thirds buy 1% or 2% reduced fat milk; the remaining third buy whole milk.
Rice: Slightly more than half reported buying brown rice; the rest buy white rice.
Chart 6: What would it take for you to buy more at Jerry's Market? 86%
Better prices 29%
Wider selection
21%
Better quality items
Accept WIC
7%
Better customer service
7%
Finding a more convenient way to get to the store
7%
I do not want to buy more at the store
0%
Accept SNAP
0%
Cleaner
0%
Better safety
0%
11
When asked whether they would like to buy additional items at Jerry’s Market, 68% said no, 21% said yes, and 11% said I don’t know. The customers who said yes mentioned they would like the store to offer menudo, real butter, and horchata. Participants were also asked what would motivate them to buy more food from the store. Chart 6 shows that better prices, a wider selection, and better quality items would encourage them to buy more food from Jerry’s Market.
Recommendations Based on the storeowner interview, in-store assessment, and customer surveys, recommendations for the store include:
Displaying signage inside and outside promoting healthy food and beverage options. Signage could include advertisements for nutrition and health education programs in the community and the health benefits of a balanced diet. There may be an opportunity to advertise near the western union stand at the front of the store, as there is often a line of people waiting there.
Leveraging the remodeling of the front end of the store as an opportunity to display healthier food and beverages such as water, juice, fruits, vegetables, or prepared foods near the checkout areas. The unused refrigerator at the back of the store (if it is functional) could be moved closer to the front and stocked with healthy food and beverages.
Partnering with community organizations promoting nutrition education and cooking skills. Partnerships may mean mutual advertising opportunities, discount programs, or other activities that work to educate customers on healthy eating while providing a place to buy healthy food.
Stocking healthier items including:
o
Canned good options with reduced or no added sugar, salt or fat;
o
More whole wheat options including pasta, bread, and tortillas (with attention to salt content);
o
More low-fat or fat-free dairy options including milk, cheese, and yogurt; and
o
More healthy beverage options including 100% fruit juice or beverages with no added sugar.
Providing more culturally-relevant fruits and vegetables such as cactus, raw garbanzo beans, or aloe. As noted above, customers requested menudo, real butter, and horchata. There may be an opportunity to get additional customer feedback through a suggestion box or anonymous written surveys.
Storeowner Debrief After data collection and analysis, we conducted a third site visit to debrief with storeowners, share findings, and offer recommendations. Steve at Jerry’s Market is primarily concerned with economic sustainability and likes to stock items that sell. He sees education as the number one approach to creating customer demand; yet does not necessarily feel that educational outreach is his role in the community. He entertained the idea of placing educational posters and marketing materials for healthy foods in strategic places (i.e. in the produce section or by the financial services waiting line), but did not fully commit to implementing this strategy. Overall, he would like to see increased demand for healthy foods among his customers and successful examples of profitable healthy food innovations before he adopts them himself.
12
La Tarahumara (Greeley, Census Tract 1) Storeowner Interview We conducted a telephone interview in Spanish with the store owner from La Tarahumara, Patricia, to gauge interest in the project and to gather baseline data. La Tarahumara is a small independent grocery store, which has been owned by Patricia for nine years. The store’s main competitors are Jerry’s Market and Carniceria Lozano because they offer the same products as La Tarahumara. They are currently expanding the size of the store and adding a small restaurant inside. Patricia estimates the store serves over 200 people per day but is not sure how many use her store as their main grocery store. Patricia sees herself as a member of the community and believes the store helps support the community by supplying food. The store is currently in the process of applying to accept SNAP benefits. The store sells a wide variety of fresh fruits and vegetables in a section at the back of the store and they currently have an adequate refrigeration system. Patricia estimates approximately 40% of total food sales§ are fresh fruits and vegetables. She does not have any challenges or barriers to carrying fresh produce and mentioned that losing produce is normal. They clean the stands and eliminate bad produce twice a day, but do not throw away much. The store also has a large meat counter in the back where they sell a wide variety of meats, including pork, beef, chicken, and some fish. They do not offer any lean meat options. Patricia mentioned they do not have any barriers carrying fresh meat, but sometimes prices increase, which limits the choice. La Tarahumara relies on twenty vendors to maintain inventory: one is from Los Angeles and some are from Denver. Patricia’s husband takes care of the distribution side of the business, so she was not sure about the names of specific vendors. Some make deliveries once a week or once every two weeks. Otherwise, Patricia and her husband pick up the products themselves. When deciding what to sell, Patricia knows the market well and goes with her instinct about what people will like. She feels she is right most of the time. The store currently sells a wide variety of fresh fruits, including some seasonal options. They also offer many fresh vegetables, many of which are culturally relevant. However, Patricia commented they are limited in the types of vegetables they can sell by the low cultural consumption of vegetables; she feels Latinos do not eat a variety of vegetables. Patricia is interested in selling more healthy food options of all types. When asked about her experience selling fresh foods, she said she has sold fresh food from the beginning and owes much of her success to hard work and the support of community members; they liked her idea and the store has grown a lot since she first started.
§
We believe this may be an overestimation, given that less than 10% of her inventory is fresh fruits and vegetables.
13
In-Store Assessment We also conducted an in-store food assessment at La Tarahumara,. On the outside wall there are giant advertisements promoting fresh meat and produce. There are no healthy food advertisements inside the store. However, there is signage inside advertising physical activity initiatives (“Run, Walk, Roll”), as well as advertisements for cooking classes and opportunities for SNAP participants to learn how to get food. La Tarahumara sells a variety of staple items, including bread, cereal, canned goods, vegetables, fruits, fresh meats, juice, water, milk and other dairy products, as well as junk food like candy, chips, and soda. The store additionally sells tobacco. The produce section is large and located at the back of the store. Items in the main checkout area include candy and chips, as well as some fruit. They also sell natural medicine and other healthy supplements such as moringa powder and electrolytes. The store offers a wide variety of fresh whole fruits, most of which appeared to be good quality. They also offer some canned fruit options; however, all canned fruit was in syrup (added sugar), with the exception of pineapples which were in 100% juice. The store also offers a wide variety of fresh whole vegetables, most of which appeared to be good quality. The most noticeable attribute of the produce section is that it includes a wide variety of culturally-relevant produce including cactus, plantains, raw garbanzo beans, and aloe. While they sell several canned vegetable options, only one Chart 7: Customer Age was salt-free. They also offer whole grain cereal and brown rice, as well as many dried beans and other whole grain options. While they offer a whole grain tortilla option, they are high in 9% salt. The store does not offer low-fat or skim milk options and the whole milk was out of stock. However, they offer a part46% skim mozzarella option at the deli counter. There were fewer options for 100% juice compared to juice drinks or other sugar36% sweetened beverages.
