Table 1. Studies Published from 1978 Through 2012 on Supermarket and Grocery Store Interventions (N = 33) to Promote Healthful Eating, by Strategy Used^a .

Strategy/Intervention	Summary Data
Point-of-Purchase
Supermarket information project ( 58 )
Setting, location, and yearb	2 Intervention supermarkets and 1 control supermarket, Fresno, California, 1978
Activities and duration	Index card brochures distributed in stores but designed for home use; 4 months
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; knowledge and beliefs; sales data
Effectiveness	No changes in sales of targeted items; tripled anticipated response rate for information inquiries; store managers reported customer satisfaction with point-of-purchase
Supermarket nutrition intervention ( 52 )
Setting, location, and yearb	3 Supermarkets in suburbs of northern New Jersey, 1990
Activities and duration	Videocassettes, demonstrations, and printed materialsc; 6 months
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs; sales data
Effectiveness	No effect on food-purchasing behavior
Nutrition for a Lifetime System ( 59 – 61 )
Setting, location, and yearb	1 Supermarket with control and experimental shoppers, location not available, 1991–2001 (59)
Activities and duration	In-store video programs and printed feedback on intended-purchase function (providing customers with individualized reduced fat and increased complex carbohydrate alternatives); 2 months
Design	Prospective measurement with comparison group
Main outcomes measured	Sales data; intention; preferences; dietary intake; knowledge and beliefs
Effectiveness	25% Greater increase in purchasing of targeted items in intervention compared with control shoppers; interactive nutrition information system used by more than 1,400 (nonpaid) people
Paint Your Plate ( 23 )
Setting, location, and yearb	11 Stores had interactive display events; 6 stores had brochures; Greater Sudbury, Canada, 2009
Activities and duration	Interactive display events with public health staff, a display, resources, and food samples vs brochures; 1 month
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs
Effectiveness	Event participants more likely to identify serving size of fruit and vegetables and recommended number of servings of fruits and vegetables
Educational intervention ( 44 )
Setting, location, and yearb	4 Experimental and 4 control supermarkets in Twin Cities, Minnesota, 1982
Activities and duration	Printed materialsc throughout dairy section; 6 months
Design	Prospective measurement with comparison group
Main outcomes measured	Sales data; knowledge and beliefs
Effectiveness	No clear effect of intervention on nutrition knowledge or sales of targeted products
Point-of-purchase health information ( 32 )
Setting, location, and yearb	1 Intervention and 1 control supermarket, Gosen City, Japan, and Tagami Town, Japan, 2011
Activities and duration	Health-related printed materialsc; 3 months
Design	Prospective measurement with comparison group
Main outcomes measured	Sales data
Effectiveness	18.7 Percentage points greater mean adjusted change in sales of total vegetables in intervention vs control
Point-of-Purchase and Pricing
Demonstration cancer control project for Iowa farmers ( 38 )
Setting, location, and yearb	4 Control and 4 intervention supermarkets, small towns in Iowa, 1997
Activities and duration	Printed materialsc, menus signage; coupons, food demonstrations; 8 months
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; fruit and vegetable intake
Effectiveness	18% to 43% of shoppers were exposed to intervention activities; no evidence of effect on consumption of fruits and vegetables
Point-of-Purchase and Promotion and Advertising
Special Diet Alert ( 34 , 62 , 63 )
Setting, location, and yearb	10 Intervention grocery stores in Washington, DC, and 10 control grocery stores in Baltimore, Maryland, 1992
Activities and duration	Brand-specific shelf markers, take-away information booklets, radio and television spots; 24 months
Design	Prospective measurement with comparison group
Main outcomes measured	Sales data
Effectiveness	Sales of shelf-marketed products increased; media schedule reach was 86% of target population
M-Fit supermarket shelf-labeling program ( 39 )
Setting, location, and yearb	18 Supermarkets, Detroit, Michigan, 2000
Activities and duration	Color-coded shelf labels, banners, produce and dairy signs, shopping guide; duration unknown
Design	Single group, same point in time
Main outcomes measured	Awareness and use
Effectiveness	Overall intervention awareness was 28.8%; of those aware of the program, 56% used the program
Shop for Your Heart ( 24 , 64 – 66 )
Setting, location, and yearb	3 Grocery stores and 2 supermarkets, Montreal, Canada, 1995–1998
Activities and duration	Printed materialsc, guided tours, taste tests, 1-time cholesterol screening event; 4 months
Design	Single group, same point in time
