Increasing Healthful Food Choice and Strengthening Rural Grocery Stores Through Nutritional Education and Labeling

INCREASING HEALTHFUL FOOD CHOICE AND STRENGTHENING RURAL GROCERY STORES THROUGH NUTRITIONAL EDUCATION AND LABELING

Sponsoring Institution

National Institute of Food and Agriculture

Project Status

TERMINATED

Funding Source

AFRI COMPETITIVE GRANT

Reporting Frequency

Annual

Accession No.

1002521

Grant No.

2014-68006-21850

Project No.

KS603009

Proposal No.

2013-05169

Multistate No.

(N/A)

Program Code

A1621

Project Start Date

Apr 1, 2014

Project End Date

Mar 31, 2017

Grant Year

2014

Project Director
Procter, D. E.

Recipient Organization
KANSAS STATE UNIV
(N/A)
MANHATTAN,KS 66506

Performing Department
Center Engagement Comm Develop

Non Technical Summary
The long-term goal of this proposal is for rural communities to sustain these small businesses,promote healthful food access, and strengthen local economies and food systems. We postulatethat innovative nutrition labeling technology coupled with Extension nutrition outreach tailoredto point-of-sales holds promise in achieving these goals. One such nutritional labelingtechnology is a nutritional value scoring system, where nutritional quality of each food item ispresented as single numerical score. Our proposition is examined by assessing the impacts ofnutritional outreach program and nutritional scoring system on rural food systems targetinggrocery stores.The investigation team consists of research and Extension personnel at Kansas State Universityand University of Minnesota. The project is made feasible by two business collaborators,Affliated Foods Midwest, a wholesale cooperative that serves about 800 stores in the ruralMidwest, and NuVal, a provider of the NuVal nutritional scoring system. The project recruitsfive grocery stores in the rural Midwest as our experiment sites.

Animal Health Component

Research Effort Categories

Basic

100%

Applied

(N/A)

Developmental

(N/A)

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
607	6050	3010	34%
608	6050	3010	33%
607	6099	3030	33%

Knowledge Area
607 - Consumer Economics; 608 - Community Resource Planning and Development;

Subject Of Investigation
6050 - Communities, areas, and regions; 6099 - People and communities, general/other;

Field Of Science
3030 - Information and communication; 3010 - Economics;

Keywords

Goals / Objectives
1. Estimate the distinct and combined impacts of Extension nutrition education andnutritional scoring system on attitudes toward healthy eating among rural residents.2. Estimate the distinct and combined impacts of Extension nutrition education andnutritional scoring system on perceptions about the nutritional quality of foods offered inthe community grocery store among rural residents.3. Estimate the distinct and combined impacts of Extension nutrition education andnutritional scoring system on food purchases of healthful food items at the communitygrocery store.4. Estimate the distinct and combined impacts of Extension nutrition education andnutritional scoring system on inventory and food sales of healthful food items of thecommunity grocery store.5. Estimate the distinct and combined impacts of Extension nutrition education andnutritional scoring system on the rural food environment around the community grocerystore.In order to induce any changes in behavior - i.e., rural residents are consuming more healthfulfoods through locally owned grocery stores - we must first see changes in attitudes andperceptions. Objectives one and two measure the effectiveness of the interventions to change themindset of rural residents.Extension Objectives include:6. Create an Extension teaching module on the use of innovative nutrition labeling tosupport healthful food selection at local grocery stores.7. Test and incorporate the newly developed Extension teaching module in existingExtension nutrition programming.Project Narrative38. Share lessons learned and ?best practices? with Extension Educators in Kansas andMinnesota in a workshop affiliated with the Rural Grocery Summit.9. Expand Extension nutrition education, local/sustainable foods and economicdevelopment programming to include more extensive information on the benefits of localfoods to retailers and consumers and how to incorporate healthy, locally grown foods intothe rural grocery retail environment.10. Based on research findings, disseminate successful ?best practices? modules and tools toExtension users via eXtension, USDA's SNAP-Ed Connection, and the U of M ExtensionCommunity and Local Food Resources.11. Submit research findings to appropriate research venues including The Journal ofNutrition Education and Behavior in order to maximize Extension adoption of bestpractices.