Customer Interview Surveys were administered in-person at the store in both English and Spanish. Twelve customers participated in the survey. Chart 7 shows the age distribution of participants, with a slight majority (55%) ages 35 or younger. The majority of participants were male (67%). For self-reported race/ethnicity, 100% selected Hispanic/Latino/ and/or Spanish origin and 8.3% selected White/Caucasian (participants could choose more than one option). The majority of customers do not buy most of their groceries at La Tarahumara, but shop at larger stores such as Wal-Mart, King Soopers, Safeway, Save A Lot, Lowes, and Sam’s Club. Most respondents live a few minutes from La Tarahumara and all of them drive to the store.
14
9%
19-25
26-35
36-45
46-55
55+
Chart 8: Do you buy most of your groceries at La Tarahumara?
Yes 25%
No 75%
Chart 9: Shopping Frequency 8%
Chart 9 shows self-reported shopping frequency among customers surveyed. Almost half of respondents shop at La Tarahumara two to three times per week and a few (8%) shop there four or more times per week.
17%
17% 41% 17%
2-3 times per year About one time per week 4 or more times per week
0%
About once per month 2-3 times per week
Participants were also asked which types of items they buy at La Tarahumara. Figure 9 shows that the top four items customers buy are meat, vegetables, fruits and cheese.
Figure 9: Products Commonly Bought at La Tarahumara Meat/ Protein
92%
Vegetables
75%
Fruits
67%
Cheese
50%
Beans
25%
Milk
17%
Yogurt
17%
Breads
8%
Rice
8%
Customers were asked to elaborate on the types of items they buy in each category to determine the extent to which they were buying healthier options. Most customers reported buying:
Meat/Protein: Beef, followed by pork, chicken, and fish.
Vegetables: Whole, fresh vegetables.
Fruits: Whole, fresh fruit.
Milk: 2% reduced fat milk.
Breads: White bread.
Rice: White rice.
15
When asked whether they would like to buy additional items at La Tarahumara, 70% said no, 20% said yes, and 10% said I don’t know. The customers who said yes mentioned that they would like the store to offer more spices and menudo. As a follow-up question, participants were asked what would motivate them to buy more food from the store. Figure 10 shows that wider selection, better prices, and better quality items would encourage them to buy more food from La Tarahumara.
Figure 10: What would it take for you to buy more at La Tarahumara? Cleaner
0%
Better safety
0%
Better customer service
0%
Accept WIC
9%
Accept SNAP
9%
Finding a more convenient way to get to the store
18%
I do not want to buy more at the store
27%
Better quality items
27%
Better prices
27%
Wider selection
36%
Recommendations Based on the storeowner interview, in-store assessment, and customer surveys, recommendations for the store include:
Displaying signage inside. While the store already advertises fresh food on the outside wall, there is an opportunity to display signage inside of the store promoting healthy food and beverage options, especially around the checkout area.
Placing a more attractive display of a variety of fruits and vegetables near the checkout area to facilitate increased purchasing. Though the store already sells fruit near the checkout area, there was only one variety of fruit and it is placed in a tray near the ground, which may go easily unnoticed.
Partnering with community organizations promoting nutrition education or cooking skills. Partnerships could mean mutual advertising opportunities, discount programs, or other activities that work to educate customers on healthy eating while providing a place to buy healthy food.
Stocking healthier items including:
o
Canned good options with reduced or no added sugar, salt or fat;
o
More whole wheat options including pasta, bread, and tortillas (with attention to salt content);
o
More low-fat or fat-free dairy options including milk, cheese, and yogurt; and
o
More options for healthy beverage including 100% fruit juice or beverages with no added sugar.
There may be an opportunity to get additional feedback through a suggestion box or written surveys that customers can complete anonymously.
16
Storeowner Debrief Patricia was not available for the follow-up meeting, but her husband (co-owner) took time to debrief with us. He was very interested in the findings and we had an engaging conversation about the possible changes to the store. He was most interested in displaying more fruits at the front of the store because he had already noticed an increase in sales of oranges since placing them in a crate by the checkout area. He agreed that he would start making small changes based on the recommendations and even pulled another employee aside to talk with us because she would be responsible for making the changes.
BUILDING RELATIONSHIPS Community Partners In an effort to establish local partnerships, we reached out to the North Colorado Health Alliance and had an informational meeting with Carlee Rosen, the Campaign Coordinator for the Make TODAY Count! campaign. As a result of this meeting, we began outreach to additional community partners including the Weld County Food Bank, the Greeley Downtown Development Authority, and the Food Access Task Force. We also reached out to the Colorado Fresh Food Financing Fund, the Colorado Enterprise Fund, and other financing organizations in an effort to learn more about financing options for small stores interested in selling healthier foods. Lastly, we met with the Denver Healthy Corner Store Initiative to share lessons learned and discuss a possible partnership. Outreach efforts, including emails, phone calls, and in-person meetings culminated in a food access meeting with regional partners to discuss challenges and solutions to food access in the area (Appendix F). The experience and expertise of those in the room generated high-level discussion around food access issues and ideas for the region (main discussion topics are included in the Recommendations for Year Three below). The group agreed that continued collaboration would be useful for moving the work forward and agreed to stay connected. Given that North Colorado Health Alliance has relationships with many of the organizations present and works on a diverse number of projects in the county, they agreed to take on the role of convener and facilitate communication moving forward.
CHALLENGES AND OPPORTUNITIES We experienced several roadblocks throughout the course of the project. First, store recruitment was challenging for several reasons:
Small storeowners are busy running their stores;
There was a lack of available incentives for storeowner participation;
Some store owners are barely surviving and do not want to spend resources selling healthy foods with low profit margins; and
Some small stores had closed between Year One and Year Two.
Though a few stores agreed to make small changes, it is unlikely the changes will be enough to impact overall food access and health in the area. To increase participation among storeowners, a comprehensive approach including incentives for participation and community relationship-building to increase buy-in are essential. Other challenges include lack of appropriate funding streams for owners who want to make big changes to their stores but lack the capital to do so. Despite numerous grants and loan programs, there is a segment of the independent retailer population that cannot access these funds. Additionally, larger stores, such as
17
Safeway, have deed restrictions that prohibit vacated space from being used for grocery retail purposes for ten years. Strategies like these contribute to a lack of food access among residents, especially low-income populations and people who lack access to transportation. As discussed in the recommendations section below, other approaches to improving food access should be implemented in conjunction with attempts to increase healthy food retail.
RECOMMENDATIONS FOR YEAR 3 SCOPE OF WORK The following recommendations and ideas for Year Three scope of work are in service of advancing of work on rural food access in Colorado and build on knowledge gained through both the Weld County pilot project and the regional food access meeting.
