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From the Schools and Programs of Public Health MOBILIZING YOUNG PEOPLE IN COMMUNITY EFFORTS TO IMPROVE THE FOOD ENVIRONMENT: CORNER STORE CONVERSIONS IN EAST LOS ANGELES Mienah Z. Sharif, MPH Jeremiah R. Garza, MA, MPH Brent A. Langellier, MA, PhD Alice A. Kuo, MD, PhD Deborah C. Glik, ScD Michael L. Prelip, DPA Alexander N. Ortega, PhD Latino young people are significantly more likely to be obese than their non-Latino white peers. 1–3 Higher obesity rates place Latino young people—one of the largest, fastest-growing ethnic groups in the United States—at a heightened risk for developing a range of chronic diseases, including obesity, cardiovascu- lar disease (CVD), and type 2 diabetes. 4–8 Moreover, Latinos are far from meeting the recommended daily intake of fruit and vegetables, 9–12 which is a critical public health concern considering that maintaining a healthful diet, including fruit and vegetables, is a key strategy for preventing chronic disease. 13–21 The food environment influences dietary behavior. However, social and economic factors lead to stark variations in the composition and quality of food among communities that help explain disparities in dietary practices and health outcomes. 22–28 Specifically, low-income communities of color have less access to fresh, affordable fruit and vegetables than more afflu- ent communities. 25,26,29–31 Furthermore, low-income, racial/ethnic minority families often find it easier to purchase energy-dense foods (characterized as high in fat, calories, and sugar) than healthier options, such as fresh fruit and vegetables. 25,29,32–34 One such example is East Los Angeles (East LA), an urban, predominantly Mexican-American community that has limited access to affordable, healthful food, but an abundance of fast-food restaurants and other sources of unhealthful food. 35,36 The food environment is one factor that helps explain why East LA residents experience higher rates of heart disease, diabetes, hypertension, and stroke than residents of more affluent LA neighborhoods. 37 Converting corner stores to improve access to affordable, healthful foods is one potential strategy to improve the food environment. 28,34,38–44 There is no one definition, or approach, for conducting corner store conversions. However, common strategies include improving the store’s facade and installing refrigera- tion units to store the newly available fresh produce. 44 The University of California, Los Angeles (UCLA) Center for Population Health and Health Disparities (CPHHD) implemented a community-engaged corner store conversion project called Proyecto Mercado- FRESCO (Fresh Market Project) in East LA and the neighboring community of Boyle Heights. This inter- vention converted four locally owned corner stores with the goal of increasing access to healthful food and reducing CVD risk. The CPHHD approach emphasized collaboration among community residents and orga- nizations, public health agencies, local public schools, and store owners. 44–47 The process included moving less healthful food items (i.e., chips, soda, and candy) to the back of the store, installing a fresh produce section at the front, improving the interior and exterior store facade, replacing alcohol and tobacco advertisements with healthful food messages, and providing business skills training to store owners. A major supplement to the conversion was a youth- driven campaign of community nutrition education and social marketing to promote the converted stores and increase the purchase of fruit and vegetables. 45–47 An elective course was implemented at two public high schools, one in East LA and one in Boyle Heights, to build the capacity of local students to lead the com- munity social marketing campaign. Students received classroom and field training in nutrition, food justice, media production, and social marketing. The campaign consisted of the following activities: performances at schools, community centers, and parks; short videos on buses; the design and dissemination of posters at bus shelters and marketing materials in neighborhoods surrounding converted stores; and cooking demonstra- tions at the stores (Photos 1 and 2). In addition to lead- ing the social marketing campaign, young people were actively involved in the stores’ physical transformation. The importance of youth perspectives in imple- menting policy advocacy, social marketing, and health projects has been well established in tobacco and substance use prevention. 48–54 While some reports document the engagement of low-income, minority young people in advocating for improvements in their access to healthful food, few reports focus on corner store interventions, and none use qualitative Public Health Reports / July–August 2015 / Volume 130

Mobilizing Young People in Community Efforts to Improve the Food Environment: Corner Store Conversions in East Los Angeles