Project Methods
Objective three looks at the impacts of these interventions on behavior of patrons of ruralgrocery stores. If effective as intended, the changes in behavior induced by the interventionscould be discerned from household food purchases that have shifted towards food items that areconsidered more healthful. Moreover, most consumers shop for groceries at multiple outlets. Ifresidents have improved perceptions of the nutritional quality of foods that rural grocery storesoffer, current patrons of rural grocery stores might switch one or more of their regular shoppingtrips to non-locally owned supermarkets or super centers to locally owned grocery stores. If theword spreads sufficiently, rural grocery stores might see new patrons.Objective four examines the impacts of these interventions on stores. If the interventionsencourage the patrons to seek out more healthful food items, we would expect to see the changesreflected in the composition of products that are carried by and sold at stores. Depending on therelative prices of more healthful food items relative to general items, the overall sales figures areexpected to change. If the interventions have successfully increased traffic into the store, thesales figures should increase.Objective five looks for new or expanded synergies, collaborations, and partnerships among foodhub organizations, businesses, and institutions that result from the project's experimentalinterventions.Objective six will be addressed by a collaborative of Extension Specialists working inconsultation with local Extension educators to design an educational module. The module anddelivery methods will be discussed between local educators and Extension Specialist to captureboth content and best delivery ideas for this public education strategy. The modules will beintended to educate consumers on nutritional values of foods, and will integrate the NuVal Foodand Nutrition Labeling program messages and resources for public education about nutritionalvalues. The materials will also incorporate other creative message delivery mechanisms. Thesemay include point-of-sales posters, shopping fliers, isle signs, audio and video messagesdelivered in the store, and public informational campaigns.We will then test and incorporate the newly developed Extension teaching module (objectiveseven). Testing of the materials will seek feedback on effectiveness of content, delivery, andover-all impact on food purchasing. Assessments of the educational approach will assess howwell the messages ?stick? with the rural audience. Final edits will be made based on thefeedback and suggested for improved effectiveness for content and delivery. Lessons oneffective delivery and updated materials will be shared with other Extension educators fromKansas and Minnesota (objective eight) at a workshop in conjunction with the Rural GrocerySummit.Research outcomes from this study may also document economic impact data related to theintegration of healthier foods to the local store, and the economic benefits of integrating the saleof locally grown and produced foods. These additional research findings will be documentedand shared to provide information on the benefits of local foods to retailers and consumers(objective nine).To achieve objective ten, project collaborators will disseminate successful ?best practices?modules and tools to Extension users by investigating use of eXtension, USDA's SNAP-EdConnection, and the U of M Extension Community and Local Food Resources. Materials will bedesigned for dissemination by the local Family Nutrition Program (FNP) Extension educator aspart of the existing USDA/FNS funded Kansas SNAP-Ed program, so that they can be utilizedacross the U.S.