Community engagement for sustainability – Engaging local and regional stakeholders in the effort is important for success and sustainability. Stakeholders should be diverse and include both traditional and nontraditional partners such as representatives from rural community organizations, community members, local and state government agencies (including public health, education, and agriculture), distributors, producers, and business owners, among others.
Strengthened distribution networks – Facilitating connections between distributors and food retail outlets is an important part of strengthening distribution networks. An improved distribution system for smaller stores would help facilitate stores selling healthier food at reasonable prices by increasing frequency of delivery, reducing spoilage and improving the quality and variety of fresh produce.
Continued communication with storeowners from Year One and Two – Several stores, including La Tienda, El Mercado and La Tarahumara, expressed interest in making changes to stores and a desire to be kept informed about emerging resources and opportunities. It is important to follow up with these stores and offer continued support towards their efforts.
Mobile Markets – Focusing the addition of mobile markets in strategic locations, such as major employers in the area, could be an innovative way to increase healthy food access. Targeting employers with regularly scheduled shift changes (e.g. JBS, etc.) may be a way to reach a large number of people at once.
Financing – Some funding sources focus on innovative approaches to food access (Colorado Fresh Food Financing Fund), and others offer flexible options for stores that focus specifically on healthy food retail (Colorado Enterprise Fund). Connecting storeowners to reasonable financing options is one way to help stores make changes and sell healthier food.
Small business development – Some organizations, such as East Colorado Small Business Development Center, provide services that help small business owners develop sustainable business models. These types of services can be useful to small storeowners and help them learn how to sell healthier foods to their customers without sacrificing profit.
Food Hubs – Jeremy West, Food Service Director with the Evans-Greeley school district, has developed a central processing kitchen model with the goal of working with other school districts in the area, and potentially retailers and other institutions in the community. He is in the process of developing systems and infrastructure to increase processing and distribution capacity. Models like his can be innovative tools to increasing access to fresh produce among small retail stores that don’t have the ability to access consistent and affordable produce from traditional distributors.
18
Joint-use agreements – Jeremy West is also working on a project to create a “food corridor,” which includes joint-use agreements to allow people to rent out parts of the school, including the kitchen. This model allows for small businesses to process and sell foods within the confines of food safety laws without investing in expensive commercial kitchen facilities. Providing ready-to-eat fruits and vegetables can be an effective way to increase produce sales in convenience store settings.
New grocery stores – Bringing in grocery stores to fill the gap created by Safeway’s closing could help increase access to healthy food. Unfortunately, Safeway has a deed restriction on the land that prohibits any grocery food retailer from utilizing that location for ten years after closing. The East Colorado Small Business Development Center has a client that hopes to open a healthy food store in another part of downtown Greeley to fill the food access gap Safeway has created.
Policy changes – Engaging City Council and County Commissioners to create and pass policies that prevent stores like Safeway from placing deed restrictions that negatively affect food access, for example, is a way to preemptively address current barriers and keep them from being a persistent problem.
Chain store engagement – Targeting chain stores instead of independent stores to make healthy changes may be a way to increase healthy food access in rural areas. For example, the Loaf ‘n’ Jugs chain in Pueblo has made healthy changes.** If successful, chain stores have the ability to make changes on a larger scale than smaller independent stores.
Farmers’ Markets expansion – Holding farmers’ markets on more days and at times that better suit community schedules can help reach segments of the population that could not attend these markets during the traditional weekend morning hours (e.g. senior citizens, handicapped residents, etc.)
Commercial kitchens –Commercial kitchens, such as the Weld County Food Bank’s, could be open to the public after operating hours. These kitchens could be a space to hold processing and food safety training so that small business owners can prepare and process fresh fruits and vegetables and other healthy foods in a way that better meets consumer demands (such as frozen, cut and read-toeat foods, etc.)
CONCLUSION As Year Two of the project progressed, it became clear that recruiting storeowners to participate in healthy food retail pilot projects is challenging and requires a substantial community-based participatory effort, as well as appropriate incentives for storeowners, to enact change. In addition, we found that relying solely on retail stores to address rural food access will not necessarily create the magnitude of change that is needed to positively impact health outcomes. Healthy food access in rural areas is complex and requires addressing all three types of access, including informational, economic, and geographic. While food retail presents an opportunity to address part of the geographic access issue by ensuring customers have a place to go to procure healthy food, the issue of transportation to stores remains. Barriers related to informational access, such as culturally appropriate education for consumers about the benefits of healthy food consumption and the dangers of diets high in fat, sugar, and sodium, is another important part of food access. In fact, storeowners strive to meet consumer demand and many believe that healthy food is not what customers want to buy. Lastly, economic access is especially relevant in low-income rural areas, both **Through
outreach efforts, we learned that a store manager, supported by the Pueblo City-County Health Department, championed the changes in the Pueblo Loaf ‘n’ Jug. He was recently promoted to a regional position, where he will hopefully be able to create change on a larger scale.
19
for storeowners and customers. The gap in funding sources for small store owners is one example of an economic barrier uncovered during Year Two. The recommendations offered for Year Three intentionally explore opportunities and solutions across all three levels of access, emphasize the importance of strategic community engagement, and suggest that approaching the work through an equity lens will have the highest likelihood of success in increasing access to healthy food in rural areas.
