BACKGROUND Many lower-income and racially diverse communities in the U.S. have limited access to healthy foods, with few supermarkets and many small convenience stores, which tend to stock limited quantities and varieties of healthy foods. To address food access, in 2015 the Minneapolis Staple Foods Ordinance became the first policy requiring food stores to stock minimum quantities and varieties of 10 categories of healthy foods/beverages, including fruits, vegetables, whole grains and other staples, through licensing. This study examined whether: (a) stores complied, (b) overall healthfulness of store environments improved, (c) healthy customer purchases increased, and (d) healthfulness of home food environments improved among frequent small store shoppers. METHODS Data for this natural (or quasi) experiment were collected at four times: pre-policy (2014), implementation only (no enforcement, 2015), enforcement initiation (2016) and continued monitoring (2017). In-person store assessments were conducted to evaluate food availability, price, quality, marketing and placement in randomly sampled food retailers in Minneapolis (n = 84) and compared to those in a nearby control city, St. Paul, Minnesota (n = 71). Stores were excluded that were: supermarkets, authorized through WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), and specialty stores (e.g., spice shops). Customer intercept interviews were conducted with 3,039 customers exiting stores. Home visits, including administration of home food inventories, were conducted with a sub-sample of frequent shoppers (n = 88). RESULTS Overall, findings indicated significant improvements in healthy food offerings by retailers over time in both Minneapolis and St. Paul, with no significant differences in change between the two cities. Compliance was low; in 2017 only 10% of Minneapolis retailers in the sample were fully compliant, and 51% of participating Minneapolis retailers met at least 8 of the 10 required standards. Few changes were observed in the healthfulness of customer purchases or the healthfulness of home food environments among frequent shoppers, and changes were not different between cities. CONCLUSIONS This study is the first evaluation a local staple foods ordinance in the U.S. and reflects the challenges and time required for implementing such policies. TRIAL REGISTRATION NCT02774330 .

中文翻译：

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对美国首个主食条例的评估：对食品商店产品，顾客购买和家庭食物环境的营养质量的影响。

背景技术在美国，许多低收入和种族多样化的社区对健康食品的获取受到限制，很少有超市和许多小型便利店，这些商店往往储存有限数量和种类的健康食品。为了解决获取食物的问题，2015年，《明尼阿波利斯主要食品条例》成为第一条要求食品商店通过许可，以最低数量和种类存储10类健康食品/饮料的政策，包括水果，蔬菜，全谷类食品和其他主食。这项研究调查了：（a）商店是否合规；（b）商店环境的整体健康状况得到改善；（c）顾客的健康购买量增加了；（d）经常购物的小商店顾客中家庭食物环境的健康状况是否得到改善。方法该自然（或准）实验的数据收集了四次：政策前（2014），仅实施（不执行，2015），启动实施（2016）和持续监控（2017）。对明尼阿波利斯市（n = 84）的随机抽样食品零售商进行了亲自店面评估，以评估食品的可获得性，价格，质量，行销和摆放位置，并将其与附近的控制城市明尼苏达州圣保罗市的食品零售商进行比较（n = 71） ）。不包括以下商店：通过WIC（妇女，婴儿和儿童特殊补充营养计划）授权的超市和专卖店（例如香料店）。对3039名离开商店的客户进行了客户拦截采访。进行家庭访问，包括管理家庭食物库存，这些访问者是经常购物者的子样本（n = 88）。结果总体而言，调查结果表明，明尼阿波利斯和圣保罗的零售商在健康食品供应方面的情况随时间有了显着改善，而两个城市之间的变化没有显着差异。依从性差；在2017年，样本中只有10％的明尼阿波利斯零售商完全符合要求，而51％的明尼阿波利斯参与零售商至少达到了10个必需标准中的8个。在经常购物的人群中，顾客购买的健康度或家庭食物环境的健康度变化不大，而城市之间的变化也没有变化。结论本研究是对美国当地主要食品条例的首次评估，反映了实施此类政策所面临的挑战和所需时间。试用注册NCT02774330。两个城市之间的变化没有显着差异。依从性差；在2017年，样本中只有10％的明尼阿波利斯零售商完全符合要求，而51％的明尼阿波利斯参与零售商至少达到了10个必需标准中的8个。在经常购物的人群中，顾客购买的健康度或家庭食物环境的健康度变化不大，而城市之间的变化也没有变化。结论本研究是对美国当地主要食品条例的首次评估，反映了实施此类政策所面临的挑战和所需时间。试用注册NCT02774330。两个城市之间的变化没有显着差异。依从性差；在2017年，样本中只有10％的明尼阿波利斯零售商完全符合要求，而51％的明尼阿波利斯参与零售商至少达到了10个必需标准中的8个。在经常购物的人群中，顾客购买的健康度或家庭食物环境的健康度变化不大，而城市之间的变化也没有变化。结论本研究是对美国当地主要食品条例的首次评估，反映了实施此类政策所面临的挑战和所需时间。试用注册NCT02774330。明尼阿波利斯的参与零售商中有51％达到了10项标准中的至少8项。在经常购物的人群中，顾客购买的健康度或家庭食物环境的健康度变化不大，而城市之间的变化也没有变化。结论本研究是对美国当地主要食品条例的首次评估，反映了实施此类政策的挑战和所需时间。试用注册NCT02774330。明尼阿波利斯的参与零售商中有51％达到了10项标准中的至少8项。在经常购物的人群中，顾客购买的健康度或家庭食物环境的健康度变化不大，而城市之间的变化也没有变化。结论本研究是对美国当地主要食品条例的首次评估，反映了实施此类政策所面临的挑战和所需时间。试用注册NCT02774330。