A systems framework for implementing healthy food retail in grocery settings

Area of Science:

• Public Health
• Health Promotion
• Retail Management

Background:

• Food retailers face complex barriers to implementing healthy food initiatives.
• The Systems Thinking Approach for Retail Transformation (START) framework aids healthy food retail interventions in community settings.
• This study tested the START framework's applicability in a grocery store setting.

Purpose of the Study:

• To adapt the START framework for healthy food retail interventions in grocery stores.
• To identify specific factors and relationships relevant to the grocery retail environment.
• To guide interventions aimed at increasing healthy food availability and promotion.

Main Methods:

• Secondary analysis of 16 semi-structured interviews with grocery retailers and stakeholders.
• Deductive coding of interviews against the existing START framework.
• Development of causal loop diagrams and extension of the START map using Vensim software to create the START-G map.

Main Results:

• A grocery-specific version of the START map (START-G) was developed.
• Key themes included the importance of 'Getting Started' with proof-of-concept interventions and 'Focusing on the customer' through sales data.
• Challenges included disrupting the 'Supply-side status quo' favoring less healthy options, but opportunities in 'Healthy food as innovation' and 'Corporate social responsibility' were identified.

Conclusions:

• Significant differences exist in implementing healthy food retail in grocery versus health promotion settings.
• The START-G map provides guidance for addressing commercial interests that promote less healthy foods.
• Recommendations include addressing business outcomes and supplier relationships to facilitate healthy food retail.