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Oxford University Press, European Journal of Public Health, Supplement_5(30), 2020

DOI: 10.1093/eurpub/ckaa166.395

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Towards an impactful intervention in a food retail setting - insights from transition management

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Abstract Issue Socioeconomic inequalities in diet and health form a persistent public health problem. Environmental, non-agentic interventions are most likely to be equitable, but have to be implemented in a wider system with interests other than health promotion. Description of the Problem The Supreme Nudge project (2017-2022) implements a health promotion intervention (niche experiment) in a supermarket setting (regime context). As a sufficiently impactful intervention is likely to conflict with interests of the setting, the Transition Management (TM) framework is used to guide design and implementation. Following the four steps in this cyclical model, we explore the context of the food retail system and identify key players; develop coalitions, shared visions and transition agendas; mobilize actors and implement the intervention; and evaluate, monitor and learn from the intervention. Interviews and focus groups were held to address these steps. Results The Dutch supermarket context consists of multiple chains that, after several price wars, are shifting competition from price to corporate social responsibility goals, including health promotion. Together with key supermarket players, a shared vision was defined: making healthy dietary choices easier while striving for neutral business outcomes. Transition paths towards this vision, including their barriers and facilitators, were explored. Additional actors were mobilized to adapt and refine intervention components, and the intervention will be implemented mid-2020. The intervention will be monitored and evaluated to facilitate upscaling. Lessons Applying the TM framework facilitated the development of coalitions and a shared vision, the co-creation of intervention components and identification of transition paths. This is likely to also benefit implementation and upscaling of the intervention. Applying the TM framework will also be useful for transferring successful interventions to other contexts. Key messages Implementing a health promotion in a food retail setting is challenging because of the conflicting interests. The Transition Management framework can facilitate successful implementation through creating a shared vision and foreseen transition paths.