Applying the Social Ecological Framework and Social Cognitive Theory to food desert interventions: What is effective, ineffective, and where to go from here

Abstract

Living in a food desert is associated with worse health outcomes, and consequently there has been an increasing amount of intervention research on how improve access to and consumption of healthy foods among people who live in these areas. This thesis aimed to identify interventions in food deserts and among other low-income populations that implemented a healthy eating intervention and measured either sales or consumption of healthy foods before and after the intervention. Searches of a list of pre-specified phrases were conducted on Google Scholar to identify food desert interventions. Forty-five articles were identified through these searches that met inclusion criteria. Of these, 7 targeted individuals, 22 targeted the community, 9 targeted public policy, and 7 were multilevel. 32 interventions succeeded at increasing participants’ consumption of healthy foods, and 7 of the 13 that did not were interventions that tested the effects on diet of a new grocery store in a food desert. Opening new grocery stores in food deserts has long been championed as the next step in addressing the nutritional inequality that exists between residents of food deserts and residents of wealthier areas. However, there was little evidence found to suggest that this is an effective solution to the problem. Policies that incentivize the purchase of healthy foods and multilevel interventions that pair community-level changes in food access with individually-based education interventions were found to be the most effective interventions.