Abstract
BACKGROUND: Improving access to supermarkets has been shown to improve some dietary outcomes, yet there is little evidence for such effects on children. Relatedly, there is a dearth of research assessing the impact of a structural change (i.e. supermarket in a former food desert) on the home environment and its relationship with children's diet. OBJECTIVE: Assess the relative impact of the home environment on children's diet after the introduction of a new supermarket in a food desert. METHODS: Among a randomly selected cohort of households living in a food desert, parental diet was assessed before and after the opening of a full-service supermarket. The home environment and children's intake of fruits and vegetables was measured at one point - after the store's opening. Structural equation models were used to estimate the pathways between changes in parental dietary quality at follow-up and children's dietary intake through the home environment. RESULTS: Parental dietary improvement after the supermarket opened was associated with having a better home environment (β = 0.45, p = 0.001) and with healthier children's dietary intake (β = 0.46, p < 0.001) through higher family nutrition and physical activity scores (β = 0.25, p = 0.02). CONCLUSIONS: Policy solutions designed to improve diet among low-resource communities should take into account the importance of the home environment.