Progress 04/01/14 to 03/31/17

Outputs
Target Audience:There are two primary audiences for this project: (1) citizens living in the rural communities of Conway Springs, Kansas; Onaga, Kansas; and Randall, Minnesota and (2) the rural grocery store owners in these three small towns. There is also a broader, secondary audience for this project. The results of this project are targeted to citizen leaders who are interested in establishing grocery stores in rural communities as well as healthy food access stakeholders. Changes/Problems:Key to identifying results of this study was a pre and post analysis of rural grocery buying patterns. We sought to study any changes in buying patterns in two ways: (1) by conducting a monthly food inventory analysis of the three rural grocery stores during the duration of the study and (2) by examining the food purchasing patterns of the rural grocery customers during the duration of the study. To capture the inventory data for the grocery stores we have worked with the food distributor - Affiliated Foods Midwest - and they have provided all the inventory data. To identify changes in food purchasing patterns for rural grocery customers, we instituted a loyalty card (Loyalty Lane) and charted customer purchases. Additionally, to identify the nutritional value of these purchases, we have worked with NuVal LLC and their nutritional scoring system. We have run into a major challenge working with NuVal. Both the University of Minnesota and Kansas State University require private companies to sign a no-liability contract. NuVal has refused to sign this document and wants to reserve the right to sue each university if deemed necessary. Both universities are refusing to collaborate any further with NuVal. I am nearly certain that we will not receive the NuVal scores. Dr. Hikaru Peterson - U. of MN - is examining alternatives to the NuVal scoring system. A second challenge occurred with staff transitions. During the project timeframe Dr. Dan Kahl left KSU and Dr. Hikaru Peterson left KSU. They both remained involved with the project on a limited basis, but communications and coordination of work were challenges. It definitely slowed down the work. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest?In all three years, the AFRI team also made use of three media resources (the RGI Twitter, Facebook, and website) to disseminate information relevant to the AFRI project. The Rural Grocery Tool Kit was posted to the RGI website in Year 1, and RGI regularly posted on social media about resources available through it during the remaining years. Announcements and updates about the AFRI project also were posted to the RGI website and social media accounts throughout the three years of the project. In year3, the U. of Minnesota team: Presented on the results of the AFRI project and Minnesota Rural Grocery Survey at outreach events at U of M and Hamline University Presented on farm-to-grocery best practices at the Minnesota Organic Conference Created a new Rural Grocery Stores web page on the U of M Extension RSDP website, which includes a link to the RGI website (Rural Grocery Tool Kit, best practices articles) Posted resources developed in conjunction with the AFRI project on the new Rural Grocery Stores web page, including: the Fresh Produce Toolkit, four farm-to-grocery case studies, results of the 2015 Minnesota Rural Grocery Survey, and a highlights summary of the 2014 Rural Grocery Summit Dr. David Procter and Dr. Hikaru Peterson have two manuscripts under review from this project: A Case Study of Independent Grocers in the U.S. Rural Midwest, Currently being considered as a "revise and resubmit" with the Journal of Hunger and Environmental Nutrition Barriers to Operating Healthy Food Retail in Rural Kansas, Under review at the Journal of Agriculture, Food Systems, and Community Development What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? In Year 3, AFRI team members worked toward wrapping up research activities and disseminating results of the project. The AFRI team organized and held the 5th National Rural Grocery Summit in June 2016. There were 155 participants in attendance The majority of participants were from Kansas (63.2%), but participants also came from 11 other states (with locations spanning the East and West coasts). There were a variety of stakeholders among participants, including representatives from grocery stores, universities, communities, non-profit agencies, government agencies, businesses, funding agencies, and food suppliers. Attendees reported that their participation in the RGI is motivated by helping/sustaining rural communities and/or rural grocery stores, gaining information/ideas, and increasing healthy food access. Survey respondents agreed that the summit provided them opportunities to network/connect with other rural grocery stakeholders (e.g., funders, distributors, owners), discuss significant issues and challenges faced by rural grocery stores, and discuss the latest models for providing healthy food access to rural communities. When describing highlights of the summit, survey respondents most frequently mentioned networking/meeting others. They also cited hearing from grocery store owners, the people in attendance in general, as well as specific individuals in attendance. When listing the most important people they connected with at the summit, the most frequently listed people were David Procter, the AFRI project PI, and the two keynote speakers: Nick Graham and Marci Penner. Additional AFRI team members mentioned were: Karen Lanthier, Hikaru Peterson, Sandy Procter, Affiliated Foods, Chandra Ruthstrom, and Jenny Osner. Survey participants most frequently indicated it was most likely they would collaborate with Karen Lanthier and David Procter in the future, both AFRI team members. Respondents described that their experience at the