Cross-sectional analysis of a community-based cooperative grocery store intervention in Saskatoon, Canada.

Lotoski, Larisa C. ; Engler-Stringer, Rachel ; Muhajarine, Nazeem 等

Those living in disadvantaged neighbourhoods experience disparity in their nutrition environment, (1) often having access to fewer supermarkets, (2) which offer the most affordable (3) and widest range of healthy foods. (4) Between 1984 and 2004, the west side inner-city low-income or 'core' neighbourhoods of Saskatoon, Canada saw a major decline in the number of local grocery stores (from 12 to 5). By 2004, Saskatoon's lowest-income neighbourhoods contained no major chain grocery stores, (5) forcing residents without car access to spend anywhere from 45-60 mins to reach a grocery store. (6) Saskatoon's core has high concentrations of fast-food outlets and convenience stores, (5,7) which often offer less healthful foods at relatively higher prices. (8) In the recent past, Saskatoon's core neighbourhoods have experienced a combination of stores favouring the availability of low-nutrient but energy-dense foods and thus creating conditions that could threaten people's health. (2)

The core neighbourhoods of Saskatoon are defined by a high level of deprivation, are a place of residence for multiple marginalized populations, and prior to the fall of 2012, were characterized by a food desert. (2) In September 2012, a full-service not-for-profit cooperative grocery store, the Good Food Junction (GFJ), was opened in an effort to improve healthy food access in the area. The GFJ is a large-scale (4900 sq ft) full-service grocery store offering a full range of fresh, frozen and packaged foods. The GFJ is located in Station 20 West, which also houses a community kitchen space, offices for community-based research, organizations and meetings, and health programming, and is located within walking distance of four low-income neighbourhoods. The GFJ functions using a community-led cooperative not-for-profit business model and provides competitive pricing. Lifetime memberships, costing $5 CDN, provide members with partial ownership of GFJ and are available to all customers, however they are not a requirement to make purchases from the GFJ. The location, size, and business goals and model are a direct result of approximately seven years of community consultation, in-depth qualitative and quantitative research and market analysis carried out in the surrounding communities. (7)

Few studies exist examining the impact of nutrition environment interventions on deprived populations. (9) An educational and environmental nutrition intervention promoting healthful diets demonstrated a significant increase in healthy food acquisition. (9) A new chain grocery store in Flint, MI became the primary grocer of those who were most food insecure, (10) but the opening of a large-scale supermarket in Philadelphia, PA resulted in no significant improvement in BMI, fruit and vegetable (FV) intake or perceived access to food, even though over half of the study's respondents adopted the grocery store for at least some of their shopping. (11)

To date, there are only limited published reports examining the impact of a full-service grocery store food intervention aimed at addressing nutritional health inequalities in a community-based not-for-profit setting. (10,11) The aim of this research, therefore, is to examine the awareness and use of GFJ about one year after its opening. Specifically, we hypothesized that residents of core neighbourhoods surrounding GFJ would demonstrate awareness of, and further, would report ever use and primary use of GFJ.

METHODS

Recruitment

A total of 1,459 households were identified from City of Saskatoon sources as being within a 750 m road network buffer of the GFJ grocery store. Non-residential, inaccessible, unsafe, vacant and non-existent household properties (n = 271) and individuals who participated in a previous study (n = 47) were excluded from further recruitment. The remaining 1,141 households were approached between July and November 2013 using door-to-door sampling. Sampling occurred on both weekdays and weekends during daytime and evening hours. If participants were not immediately available to participate in the study, alternative appointments were made to allow for their inclusion. Non-responding households were informed of the study using printed door hangers and were approached by surveyors a maximum of 3 times, with each visit being at an alternative time and day. One hundred and eighty residents refused to participate and 596 households were approached 3 times with no response. The final sample included all consenting participants (n = 365) who were the household primary food shoppers (representing 32% of 'eligible' households).