20
REFERENCES Averill, M. (February 27, 2014). Tulsa grocery store takes healthy food on the road. Retrieved from: http://www.tulsaworld.com/news/health/tulsa-grocery-store-takes-healthy-food-on-theroad/article_74adce1b-c86f-5d30-966a-cae0f1b0e23c.html ChangeLab Solutions, 2015. Publications and Webinars on Healthy Food Retail. Retrieved from: Edmundson, Z. (January 6, 2015). Could produce on wheels be the answer to America’s food desert crisis? Takepart. Retrieved from: McColl, S. (January 29, 2015). If grocery stores aren’t coming to food deserts, why not sell produce at the train station instead? Takepart. Retrieved from: Upstate Colorado, Economic Development. 2013-2014 Economic & Demographic Profile; Weld County, Colorado. Retrieved from: http://www.upstatecolorado.org/doc_library/content/weld_county_data/201314%20Weld%20Profile.pdf
21
APPENDIX A COMMUNITY COMMONS MAPS FOR WELD COUNTY Basic Demographics
22
23
24
Food Access
25
26
27
Employment
28
29
APPENDIX B WELD COUNTY EMPLOYMENT INFORMATION
30
All data from: Upstate Colorado, Economic Development. 2013-2014 Economic & Demographic Profile; Weld County, Colorado. Retrieved from:
31
APPENDIX C STORE OWNER INTERVIEW PROTOCOL (Adapted from the CDPHE protocol. Conducted in both English and Spanish.) The Weld County Healthy Neighborhood Stores Pilot Project is a voluntary program designed to increase access to healthy foods and beverages by increasing healthy food and beverage options in neighborhood stores. Healthy foods identified by the United States Department of Agriculture include 5 food groups: fruits, vegetables, grains, dairy products and protein foods. This project builds relationships with store owners and asks them to make gradual changes with support and training. With this assistance, store owners are willing to sell healthy products and believe these changes can be sustainable and profitable. Your voluntary participation is requested. Please take a moment to fill out this survey to help guide our project. Thank you. Store Name: Address: Owner/Manager Name and Title: Date: ___/___/_______
Background: 1. a. Are you a resident of the neighborhood in which your store is located? Yes No b. If a resident, how long have you lived in this neighborhood? _______ years 2. a. Do you rent or own the store space? Rent Own b. If you own the space, how long have you owned it? ________years 3. a. What are the benefits of having a store at this location? b. What are the downfalls/barriers of having a store at this location? 4. a. What stores are your biggest competitors? b. Why? 5. a. Do you have any plans for any physical improvements to your store in the next year? Yes No b. If yes, please describe: 32
6. a. Do you currently have a refrigeration system? Yes No b. Do you have anything else to share related to your refrigeration system? (e.g. it breaks down often, energy bills are high from running it, it is broken or in need of repair/removal, you have plans for replacing it in the near future)
WIC/SNAP: 7. Do you accept food stamps (SNAP)? Yes No c. If no, why? ___________________________________________________________ 8. Do you accept WIC vouchers? Yes No c. If no, why? ___________________________________________________________ 9. What percentage of your customers do you estimate use food stamps (SNAP)? Less than 10% 10-19% 20-30% Greater than 30% Do not accept food stamps (SNAP) 10. What percentage of your customers do you estimate use WIC vouchers? Less than 10% 10-19% 20-30% Greater than 30% Do not accept WIC 11. What percent of your total annual sales come from food stamps (SNAP)? ______% 12. What percent of your total annual sales come from WIC? _______%
Advertising, Products & Inventory: 13. a. Do you currently use advertising for your store such as flyers or newspaper ads? Yes No b. If yes, what kind of advertising do you use? 14. Who orders the products for the store? 33
15. How are the items for sale determined? 16. Who decides on item placement in the store?
Vendors & Representatives: 17. Approximately how many vendors do you rely on to maintain inventory? 18. a. Does the store currently order from any produce suppliers? Yes No b. If yes, which suppliers? c. Do they deliver? Yes No d. If yes, how often do they deliver? 19. Does the store receive incentives (i.e. payment, discounts) for the placement of ads/promotional items for the following? (Select all that apply.) Tobacco Alcohol Sugar-sweetened beverages (soda, sports drinks, energy drinks, etc.) Chips/candy Lottery (Lotto) Other: ________________________________________________________ None
Products Offered: 20. a. Does the store carry (sell) any fruits? (Select all that apply.) Fresh—year-round Fresh—seasonally Canned Frozen None b. If yes, describe the varieties of fruits carried currently and in other seasons: 21. a. Does the store carry (sell) any vegetables? (Select all that apply.) Fresh—year-round Fresh—seasonally Canned Frozen None
34
b. If yes, describe the varieties of vegetables carried currently and in other seasons: 22. What challenges or barriers has the store encountered in carrying fresh produce? (Select all that apply.) Finding produce to sell Buying affordable produce Spoilage before it sells No refrigeration Inadequate or unreliable refrigeration Other, please describe: _____________________________________________ 23. a. Which of the following items are you interested in selling (select all that apply): Fruit Vegetables Low-fat dairy products Lean meat/chicken/fish Other protein (tofu, beans, nuts) Whole wheat or whole grain products None of the above b. If none, why? _________________________________________________________ 24. Do you have any ideas or plans to increase the availability, visibility and affordability of fresh produce and healthy foods in your store?
Customer Base: 25. Tell us about your customer base. a. Persons who do not speak English Many customers Some customers Few or no customers i. If many, what languages do they speak? b. Regular customers Many customers Some customers Few or no customers c. People who live close by Many customers Some customers Few or no customers d. Commuters Many customers Some customers Few or no customers 35
e. Seniors Many customers Some customers Few or no customers f.
Youth/Students Many customers Some customers Few or no customers
g. Other customers who make up your customer-base (please describe): 26. What types of customers spend the most money at the store? (Select all that apply) Regular customers People who live close by Commuters Seniors Youth/Students Other (please describe): _____________________________________________ 27. How is your relationship with your customers? Excellent Very good Good Fair Poor 28. On average, how many customers do you have each day? Under 50 50-100 101-150 Over 200 29. a. Do you have a way to track the number of customers that come in each day? Yes No b. If yes, please describe how: __________________________________________ 30. What are the busiest days of the week? (Select all that apply.) Monday Tuesday Wednesday Thursday Friday Saturday Sunday All the same 36
31. What are the busiest times during the day? 32. a. On school days, do students shop here on their way to and from school, or during the school day? Often Sometimes Rarely Never b. Approximately how many students come in on an average school day? _________ c. What products do students buy? (Select all that apply.)
Chips Milk Candy Other dairy (cheese, yogurt) Juice Bread/Cereal Soda Fruits Energy/sports drinks Vegetables Meat Student’s don’t shop at this store Other: ____________________________________________
Customer Purchasing Behaviors: 33. What are the 3 top-selling categories of items sold in the store, including nonfood items? 34. What are the 3 lowest-selling categories of items sold in the store, including nonfood items? 35. What are the 3 top-selling categories of food and beverage items sold in the store? 36. What are the 3 lowest-selling categories of food and beverage items sold in the store? 37. What percentage of customers shop for groceries (food staples such as eggs, milk, cereal, beans, etc.) _____________%
Belief about role of store in community: 38. Do you see yourself as a member of the community/neighborhood where your store is located? Yes No 39. Does your store help support the community? Yes No 40. If yes, please describe how:
37
41. Do you think offering fresh produce to your customers will benefit the health of the community? Yes No 42. Would you be willing to work with youth, community based organizations, and/or neighborhood residents on this project? Yes No
Additional Comments:
38
IN-STORE VISUAL ASSESSMENT (Adapted from the CDPHE and the Pueblo City-County Health Department Healthy Corner Store Pilot Project protocol) 1. Store type (choose one): Convenience store with or without gas (Corporate owned) Small market (Small business owner) Drug store/pharmacy (Walgreens) Large grocery store (King Soopers, Safeway) Wal-Mart Discount store (Dollar General, Family Dollar) Other, specify:___________________________________________________ 2.
