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Grant Details

Grant Number: 1R01CA140326-01A1 Interpret this number
Primary Investigator: Ayala, Guadalupe
Organization: San Diego State University
Project Title: El Valor DE Nuestra Salud (the Value of Our Health)
Fiscal Year: 2010


DESCRIPTION (provided by applicant): Dietary intake is an important determinant of risk for obesity and cancer. Consumption of fruits and vegetables reduces risk, yet among Latinos, there is now clear evidence that fruit and vegetable consumption decreases with greater acculturation to the U.S. Interventions targeted at the intrapersonal and interpersonal levels of the Socio-Ecological Framework have resulted in changes to dietary intake. However, these studies have neglected to consider that unless changes occur at higher levels of influence (e.g., in stores, in restaurants), individual behavior changes are unlikely to be reinforced and sustained. We propose to refine a pilot-tested intervention to change the food environment of grocery stores to promote consumption of fruits and vegetables. El Valor de Nuestra Salud [The Value of Our Health] will identify, recruit, and match 18 grocery stores (specifically small-to-medium sized Latino grocery stores or tiendas) and randomize them into one of two conditions: intervention versus a no-treatment control condition. The intervention will consist of two communication change strategies and two structural change strategies with the goal of changing aspects of the social and physical environments. The intervention will include employee and manager trainings to promote sales of fruits and vegetables and how to conduct a food marketing campaign. In addition, we will provide equipment and other material resources to the tiendas to promote sales of ready-to-eat fruits and vegetables, and to work with them to modify selections available in the meat and ready-to-eat food departments. Efficacy will be evaluated at the store customer level in terms of baseline to immediate post-intervention (6 months post-baseline) changes in self-reported fruit and vegetable intake in a sample of 360 adult store customers, and maintenance of these changes at the 6-month follow-up (12 months post-baseline). Levels of serum carotenoids collected in a 25% subsample of customers will provide evidence for the validity of dietary self- report. Intervention effectiveness will be evaluated at the employee, manager, and store levels using both self-reported and observed methodological approaches. The RE-AIM framework will be used to assess the potential for disseminating the intervention if it results in improvements in customers' dietary intake. This study is responsive to NCI's call for proposals on Diet and Communication, and given the involvement of a Mexican/Mexican-American population, is responsive to NCI's mission to reduce racial/ethnic health disparities. PUBLIC HEALTH RELEVANCE: Risk for obesity and certain cancers are higher among U.S. Latinos as compared with non-Latinos. Risk factors for obesity and cancer include not eating enough fruits and vegetables and other healthy foods, and this is particularly pronounced among Latinos who have less access to healthy foods. This study adds to the growing body of research on environmental-level interventions by proposing to work with Latino grocery stores to increase the availability of fruits and vegetables and ultimately impact the diets of its customers.


The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption.
Authors: Ayala G.X. , Pickrel J.L. , Baquero B. , Sanchez-Flack J. , Lin S.F. , Belch G. , Rock C.L. , Linnan L. , Gittelsohn J. , Ji M. , et al. .
Source: The international journal of behavioral nutrition and physical activity, 2022-02-17; 19(1), p. 19.
EPub date: 2022-02-17.
PMID: 35177070
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Distributing and Sourcing Local Produce in Latino-focused Food Stores: A Qualitative Study with Stores and Small Farmers in San Diego County.
Authors: Sanchez-Flack J. , Wasserman R. .
Source: Ecology of food and nutrition, 2020-11-01; 59(6), p. 656-674.
EPub date: 2020-06-03.
PMID: 32490700
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Evaluation of Store Environment Changes of an In-Store Intervention to Promote Fruits and Vegetables in Latino/Hispanic-Focused Food Stores.
Authors: Sanchez-Flack J. , Baquero B. , Lin S.F. , Belch G. , Pickrel J.L. , Anderson C.A.M. , Arredondo E. , Martinez M.E. , Mayer J. , Ji M. , et al. .
Source: International journal of environmental research and public health, 2019-12-20; 17(1), .
EPub date: 2019-12-20.
PMID: 31861788
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Fruit and Vegetable Intake of US Hispanics by Food Store Type: Findings from NHANES.
Authors: Sanchez-Flack J.C. , Anderson C.A.M. , Arredondo E.M. , Belch G. , Martinez M.E. , Ayala G.X. .
Source: Journal of racial and ethnic health disparities, 2019 Feb; 6(1), p. 220-229.
EPub date: 2018-07-19.
PMID: 30027480
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Examination of the Relationship between In-Store Environmental Factors and Fruit and Vegetable Purchasing among Hispanics.
Authors: Sanchez-Flack J. , Pickrel J.L. , Belch G. , Lin S.F. , Anderson C.A.M. , Martinez M.E. , Arredondo E.M. , Ayala G.X. .
Source: International journal of environmental research and public health, 2017-10-27; 14(11), .
EPub date: 2017-10-27.
PMID: 29077075
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Who Is Influencing Whom? Latino Parent-Child Request Interactions and Product Purchases in Food Retail Environments.
Authors: Castro I.A. , Calderon J. , Ayala G.X. .
Source: Social marketing quarterly, 2017 Jun; 23(2), p. 155-168.
EPub date: 2017-01-05.
PMID: 29081718
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What Happens When Parents and Children Go Grocery Shopping? An Observational Study of Latino Dyads in Southern California, USA.
Authors: Calderon J. , Ayala G.X. , Elder J.P. , Belch G.E. , Castro I.A. , Weibel N. , Pickrel J. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2017 Feb; 44(1), p. 5-12.
EPub date: 2016-07-09.
PMID: 27162238
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Measures of Retail Food Store Environments and Sales: Review and Implications for Healthy Eating Initiatives.
Authors: Glanz K. , Johnson L. , Yaroch A.L. , Phillips M. , Ayala G.X. , Davis E.L. .
Source: Journal of nutrition education and behavior, 2016 Apr; 48(4), p. 280-8.e1.
PMID: 27059314
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What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California.
Authors: Sanchez-Flack J.C. , Baquero B. , Linnan L.A. , Gittelsohn J. , Pickrel J.L. , Ayala G.X. .
Source: Ecology of food and nutrition, 2016; 55(2), p. 163-81.
EPub date: 2016-01-22.
PMID: 26800243
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A store-based intervention to increase fruit and vegetable consumption: The El Valor de Nuestra Salud cluster randomized controlled trial.
Authors: Ayala G.X. , Baquero B. , Pickrel J.L. , Mayer J. , Belch G. , Rock C.L. , Linnan L. , Gittelsohn J. , Sanchez-Flack J. , Elder J.P. .
Source: Contemporary clinical trials, 2015 May; 42, p. 228-38.
EPub date: 2015-04-27.
PMID: 25924592
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A three-decade evolution to transdisciplinary research: community health research in California-Mexico border communities.
Authors: Elder J.P. , Ayala G.X. , McKenzie T.L. , Litrownik A.J. , Gallo L.C. , Arredondo E.M. , Talavera G.A. , Kaplan R.M. .
Source: Progress in community health partnerships : research, education, and action, 2014 Autumn; 8(3), p. 397-404.
PMID: 25435566
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Lessons learned from small store programs to increase healthy food access.
Authors: Gittelsohn J. , Laska M.N. , Karpyn A. , Klingler K. , Ayala G.X. .
Source: American journal of health behavior, 2014 Mar; 38(2), p. 307-15.
PMID: 24629559
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