summit will change their practices related to outreach/building partnerships. The summit was successful at disseminating information/resources and strategies/tools, including those on healthful grocery topics. The nutrition education training developed through the grant was included among the information/resources. The opening and closing sessions as well as some breakout sessions provided information related to the local food environment and the importance of access to and promotion of healthful foods in rural communities. The evaluator documented five breakout sessions with healthful grocery applications. An additional two sessions containing healthy grocery content ran concurrent to other health-related breakouts. The sessions, collectively, shared many strategies and resources related to increasing access to healthy foods and promoting healthy and local food choices. Four AFRI team members presented during some of these healthful grocery sessions. During Breakout Session #8 ("Encouraging Rural Customers to Shop Healthy"), AFRI team members introduced the nutrition education classes, grocery store tour, and grocery shopping challenge developed through the AFRI grant. Team members described and shared lessons learned from implementing the new education approach in rural communities in Kansas and Minnesota. When describing highlights of the summit, survey respondents frequently mentioned gaining strategies/applications, learning/gaining information, and information from keynote sessions. Several other highlights were related to various types of information received, such as on distribution/hubs, succession, food policy, and healthy foods. Survey respondents agreed that the summit shared current information about rural grocery stores and about rural community sustainability, and provided new information/resources that they will apply in their work. The summit provided opportunities to increase stakeholders' understanding of and skills related to strategies for healthy foods. Some participants described changes they will make in their work-related or personal practices due to the increased understanding and skills/strategies. Participants who attended Breakout Session #8 ("Encouraging Rural Customers to Shop Healthy") agreed that it increased their knowledge of strategies for and their understanding of the importance of nutrition education in grocery stores, and that they are likely to use the nutrition education strategies. Respondents described that their experience at the summit will change their practices related to trying new store ideas/strategies in general, pursuing healthy food initiatives, and increasing nutrition education. Several survey respondents indicated they plan to use them in the following ways: pursuing healthy food programs or initiatives, sharing the information/resources with others, using it in grocery stores or communities, and exploring options for farmer's markets/local produce. As a result of the presentation at the 5th Rural Grocery Summit, AFRI team members in K-State Research and Extension formed a partnership with fellow session presenter from Missouri Extension to bring the grocery store/community curriculum "Stock Healthy, Shop Healthy" to Kansas SNAP-Ed in at least 10 locations. The evaluation team interviewed case study grocers to gain final reflections. Grocers reported achieving several desired impacts of the project, which provides evidence of the AFRI project meeting short-term (increased awareness, understanding) and medium-term (improved behaviors) outcomes. All stores shared that they are: stocking more healthy foods, providing customers with more information on healthy foods, and communicating or collaborating more with other entities/organizations (e.g., local producers) to provide healthy foods. Individual stores shared that they are: selling more healthy foods and noticing changes in customers' knowledge, skills, or attitudes for healthy shopping. Grocers reported realizing other benefits of the partnership with K-State as well. Both Kansas stores cited: receiving money for a community project, implementing NuVal in their store, and gaining exposure to a healthier way of eating. These benefits are consistent with their initial motivations for participating in the project. Grocers shared during the Year 2 interviews that their reasons for being involved in the project included: a desire to educate the community on healthy eating or generally promoting the health of the community, incorporation of the NuVal program, and monetary rewards for the community. Individual stores mentioned increased awareness in the community of the store's activities and of locally owned/rural products. Related to the community grants, both stores used a process that allowed community members to have a say in the type of community project pursued with the grant funds. Both stores mentioned community projects with a health-related focus. AFRI team members at U of M: Finished preparation of fact sheets to disseminate the findings of the Minnesota Rural Grocery Survey more broadly, including a Fresh Produce and Farm to Rural Grocery fact sheet Completed research case studies of farm-to-grocery relationships, including the one created between the Minnesota experimental store and new local producer partner Reported the new partnership between the rural grocery store and local producer in Minnesota resulted in the store selling new local products in June 2016 (increasing the store's inventory of local, fresh products) Created a Fresh Produce Toolkit, which includes eight documents/resources on how to incorporate locally grown, fresh produce into rural grocery stores, including purchasing local produce and templates for creating a local food policy/local food application process, and mailed it to 250 rural grocers in Minnesota Began working to develop a Farm-to-Rural-Grocery Toolkit