Data collection

Quantitative surveys were administered in English by trained interviewers in participants' homes. Participants were asked if they were aware of the GFJ (nominal dependent variable, NDV), if they had ever shopped at GFJ (NDV) or use it as their primary grocery store (NDV), and if not, what their primary grocery store was (name and location; NDV). Mode of transportation to and from the GFJ and/or the household's primary grocery store were further questioned (your car, got a ride, bus, bike, walk, cab, other; nominal independent variable, NIV). Demographic information collected included age (categorical independent variable, CIV), sex (NIV), immigrant status (newcomer to Canada, less than 5 years in Canada; NIV), Aboriginal status (Status and non-Status First Nations, Metis or Inuit; NIV), marital status (Partnered: married or living common law, or Non-partnered: divorced, separated, widowed, single--never married; NIV), highest educational attainment (NIV), income (CIV) and occupation (NIV).

CHEP Good Food Inc. (CHEP) (formerly Child Hunger Education Program) is a Saskatoon-based non-profit organization aimed at improving access to healthy food. CHEP programs, which are available within the four neighbourhoods surveyed, include the CHEP Good Food Box (an alternative food distribution service), CHEP Community Markets (wholesale-priced community-based fresh FV markets), Collective Kitchens (small-group bulk meal preparation), Seniors' Markets (fresh FV markets held in seniors' complexes), and community gardens. Participants were asked whether they participated in these and other food-based programs and initiatives (yes or no for each nominal independent variable). Ethics approval for this study was obtained from the University of Saskatchewan's Research Ethics Board.

Data analysis

The study population was characterized and stratified by those who had ever shopped at GFJ. The 2006 Census of Population (12) and 2011 National Household Survey (13) were used for comparison between the survey, representative neighbourhoods and the remainder of the city of Saskatoon populations. Pearson's chi-square test was used to examine whether those who had ever shopped at GFJ were significantly different from never-shoppers when stratified by the independent variables described below.

Independent variables were individually examined in models predicting ever use and primary use of the GFJ with univariate logistic regression. Based on the logistic regression model-building strategies from Hosmer and Lemeshow, independent variables found to have a p < 0.20 were tested in a multivariate logistic regression model. (14) In the multivariate model-building strategy, variables were excluded if they did not significantly contribute to the prediction of ever use or primary use of the GFJ (p < 0.05). Following establishment of the models' main effects, independent variables were tested for collinearity, interactions and confounding (>10% change in the main effect's OR).

All data analyses were performed using SPSS (version 22, IBM, Armonk, NY). A statistical significance of 5% (p < 0.05) was used for all analyses.

RESULTS

Within the geographic boundary surveyed, 32% of households participated in the study (365 of 1,141). Among the 365 respondents, 20 were not aware of GFJ's existence (5%). Of the 345 individuals who were aware of GFJ, 251 had shopped there at least once (69%). The majority of household primary shopper respondents were female (65%). The survey group was older (median age of 45 years) than the populations in the representative neighbourhoods (King George, Pleasant Hill, Riversdale and Westmount) and the remainder of Saskatoon, and had a higher proportion of senior citizens. Both the representative neighbourhoods and the survey population had a higher proportion of Aboriginal people (Status and non-Status First Nations or Metis) and households with an annual income of less than $30,000, in comparison to the remainder of the city of Saskatoon (Table 1).

Of those who had ever shopped at GFJ, a significant proportion identified as Aboriginal and not being new immigrants. Members of the general population (non-Aboriginal, non-senior citizens and individuals who have lived in Canada at least 5 years) were significantly less likely to have ever shopped at GFJ. Of those who identified as Aboriginal, 82% shopped at GFJ at least once (vs. 66% of non-Aboriginals, Pearson's chi-square p = 0.001). Annual household income was significantly different between GFJ shoppers and non-shoppers, with the majority of households using GFJ having an income of less than $20,000 per year (Table 2).

A significant proportion of GFJ users also used at least one food-based program. Of those surveyed, users of the CHEP Community Markets (50 of 56), CHEP Good Food Box (26 of 29), Seniors' Markets (4 of 4), and Collective Kitchens (17 of 17) were significantly more likely to have shopped at GFJ compared to those who did not use these programs. Aboriginal respondents were significantly more likely to utilize other food services, such as charitable food programs (e.g., food banks and soup kitchens), CHEP Community Markets and Seniors' Markets in comparison to non-Aboriginals (data not shown). Users of charitable food programs or the Saskatoon Farmers' Market or those who obtained food directly from producers, hunters or gatherers were not significantly more likely to have shopped at GFJ (Table 2).

