***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Lowering the price of fruit and vegetables is a promising strategy in stimulating the purchase of those foods . However , the true effects of this strategy are not well studied and it is unclear how the money saved is spent . The aim of this study is to examine the effects of a 25 % discount on fruits and vegetables on food purchases in a supermarket environment . Methods A r and omized controlled trial with two research conditions was conducted : a control condition with regular prices  ( n = 52 ) and an experimental condition with a 25 % discount on fruits and vegetables  ( n = 63 ) . The experiment was carried out using a three-dimensional web-based supermarket , which is a software application in the image of a real supermarket . Data were collected in 2010 in the Netherl and s. Participants received a fixed budget and were asked to buy weekly household groceries at the web-based supermarket . Differences in fruit and vegetable purchases , differences in expenditures in other food categories and differences in total calories were analyzed using independent sample s t-tests and multiple linear regression models accounting for potential effect modifiers and confounders . Results The purchased amount of fruit plus vegetables was significantly higher in the experimental condition compared to the control condition ( Δ984 g per household per week , p = .03 ) after appropriate adjustments . This corresponds to a 25 % difference compared to the control group . Both groups had similar expenditures in unhealthier food categories , including desserts , soda , crisps , c and y and chocolate . Furthermore , both groups purchased an equal number of food items and an equal amount of calories , indicating that participants in the discount condition did not spend the money they saved from the discounts on other foods than fruits and vegetables . Conclusion A 25 % discount on fruits and vegetables was effective in stimulating purchases of those products and did neither lead to higher expenditures in unhealthier food categories nor to higher total calories purchased . Future studies in real supermarkets need to confirm these findings OBJECTIVE This study tested the efficacy of a multicomponent supermarket point-of-purchase intervention featuring in-person nutrition education on the nutrient composition of food purchases . DESIGN The design was a r and omized trial comparing the intervention with usual care ( no treatment ) . SETTING AND PARTICIPANTS A supermarket in a socioeconomically diverse region of Phoenix , AZ . One hundred fifty-three adult shoppers were recruited onsite . INTERVENTION The intervention consisted of brief shopping education by a nutrition educator and an explanation and promotion of a supermarket point-of-purchase healthful shopping program that included posted shelf signs identifying healthful foods , sample shopping lists , tips , and signage . MAIN OUTCOME MEASURES Outcomes included purchases of total , saturated , and trans fat ( grams/1,000 kcal ) , and fruits , vegetables , and dark-green/yellow vegetables ( servings/1,000 kcal ) derived through nutritional analysis of participant shopping baskets . ANALYSIS Analysis of covariance compared the intervention and control groups on food purchasing patterns while adjusting for household income . RESULTS The intervention result ed in greater purchasing of fruit and dark-green/yellow vegetables . No other group differences were observed . CONCLUSIONS AND IMPLICATION S Long-term evaluations of supermarket interventions should be conducted to improve the evidence base and to determine the potential for influence on food choices associated with decreased chronic disease incidence Purpose . Nutrition education and labeling may help consumers to eat less fat . The purpose of this study is to assess the effect of nutrition education with and without shelf labeling on reduced fat intake in Dutch supermarkets . Methods . The design consisted of a r and omized , pretest-posttest , experimental control group design . In total , 2203 clients of 13 supermarkets were included in the sample .  Total fat intake of clients and behavioral determinants of eating less fat were measured by a question naire . A mixed-effect regression model was used for the analysis . Results . No significant effects were found for the educational intervention , alone or with the labeling , on total fat intake and the psychosocial determinants of eating less fat . Conclusion . Nutrition education and labeling of low-fat food products in supermarkets did not prove to be effective strategies . The fact that the supermarket is a highly competitive environment may have accounted for this lack of effect BACKGROUND Price can influence food purchases , which can influence consumption . Limited laboratory research has assessed the effect of price changes on food purchases , and no research on individual differences that may interact with price to influence purchases exists . OBJECTIVE We aim ed to assess the influence of price changes of low-energy-density ( LED ) and high-energy-density ( HED ) foods on mother 's food purchases in a laboratory food-purchasing analogue . DESIGN Mothers were r and omly assigned to price conditions in which the price of either LED or HED foods was manipulated from 75 % to 125 % of the reference purchase price , whereas the price of the alternative foods was kept at the reference value .  