Which products are advertised outside the store? (Select all that apply) Tobacco products/E-cigarettes/vapors Alcoholic beverages Healthy food or drink _____________________________________________ Sugary drinks ____________________________________________________
3.
Does this store have any health-promoting signage outside the store? Alcoholic beverage counter-marketing or health warning signs Tobacco product counter-marketing or graphic warning signs (other than We Card signs) Promotion of healthy food and non-alcoholic beverages None of the above
4.
Does the store have any health-promoting signage inside the store? (Select all that apply) Alcoholic beverage counter-marketing or health warning signs Tobacco product counter-marketing or graphic health warning signs (other than We Card) Promotion of healthy food and non-alcoholic beverages None of these
5.
What items are currently sold at this store? (Select all that apply) Alcohol Hot beverages (coffee, cappuccino, tea etc.) Bread/Cereal Candy
Juice
Canned goods
Lottery ticket
Chips
Meat
Donuts, pastries
Milk
Fruits
Other dairy (i.e. cheese, yogurt)
Gas
Prepared hot/cold foods (hot dogs, sandwiches, nachos)
39
Soda/Energy drinks (Red Bull, Monster)/Sport drinks (PowerAde, Gatorade)
Water/unsweetened beverages
Other:
Tobacco/tobacco products Vegetables In the main checkout area, are any of these placed on/next to the counter(s)? (Select all that apply) Alcoholic beverages Sugary drinks (soda, sports/energy, chocolate milk etc.) Candy Chips, peanuts or other snacks Fresh fruit Fresh vegetables Other __________________________________________________________ 6.
What type of fruit is sold here? (if canned/frozen, note if there are any reduced fat/sodium/sugar options) Fresh, whole Fresh, chopped Frozen Canned None of the above
7.
Overall availability of fresh fruit: Limited (1-3 types) Moderate variety (4-6 types) Wide variety (7 or more types) None of the above
8.
Overall quality of fresh fruit (look for wilting, decay, shrivel, brown stems, color changes): All or most fruit are poor quality Mixed: more poor than good Missed: more good than poor All or most is good quality
9.
What types of vegetables are sold here? (if canned/frozen, note if there are any reduced fat/sodium/sugar options) Fresh, whole Fresh, chopped Frozen Canned None of the above 40
10.
Overall availability of fresh vegetables: Limited (1-3 types) Moderate variety (4-6 types) Wide variety (7 or more types) None of the above
11.
Overall quality of vegetables (look for wilting, decay, shrivel, brown stems, color changes): All or most fruit are poor quality Mixed: more poor than good Missed: more good than poor All or most is good quality
12.
13.
14.
What fruits and vegetables are currently displayed? (Select all that apply) Apples Grapes Avocado
Green/red peppers
Bananas
Lemons/limes
Beans (pinto, black, kidney other)
Lettuce
Berries
Melons
Broccoli
Onions
Carrots
Oranges
Celery
Peaches
Cherries
Pineapple
Chili peppers
Potatoes
Corn
Tomatoes
Cucumbers
Other:__________________________
What is the cost of milk at this store?
Whole
2%
1%
Pint
______________________________________________________
Quart
______________________________________________________
Half gallon
______________________________________________________
Gallon
______________________________________________________
What is the cost of soda at this store? 12 oz can/bottle
_______________
20 oz bottle
_______________
24 oz fountain
_______________
32 oz fountain
_______________ 41
Skim
15.
16.
What is the cost of the following beverages? 100% juice
12 oz.
____________
Juice drink
16 oz.
____________
Sports drink (Gatorade)
20 oz.
____________
Energy drink (Red Bull)
8.3 oz.
____________
Sweetened coffee drink
13.7 oz.
____________
Bottled water
16 oz.
____________
What grains and beans are sold at this store? (Select all that apply) Whole grain cereal Whole grain pasta Brown rice Dried or canned beans
17.
Is there reduced fat dairy sold at this store? (Cheese, yogurt, sour cream etc.) Yes No
Additional Comments:
42
CUSTOMER SURVEY PROTOCOL (Adapted from the CDPHE and the Pueblo City-County Health Department Healthy Corner Store Pilot Project protocol. Conducted in both English and Spanish.) The Weld County Healthy Neighborhood Stores Pilot Project is a voluntary program designed to increase healthy food and beverage options in neighborhood stores (such as fruits, vegetables, grains, dairy products and protein foods). Your participation in this survey will help identify the foods you want in your community. Home Zip Code: _________ 1. 2. Where do you get most of your groceries? __________________________________(store name) a) Approximate location of store:______________________________ (nearest intersection) 3. How far away is this store from your home? _________ minutes a) How do you usually travel here? (check one) Walking Biking Driving Bus Other: _________________
4.
Which items do you usually buy from this store ? Item
5.
Product Type (circle all that you buy)
Do you buy? (circle one)
Milk
Yes
No
Nonfat/ Skim
1%
2%
Whole
Meat/Protein
Yes
No
Beef
Chicken
Pork
Fish
Vegetables Fruits Breads Rice Cheese Yogurt Beans (pinto, black, kidney, lentil, etc.)
Yes Yes Yes Yes Yes Yes
No No No No No No
Fresh, whole Fresh, whole White White
Fresh, chopped Fresh, chopped Whole Wheat Brown
Frozen Frozen
Canned Canned
Yes
No
On average, how often do you shop at this store? (Check one) Never About one time per week 2-3 times per year
2-3 times per week
About once per month
4 or more times per week
2-3 times per month
6.
Other (soy, almond, etc.) Soy Products
Are there any other types of food that you would like to buy from this store that are currently unavailable? Yes No I don’t know
43
a)
7.
If yes, which items would you like to buy?
What would it take for you to buy more of your food at this store? (Select all that apply.) Cleaner Finding a more convenient way to get to the store Wider selection Better prices
Accept WIC
Better quality items
Accept SNAP (Food Stamps)
Better customer service
I do not want to buy more food at the store
Better safety Other comment:
8. What is your age: _______ years 9.
Gender: Male Female
10.
What is your race/ethnicity? (Select all that apply) White or Caucasian Hispanic, Latino/a or Spanish origin Black or African American American Indian or Alaskan Native Asian Native Hawaiian or other Pacific Islander Other, please specify: ______________________________________
11.
How many people live in your household (including yourself)? a) Number of adults __________ b) Number of children (18 years old or younger) ________
12.