Main outcomes measured	Awareness and use; process measures
Effectiveness	Overall intervention awareness 52%; of those aware of the program, 6% used the program
Foods for Health ( 35 , 67 )
Setting, location, and yearb	90 Intervention supermarkets, Washington, DC; comparison supermarkets (number not reported), Baltimore, MD, 1983–1986
Activities and duration	Shelf and window signs, banners, printed materialsc, newspaper advertising, radio spots; 12 months
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; knowledge and beliefs; sales data; process measures
Effectiveness	Improvements in nutrition knowledge in intervention compared with control group
Food for Health: the Carbohydrate Connection ( 53 )
Setting, location, and yearb	3 Intervention supermarkets and 2 comparison supermarkets, town in New York State, 1982
Activities and duration	Fact sheet, recipe cards, placard on shelf near target food; newspaper and radio messages; 4 months
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; knowledge and beliefs; dietary intake; sales data
Effectiveness	Improved nutrition knowledge and food use scores among those aware of the campaign; increase in purchase of targeted items
Eat for Health ( 36 , 55 , 68 , 69 )
Setting, location, and yearb	>100 Intervention supermarkets, Washington, DC; and 30 control supermarkets, Baltimore, Maryland, 1989–1994
Activities and duration	Shelf labels; information guide; monthly bulletin; signs in produce sections; television, radio, and print advertising; and brief in-store videos; 24 months
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; knowledge and beliefs; fat intake; sales data; process measures
Effectiveness	Modest effect on food purchasing behaviors; improved nutrition knowledge, attitudes, and self-reported food purchasing behaviors; approximately 200,000 people exposed to campaign
Four Heart Program ( 54 )
Setting, location, and yearb	3 Supermarkets and 1 grocery store, Pawtucket, Rhode Island, 1990
Activities and duration	Brand-specific shelf labels, signs, printed materialsc, contests, and blood pressure and cholesterol screening, counseling, and referral events; 48 months
Design	Multiple measurement, no comparison group
Main outcomes measured	Awareness and use
Effectiveness	24% Correctly identified intervention labels; 54% reported being encouraged to purchase identified food. Reach: 1,179 participants and 4,913 population totals; 636 were encouraged to purchase labeled products
Shop Smart for Your Heart ( 41 )
Setting, location, and yearc	17 Grocery stores in 3 Minnesota locations: Mankato, Fargo, and Moorhead, 1987
Activities and duration	Shelf labels, taste testing, printed materialsc, newspaper advertisement, grocery cart inserts; 4 months
Design	Multiple measurement, no comparison group
Main outcomes measured	Awareness and use
Effectiveness	40% Were aware of intervention; 17% to 41% reported that signs influenced their food choices
Lean Meats Make the Grade ( 40 )
Setting, location, and yearb	8 Grocery stores in 3 Minnesota locations: Mankato, Fargo, Moorhead, 1988
Activities and duration	Taste testing, printed materialsc, and package labels; 1 month
Design	Prospective measurement with comparison group
Main outcomes measured	Awareness and use; knowledge and beliefs; sales data
Effectiveness	Greater awareness in intervention (69%) than in comparison (58%) communities; improved nutrition knowledge; increased sales of targeted items
Low-fat nutrition education and labeling ( 29 )
Setting, location, and yearb	13 Supermarkets including control and 2 intervention groups, the Netherlands, 2004
Activities and duration	Printed materialsc, self-help manual, contest, shelf label; 6 months
Design	Prospective measurement with comparison group
Main outcomes measured	Fat intake; knowledge and beliefs; intentions
Effectiveness	No significant effects on total fat intake or psychosocial determinants
The Good Book of Nutrition ( 56 )
Setting, location, and yearb	6 Chain supermarkets, Central Florida, 1993
Activities and duration	Taste testing, nutrition information, store advertisements, newspaper advertisements, cookbook, skirting for information booth, printed banners, posters, package stickers, and shelf tags; 1 month
Design	Single group, same point in time
Main outcomes measured	Awareness and use; knowledge and beliefs
Effectiveness	23% Of shoppers were aware of campaign; 3% of shoppers made changes to their diet
Shop Smart Tour ( 25 )
Setting, location, and yearb	Supermarket chain in 40 communities, British Columbia, 1993
Activities and duration	Aisle-by-aisle supermarket tour that taught consumers skills in making food choices; follow-up at 3 months
Design	Before and after, no comparison group
Main outcomes measured	Intentions