To better understand respondents' use of the GFJ, binary univariate and multivariate logistic regression was performed on all variables in the creation of a model predicting ever use of the GFJ. In the final multivariate logistic regression model, Aboriginals and users of the CHEP Community Markets were significantly more likely to have used GFJ in comparison to non-Aboriginals and non-market users (OR = 2.0, p = 0.03 and OR = 2.7, p = 0.04 respectively). New immigrants to Canada were significantly less likely to have ever used the GFJ (OR = 0.3, p = 0.05). Annual household income per person and highest level of educational attainment were confounders of CHEP Community Market use and new immigrants to Canada respectively in the multivariate logistic regression model (Table 3).

To better understand respondents' primary use of the GFJ, binary univariate and multivariate logistic regression was performed on all variables in the creation of a model predicting primary use of the GFJ. From the surrounding community sampled, 30 households (or 8.2% of those surveyed) chose GFJ as their primary grocery store. In the final multivariate logistic regression model, Aboriginal people were significantly more likely to choose GFJ as their primary grocery store (OR = 2.6, p = 0.04). Use of charitable food services, use of CHEP Community Markets, marital status and active transport to or from GFJ were confounders of Aboriginal status in the final multivariate logistic regression model (Table 4).

To better understand mode of transportation both to and from GFJ and other primary grocery stores of choice, prevalence of active, inactive, private and public forms of transportation were quantified. Travel to and from the GFJ was by foot in 75% and 73% of shoppers respectively. Of those who chose GFJ as their primary grocery store, 80% walked to and from the store (Table 5). Of those who chose other grocers as their primary store, over half relied on the use of personal vehicles and 11% used taxicabs, both costly modes of transportation.

CONCLUSION

In this paper, we have characterized differences in the awareness and use of a cooperative not-for-profit grocery store, established in a previous food desert, about one year after its opening. Awareness of and the early uptake of a not-for-profit grocery store (a population-level health intervention) are key prerequisites for establishing this ambitious intervention and eventually meeting its health goals. Local residents surveyed were highly aware of the presence of the GFJ, with the majority having shopped there at least once. Substantially fewer residents chose GFJ as their primary grocery store. Users of GFJ had a significantly lower annual household income and were more likely to use local community-based food programs and services in comparison to non-users.

The level of GFJ awareness among those surveyed was unexpectedly high, with only 5% being unaware of its presence one year after establishment. In comparison to a healthy corner store intervention, where awareness after 6 months of establishment was only 30.6%,15 the majority of local residents were both aware of and users of the GFJ.

In both our models predicting any use and primary use of the GFJ, Aboriginal people were significantly more likely to use GFJ. A 2011 Statistics Canada report indicated that 29% of urban-dwelling Aboriginal people experienced household food insecurity, and this subset population had poorer levels of health. (16) The GFJ offers a variety of food options which comprise some of the foods included in a traditional Aboriginal diet in the Prairies (e.g., wild rice, neck bones, and Northern whitefish).

Marginalized populations, including Aboriginal people, are often targets of health-promoting programs and services, but it is these populations that are often the hardest to reach. The GFJ intervention provides a counter-example of this commonly held pattern. Our results also provide unanticipated insight into the use of community-based food initiatives among Aboriginal people. The marked differences in use of other community-based food programs located within the surveyed neighbourhoods and the GFJ in Aboriginal people may indicate greater awareness of community-based initiatives among core neighbourhood Aboriginal residents.

In a similar grocery store intervention based in Philadelphia, PA, 26.7% and 51.4% of respondents respectively adopted the supermarket as their primary grocery store or used it for any shopping. (11) While a greater proportion of our study population used GFJ for any shopping, substantially fewer used it as their primary store, an adoption rate similar to one found in a Flint, MI grocery store intervention study (10%). (10)

Food environment, most commonly described through supply-based access, describes location and accessibility of food outlets, food price, promotion and placement of food, the food settings in workplaces and schools, and marketing and media promoting food choices. (17) What is rarely explored are the complex food practices low-income people develop to meet their nutritional needs. Here we briefly explored the notion of accessing food through alternative sources and found only selective sources to be associated with GFJ use. Users of at least one food-based program were significantly more likely to have shopped at GFJ. This confirms that residents surveyed seek out alternative sources of food to supplement their diet. An in-depth understanding of how individuals utilize these food sources has not been developed and requires further investigation.