Do you or anyone in your household receive any of the following? (Select all that apply.) WIC SNAP
Additional Comments:
44
APPENDIX D Figure 1: Customer Age
STOREOWNER DEBRIEFS La Tarahumara
9%
Summary of findings: Customer Surveys
46%
Surveys were administered in-person at the store in both English and Spanish. Twelve customers participated in the survey. Figure 1 shows the age distribution of participants, with a slight majority (54%) ages 35 or younger. The majority of participants were male (67%). For self-reported race/ethnicity, 100% selected Hispanic/Latino/ and/or Spanish origin, and 8% also selected White/Caucasian. Figure 2: Shopping Frequency 8%
17% 17%
41% 17% 2-3 times per year About one time per week 4 or more times per week
About once per month 2-3 times per week
36%
9% 19-25
26-35
36-45
46-55
Most customers (75%) do not buy most of their groceries at La Tarahumara. Many customers buy their food from larger stores such as Wal-Mart, King Soopers, Safeway, Save A Lot, Lowes, and Sam’s Club. Figure 2 shows self-reported shopping frequency among customers surveyed. More than half of respondents (58%) shop at La Tarahumara one to three times per week and a few shop there four or more times per week (8%). Most respondents live less than a few minutes from La Tarahumara and all of them drive to the store.
Figure 3: Products Commonly Bought at La Tarahumara Meat/ Protein
92%
Vegetables
75%
Fruits
67%
Cheese
50%
Beans
25%
Milk
17%
Yogurt
17%
Breads
8%
Rice
8%
45
Figure 3 shows that the top four items that customers buy are meat/protein, vegetables, fruits and cheese. Customers were asked to elaborate on the types of items they buy in each category to determine the extent to which they were buying healthier options. When asked whether they would li ke to buy additional items at La Tarahumara, 70% said no, 20% said yes, and 10% said I don’t know. The customers that said yes mentioned that they would like the store to offer more spices and menudo. As a follow-up question, participants were asked what would motivate them to buy more food from the store. The majority said wider selection (36%), better prices (27%), and better quality items (27%) would encourage them to buy more food from La Tarahumara.
Meat/Protein: Customers reported buying beef, followed by pork, chicken and fish. Vegetables: Most customers buying whole fresh vegetables.
reported
Fruits: Most people reported buying whole fresh fruit. Milk: Most customers reported buying 2% reduced fat milk. Breads: Most customers reported buying white bread. Rice: Most customers reported buying white rice.
Summary of findings: In-Store Assessment In addition to storeowner interviews, we conducted an in-store food assessment at La Tarahumara through the lens of healthy food availability. Most of what’s found at the store reflects the buying patterns of customers. On the outside wall there are giant advertisements promoting fresh meat and produce (pictured right). There are no healthy food advertisements inside the store. However, there is signage inside the store for physical activity initiatives (“Run, Walk, Roll”), as well as advertisements for cooking classes and opportunities for SNAP participants to learn how to get food. La Tarahumara sells a variety of staple items, including bread, cereal, canned goods, vegetables, fruits, fresh meats, juice, water, milk and other dairy products; as well as candy, chips, donuts/pastries, and soda. The produce section is large and located near the back of the store to the left – a common layout seen in many larger grocery stores. Still, items in the main checkout area include sugar sweetened beverages, candy, and chips. They also offer some fruits near the checkout area, as well as natural medicine and health supplements, such as moringa powder and electrolytes, toward the front of the store. The store offers a wide variety of fresh whole fruits and vegetables, all or most of which appeared to be good quality. Compared to other stores in the area, La Tarahumara has a wide variety culturallyrelevant vegetables and fruits, including cactus, plantains, raw garbanzo beans, and aloe. La Tarahumara offers a variety of canned food, including fruits, vegetables, beans, broths, and meat. Most canned fruit was in syrup (added sugar), with the exception of pineapples, which were in 100% juice. For canned vegetables, there was only one reduced-, low-, or no-sodium option available. For other canned food items, such as meats, broths, and beans, there were very few fat-free or low-fat options.
46
La Tarahumara offers whole grain cereal and brown rice, as well as many dried beans and other whole grain options. While they offer a whole grain tortilla option, they are high in salt. The store does not offer low-fat or skim milk options and the whole milk was out of stock. However, do offer a part-skim mozzarella option at the deli counter. There were fewer options for 100% juice compared to juice drinks or other sugar-sweetened beverages.
Recommendations Based on the storeowner interview, in-store assessment, and customer surveys, we have listed recommendations for the store to consider.
The store already advertises fresh food on the outside wall. However, there is an opportunity to display signage inside of the store promoting healthy food and beverage options, especially around the checkout area.
Though the store already sells fruit near the checkout area, there was only one variety of fruit and it is placed in a tray near the ground, which may go easily unnoticed. Placing a more attractive display of a variety of fruits and vegetables near the checkout area may facilitate increased purchasing.
Partner with community organizations working on nutrition education and/or cooking skills. Partnerships could include mutual advertising opportunities, discount programs, or other activities that work to educate customers on healthy eating while providing a place to buy the healthy food.
Stock healthier items including: o Canned good options with reduced or no added sugar, salt or fat. o More whole-wheat options, including pasta, bread and tortillas (with attention to salt content). o More low-fat or fat-free dairy options, including milk, cheese and yogurt. o More options for healthy beverages, including 100% fruit juice or beverages with no added sugar.
There may be an opportunity to get additional feedback through a suggestion box or written surveys that customers can complete anonymously.
Resources This section includes a list of resources available to contribute to a healthier food environment for the community.
Financing
Colorado Enterprise Fund:
o
Contact: Anne Misak, Healthy Food Program Manager, (720) 473-4070,
[email protected].
o
Website: http://www.coloradoenterprisefund.org/
Green for Greens: Tips on finding funding for healthy food retail
47
o
Website: http://changelabsolutions.org/publications/green-for-greens
Community Contacts
North Colorado Health Alliance: Works with a variety of partners to improve health in Weld and
Larimer counties. o
o
Contact:
Carlee Rosen, Make Today Count! Campaign Coordinator, (970) 346-2505,
[email protected].
Kim Jerome, Community Care Corps Coordinator, (970) 301-4673,
[email protected].
Website: http://www.northcoloradohealthalliance.org/
Greeley Downtown Development Authority:
o
Contact: Pam Bricker,
[email protected].
Executive
o
Website: http://www.greeleydowntown.com/
Director,
(970)
356-6775,
Weld County Department of Public Health and Environment:
o
Contact: Leslie Beckstrom, Healthy Eating and Active Living Coordinator, (970) 3046470, ext. 2387,
[email protected].
o
Website: http://www.co.weld.co.us/Departments/HealthEnvironment/index.html
Nutrition Education
Cooking Matters: Empowers families with the skills to stretch their food budgets and cook
healthy meals through Interactive Grocery Store Tours, Hands-On Cooking Courses, and Educational Tools. o
o
Websites:
http://cookingmatters.org/
http://www.co.weld.co.us/Departments/HealthEnvironment/HealthEducationProgra ms/CookingMatters.html
Contact: Olga Gonzalez, Weld County Department of Public Health and Environment, (970) 304-6470, ext. 2382 or
[email protected].
