Examining the impact of a restrictive retail food environment intervention on pharmacy sales over time in Baddeck, Nova Scotia
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Introduction: Sugar-sweetened beverages are a significant source of dietary sugar intake for both adults and children in Canada and around the world. Consumption of excessive amounts of sugar is a risk factor for a variety of chronic diseases, including obesity, type 2 diabetes and cardiovascular disease. The retail food environment influences how individuals choose and access food. This study examines the impact of removing all sugar-sweetened beverages from a rural pharmacy on the mean expenditure per transaction for four product categories: minimally processed beverages; minimally processed snack food; ultra-processed beverages; and ultra-processed snack food. Methods: Sales data were obtained from a pharmacy in Baddeck, Nova Scotia, Canada, from September 1, 2013 to September 30, 2015. The NOVA classification system was used to categorize items for analysis. The primary outcome measure was mean expenditure per transaction for each of the four product categories. Results: Overall, the number of beverage sold decreased substantially (-34%) after the intervention. Prior to the intervention, ultra-processed beverages accounted for half of all beverages sold. The intervention removed this entire product category, so while minimally processed beverages and other beverages saw an increase in the number of items sold, this increase did not compensate for the removal of all ultra-processed beverages. During the same time period, the number of food products and prescriptions sold increased slightly (4% and 9%, respectively) and the number of non-food products sold decreased slightly (-2%). Revenue from beverages decreased by 20% after the intervention, yet revenue from food and non-food products increased (17% and 2%, respectively). Revenue from prescriptions decreased by 2% after the intervention. While there was no significant change in the percentage of total store revenue that food and beverages accounted for before and after the intervention, the food and beverage category as a whole makes up such a small fraction of overall store sales that these changes result in a relatively minor loss of revenue at the pharmacy. After the intervention, a larger proportion of transactions contained at least one minimally processed beverage; minimally processed snack food and processed snack food. The mean expenditure per transaction did not change significantly after the intervention. Conclusions: This study is one of the first to examine the impact of a restrictive retail food environment intervention on pharmacy sales. With the expanding selection of food and beverage products available in pharmacies, pharmacies play an increasingly important role in creating healthy food environments. Findings from this study suggest that this type of restrictive intervention can be implemented with a very minor loss to overall store revenue after the removal of all sugar-sweetened beverages. These findings also suggest opportunities for further research using sales data in different contexts and jurisdictions.
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Dana Zummach (2017). Examining the impact of a restrictive retail food environment intervention on pharmacy sales over time in Baddeck, Nova Scotia. UWSpace. http://hdl.handle.net/10012/12783