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Section D
Baltimore Healthy Stores

Baltimore Healthy Stores Goals
To increase availability and access to healthy foods for residents of
Baltimore City
To promote these foods at the point of purchase
To work in collaboration with community agencies, the city of
Baltimore, and local food sources
3

Healthy Foods Availability in Baltimore City*
Type of food stores
Healthy food
availability
index, mean
(range 0–27)
Skim milk
(%)
Supermarkets (16) 19.0 100
Grocery/corner
stores (107)
“Behind-the-
glass” stores (20)
Convenience stores
(33)
4.4 25
2.0 0
3.8 36
Fruit
(%)
1–25
≥26
25
69
43
3
0
0
33
0
*Franco data, n = 176
Vegetables
(%)
1–25
≥26
13
81
57
3
0
0
21
0
Whole wheat
bread
(%)
100
8
0
24
4

A Corner Store
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
5

Store Interior
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
6

Baltimore Healthy Stores, Round 1
East Baltimore: intervention area
West Baltimore: comparison area
Store sample
- Two supermarkets per area
- Six to seven small stores per
area
Consumer sample
- Eighty-seven respondents per
area
7

Top Sources of Energy, Fat, and Sugar (Baltimore City)
Top ten sources of energy, fat, and sugar of inner city adult
respondents in Baltimore (Sharma et al.)
Food item
Energy Fat Sugar
Energy
(%)
Food item
Fat
(%)
Food item
Sodas 9.5 Chicken 12.1 Sodas 34.1
Chicken 8.2 Hot dogs, sausages 8.1 Sugary drinks (iced tea, punch) 15.2
Breads 6.0 Chips 6.3 Juices 9.0
Cake, donut and other pastry 4.2 Meat dishes 5.2 Sugar and syrup 8.3
Sandwiches and burgers 4.0 Margarine and butter 5.2 Cake, pastry and donut 4.2
Sugary drinks 3.8 Cake, donut and other pastry 5.1 Candies 4.1
Chips 3.7 Mayo, salad dressing, dips 4.9 Ice cream 3.2
Pasta dishes 3.3 Sandwiches and burgers 4.5 Cookies 2.5
Meat dishes 3.1 Cheese 4.3 Fruits 2.1
Candies 2.9 Eggs 4.0 Cereals 1.6
Total 48.7 Total 59.8 Total 84.3
Sugar
(%)
8

Baltimore Healthy Stores Phases
Phase 0: Teasers/Recruitment
Phase 1: Healthy Eating for your Kids
Phase 2: Cooking at Home
Phase 3: Healthy Snacks
Phase 4: Carryout Foods
Phase 5: Low-Calorie Drinks
9

Intervention Activities
Stop, Shop, Save
Phase 2: Healthy Breakfast
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
10

Phase 0: Documents for Store Owners
Cultural guidelines for Korean store owners
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
11

Phase 1: Low-Calorie Beverages
Educational display
Flyer
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
Coupon
12

Phase 2: Healthy Breakfast
Educational display
Flyer
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
Toasted Os vs. Sugar Flakes
13

Phase 3: Cooking at Home
Posters
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
14

Phase 4: Healthy Carryout
Educational display Flyer
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
15

Phase 5: Healthy Snacks
Posters
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
16

BHS Evaluation Plan
Instrument Pre- Mid- Post-
Process evaluation
Store process evaluation
Store owner process evaluation
Cooking demo, taste test evaluation
Cooking demo, taste test customer evaluation
Weekly interventionist progress report
Store impact and feasibility
Store impact questionnaire
Bi-weekly food sales (corner)
In-depth interviews
Customer impact and feasibility
Customer impact questionnaire
Food frequency questionnaire
Customer feasibility interviews
x
x
x
x
x
x
x x
x
x
x
x
x
x
x
x
x
x
Follow-
up
x
17

Store Results
Average stocking/sales feasibility scores at baseline, post-phase,
and post-intervention
Average stocking feasibility scores
(Score range 0–10)
Average sales feasibility score
(Score range 0–10)
Intervention Comparison Significance Intervention Comparison Significance
Baseline 5.9 ± 2.0 6.8 ± 1.6 NS 4.4 ± 1.8 5 ± 1.5 NS
Post-phase 8.3 ± 1.0 6 ± 1.8 0.004 7.1 ± 2.0 5.8 ± 1.8 0.05
Post-
intervention
7 ± 2.0 5.5 ± 1.5 0.009 6.4 ± 1.8 4.7 ± 1.5 0.003
18

Eight Total Programs
Image source: Baltimore Healthy Stores program. Johns Hopkins University.
20

Healthy Stores Studies Summary
Program
Marshall Islands
Healthy Stores
Apache Healthy
Stores 1,2
Zhiiwaapenewin
Akino’maagewin
Baltimore Healthy
Stores 1,2
Healthy Foods
Hawaii
Healthy Foods North
(Arctic)
Navajo Healthy
Stores
Basic
store
activities
Intervention components Impact observed
Other
store
activities
Media Other venues
Consumer
psychosocial
factors
X X Knowledge
X X
X X
X X
X X
X X
X
(Commodity,
vendors rd 2)
X
(Schools,
HSS)
X (CAC,
churches)
X (Producers,
distributors)
X (Worksites,
HSS)
Knowledge
Knowledge
(assoc. w/
exposure)
Intentions
Consumer
behavior
Healthy food
purchasing
Healthy food
purchasing and
consumption
Healthy food
purchasing
Healthy
cooking
methods,
purchasing
labeled foods
Store
N/A
Increased
stocking and
sales
N/A
Increased
stocking and
sales
? ? ?
? ? ?
X X X ? ? ?
21

Funders
Center for a Livable Future
USDA/Food Assistance Nutrition Research Program
USDA/National Research Institute
Robert Wood Johnson Foundation Healthy Eating Research program
American Diabetes Association
Stulman Foundation
Isador and Gladys Foundation
24