| This research assessed the availability, quality, pricing, and marketing of healthy and less healthy foods in food stores in two rural communities in southern Oklahoma with a high proportion of Native American residents, in order to identify aspects of the consumer food environment that may contribute to poor health outcomes and that hold potential as targets for future interventions. Two different tools were used, the Nutrition Environment Measures Survey for Stores (NEMS-S) and the Food Availability and Marketing Survey (FAMS), with the intent to evaluate differences between the tools as well as strengths and weaknesses of each tool. NEMS-S and FAMS yielded consistent measurements of food availability across store types. FAMS alone investigated food marketing. The only grocery store in the area offered a wide variety of healthy foods, including high quality, competitively priced fresh produce. The dollar store and convenience stores did not offer any fresh produce. Convenience stores sold few healthy options. The dollar store offered more healthy options than convenience stores. Marketing almost exclusively promoted less healthy foods. In particular, prominent placement of less healthy options near checkout aisles and cash registers occurred at all stores. Promising possibilities for future food store interventions in these communities may include promoting healthy checkout aisles; improving stocking of healthy items at convenience stores; and using placement and promotion to increase the visibility of healthy options already present in stores. |