Publications

Progress 04/01/15 to 03/31/16

Outputs
Target Audience:There are two primary audiences for this project: (1) citizens living in the rural communities of Conway Springs, Kansas; Onaga, Kansas; and Randall, Minnesota and (2) the rural grocery store owners in these three small towns. There is also a secondary audience and they are individuals, citizen leaders, and healthy food stakeholders who are interested in increasing access to healfhful foods in rural communities. Changes/Problems:Key to identifying results of this study was a pre and post analysis of rural grocery buying patterns. We sought to study any changes in buying patterns in two ways: (1) by conducting a monthly food inventory analysis of the three rural grocery stores during the duration of the study and (2) by examining the food purchasing patterns of the rural grocery customers during the duration of the study. To capture the inventory data for the grocery stores we have worked with the food distributor - Affiliated Foods Midwest - and they have provided all the inventory data. To identify changes in food purchasing patterns for rural grocery customers, we instituted a loyalty card (Loyalty Lane) and charted customer purchases. Additionally, to identify the nutritional value of these purchases, we have worked with NuVal LLC and their nutritional scoring system. We have run into a major challenge working with NuVal. Both the University of Minnesota and Kansas State University require private companies to sign a no-liability contract. NuVal has refused to sign this document and wants to reserve the right to sue each university if deemed necessary. Both universities are refusing to collaborate any further with NuVal. I am nearly certain that we will not receive the NuVal scores. Dr. Hikaru Peterson - U. of MN - is examining alternatives to the NuVal scoring system. What opportunities for training and professional development has the project provided?Throughout March 2016, U. of MN Extension held a number of in-store demonstatons / trainings on fresh produce handling, marketing, and storage for locally grown and standard fresh produce. How have the results been disseminated to communities of interest?Four presentations based on this research project were delivered at the 5th National Rural Grocery Summit. Wichita, KS. June 2016 Procter delivered four briefing on the work: (1) a briefing before the U.S. House of Representatives Hunger Caucus, May 2015; (2) a briefing at The Food Trust convening on Healthy Food Distribution, October, 2015; (3) a briefing before the North Dakota rural grocery association, January, 2016; and (4) a briefing to the Alabama Extension Family and Consumer Sciences' agents, January, 2016). What do you plan to do during the next reporting period to accomplish the goals?Our research goal for the next reporting period is to have all the data collected (through NEMS, intercept surveys, grocery inventory data, and individual customer sales data) and analyzed. Additionally, our goal is to have manuscripts written and ready for submission. Our Extension goal is to incorporate the in-store education modules into FCS trainings and additionally, incorporate the in-store education modules into SNAP-Ed education. These trainings are already schedule for October, 2016.

Impacts
What was accomplished under these goals? Our research team has collected most of the data available for this study. We have the of the pre and post intervention NEMS. We have grocery inventory data for all three case study grocery stores spanning the research time period. We have the data from the rural grocery store customer intercept surveys. We are trying secure individual customer sales data from a loyalty program that was specifically installed in the three case study stores for this research (more on this under challenges). We had also hoped to receive nutritional scoring data from NuVal, but that appears not to be able to happen (more on this under challenges). The data we do have is currently being analyzed by Dr. Hikaru Peterson and her team at the University of Minnesota. Major Goal #6: We have created an Extension teaching module for in-store nutriton education. Major Goal #7: The Extension teaching module is being incorporated into the SNAP-Ed teaching in Kansas Major Goal #8: The in-store nutrition education modules were shared at the 2016 5th National Rural Grocery Summit in Wichita, KS on June 6, 2016. Major Goal #9: During May, 2015, University of Minnesota Extension developed education material and signage for promoting locally grown foods (Minnesota Grown). They provided a list of local growers within 50 miles of our case study store in Minnesota. Throughout March 2016, U. of MN Extension held a number of in-store demonstatons on fresh produce handling, marketing, and storage for locally grown and standard fresh produce.

Publications

Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Peterson, H. (2016). A case study of strategies to increase grocery sales. Presentation to 5th National Rural Grocery Summit. Wichita, KS.
Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Procter, D.E. (2016). Making a difference through the rural grocery initiative. Presentation to the 5th National Rural Grocery Summit. Wichita, KS.
Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Procter, S.B. & Tynon, E. (2016). What works and doesnt work with in-store nutrition education: Results from a national AFRI grant project. Presentation to the 5th National Rural Grocery Summit. Wichita, KS
Type: Journal Articles Status: Under Review Year Published: 2016 Citation: Peterson, H. and Procter, D.E. (2016). A case study of independent grocers in rural Midwest. Submitted to Renewable Agriculture and Food Systems.
Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Lanthier, K. (2016). Nutrition education and outreach in Minnesota: Successes and challenges experienced during AFRI grant project. Presentation to the 5th National Rural Grocery Summit. Wichita, KS
Type: Book Chapters Status: Published Year Published: 2015 Citation: Procter, D.E. (2015). Strengthening rural communities and food access through higher education regional development. In The Role of Higher Education in Regional and Community Development and in the Time of Economic Crisis. Ed. Caroline Carlot, Jean-Marie Filloque, Michael Osborne and Peter Welsh. Leicester: National Institute of Adult Continuing Education. pp. 75-94.