Effectiveness	23% to 33% of 48 participants intended to alter dietary behavior in targeted direction; posttest purchase of low-fat dairy products, whole grain products, and polyunsaturated spreads was greater than intention to purchase at baseline; posttest purchase of legumes and tofu was less than intention to purchase at baseline
1% Or Less campaign ( 57 , 70 – 72 )
Setting, location, and yearb	8 Intervention stores in Clarksburg, West Virginia, and Bridgeport, West Virginia, and 6 comparison stores in Wheeling, West Virginia, 1998–2005
Activities and duration	Focused message was communicated through paid advertising, public relations activities, and community-based education programs: newspaper, radio, and television advertisements, press conferences, blinded taste tests at supermarkets; signs in dairy case; 2 months
Design	Prospective measurement with comparison group
Main outcomes measured	Preferences; sales data
Effectiveness	Increased sales of targeted items; reach: 231 participants and 257 population totals
Healthy Kids ( 50 )
Setting, location, and yearb	1 Intervention store, Roanoke, Virginia, 2012
Activities and duration	Low-to-the-ground kiosk displaying featured food items; 3 months
Design	Multiple measurement, no comparison group
Main outcomes measured	Sales data; awareness and use
Effectiveness	Overall significant increase in proportion of sales of featured items to total store sales
5 A Day ( 49 , 73 , 74 )
Setting, location, and yearb	3 Intervention and 3 comparison stores, supermarket chain in eastern Massachusetts, 1995–2001
Activities and duration	Take-home audiotapes and in-store public service announcements; 1 month
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs; fruit and vegetable intake; intentions; process measures
Effectiveness	Increased knowledge scores in intervention group compared with control group; no effect on fruit and vegetable intake, beliefs, or intentions
Point-of-purchase, Pricing, and Promotion and Advertising
Tasty and Healthy Campaign ( 30 )
Setting, location, and yearb	12 Intervention and 6 control butcher shops, Limburg province, the Netherlands, 2006
Activities and duration	Product labels, price reductions, printed materialsc, mobiles, training employees, television and radio commercials, newspaper advertisements; 3 months
Design	Prospective measurement with comparison group
Main outcomes measured	Dietary intake; awareness and use; intentions
Effectiveness	71% of customers were aware of campaign; no effects on nutrition behavior or intentions
Kansas LEAN ( 42 )
Setting, location, and yearb	1 Supermarket, Kansas, 1996
Activities and duration	Prompting by food manufacturer demonstrators consisted of verbal encouragements, taste samples, and coupons; 9.5 hours
Design	Prospective measurement with comparison group
Main outcomes measured	Trained observers counted the number of targeted food items placed by customers into their shopping carts.
Effectiveness	Increased consumer purchases of targeted items
Lifestyle 2000 Flavour Without Fat ( 27 )
Setting, location, and yearb	6 Intervention supermarkets, Bunbury, Australia, 1991
Activities and duration	Large mobiles, vinyl striping on produce bins, shelf talkers, cardboard canopies, and barbers’ poles for dairy cabinets included project logo; low-fat dairy products relocated in 1 section of the dairy cabinet; coupons, printed materialsc, and option to get Flavour Without Fat cookbook; low-fat product taste testing; 4 months
Design	Single group, same point in time
Main outcomes measured	Awareness and use; process measures
Effectiveness	52% Were aware of supermarket promotion; of those aware, 22% reported it had influenced their food choices; sales of targeted items increased during demonstration periods
Guided supermarket tours ( 31 , 75 )
Setting, location, and yearb	9 Supermarkets, The Netherlands, 1996–1998
Activities and duration	Nutrition education tour given by dietitians (and promoted in mass media); printed materialsc, games played, taste testing; 4 months
Design	Multiple measurement, no comparison group
Main outcomes measured	Knowledge and beliefs; intentions; process measures
Effectiveness	Improved knowledge; 45% of children and 70% of adults intended to buy more low-fat products
Point-of-Purchase, Increased Availability of Healthful Foods, Promotion and Advertising
Marshall Islands Healthy Stores ( 28 , 76 )
Setting, location, and yearb	12 intervention and 11 control large and small food stores, Majuro Atoll, Republic of the Marshall Islands; 2006–2007
Activities and duration	Newspaper articles, video, and radio announcements; stocking of key foods; shelf labels, cooking demonstrations; printed materialsc; 2.5 months
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs; awareness and use; process measures
Effectiveness	Exposure associated with increased diabetes knowledge score; sales of select targeted foods increase; consumer exposure was moderate to high: 65% of respondents had heard half or more of the 7 radio spots, 59% had seen half or more of the newspaper ads, and 31% had seen video aired on local television; reach: 120 participants; 185 population totals
