To increase consumption of fruit and vegetables, customer insight analysis was used to determine the best route for a mobile food store around Great Yarmouth and Waveney Primary Care Trust.

Improving the health and wellbeing of the population Great Yarmouth and Waveney Primary Care Trust required a sustainable programme to increase the consumption of fresh fruit and vegetables, targeting those who eat fewer than one piece of fruit and vegetables per day and are at greatest risk of heart attacks, strokes or diabetes.

The areas of Great Yarmouth, Lowestoft and Beccles have high levels of deprivation, with unemployment levels in both areas exceeding the national average.  

Comparisons of the Great Yarmouth and Waveney population with the Health Survey for England found that over a third of the Great Yarmouth and Waveney population (34.73 per cent) consume fewer than one serving of fruit and vegetables a day.  

Approach

In response, the PCT decided to introduce a mobile food store to increase fruit and vegetable intake by increasing access to wholesale-price produce, providing information on food preparation and directing customers to lifestyle improvement programmes available in the area. The project began in June 2008.

The outreach service targeted, at postcode level, people eating fewer than one vegetable and piece of fruit a day. Offering affordable, low cost fresh produce, the mobile store is manned by health trainers who provide information, tasting sessions, and signposting to healthier lifestyle services including breastfeeding, community nutrition, weight management, stop-smoking services and physical activity programmes.

Objective

The objective is to offer a mobile, holistic health information service that stimulates healthier lifestyles and reduces inequalities. Working at grassroots level, the health trainers proactively engage members of the community in order to motivate, encourage and sustain positive health behaviour changes in the local population.

To achieve these aims Great Yarmouth and Waveney PCT concluded that it would need external expertise. This would focus on identifying the best route for the mobile food store based on the health and lifestyle needs of the population.

Data strategy

Determining the best route for a mobile food store involved mapping, by postcode, people likely to consume fewer than one portion of fruit and veg a day, and their likelihood to be at risk of a heart attack, stroke and diabetes.

The PCT opted to use the Mosaic Public Sector lifestyle segmentation system. Mosaic divides the population into 61 lifestyle types aggregated to 11 lifestyle groups based on social, economic and cultural behaviour. By combining this with the Health Survey for England and national hospital data, it was possible to understand how likely people in each postcode were to consume fewer than one portion of fruit and veg a day, and to be admitted to hospital for a heart attack, stroke and diabetes.

As the mobile food store visits communities at different times of the day, it was important to understand the concentrations of target population during the day and at their residential location. Using Daytime Mosaic it was possible to ensure that the optimal daytime routes were planned.

To promote the store, Mosaic Public Sector was used to understand more about the lifestyles, communication preferences and community settings of the target populations. Leaflets were distributed and posters put in GP surgeries where the target audience were registered, as well as magazine adverts, articles in the local free newspaper and an advert on the local radio station based on the communication preferences of the specific Mosaic types.  

The mobile food store collected data on the postcodes of the people using the store, which services they were signposted to and the types of produce consumed.

The results

After five months, the mobile food store recorded the following results:

  • 650 customers on average visited every month.
  • 137 customers were referred to other health services such as breastfeeding, stopping smoking and the health trainer service.

A service evaluation has been conducted by the University of East Anglia with the help of NHS Great Yarmouth and Waveney. It measured the impact of the store on the health of the elderly, low income families, pregnant women and people on a poor diet in the area. The service evaluation concluded:

  • There was a self-reported increase in fruit and vegetable consumption of 1.8 portions per day following contact with the mobile food store, equating to an average increase of 26 per cent in people consuming the recommended five or more a day. There was also a 75 per cent reduction in the number of people eating fewer than one portion of fruit and vegetables per day.
  • Customers were highly receptive to the campaign with a response rate of 88 per cent and 79.2 per cent of customers “really liking” the mobile food store and visiting on a weekly basis.
  • 61.8 per cent of customers were classified as being unemployed or receiving benefits and 43 per cent considering themselves overweight.

Increasing the consumption of fruit and vegetables is key to reducing health inequalities and to improving the general wellbeing of the population. Its effectiveness is measured by its direct impact on behaviour.

A critical factor in implementing the mobile food store was the ability to target the population at a postcode level depending on their uptake of fruit and vegetables. This project demonstrates the impact of a data-led strategy through the imaginative use of segmentation allied to healthcare data that has enabled Great Yarmouth and Waveney PCT to implement an innovative outreach service.