Leveraging Retail Partnerships for Primary Cancer Prevention: Evaluating a Fruit and Vegetable Incentive Program for Seniors in Guam

PURPOSE Food insecurity among older adults is a critical public health challenge, often exacerbated by fixed incomes and rising healthcare costs. In partnership with Pay-Less Supermarkets, a chain of local stores in Guam, the Racial and Ethnic Approaches to Community Health Project in Guam implemented a public health intervention to evaluate the efficacy of enhanced education and marketing campaigns to an existing Fruit and Vegetable Program (FVP), Fresh Savings for Seniors (FSS), designed to increase access to fresh fruits and vegetables among seniors on Mondays. The primary objective was to determine the impact of the intervention’s educational campaigns on the program’s reach by evaluating produce sales and comparing uptake by seniors. METHODS The intervention was rolled out on August 18, 2025, across eight commercial supermarkets in Guam to promote a 10% discount on produce for seniors (aged 55+). Distributed materials included point-of-sale branded reusable bags, produce-aisle shelf-talkers (mini-promo-flags), and in-store television media broadcasting nutritional education videos. Implementation fidelity and retail environment constraints were monitored via on-site audits. Program reach was tracked using supermarket transactional sales records from July 2024 through December 2025, evaluating monthly transaction volume and total discount distributions. RESULTS Transactional data revealed a year-over-year increase in program utilization and financial distribution during the intervention period. Comparing August 2024 to December 2024 to the same months in 2025, total nutritional subsidies distributed to seniors rose by 8% (from $36,282.85 to $39,175.15). Coinciding with the August 2025 campaign rollout, initial monthly utilization reached a peak of 7,201 transactions, outpacing the August 2024 baseline of 5,547 transactions. Site audits revealed real-world implementation barriers, including inconsistent shelf-talker displays due to high retail inventory turnover, which required ongoing staff re-education. CONCLUSION Public-private retail partnerships can successfully distribute targeted point-of-sale education and sustain high volumes of nutritional incentives in low-resource settings. While initial rollout periods show strong community engagement, managing retail environment variables and maintaining consistent promotional presence are critical to sustaining long-term dietary modification pathways for primary cancer prevention.