USDA Choose My Plate: Provides tools and resources for healthy eating, including handouts and
videos.
o Website: http://www.choosemyplate.gov/
Weld County Extension (EFNEP and SNAP-Ed): Provides nutrition education for low-income
audiences.
o Website: http://www.ext.colostate.edu/snaped-efnep/ o
Contact: Jane Burnett, (970) 342-5334 or
[email protected]
48
Nutrition.gov: Provides menu plans, shopping tips, and healthy food alternatives in English and
Spanish)
o Website: http://www.nutrition.gov/shopping-cooking-meal-planning/food-shopping-andmeal-planning
Marketing and Business Strategies
Materials for Storeowners: o
Retail Fruit & Vegetable Marketing Guide
o
Sell Healthy! Guide
o
Website: http://www.healthycornerstores.org/
Healthy Food Access Portal: Includes information and resources for healthy corner stores.
o
Website: http://changelabsolutions.org/
Healthy Corner Stores Network: Includes resources and information for healthy corner stores.
o
Website: http://cachampionsforchange.cdph.ca.gov/Pages/toolsforchange.aspx
ChangeLab Solutions: Includes printable materials, webinars and tips.
o
http://changelabsolutions.org/sites/default/files/Calculating_Selling_Area_for_Healthy_ Retail_FINAL_20140210-updated.pdf
Champions for Change: Includes printable materials, tips and helpful website links.
o
http://policylinkcontent.s3.amazonaws.com/Sell%20Healthy%20Guide(1).pdf
Calculating Selling Area for Healthy Retail
http://www.cdph.ca.gov/programs/cpns/Documents/Retail%20FV%20Marketing%20 Guide_5_060811_FINAL.pdf
Website: http://www.healthyfoodaccess.org/retail-strategies/corner-stores
USDA Food and Nutrition Service: Includes information about becoming a SNAP retailer. o
Website: http://www.fns.usda.gov/snap/retailers-0
49
Jerry’s Market
Figure 1: Customer Age
Summary of findings: Customer Surveys 15%
Surveys were administered in-person at the store in both English and Spanish. Twenty customers participated in the survey. Figure 1 shows the age distribution of participants, with a slight majority (55%) ages 46 or older. The majority of participants were female (71%). For self-reported race/ethnicity, 88% selected Hispanic/Latino/ and/or Spanish origin, 12% selected White/Caucasian, and 1% selected Other. Figure 2: Shopping Frequency
30%
20%
10%
25%
19-25
26-35
36-45
46-55
55+
Most customers (90%) do not buy most of their groceries at Jerry’s Market. Many 15% customers come to Jerry’s Market for the 30% financial services offered, including money 15% transfers or bill pay, and only occasionally pick up additional items while they are there. Other customers mentioned that they 20% 20% come to Jerry’s when they need to quickly pick up an item they ran out of at home. About once per month About one time per week Most respondents buy their food from larger 2-3 times per week 2-3 times per month stores such as King Soopers, Sam’s Club, 4 or more times per week Save A Lot and Lowes. Figure 2 shows selfreported shopping frequency among customers surveyed. Half of respondents shop at Jerry’s one to three times per month and a few shop there four or more times per week (15%). Most respondents live less than ten minutes from Jerry’s Market (by their preferred method of transportation). The majority drives to the store (90%), while some walk (20%) and a few bike (5%). Some participants use multiple methods of transportation. 0%
Figure 3: Products commonly bought at Jerry's Market Fruits
78%
Vegetables
78%
Breads
61%
Beans
50%
Meat Protein
50%
Milk
50%
Cheese
44%
Yogurt Rice
33% 28%
50
Figure 3 shows that the top three items that customers buy are fruits, vegetables and breads. Customers were asked to elaborate on the types of items they buy in each category to determine the extent to which they were buying healthier options.
Fruits: Most people reported buying whole or chopped fresh fruit and very few buy canned. Vegetables: Most customers reported buying whole fresh vegetables and very few buy canned. Breads: Slightly more than half of participants reported buying whole wheat and almost half buy white bread. Some buy both options.
When asked whether they would like to buy additional items at Jerry’s Market, 68% said no, 21% said yes, and 11% said I don’t know. The customers that said yes mentioned that they would like the store to offer menudo, real butter and Mexican store horchata. As a follow-up question, participants were asked what would motivate them to buy more food from the store. The majority said better prices (86%), wider selection (29%), and better quality items (21%) would encourage them to buy more food from Jerry’s Market.
Meat/Protein: Customers reported buying beef, followed by pork and chicken. Milk: About two-thirds of customers buy 1% or 2% reduced fat milk and the remaining third buy whole milk. Rice: Slightly more than half of customers reported buying brown rice, while the rest buy white rice.
In-Store Assessment In addition to storeowner interviews, we conducted an in-store food assessment at Jerry’s Market through the lens of healthy food availability. Most of what’s found at the store reflects the buying patterns of customers. Jerry’s Market has a good relationship with its customers and tries to meet their needs in a way that’s economical. There are no advertisements for food (either healthy or unhealthy) outside of the store, but there are four vending machines with large pictures of soda to the left of the entrance. Jerry’s sells a variety of staple items, including bread, cereal, canned goods, vegetables, fruits, fresh meats, juice, water, milk and other dairy products; as well as candy, chips, donuts/pastries, and soda. The store also sells hot beverages, prepared food items, tobacco, and lottery tickets. The produce section is large and located near the front of the store to the left – a common layout seen in many larger grocery stores. Still, items in the main checkout area include sugar sweetened beverages, candy, and chips; no healthier options are displayed near the checkout area. The store offers a wide variety of fresh whole fruits and vegetables, all or most of which appeared to be good quality. Compared to other stores in the area, Jerry’s appeared to have fewer culturallyrelevant vegetables and fruits. Jerry’s offers a variety of canned food, including fruits, vegetables, beans, broths, and meat. Most canned fruit was in syrup (added sugar), with the exception of peaches and pineapples which were in 100% juice. For canned vegetables, there were no reduced-, low-, or no-sodium options available. For
51
other canned food items, such as meats, broths, and beans, there were very few fat-free or low-fat options. Jerry’s offers whole and 2% milk, with no options for 1% or fat-free milk. They also offer whole grain cereal and brown rice, as well as many dried beans, peas, and lentils. There were fewer options for 100% juice compared to juice drinks or other sugar-sweetened beverages.
