Healthy Foods and Small Stores: Customer Perspectives from Rural Maryland

In the United States, access to healthy foods has been an important area of investigation in the effort to alleviate the obesity epidemic. Access to healthy foods encompasses access to food stores that sell fruits, vegetables, and other staple foods at affordable prices. Small stores have been targeted as a venue for healthy food interventions because they are a ubiquitous part of the food environment and tend to stock unhealthy foods. There is a rich body of literature examining small food stores as a platform to increase access to healthy foods in under‐served urban areas while the needs of rural areas have remained under‐explored. This study examined customer perspectives on healthy foods and small stores in rural Maryland with the goal of investigating how rural small food stores could be used to expand access to healthy foods. In‐depth interviews were conducted with 14 small store customers in 3 rural Maryland counties. To reflect the heterogeneous nature of small rural Maryland food stores, the participant sample included customers from convenience stores (stand‐alone and attached to gas stations), liquor stores, delis, and small, independent grocers. Participants shopped multiple times per week at small stores versus less than once a week at large stores (e.g. supermarkets). Participants described barriers to overall healthy food purchasing as time, effort, knowledge, the desire to consume less healthy foods, and seasonality. Most participants named fruits and vegetables as healthy foods and said they would like to see produce sold at small stores. However, participants expressed concerns over the freshness of foods, particularly fruits and vegetables, at small stores. While some participants considered health and/or nutritional information in food purchasing decisions, food price was a major factor. Participants said that advertising and word of mouth were ways that they were prompted to try new products. In‐store taste tests were suggested as a way to encourage healthy food purchasing at small stores. Our findings suggest that rural small stores could be a viable platform for increasing access to healthy foods as they are frequently used by customers and customers would like to have healthy foods available at small stores. Based on these findings, major factors that could influence the success of the sales of new healthy foods at rural small stores are the freshness of perishable foods and competitive pricing. By utilizing participant suggested advertising, word of mouth promotion, and in‐store taste tests, a market for healthy foods could be established in rural small stores and increase healthy food access for underserved populations.