Section B
Marshall Islands Healthy Stores
The Republic of the Marshall Islands
2
Majuro
3
Large Store in Majuro
4
Small Store in Majuro
5
Small Store Interior
6
Feeding of Children
7
Research in the Marshall Islands

Pilot work in households, 1996–1998

Observational study of intra-household food allocation, 1998–1999

Home visit intervention trial, 1999–2000

Food store intervention trial, 2001
8
Percent in BMI Category, Marshallese Adults

Percent in BMI category, Marshallese adults by sex (pilot)
Sex
Underweight
(BMI < 18.5)
Normal
(18.5 < BMI < 25)
Overweight
(25 < BMI < 30)
Obese
(BMI > 30)
Male
3.4
46.2
29.0
21.0
Female
4.1
35.4
29.2
31.3
9
Body Fat, by Age and Sex

Trends in percent body fat for Marshallese men and women
Female
Male
Source: Wellens, R. I., Roche, A. F., Khamis, H. J., et al. (1996). Relationships between the body mass index and body
composition. Obesity Res, 4, 1, 35–44.
10
Undernutrition in Marshallese Children (Pilot Study)
Age group, yrs.
Stunted
(HAZ < - SD)
Low weight for age
(WAZ < -2 SD)
Wasted
(WTHTZ < -2 SD)
1–4.9
(n = 138)
35.5
28.3
5.1
5–9.9
(n = 248)
36.3
17.3
0.8
10–18
(n = 324)
43.5
17.6
0.7
11
Marshall Islands Food Store Intervention

Urban atoll only

Three large stores

Nine small stores

Four-stage promotional period over three
months in 2001

Stocking healthy alternative foods

Mass media
-  Radio announcements, posters, newspaper ads

In-store promotions
-  Cooking demonstrations, taste tests, shelf labels, recipe cards
12
Food Store Intervention Evaluation

Stores
-  Sales of key foods, pre–post
-

Attitudes towards promoting healthy foods
Customers (n = 100 pre, 185 post)
-  Purchase of key foods
-  Label reading and diabetes knowledge
-  Cooking practices
-  Exposure to program
13
Number of Different Exposures to In-Store Source (%)
Format
1
or
more
2
or
more
3
or
more
4
or
more
5
or
more
6
or
more
7
or
more
8
or
more
Shelf labels
42
XX
XX
XX
XX
XX
XX
XX
Cooking demos
61
55
47
34
24
18
16
6
Recipe cards
59
56
52
48
35
26
22
20
Posters (saw)
79
74
XX
XX
XX
XX
XX
XX
Posters (read)
67
63
XX
XX
XX
XX
XX
XX
n = 185
14
Label Reading Intervention and Diabetes Knowledge

Effect of exposure to the intervention on label reading and diabetes
knowledge*
Cognitive
variable
In-store
exposure OR
95% CI
Mass media
exposure OR
95% CI
Diabetesrelated
knowledge
1.076
1.027–1.128
1.077
1.006–1.153
Label-reading
knowledge
1.113
1.059–1.169
1.147
1.066–1.234
*Adjusted for age, sex, and education level
15
Exposure to Intervention on Healthy Purchases

Effect of exposure to the intervention on purchasing of healthy
foods1,2
16
Exposure to Intervention on Healthy Purchases

Effect of exposure to the intervention on purchasing of healthy
foods1,2
17