The furthest distance of households surveyed from GFJ roughly equates to a 10-min walking distance, and the majority of users chose an active form of transportation to and/or from the GFJ. Transportation is the most common barrier to accessing healthy food among seniors. (18) In the Flint, MI grocery store intervention, barriers to food security were diminished with a high proportion of car ownership, but those who were most food insecure shopped at the closest grocery store available. (10) With increased age and disease onset, individuals often lack vehicle ownership and are more likely to be malnourished. (19,20) In a qualitative study examining food insecurity in elderly women, all eight participants had some level of restricted mobility and relied on family members for access to grocery stores, (21) yet 60% of seniors surveyed who reported shopping at GFJ reached the store using active transport, indicating the importance of its proximity to core neighbourhood residents. Restricted mobility and reliance on others for transportation may explain why 22% of seniors surveyed chose other grocers as their primary food source.

In our model predicting shopping at GFJ, new immigrants to Canada were significantly less likely to shop there. Households of new immigrants to Canada have a higher prevalence of food insecurity than non-immigrants and non-recent immigrant households (22) and can experience food insecurity through limited access to foods to which they are accustomed. (23) New Chinese immigrants and Chinese immigrants living with lower household incomes show a significantly higher preference for Chinese supermarkets, but ability to indulge this preference is dependent on accessibility. (24) Chinese, Filipino and Southeast Asian people comprise 71% of the minority population residing within the four neighbourhoods sampled. (12) Within a 1400 m radius of GFJ, at least three specialty food stores exist, offering Chinese, East Asian, and Middle Eastern foods. As it has been shown that immigrants tend to maintain the traditional diets of their country of origin, (25) new immigrants may choose other more culturally appropriate markets over GFJ.

Individuals living within a lower socio-economic position (SEP) are significantly more likely to perceive nearby supermarkets as being within a walkable distance than those living within a higher SEP. (26) The survey was collected during summer and fall months, which bring moderate temperatures, and in 2013, minimal snow cover. The survey period, buffer distance, and overall lower socio-economic status of the neighbourhood residents may explain the large proportion of those who chose an active form of transportation to and from GFJ, and the reliance on vehicles for access to other primary grocery stores.

The length of time participants have lived in the sampled neighbourhood was not captured during this study. Individuals living in neighbourhoods for less than two years are significantly more likely to demonstrate a mismatch between perceived and objective measures of their neighbourhood built environment, (27) yet a year after its opening, only 5.5% of those surveyed were unaware of GFJ's existence. In three similar studies, previous response rates ranged from a low 7%10 and 21.5%11 using phone surveys, to a high 62% using door-to-door sampling. (28) This study's response rate of 32% fell within this range, resulting in a sample representative of the neighbourhoods surveyed. As expected given the survey neighbourhoods' demographic makeup, our sample had good representation of Aboriginals, newcomers and senior citizens.

The GFJ supermarket was constructed to provide Saskatoon's core neighbourhood residents with access to healthy food in a previous food desert. Further research is required to determine whether the presence of a not-for-profit supermarket in the core neighbourhoods can improve diet quality and eventually long-term health outcomes. Our results confirm that the GFJ in its early stages of establishment is able to serve households where food insecurity is likely, and affirm the importance and need for a full-service supermarket in Saskatoon's inner city.

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Received: July 24, 2014

Accepted: January 12, 2015

Larisa C. Lotoski, MSc, [1] Rachel Engler-Stringer, PhD, [1,2] Nazeem Muhajarine, PhD [1,2]

Author Affiliations

[1.] Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK

[2.] Saskatchewan Population Health and Evaluation Research Unit, University of Saskatchewan, Saskatoon, SK

Correspondence: Larisa Lotoski, Department of Community Health & Epidemiology, Health Science Building, 107 Wiggins Road, University of Saskatchewan, Saskatoon, SK S7N 5E5, Tel: [telephone] 306-966-2250, E-mail: [email protected]

Acknowledgements: This work was funded by CIHR Grant 127084 awarded to Nazeem Muhajarine and Rachel Engler-Stringer. We are grateful to Project Manager, Tracy Ridalls, and Research Assistants Amanda Guthrie, Elsie Piche-Johnson, Melissa Gan and Jacinda Sigurdson of the Saskatchewan Population Health and Evaluation Research Unit for their coordination of data collection.

