Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Master of Science in Nutrition and Food Systems (MSNFS)

Document Type

Master's Thesis


Agriculture, Food and Environment


Dietetics and Human Nutrition

First Advisor

Dr. Alison Gustafson


The prevalence of obesity is greater in rural communities, and current health promotion interventions have not shown broad positive impacts on dietary patterns in these areas. Focusing community-based efforts on unconventional food retailers is a unique avenue to encourage healthier food choices in rural populations. This study used shelf-wobblers to market healthier snack and beverage items at convenience stores (n=5) in a rural Kentucky county. Selection of healthy snacks and beverages from the store inventory was conducted using the CDC Food Service Guidelines for Federal Facilities calculator. Items were sorted into four categories: meal replacement snacks, high-protein snacks, low-fat carbohydrate snacks, and no-calorie drinks. Monthly sales data was collected to measure baseline sales and post-intervention sales. This data was analyzed using a difference-in-differences economic model, which assessed percent changes in sales within and among the five stores. This study found an overall increase in healthier snack and beverage purchases after implementation of the marketing wobblers. The findings of this study provide unique insight into community-based efforts for health promotion in unconventional food retailers in the Appalachian region.

Digital Object Identifier (DOI)

Funding Information

This study was supported by the Centers for Disease Control and Prevention's High Obesity Program (no.: 3200003634) in 2020.