Progress 04/01/14 to 03/31/15

Outputs
Target Audience:There are two primary audiences for this project: (1) citizens living in the rural communities of Conway Springs, Kansas; Onaga, Kansas; and Randall, Minnesota and (2) the rural grocery store owners in these three small towns. There is also a secondary audience and that group are individual and citizen leaders who are interested in establishing grocery stores in rural communities. Efforts Rural Grocery Summit One project activity included in Year 1 is the 4th National Rural Grocery Summit held June 9-10, 2014 in Manhattan, Kansas. The national summit began in 2008 and is offered every two years. Project summit outcomes include: Based on evidence-based research, spotlight the latest and best thinking about rural grocery stores and rural community development and sustainability; demonstrate through research, the nutritional, economic development, and community benefits rural grocery stores provide; highlight case studies of rural grocery store success stories; provide network opportunities to talk directly with funders, grocery distributors, and grocery owners; and identify evidence-based strategies to establish and sustain local grocery stores. There were 180 attendees representing 50 different communities in Kansas and 15 different states and the District of Columbia. The most highly rated sessions at the summit were: Marketing Your Store via Social Media Rural Grocery Toolkit for Grocery Owners Improving Your Bottom Line: Customer Service Using Policy to Improve Rural Food Access Several summit sessions incorporated information/resources about promoting healthy food choice. Attendee's reaction to healthy food access information at the summit revealed that: the information/resources about promoting healthy food choices was useful to them they came to understand how the information/resources can be used to promote healthy food choices to consumers they planned to utilize the information/resources by: developing partnerships/collaborations discussing the information at their work/job presenting the information at farmer's markets Nutrition Education Efforts: Beginning in August 2014, Nutrition Education Team (Cooperative Research and Extension staff from Kansas and Minnesota) has engaged in monthly conference calls to collaborate on the nutrition education component of the grant. These conference calls include Extension Specialists from the University of Minnesota and Kansas State University as well as Extension educators from Sumner County and Pottawatomie County in Kansas and Morrison County in Minnesota. Nutrition education modules were developed and assembled with input and feedback from all members of the nutrition education team. As part of the nutrition education, a $10 "store challenge" incentive was added to promote learning in the store. The nutrition education program in Conway Springs, Kansas (Sumner County) commenced at the end of February 2015 and will continue through the end of May 2015. Nutrition education programs were launched in Onaga, Kansas and Randall, Minnesota beginning June 1st, 2015. In an effort to gauge the nutritional environment prior to the launch of the nutrition education program and the nutritional scoring system, the nutrition education team collaborated to complete the Nutritional Environmental Measures Survey (NEMS) in January 2015. Briana Rockler, Alexsis Stensland and Laura Perdue completed the NEMS training course and all in-store assessments were completed in January 2015. Products Developed: Nutrition education modules for implementation in Conway Springs KS, Onaga KS, and Randall MN. NuVal Scoring System Food labels or signpost labels are discussed as means to help consumers to make informed food choices. It is theorized that more informed nutritional labeling will result in more positive attitudes toward healthful eating and possibly healthier food purchases. There is, however, only limited evidence regarding the impact of food labeling to differentiate between more or less healthy food and whether this labeling changes attitudes in perceived healthiness as well as the actual food purchases. A second intervention was the introduction of a nutritional quality index system into our three rural grocery case studies stores. The Nutritional Scoring System (NuVal) is a food scoring system that allows grocery shoppers to see - at a glance - the nutritional value of the food they are buying. NuVal Scores summarize comprehensive nutritional information into a number between 1 and 100. Each NuVal Score takes into account the nutrients and nutrition factors - the good (protein, calcium, vitamins) and the not-so-good (sugar, sodium, cholesterol) - and provides a nutritional score to help consumers make better decisions about the nutritional value of the food they are purchasing. The NuVal system scores food on a scale of 1 to 100. The higher the NuVal Score, the better the nutrition. The NuVal intervention was launched at the Randall, Minnesota and the Onaga, Kansas store in February, 2015. The scoring system was inserted into each of these stores and accompanied by educational materials provided by NuVal, LLC. The NuVal scoring system and educational materials are based on research conducted by their company. The NuVal system and educational materials was subsequently launched in the Conway Springs, Kansas store in June, 2015. Changes/Problems:There have been two significant