Department of International Health
Joel Gittelsohn, PhD, is one of the country's leading researchers in the design and evaluation of food store-based interventions to increase access and point of purchase promotions for healthier eating. At any given time, a glimpse at Gittelsohn's research projects reflects what is going on in the world of inner-city nutrition-related behavior change interventions and food security.
He is the architect of the Baltimore Healthy Stores project, and similar projects in the Marshall Islands, on Apache and Navajo reservations, and with First Nations (an indigenous Canadian population), which work to provide culturally acceptable healthy options in small food stores, which typically have little selection.
"The Healthy Stores work was initiated based on funding from the Center for a Livable Future," Gittelsohn said. "The Center for a Livable Future has been incredibly supportive of the work with food stores and in efforts to change the food environment."
The Healthy Stores interventions include promotional materials, signage in the stores, taste tests and cooking demos to reinforce the messages designed using health communication and social marketing techniques.
"What might be seen as surprising is that you can get some significant impact consistently by a series of relatively brief interactions with consumers supported by or reinforced by media," Gittelsohn said. "A lot of times people think the only way you are going to get people to change their behavior is to sit them in a classroom or counsel them individually, and I'm sure that works and I know that works. But it's also important to know that you can really achieve some impact in terms of psychosocial change in terms of behavioral change and impact on sales in stores from repeated, albeit brief interactions in a supermarket, for example. Although I have not assessed this yet, it is potentially true that it could also impact health outcomes."
At the moment, much of Gittelsohn's research is going on in Baltimore City-with five overlapping projects aimed at improving the city's food environment. One of the projects is "Baltimore Healthy Eating Zones," an obesity prevention program aimed at African American youth and funded by the Robert Wood Johnson Foundation. Specifically, the project will modify the food environment around recreation centers in the city. Point of purchase promotions will be offered at food vendors near the recreation centers, and peer mentors will be trained in health education in conjunction with the program, which is expected to begin its intervention phase in early September 2009. Health promotion messages are also being crafted for delivery by the peer mentors.
"A lot of these kids get a substantial amount of calories from meals and snacks at corner stores, carry out restaurants and from the recreation center," he said. "I think this program can help change the environment from which youth select foods."
Another project on Gittelsohn's plate is called "Healthy Bodies, Healthy Souls," which seeks to improve eating habits and increase physical activity in 15 African American churches in Baltimore City, and reduce the risk for diabetes. Funded by the American Diabetes Association, the program aims to change the food environment both within and outside of local churches.
As if those projects weren't enough to keep Gittelsohn busy, he's also conducting formative research to determine the contribution of take-out restaurants and other prepared food sources in caloric intake.
Despite challenges in securing funding for all his potential research projects, maintaining staff, and engaging store owners, Gittelsohn said what keeps him motivated is the excitement and challenge offered by each stage of the research process.
"I like the formative collaborative participatory work in the beginning to engage communities and develop interventions," he said. "I also enjoy the implementation, writing grants and papers and being innovative and building off previous work, as well as coming up with new approaches and assessing the impact."
Buying into Nutritious Eating
Johns Hopkins Public Health Magazine, 2006