Conflict of Interest: None to declare.

Table 1. Study population characteristics, Good Food Junction
study, Saskatoon, SK

                    Surveyed    Neighbourhoods   Saskatoon (excluding
                     group         surveyed            surveyed
                                                   neighbourhoods)

Total population      365           10,585             256,430
(n) *

Age, years         45 (18-85)   33 (less than      36 (less than 1
(median                           1 year-97)       year-100+ years)
(min, max))
([dagger])

                          (%)   (%)     Range, by     (%)
                                      neighbourhood
                                       (%Min-%Max)

Sex (Female) ([dagger])   65    49       (46-50)      52
Aboriginal identity *     38    34       (23-43)       9
Senior citizens (65+      16    10       (9-11)       13
  years) ([dagger])
Annual household
    income ([dagger])
  < $10,000               12    17       (6-26)        5
  $10,000 to < $20,000    26    21       (11-26)      12
  $20,000 to < $30,000    10    19       (16-23)      14
  [greater than or        27    43      (31 -60)      68
    equal to] $30,000
Doesn't know or           25    --         --         --
  declined to answer

                            Range, by
                          neighbourhood
                           (%Min-%Max)

Sex (Female) ([dagger])      (6-70)
Aboriginal identity *        (0-28)
Senior citizens (65+         (0-82)
  years) ([dagger])
Annual household
    income ([dagger])
  < $10,000                  (0-46)
  $10,000 to < $20,000       (0-42)
  $20,000 to < $30,000       (0-29)
  [greater than or           (0-98)
    equal to] $30,000
Doesn't know or                --
  declined to answer

* 2011 National Household Survey, Statistics Canada.

([dagger]) 2006 Census, Statistics Canada.

Table 2. Correlates associated with those who have shopped at the
Good Food Junction at least once

Variable              Description                Total
                                                  (n)

Total population                                  345
Age, years            18-24                       27
                      25-39                       99
                      40-64                       169
                      65+                         50
Sex                   Female                      221
                      Male                        124
Aboriginal            Non-Aboriginal              207
                      Status and non-Status       135
                        First Nations,
                        Metis, Inuit
New immigrant         No                          325
                      Yes                         20
Senior citizen        No (< 65 years)             287
                      Yes (65+ years)             58
General population    No                          209
                      Yes                         136
Marital status        Non-partnered (single,      218
                        separated, widowed,
                        divorced)
                      Partnered (married or       127
                        living common law)
Highest level of      Less than high school       101
  educational         Completed high school       108
  attainment            and/or some college
                      Completed college           87
                        and/or some
                        university
                      Completed university        48
Annual household      < $10 000                   104
  income per person   $10 000 to < $20,000        85
                      $20,000 to < $30,000        30
                      [greater than or            42
                        equal to] $30,000
                      Doesn't know                56
                      Declined to answer          29
Occupation            Unemployed                  60
                      Caregiver/homemaker         68
                      Employed                    126
                      Student                     33
                      Retired                     58
Use of other food-    Community garden            20
  based programs      CHEP * Good Food Boxes      29
  (stratified)        Charitable food services    155
                      Direct attainment of        94
                        food from producers
                        or hunters/gatherers
                      Farmers' Market             124
                      Collective Kitchens         17
                      CHEP Community Market       56
                      Seniors' Market              4
                      Other programs               9

Variable              Description                Have shopped at GFJ?

                                                    No         Yes
                                                 (n (%))     (n (%))