Mothers completed purchases for 2 income levels ( $ 15 or $ 30 per family member ) . RESULTS Purchases were reduced when prices of LED ( P < 0.01 ) and HED ( P < 0.001 ) foods were increased .  Maternal BMI  interacted with price to influence purchases of HED foods when the price of  HED  foods increased ( P = 0.016 ) and interacted with price to influence purchases of LED foods when the price of HED foods increased ( P = 0.008 ) . CONCLUSION These results show the relevance of considering price change as a way to influence food purchases of LED compared with HED foods and the possibility that individual differences may influence the own-price elasticity of HED foods and substitution of LED for HED foods UNLABELLED RATIONALE , AIMS & OBJECTIVE : Tools for the assessment of the quality of research studies tend to be specific to a particular research design ( e.g. r and omized controlled trials , or qualitative interviews ) . This makes it difficult to assess the quality of a body of research that addresses the same or a similar research question but using different approaches . The aim of this paper is to describe the development and preliminary evaluation of a  quality assessment tool that can be applied to a method ologically diverse set of research articles . METHODS The  16-item quality assessment tool ( QATSDD )  was assessed to determine its reliability and validity when used by health services research ers in the disciplines of psychology , sociology and nursing . Qualitative feedback was also gathered from mixed- methods health research ers regarding the comprehension , content , perceived value and usability of the tool . RESULTS Reference to existing widely used quality assessment tools and experts in systematic review confirmed that the components of the tool represented the construct of ' good research technique ' being assessed . Face validity was subsequently established through feedback from a sample of nine health research ers .  Inter-rater reliability was established through substantial agreement between three review ers when applying the tool to a set of three research papers ( κ = 71.5 % ) , and good to substantial agreement between their scores at time 1 and after a 6-week interval at time 2 confirmed test-retest reliability . CONCLUSIONS The QATSDD shows good reliability and validity for use in the quality assessment of a diversity of studies , and may be an extremely useful tool for review ers to st and ardize and increase the rigour of their assessment s in review s of the published papers which include qualitative and quantitative work Background Research suggests that the food environment influences individual eating practice s. To date , little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities . We tested “ Waupaca Eating Smart ” ( WES ) , a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community . WES focused on labeling , promoting , and increasing the availability of healthy foods . Methods We conducted a r and omized community trial , with two Midwestern U.S. communities r and omly assigned to serve as intervention or control site . We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods . The RE- AIM framework was used to guide the evaluation and organize the results . Results Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention . On a 0 - 4 scale , the average level of satisfaction with WES was 3.14 ( SD=0.69 ) for restaurant managers and 3 ( SD=0.0 ) for store managers . On average , 6.3 ( SD=1.1 ) out of 10 possible intervention activities were implemented in restaurants and 9.0 ( SD=0.0 ) out of 12 possible activities were implemented in food stores . One month after the end of the pilot implementation period , 5.4 ( SD=1.6 ) and 7.5 ( SD=0.7 ) activities were still in place at restaurants and food stores , respectively . The intervention reached 60 % of customers in participating food outlets . Restaurant food environment scores improved from 13.4 to 24.1 ( p < 0.01 ) in the intervention community and did not change significantly in the control community . Food environment scores decreased slightly in both communities . No or minimal changes in customer behaviors were observed after a 10-month implementation period . Conclusion The intervention achieved high levels of reach , adoption , implementation , and maintenance , suggesting the feasibility and acceptability of restaurant- and food store-based interventions in rural communities . Pilot outcome data indicated very modest levels of effectiveness , but additional research adequately powered to test the impact of this intervention on food environment scores and customer behaviors needs to be conducted in order to identify its potential to promote healthy eating in rural community setting OBJECTIVE To examine the effectiveness of two methods of increasing fruit and fruit juice intake in pregnancy :  midwives ' advice and vouchers exchangeable for juice . DESIGN Pregnant women were r and omly allocated to three groups : a control group , who received usual care ; an advice group , given advice and leaflets promoting fruit and fruit juice consumption ; and a voucher group , given vouchers exchangeable for fruit juice from a milk delivery firm . Dietary question naires were administered at ~16 , 20 and 32 weeks of pregnancy . Serum beta-carotene was measured at 16 and 32 weeks . SETTING An antenatal clinic in a deprived area . SUBJECTS Pregnant women aged 17 years and over . RESULTS The study comprised 190 women .  