Presenting Author: Usama Bilal, MD, MPH, PhD, Drexel University Urban Health Collaborative

ABSTRACT

Background: Despite acknowledgment of its influential role in shaping food choices, evidence is limited about whether residents' conceptualization of their retail food environment correlates with the one as defined by researchers.

Objectives: To gain a deeper understanding of the retail food environment, by investigating similarities and differences between objective measures and residents' perspectives.

Methods: This study incorporated Geographic Information System (GIS)-based measures, in-store surveys, and the results from a larger Photovoice project. We combined these data using a convergent parallel mixed-methods approach. We conducted this study in a low-income neighborhood in Madrid (Spain) in 2016. We assessed healthy food availability, accessibility and affordability, using GIS-based measures and in-store audits. We also analyzed the photographs and discussions from 12 participants, who engaged in a Photovoice project on their food environment.

Results: Quantitative results depicted a widely-served and highly accessible retail food environment, in which supermarkets scored highest in terms of healthy food availability (36.5 out of 39), and 98.9% of residents could access a healthy food store within a walking travel distance of less than 15 minutes. Qualitative results showed that participants preferred small local businesses over supermarkets, and revealed built environment obstacles for elderly residents. They also highlighted how the socioeconomic context constrained residents’ food choices.

Implications: People's experienced retail food environment is different to the one quantitatively analyzed. Results show the potential of using a mixed-methods approach to enrich food environment research and enhance public health interventions.

Authors: Usama Bilal MD, MPH, PhD; Julia Diez, MSc; Roberto Valiente; Carmen Ramons; Reyes García; Joel Gittelsohn, PhD; and Manuel Franco, MD, PhD.