Personal food environments: Perceptions of retail affordability and accessibility among mothers in Saskatoon, Canada

The intersection of built food environments, foodwork and motherhood is an opportunity to examine healthy food access from the perspective of an important food-purchasing population. The personal food environment represents a geosocial constellation of places and spaces where people access, acquire, consume and dispose of food. In this study, a combination of objective and perceptual assessments was used to uncover experiences of affordability and accessibility within Saskatoon, Saskatchewan’s retail food environment. Using a phased, explanatory mixed methods design, 60 residential neighbourhoods were stratified by socioeconomic status (SES) and built food environment attributes. An in-store survey was used to measure the overall ‘healthiness’ of 24 supermarkets and 92 convenience stores (n=116 food stores), and data was further parsed out to assess the price and availability of 32 fruit and vegetable items in supermarkets. Spatial data was used to characterize food store density and distribution at the neighbourhood level. In the second, qualitative phase of the study, three nested interview approaches were used to uncover perceptions of affordability and accessibility, and to create narratives of personal food environments. Participants were recruited from families who had participated in the Smart Cities, Healthy Kids (SCHK) study led by the Saskatchewan Population Health and Evaluation Research Unit at the University of Saskatchewan. Using in-store survey and neighbourhood census findings from the quantitative phase, a qualitative sampling frame was developed to find maximum variation of built FE attributes. This frame guided participant sampling for the subsequent qualitative phase of sit-down interviews (n=27), photovoice interviews (n=7) and go-along interviews (n=3). The latter interview approach is an in-situ inquiry method that relied on experiential prompts to elicit an understanding of perceptions of affordability and accessibility among participants. \nIn the first phase, no discernable quantitative differences were found in the overall price or availability of healthy foods offered in supermarkets across Saskatoon. However, a slight difference in the price of fruits of vegetables between high and low SES neighbourhoods suggests that residents in the latter may be paying more. Low SES neighbourhoods had nearly twice the density of convenience stores than high or mid SES neighbourhoods, which is troubling when considered in tandem with the absence of supermarkets in those same neighbourhoods. Content analysis was used to organize the stores named by participants into main, preferred and avoided to uncover perceptions of positive and negative store attributes. Iterative Categorization was used to thematically analyze aspects of foodwork that influenced perceptions of the retail food environment. Interviews uncovered themes of convenience and comfort that underscore the relational nature of personal food environments. Participants sought convenience by evaluating distance in terms of drivability between spaces of prescription and spaces of negotiation, with the latter representing the dynamic demands of foodwork decision-making of where to shop and when. They sought comfort in food outlets with positive attributes that were based on their perceptions of affordability and accessibility. They developed strategies to alleviate stresses associated with foodwork, such as negotiating with picky eaters or sourcing quick, healthy meals to provide to their children in-between afterschool activities. Narratives of routines of practice, developed from go-along interview data, were supplemented with photovoice data to create detailed descriptions of three personal food environments. \nThe findings of this study reinforce the importance of integrating perceptions and experiences into research that informs policy development or implementation science aimed at improving nutrition-related outcomes.

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