Frequency of fruit consumption declined during pregnancy in all groups , but that of fruit juice increased substantially in the voucher group . Serum beta-carotene concentration increased in the voucher group , from 106.2 to 141.8 micromol l(-1 ) in women with measurements on both occasions ( P = 0.003 ) , decreased from 120.0 to 99.8 micromol l(-1 ) in the control group ( P = 0.005 ) , and was unchanged in the advice group . CONCLUSIONS Pregnant women drink more fruit juice if they receive vouchers exchangeable for juice supplied by the milk delivery service . Midwives ' advice to eat more fruit has no great effect . Providing vouchers for fruit juice is a simple method of increasing its intake in a deprived population and may be useful for other sections of the community BACKGROUND Healthy Foods North ( HFN ) is a community-based intervention design ed to promote a healthy diet and lifestyle of Inuit and Inuvialuit population s in A rct ic Canada . The objective of the present study was to determine the effects of HFN on the nutrient intake of women of childbearing age . METHODS Six communities in Nunavut ( n = 3 ) and the Northwest Territories ( n = 3 ) were selected for programme implementation ; four received a 12-month intervention and two served as controls . Quantitative food frequency question naires were used to assess dietary intake at baseline and 1 year post-intervention . Among women participants aged 19 - 44 years ( n = 136 ) , 79 were exposed to the intervention and 57 were not .  Mean daily energy and nutrient intake and density were determined . Dietary adequacy was assessed by comparing the women 's daily nutrient intakes with dietary reference intakes ( DRI ) . RESULTS Main outcomes were the pre- to post-intervention changes between intervention and control groups for energy and selected nutrient intakes , nutrient density and dietary adequacy . Among the participants , the intervention had a beneficial effect on vitamin A and D intake . The percentage of individuals with nutrient intakes below the DRI increased from pre- to post-intervention for vitamin A and D in the control group but only for vitamin A in the intervention group . The programme did not have a significant impact on calorie , sugar , or fat consumption . CONCLUSIONS The HFN programme is effective in mitigating some of the negative impacts of the nutrition transition on dietary adequacy among Inuit and Inuvialuit women of childbearing age Objectives : To assess the effect on fruit and vegetable consumption , self reported , and psychological health of a “ natural experiment”—the introduction of large scale food retailing in a deprived Scottish community . Design : Prospect i ve quasi-experimental design comparing baseline and follow up data in an “ intervention ” community with a matched “ comparison ” community in Glasgow , UK . Participants : 412 men and women aged 16 or over for whom follow up data on fruit and vegetable consumption and GHQ-12 were available . Main outcome measures : Fruit and vegetable consumption in portions per day , poor self reported health , and poor psychological health ( GHQ-12 ) . Main results : Adjusting for age , sex , educational attainment , and employment status there was no population impact on daily fruit and vegetable consumption , self reported , and psychological health . There was some evidence for a net reduction in the prevalence of poor psychological health for residents who directly engaged with the intervention . Conclusions : Government policy has advocated using large scale food retailing as a social intervention to improve diet and health in poor communities . In contrast with a previous uncontrolled study this study did not find evidence for a net intervention effect on fruit and veget 
    Output:
    
Most interventions used a combination of information ( e.g. awareness raising through food labeling , promotions , campaigns , etc . )
Apart from few studies , most studies reported that store interventions were effective in promoting purchase of healthy foods .
Conclusion Given the diverse study setting s and despite the challenges of method ological quality for some papers , we find efficacy of in-store  healthy food interventions in terms of increased purchase of healthy foods .
Interventions which combine price , information and easy access to and availability of healthy foods with interactive and engaging nutrition information , if carefully design ed can help customers of food stores to buy and consume more healthy foods