challenges that we are working to address. Changes in personnel:Since the beginning of the project, we have had three personnel changes. Dr. Dan Kahl.Dr. Kahl was our primary liaison with K-State Research and Extension.He left in June 2014 to take a position at the University of Kentucky.We have hired a GRA to take on some his research and outreach commitment.In addition, Dr. Sandra Procter (Human Nutrition KSRE specialist) has taken on some of his liaison role. Kevin Chamberlin.Mr. Chamberlin was our NuVal representative.He was the individual who helped set up the NuVal scoring system in our three case study stores and also the individual who set up the NuVal webinar professional development for our project team.Mr. Chamberlin left NuVal unexpectedly in May 2015.We are unsure why or where he went.Another NuVal representative - Laura Sutherlund - has taken his place. Dr. Hikaru Peterson.Dr. Peterson is our primary researcher on this project.She has taken a position at the University of Minnesota.Dr. Peterson indicates to us that she wished to continue to work on this project.There may be some disruption as she transitions to Minnesota but she indicates she will continue to conduct research on this project. Varying levels of support from grocery stores The second challenge has been the various levels of support and commitment to the project from the case study grocery stores. There has been one store in particular where commitment to project has been less than we hoped. This store has lagged in terms of enrolling citizens in the grocery loyalty program (this is the method by which we track grocery purchases). The store employees have not seemed to embrace the study and consequently have not been enthusiastic about NuVal or nutrition education opportunities in their communication with grocery customers. Several members of the project team have encouraged the store owner and employees to promote the project in their communication with customers, but we have been disappointed by this store's response. What opportunities for training and professional development has the project provided?Professional Development Opportunities NEMS Training (January 2015) Two of our graduate students participated in NEMS training (Nutritional Environmental Measures Survey) in order to conduct in-store nutritional assessments. NuVal Training Webinar (February 2015) NuVal, LLC provided webinar training for all members of the project team to educate the team about the basics of NuVal How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Research Objectives: Estimate the distinct and combined impacts of Extension nutrition education and nutritional scoring system on attitudes toward healthy eating among rural residents. Estimate the distinct and combined impacts of Extension nutrition education and nutritional scoring system on perceptions about the nutritional quality of foods offered in the community grocery store among rural residents. Estimate the distinct and combined impacts of Extension nutrition education and nutritional scoring system on food purchases of healthful food items at the community grocery store. Estimate the distinct and combined impacts of Extension nutrition education and nutritional scoring system on inventory and food sales of healthful food items of the community grocery store. Estimate the distinct and combined impacts of Extension nutrition education and nutritional scoring system on the rural food environment around the community grocery store. We are in the data collection phase for all these research objectives and therefore, there are no results to report. Extension Objectives: Create an Extension teaching module on the use of innovative nutrition labeling to support healthful food selection at local grocery stores. In process Test and incorporate the newly developed Extension teaching module in existing Extension nutrition programming. The Nutrition Education team has developed, tested and taught nutrition education modules. During this reporting period, the team taught the nutrition education modules in Conway Springs, Kansas Share lessons learned and ?best practices with Extension Educators in Kansas and Minnesota in a workshop affiliated with the Rural Grocery Summit. The next Rural Grocery Summit will take place in June 2016. We will present the lessons learned at that summit. Expand Extension nutrition education, local/sustainable foods and economic development programming to include more extensive information on the benefits of local foods to retailers and consumers and how to incorporate healthy, locally grown foods into the rural grocery retail environment. The University of Minnesota Extension professionals have identified produce handling, storage, and display as barriers to higher quality, higher quantity and more accessible produce in rural areas. This team is developing Extension education materials to address these barriers. Based on research findings, disseminate successful ?best practices modules and tools to Extension users via eXtension, USDA's SNAP-Ed Connection, and the U of M Extension Community and Local Food Resources. These research finding will be disseminated upon the conclusion of the USDA AFRI integrated project. Submit research findings to appropriate research venues including The Journal of Nutrition Education and Behavior. This objective will be addressed upon the conclusion of the USDA AFRI integrated project.

Publications