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BACKGROUND: In 2013, the Colorado Department of Public Health and Environment (CDPHE) was awarded enhanced funding for “State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health” (RFA-1305). Some required strategies (e.g., increasing healthier food retail access) represented new areas of work for CDPHE with limited data to inform program planning.
METHODS: A mixed-mode, population-based survey (telephone, email, or postal mail) was conducted in 2013-2014 to collect data on factors that affect healthy living among Colorado adults. The study sample was drawn from the Colorado Adult Population Sample Survey Research Registry. Using SAS 9.3, prevalence and disparities relating to healthy food access and food purchasing behaviors in communities and workplaces were analyzed, and regression models were created to determine associated factors. Results were disseminated to program staff at a “data-to-action workshop”.
RESULTS: Of 3,974 survey respondents, 44% reported that they shop for fruits or vegetables once a week. Nearly all respondents (99%) reported shopping for fruits and vegetables at a grocery store or supermarket, and 96% usually drove to the grocery store. Among those who reported that it was not easy to get to a grocery store (6%), the barriers included distance being too far (77%), transportation issues (56%), physical limitations (47%), and being too busy (41%). About 9% of respondents reported buying fruits or vegetables at a convenience store at least twice a month, while 36% reported that they would likely buy fresh fruits and vegetables at their nearest convenience store if sold there. Most respondents said they wished fruits and vegetables were more available (72%), of better quality (66%), or of larger variety (72%) in their neighborhood, and 39% said cost keeps them from buying fruits and vegetables. Among employed respondents whose workplace had a cafeteria, 21% reported buying sweetened beverages, 12% reported buying chips or sweets, and 41% reported buying fruits or vegetables at least twice a month from the cafeteria; most said they would likely buy fresh fruit (79%), fresh vegetables (75%), or salad (80%) if sold at the cafeteria. Regression analyses determined factors associated with food purchasing.
CONCLUSIONS: Individual and environmental influences on healthy eating were determined. Most adult Coloradans desired increased access to fruits and vegetables. Stakeholders attended a “data-to-action workshop” to review results and determine potential target populations for strategies to improve healthy food access and purchasing in communities and workplaces.