@article{c55ebb206201409aa2c960d058ce9d23,
title = "The mismatch between observational measures and residents' perspectives on the retail food environment: A mixed-methods approach in the Heart Healthy Hoods study",
abstract = "Objective To gain a deeper understanding of the retail food environment by investigating similarities and differences between objective measures and residents' perspectives. Design The 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. Setting We conducted this study in a low-income neighbourhood in Madrid (Spain) in 2016. Subjects We assessed healthy food availability, accessibility and affordability using GIS-based measures and in-store audits. We also analysed the photographs and discussions from twelve 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 min. Qualitative results showed that participants preferred small local businesses over supermarkets, and revealed built environment obstacles for elderly residents. They also highlighted how the socio-economic context constrained residents' food choices. Conclusions People's experienced retail food environment is different from the one quantitatively analysed. Results show the potential of using a mixed-methods approach to enrich food environment research and enhance public health interventions.",
keywords = "Food environment, Geographic Information System, Healthy eating, Mixed-methods, Photovoice, Public health, Spain, Urban health",
author = "Julia D{\'i}ez and Roberto Valiente and Carmen Ramos and Reyes Garc{\'i}a and Joel Gittelsohn and Manuel Franco",
note = "Funding Information: Acknowledgements: The authors would like to thank Rosa, Beatriz, Juana, Sagrario, Encarnaci{\'o}n, Encarna, Javier, Flori{\'a}n, Julio, {\'A}ngel, Armando and Pablo for participating in the Photovoice Villaverde project and for their contribution to this research. The would also like to thank all staff members of the Health Promotion Center in Villaverde for their unique cooperation and support. Financial support: This research was funded by the European Research Council under the European Union{\textquoteright}s Seventh Framework Programme (FP7/2007–2013/ERC Starting Grant HeartHealthyHoods Agreement no. 336893). The photovoice project was co-funded by an {\textquoteleft}Ignacio Hernando de Llarramendi{\textquoteright} research grant 2014 of the MAPFRE Foundation. R.V. was supported by a predoctoral fellowship from the University of Alcal{\'a}. None of the funding sources had any role in the design, collection, analysis, writing and decision to submit the manuscript. Conflict of interest: None. Authorship: J.D, J.G. and M.F. designed the study and drafted the manuscript. J.D. and R.V. collected the quantitative data. C.R. and R.G. moderated group sessions. R.V. performed all GIS analysis. M.F. was the Principal Investigator and obtained funding for the study. All authors contributed to subsequent manuscript drafts and approved the final version. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the Ethics Research Committee of the Madrid Health Care System. Written informed consent was obtained from all participants. Publisher Copyright: Copyright {\textcopyright} The Authors 2017.",
year = "2017",
month = nov,
day = "1",
doi = "10.1017/S1368980017001604",
language = "English (US)",
volume = "20",
pages = "2970--2979",
journal = "Public health nutrition",
issn = "1368-9800",
publisher = "Cambridge University Press",
number = "16",
}