Total population                                 94 (27%)   251 (73%)
Age, years            18-24                       9 (3%)     18 (5%)
                      25-39                      33 (10%)   66 (19%)
                      40-64                      38 (11%)   131 (38%)
                      65+                        14 (4%)    36 (10%)
Sex                   Female                     61 (18%)   160 (46%)
                      Male                       33 (10%)   91 (26%)
Aboriginal            Non-Aboriginal             70 (20%)   137 (40%)
                      Status and non-Status      24 (7%)    111 (32%)
                        First Nations,
                        Metis, Inuit
New immigrant         No                         84 (24%)   241 (70%)
                      Yes                        10 (3%)     10 (3%)
Senior citizen        No (< 65 years)            81 (23%)   206 (60%)
                      Yes (65+ years)            13 (4%)    45 (13%)
General population    No                         47 (14%)   162 (47%)
                      Yes                        47 (14%)   89 (26%)
Marital status        Non-partnered (single,     56 (16%)   162 (47%)
                        separated, widowed,
                        divorced)
                      Partnered (married or      38 (11%)   89 (26%)
                        living common law)
Highest level of      Less than high school      24 (7%)    77 (22%)
  educational         Completed high school      31 (9%)    77 (22%)
  attainment            and/or some college
                      Completed college          27 (8%)    60 (17%)
                        and/or some
                        university
                      Completed university       12 (3%)    36 (10%)
Annual household      < $10 000                  18 (5%)    86 (25%)
  income per person   $10 000 to < $20,000       22 (6%)    63 (18%)
                      $20,000 to < $30,000        8 (2%)     22 (6%)
                      [greater than or           16 (5%)     26 (8%)
                        equal to] $30,000
                      Doesn't know               21 (6%)    35 (10%)
                      Declined to answer          9 (3%)     20 (6%)
Occupation            Unemployed                 16 (5%)    44 (13%)
                      Caregiver/homemaker        15 (4%)    53 (15%)
                      Employed                   42 (12%)   84 (24%)
                      Student                     8 (2%)     25 (7%)
                      Retired                    13 (4%)    45 (13%)
Use of other food-    Community garden            4 (1%)     16 (5%)
  based programs      CHEP * Good Food Boxes      3 (1%)     26 (8%)
  (stratified)        Charitable food services   35 (10%)   120 (35%)
                      Direct attainment of       29 (8%)    65 (19%)
                        food from producers
                        or hunters/gatherers
                      Farmers' Market            32 (9%)    92 (27%)
                      Collective Kitchens         0 (0%)     17 (5%)
                      CHEP Community Market       6 (2%)    50 (14%)
                      Seniors' Market             0 (0%)     4 (1%)
                      Other programs              0 (0%)     9 (3%)

Variable              Description                Chi-squared
                                                   p-value

Total population                                    0.231
Age, years            18-24
                      25-39
                      40-64
                      65+
Sex                   Female                        0.843
                      Male
Aboriginal            Non-Aboriginal                0.001
                      Status and non-Status
                        First Nations,
                        Metis, Inuit
New immigrant         No                            0.019
                      Yes
Senior citizen        No (< 65 years)               0.365
                      Yes (65+ years)
General population    No                            0.014
                      Yes
Marital status        Non-partnered (single,        0.394
                        separated, widowed,
                        divorced)
                      Partnered (married or
                        living common law)
Highest level of      Less than high school         0.685
  educational         Completed high school
  attainment            and/or some college
                      Completed college
                        and/or some
                        university
                      Completed university
Annual household      < $10 000                     0.045
  income per person   $10 000 to < $20,000
                      $20,000 to < $30,000
                      [greater than or
                        equal to] $30,000
                      Doesn't know
                      Declined to answer
Occupation            Unemployed                    0.39
                      Caregiver/homemaker
                      Employed
                      Student
                      Retired
Use of other food-    Community garden              0.449
  based programs      CHEP * Good Food Boxes        0.033
  (stratified)        Charitable food services      0.079
                      Direct attainment of          0.357
                        food from producers
                        or hunters/gatherers
                      Farmers' Market               0.653
                      Collective Kitchens           0.01
                      CHEP Community Market         0.002
                      Seniors' Market               0.218
                      Other programs                0.063

* CHEP = (formerly) Child Hunger Education Project.

Table 3. Univariate and multivariate logistic regression models
showing factors associated with those who have shopped at least
once at the Good Food Junction

Variable                    OR    p-value   95% CI        Adjusted
                                                             OR