Apache Healthy Stores (AHS) ( 46 , 77 )
Setting, location, and yearb	11 Intervention and 6 comparison stores, White Mountain and San Carlos Apache reservations, Arizona, 2005–2006
Activities and duration	Store managers given “all” and “minimum standard” list of food items to order and promote; shelf labels and printed materialsc; newspaper cartoons and radio announcements; cooking demonstrations and taste tests; educational displays; 12 months
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs; process measures; intentions
Effectiveness	No effect of intervention reported for cognitive outcomes; 1,582 contacts made with customers participating in 81 cooking demonstrations; average number of customer contacts/demonstrations was 21; reach: 5% of total population
Zhiiwaapenewin Akino’maagewin: Teaching to Prevent Diabetes ( 26 , 48 )
Setting, location, and yearb	3 Small or convenience stores, 4 medium-sized stores, and 1 large supermarket in 4 communities in northwestern Ontario, Canada, 2008
Activities and duration	Stocking and labeling of more healthful foods, printed materialsc, cooking demonstrations, taste tests; radio, cable television, newsletters, and bulletin boards for educational materials; 10 months
Design	Prospective measurement with comparison group
Main outcomes measured	Process measures; knowledge and beliefs; intentions; awareness and use
Effectiveness	Significant changes in knowledge and frequency of healthful food acquisition among intervention community respondents
Point-of-Purchase, Pricing, Increased Availability of Healthful Foods, and Promotion and Advertising
Healthy Foods Hawaii ( 45 )
Setting, location, and yearb	5 Intervention and 2 comparison stores, Oahu and Big Island, Hawaii, 2010
Activities and duration	Increased store stocking of nutritious foods, educational displays, shelf labels as educational tools, cooking demonstrations and taste tests with printed materialsc, and involvement of local producers and distributors; 11 months
Design	Prospective measurement with comparison group
Main outcomes measured	Dietary intake; process measures; knowledge and beliefs; intentions
Effectiveness	Significant effect on caregiver knowledge and attitudes; increased Healthy Eating Index score; low to moderate exposure to intervention
Baltimore Healthy Stores ( 17 , 37 , 78 – 80 )
Setting, location, and yearb	2 Intervention supermarkets and 7 Korean corner stores, East Baltimore, Maryland; 2 control supermarkets and 6 Korean corner stores, West Baltimore, Maryland, 2009–2011
Activities and duration	Designed to increase availability and sales of healthier food options in local stores; culturally relevant guidelines, nutrition education training and booklet; printed materialsc, educational displays, and shelf labels; taste tests, incentives, and giveaways; 10 months
Design	Prospective measurement with comparison group
Main outcomes measured	Knowledge and beliefs; process measures; sales data
Effectiveness	No effect on store owner outcome expectations; weekly sales of promoted foods increased when stocking improved. Reach: 2,942 participants; 55,000 population totals
Pricing and Promotion and Advertising
The Shop Smart Game ( 43 )
Setting, location, and yearb	2 Large grocery stores, Bloomington, Minnesota, 1990
Activities and duration	Aggressively advertised Bingo-style game; flyer with coupons; winning cards entered into lottery for vouchers good at participating stores; 7 weeks
Design	Multiple measurement, no comparison group
Main outcomes measured	Awareness and use
Effectiveness	High awareness of intervention
Supermarket Healthy Options Project (SHOP) ( 33 , 81 )
Setting, location, and yearb	8 Supermarkets, Lower North Island, New Zealand, 2007–2009
Activities and duration	Mailed culturally relevant nutrition education materials to participants’ homes; offered price discounts on eligible healthier food products; participants were required to use, Shop ‘N Go, the electronic handheld scanner system; 9 months
Design	Single group, same point in time
Main outcomes measured	Process measures
Effectiveness	No effect of intervention on food purchases reported; mailed recruitment efforts (73% of total recruitment efforts) were more successful than community (20%) or in-store (7%) recruitment efforts

^a Strategies were categorized as point-of-purchase, pricing, promotion and advertising, increased availability of healthful foods, and combinations thereof. Any results reported on reach are included in data on effectiveness. For main outcomes measured, process measures included reach, dose, and fidelity.

^b Year study was published; if several articles described the same intervention, the range of years of publication is provided.

^c Printed materials included at least 2 items, such as posters, recipes, or pamphlets.