Background and Objectives:
Grocery stores are the primary venues that can have a vital role in overall health. This is especially true for immigrant families, who often have limited access to healthy foods and are burdened by many diet-related diseases. Sugar-Sweetened Beverages (SSB) marketing within grocers is an obesogenic environmental factor that negatively impacts childrens eating practices. Currently, little is known about different aspects of SSB marketing to young children that influence minority parents to purchase SSBs for their children. We aimed to assess community and consumer eating environments by 1) developing a methodology that describes the price, placement, and promotion of SSBs 2) recognizing the differences in the landscape of SSB marketing within Metro Detroit grocers when compared across grocers in immigrant enclaves.

Methods:
The original Nutrition Environment Measure Survey (NEMS) could not identify SSBs marketing aspects targeted young children. To enhance the NEMS,1) organic, plant-based, unsweetened toddler and infant beverages and marketing questions to capture the SSBs promotion tactics were added; 2) enhanced NEMS was conducted in 78 grocers in immigrant enclaves(n=30) of Dearborn, Warren, Hamtramck, Detroit in Michigan and scores were compared with the scores of the grocers in Metro Detroit (comparison group(n=48)).

Results:
One-way analysis of variance revealed that grocers in immigrant enclaves have a lower NEMS score (-2.38) compared to the comparison group (-0.52), which indicated significantly higher availability of cheaper SSBs. Availability of organic, plant-based, and unsweetened toddler and infant beverages was zero in all participating grocers. Signage of cartoon characters was the most frequent retail SSB marketing tactic.

Conclusions:
Living in immigrant enclaves is linked with lower access to unsweetened and healthy beverages for toddlers, which could cause a high prevalence of early childhood obesity among this population. The findings can assist in developing and implementing healthy eating interventions in high-need areas.