Age, years
  18-24 (reference) 25-39   1     1         (0.4, 2.5)
  40-64                     1.7   0.224     (0.7, 4.2)
  65+                       1.3   0.626     (0.5, 3.5)
Sex (reference: female)     1.1   0.843     (0.6, 1.7)
Aboriginal                  2.4   0.001     (1.0, 4.0)      2.0
New immigrant               0.3   0.023     (0.1, 0.9)      0.3
Senior citizen (65+         1.4   0.366     (0.7, 2.7)
  years)
General population          0.5   0.014     (0.3, 0.9)
Declined to answer          0.4   0.486     (0.0, 6.0)
Marital status              1.2   0.395     (0.8, 2.0)
  (reference:
  partnered)
Highest level of
    educational
    attainment
  Less than high school
    (reference)
  Completed high school     0.8   0.418     (0.4, 1.4)      0.8
    and/or some college
  Completed college and/    0.7   0.265     (0.4, 1.3)      0.9
    or some university
  Completed university      0.9   0.869     (0.4, 2.1)      1.6
Annual household
    income per person
  < $10,000 (reference)     0.6   0.153     (0.3, 1.2)      0.7
    $10,000 to < $20,000
  $20,000 to < $30,000      0.6   0.257     (0.2, 1.5)      0.8
  [greater than or          0.3   0.007     (0.1, 0.7)      0.4
    equal to] $30,000
  Doesn't know              0.4   0.005     (0.2, 0.7)      0.4
  Declined to answer        0.5   0.109     (0.2, 1.2)      0.5
Occupation
  Unemployed (reference)
  Caregiver/homemaker       1.3   0.544     (0.6, 2.9)
  Employed                  0.7   0.36      (0.4, 1.4)
  Student                   1.1   0.798     (0.4, 3.0)
  Retired                   1.3   0.592     (0.5, 2.9)
Participates in             1.5   0.452     (0.5, 4.7)
  community gardens
Purchases CHEP Good         3.5   0.044     (1.0, 11.9)
  Food Box
Uses charitable             1.5   0.08      (1.0, 2.5)
  food services
Purchases food at CHEP      3.6   0.004     (1.5, 8.8)      2.7
  community market
Obtains food from           0.8   0.358     (0.5, 1.3)
  producers and/or
  hunters/gatherers
Purchases food at the       1.1   0.653     (0.7, 1.8)
  Farmers' Market

Variable                    p-value     95% CI

Age, years
  18-24 (reference) 25-39
  40-64
  65+
Sex (reference: female)
Aboriginal                  0.031     (1.1, 3.8)
New immigrant               0.045     (0.1, 0.98)
Senior citizen (65+
  years)
General population
Declined to answer
Marital status
  (reference:
  partnered)
Highest level of
    educational
    attainment
  Less than high school
    (reference)
  Completed high school     0.579     (0.4, 1.6)
    and/or some college
  Completed college and/    0.768     (0.4, 1.8)
    or some university
  Completed university      0.315     (0.6, 4.0)
Annual household
    income per person
  < $10,000 (reference)     0.386     (0.3, 1.5)
    $10,000 to < $20,000
  $20,000 to < $30,000      0.63      (0.3, 2.1)
  [greater than or          0.052     (0.2, 1.0)
    equal to] $30,000
  Doesn't know              0.010     (0.2, 0.8)
  Declined to answer        0. 216    (0.2, 1.4)
Occupation
  Unemployed (reference)
  Caregiver/homemaker
  Employed
  Student
  Retired
Participates in
  community gardens
Purchases CHEP Good
  Food Box
Uses charitable
  food services
Purchases food at CHEP      0.035     (1.1, 7.0)
  community market
Obtains food from
  producers and/or
  hunters/gatherers
Purchases food at the
  Farmers' Market

Table 4. Univariate and multivariate logistic regression models
showing factors associated with those who choose the Good Food
Junction as their primary grocery store

Variable                     OR    p-value   95% CI         Adjusted
                                                               OR