Recommendations Based on the storeowner interview, in-store assessment, and customer surveys, we have listed recommendations for the store to consider.
Display signage inside and outside of the store promoting healthy food and beverage options. This could include advertisements for nutrition and health education programs in the community, as well as the health benefits of a balanced diet. There may be an opportunity to advertise near the western union stand at the front of the store, as there is often a line of people waiting.
The remodeling of the frontend of the store provides an opportunity to display healthier food and beverages, such as water, juice, fruits, vegetables, or prepared foods, near the checkout areas. The unused refrigerator at the back of the store (assuming it is functional) could be moved closer to the front and stocked with healthy food and beverages.
Partner with community organizations working on nutrition education and/or cooking skills. Partnerships could include mutual advertising opportunities, discount programs, or other activities that work to educate customers on healthy eating while providing a place to buy the healthy food.
Stock healthier items including:
o
Canned good options with reduced or no added sugar, salt or fat.
o
More whole wheat options, including pasta, bread and tortillas (with attention to salt content).
o
More low-fat or fat-free dairy options, including milk, cheese and yogurt.
o
More options for healthy beverages, including 100% fruit juice or beverages with no added sugar.
Provide more culturally-relevant fruits and vegetables, such as cactus, raw garbanzo beans or aloe. Customers also requested additional items they would like, such as menudo, real butter and Mexican store horchata. There may be an opportunity to get additional feedback through a suggestion box or written surveys that customers can complete anonymously.
Resources This section include a list of resources available to contribute to a healthier food environment for the community.
52
Financing
Colorado Enterprise Fund:
o
Contact: Anne Misak, Healthy Food Program Manager, (720) 473-4070,
[email protected].
o
Website: http://www.coloradoenterprisefund.org/
Green for Greens: Tips on finding funding for healthy food retail
Website: http://changelabsolutions.org/publications/green-for-greens
o
Community Contacts
North Colorado Health Alliance: Works with a variety of partners to improve health in Weld and
Larimer counties. Contact:
o
Carlee Rosen, Make Today Count! Campaign Coordinator, (970) 346-2505,
[email protected].
Kim Jerome, Community Care Corps Coordinator, (970) 301-4673,
[email protected].
Website: http://www.northcoloradohealthalliance.org/
o
Greeley Downtown Development Authority:
o
Contact: Pam Bricker,
[email protected].
Executive
o
Website: http://www.greeleydowntown.com/
Director,
(970)
356-6775,
Weld County Department of Public Health and Environment:
o
Contact: Leslie Beckstrom, Healthy Eating and Active Living Coordinator, (970) 3046470, ext. 2387,
[email protected].
o
Website: http://www.co.weld.co.us/Departments/HealthEnvironment/index.html
Nutrition Education
Cooking Matters: Empowers families with the skills to stretch their food budgets and cook
healthy meals through Interactive Grocery Store Tours, Hands-On Cooking Courses, and Educational Tools. o
o
Websites:
http://cookingmatters.org/
http://www.co.weld.co.us/Departments/HealthEnvironment/HealthEducationProg rams/CookingMatters.html
Contact: Olga Gonzalez, Weld County Department of Public Health and Environment, (970) 304-6470, ext. 2382 or
[email protected].
USDA Choose My Plate: Provides tools and resources for healthy eating, including handouts and
videos.
o Website: http://www.choosemyplate.gov/ 53
Weld County Extension (EFNEP and SNAP-Ed): Provides nutrition education for low-income
audiences.
o Website: http://www.ext.colostate.edu/snaped-efnep/ o
Contact: Jane Burnett, (970) 342-5334 or
[email protected]
Nutrition.gov: Provides menu plans, shopping tips, and healthy food alternatives in English and
Spanish)
o Website: http://www.nutrition.gov/shopping-cooking-meal-planning/food-shoppingand-meal-planning
Marketing and Business Strategies
Materials for Storeowners: o
Retail Fruit & Vegetable Marketing Guide
o
Sell Healthy! Guide
o
Website: http://www.healthycornerstores.org/
Healthy Food Access Portal: Includes information and resources for healthy corner stores.
o
Website: http://changelabsolutions.org/
Healthy Corner Stores Network: Includes resources and information for healthy corner stores.
o
Website: http://cachampionsforchange.cdph.ca.gov/Pages/toolsforchange.aspx
ChangeLab Solutions: Includes printable materials, webinars and tips.
o
http://changelabsolutions.org/sites/default/files/Calculating_Selling_Area_for_Healthy_ Retail_FINAL_20140210-updated.pdf
Champions for Change: Includes printable materials, tips and helpful website links.
o
http://policylinkcontent.s3.amazonaws.com/Sell%20Healthy%20Guide(1).pdf
Calculating Selling Area for Healthy Retail
http://www.cdph.ca.gov/programs/cpns/Documents/Retail%20FV%20Marketing%20 Guide_5_060811_FINAL.pdf
Website: http://www.healthyfoodaccess.org/retail-strategies/corner-stores
USDA Food and Nutrition Service: Includes information about becoming a SNAP retailer.
o
Website: http://www.fns.usda.gov/snap/retailers-0
54
APPENDIX E STORE PICTURES Tienda Paulin
El Mercado Market
55
APPENDIX F HEALTHY FOOD ACCESS MEETING LIST OF ATTENDEES North Colorado Health Alliance, Evans, CO July 22, 2015
Sharon Crocco, Healthy Eating/Active Living Program Coordinator, CDPHE
Leslie Beckstrom, Healthy Eating Active Living Coordinator, Weld County Public Health Department
Sam Houghteling, City of Fort Collins, Industry Project Coordinator; President of NOCO Food Cluster
Kim Jerome, Community Care Corps Coordinator, North Colorado Health Alliance (NCHA)
Carlee Rosen, Make Today Count! Campaign Coordinator, NCHA
Anne Misak, Healthy Food Program Manager, Colorado Enterprise Fund
Lewis Hagler, Director of Credit Quality, Colorado Enterprise Fund
Jeremy West, Nutrition Services Director, Greeley-Evans School District #6
Karen Scopel, Natural Resources Manager, City of Greeley; Farmers’ Market Manager
Meyer Wiser, Intern with City of Greeley
Lisa Hudson, Associate Director and Director of Marketing, East CO Small Business Development Center (SBDC)
Jenn Negley, Weld County Business Consultant, East CO SBDC
Lyn Kathlene, Director, Spark Policy Institute
Ana Leon, Associate Researcher, Spark Policy Institute
Sophie Oppenheimer, Associate Researcher, Spark Policy Institute
56