Age, years
  18-24 (reference) 25-39    1.1   0.909     (0.22, 5.0)
  40-64                      1.4   0.667     (0.30, 6.4)
  65+                        0.8   0.811     (0.13, 5.1)
Sex (reference: female)      0.9   0.755     (0.40, 2.0)
Aboriginal                   3.4   0.002     (1.6, 7.6)       2.6
New immigrant                1.9   0.311     (0.54, 7.1)
Senior citizen               0.7   0.595     (0.25, 2.2)
  (65+ years)
General population           0.2   0.002     (0.05, 0.51)
Marital status               0.6   0.244     (0.30, 1.4)      0.4
  (reference: partnered)
Highest level of
    educational attainment
  Less than high school
    (reference)
  Completed high school      0.4   0.074     (0.15, 1.1)
    and/or some college
  Completed college          0.6   0.289     (0.23, 1.6)
    and/or some university
  Completed university       0.6   0.42      (0.19, 2.0)
Annual household income
  per person
< $10,000 (reference}        0.7   0.503     (0.29, 1.9)
  $10,000 to < $20,000
$20,000 to < $30,000         0.2   0.18      (0.03, 1.9)
[greater than or             0.6   0.375     (0.15, 2.0)
  equal to] $30,000
Doesn't know                 0.5   0.3       (0.17, 1.7)
Occupation
Unemployed (reference}
Caregiver/homemaker          1.0   0.986     (0.34, 2.97)
Employed                     0.4   0.148     (0.15, 1.33)
Student                      0.5   0.39      (0.10, 2.50)
Retired                      0.9   0.819     (0.28, 2.78)
Participates in              1.9   0.313     (0.54, 7.1)
  community gardens
Purchases CHEP Good          2.4   0.097     (0.85, 6.9)
  Food Box
Uses charitable              2.3   0.038     (1.1, 4.9)       1.3
  food services
Purchases food at            2.9   0.01      (1.3, 6.7)       1.9
  CHEP community
  market
Obtains food from             1    0.941     (0.42, 2.3)
  producers and/or
  hunters/gatherers
Purchases food at            0.9   0.755     (0.4, 2.0)
  the Farmers' Market
Participates in              2.4   0.192     (0.65, 8.8)
  Collective Kitchens
Active travel to GFJ         1.3   0.594     (0.50, 3.3)      1.1

Variable                     p-value      95% CI

Age, years
  18-24 (reference) 25-39
  40-64
  65+
Sex (reference: female)
Aboriginal                   0.042     (1.0, 6.7)
New immigrant
Senior citizen
  (65+ years)
General population
Marital status               0.036     (0.18, 0.95)
  (reference: partnered)
Highest level of
    educational attainment
  Less than high school
    (reference)
  Completed high school
    and/or some college
  Completed college
    and/or some university
  Completed university
Annual household income
  per person
< $10,000 (reference}
  $10,000 to < $20,000
$20,000 to < $30,000
[greater than or
  equal to] $30,000
Doesn't know
Occupation
Unemployed (reference}
Caregiver/homemaker
Employed
Student
Retired
Participates in
  community gardens
Purchases CHEP Good
  Food Box
Uses charitable              0.581     (0.51, 3.3)
  food services
Purchases food at            0.153     (0.79, 4.7)
  CHEP community
  market
Obtains food from
  producers and/or
  hunters/gatherers
Purchases food at
  the Farmers' Market
Participates in
  Collective Kitchens
Active travel to GFJ         0.863     (0.41, 2.9)

Table 5. Transportation mode to and from the Good Food Junction
and primary grocery stores

                                Other store     Any travel
                                travel n (%)   to GFJ n (%)

Mode of          Personal car   184 (54%)       44 (18%)
transportation   Got a ride      46 (13%)        7 (3%)
to primary       Bus             46 (13%)        6 (2%)
grocery store    Bike             8 (2%)         6 (2%)
                 Walk            44 (13%)      185 (74%)
                 Cab             10 (3%)         2 (1%)
                 Other            5 (1%)         1 (0%)
                 Total          343            251
Mode of          Personal car   184 (54%)       44 (18%)
transportation   Got a ride      47 (14%)        8 (3%)
from GFJ         Bus             23 (7%)         5 (2%)
                 Bike             8 (2%)         6 (2%)
                 Walk            39 (11%)      184 (73%)
                 Cab             37 (11%)        3 (1%)
                 Other            5 (1%)         1 (0%)
                 Total          343            251

                                Travel to GFJ
                                as a primary
                                    store

Mode of          Personal car    4 (13%)
transportation   Got a ride      1 (3%)
to primary       Bus             1 (3%)
grocery store    Bike            0 (0%)
                 Walk           24 (80%)
                 Cab             0 (0%)
                 Other           0 (0%)
                 Total          30
Mode of          Personal car    4 (13%)
transportation   Got a ride      1 (3%)
from GFJ         Bus             1 (3%)
                 Bike            0 (0%)
                 Walk           24 (80%)
                 Cab             0 (0%)
                 Other           0 (0%)
                 Total          30