Table 2 Summary of interview data by CFIR domain and construct, adapted construct name, and summarised finding with illustrative quote
Domain | CFIR Constructs | Adapted construct name/data included | Summarised finding | Illustrative quote |
|---|---|---|---|---|
Intervention characteristics | Intervention Source | Nil | • Intervention perceived as a 'study' • External entity perceived as funder/evaluator | “I say we’re still undergoing the study, show them the stickers, say there’s not too much I can do at this stage” (M3, T2) |
Evidence Strength and Quality# | N/A | N/A | N/A | |
Relative advantage | Included managers’ perception of the sales effect of the intervention | + Overall sales unaffected,—Overall sales decrease + Reduction in 1.25L sales, + Increase in sales of SFa and smaller volume SSBb + Increased water sales + Confectionery sales reduction when relocated from POSc -No reduction in biscuit and sugar sales + Change in sales mix,—No change in sales mix* | “Don’t believe it’s had an impact [on overall sales]…think the sales mix has changed.” (M1, T2) “We’re selling a lot more diet stuff…[previously] 2–3 pallets of Coke to 1 pallet Diet Coke, now it’s the opposite” (M2, T2) | |
Adaptability | Included references to flexibility to not implement 1.25L strategy, and references to adaptability of strategies to store infrastructure | + 1.25L exclusion option helpful + Fridge layout requirements adaptable - Fridge layout requirements not adaptable | “We’re not removing the 1.25L – the second supermarket in community that has us in competition, we were worried that if we made a change with our display, they would get our customers, to shop there” (M7, T2) | |
Trialability | Nil | + Desire to continue HS2020e after 12-week period + Feasible for set trial period | "I’d argue that we should continue – it’s not affecting us – we shouldn’t stop any" (M1, T2) | |
Complexity | Included barriers/ challenges regarding specific strategy elements | + No challenges for store managers or staff, + No significant barriers to complete strategy - Inability to minimise write-offs - Staff difficulty in following layout, + Manager support for staff accustoming to layout changes - Language/literacy barrier,—Initial planograms late/incorrect + Planograms helpful to follow layout - Stocking shelves more frequently - Adjusting stock control - Customer familiarisation to strategy - Staff turnover/absence | “Hardest thing is sugary product not going on special at the front, not on the counter or whatever. In retail it makes sense to put specials on when they’re near the date. Writing off more stock, takes time, costs money” (M8, T2) | |
Design Quality and Packaging | Included aesthetic changes in the store due to the intervention | + Overall HS2020e package well presented + Store layout changes effective (particularly 1.25L SSBb) - Shelf stripping unnoticed - Floor stickers unnoticed + Floor stickers noticed • Suggested further layout changes | “The way the project has been put together is really good – we’re still selling everything I’ve just changed the set up” (M2, T2) “I honestly can’t say the shelf stripping made any difference towards the end. Whether it’s just part of the furniture… Or we could change floor stickers more regularly, because something different is more noticeable. Otherwise it becomes same same. Different things can be done” (M2, T2) | |
Cost | Nil | + No additional financial costs, + Supplier covering cost of expired SFa drinks - Write-offs causing increased costs + No extra time cost, • Initial time cost only - Increased time cost of restocking smaller facings - Initial stock control/supply issues + No stock control/supply issues* | We are getting more wastage in sugar free drinks; [softdrink supplier] are wearing the cost of that. Other than that, no not really [any extra costs].” (M1, T2) “Maybe a bit [time consuming] at the beginning but not in a negative way.” (M4, T2) | |
Outer Setting | Patient Needs and Resources | Community Needs and Resources | + Customers need health improvement/sugar reduction • Customers need education and promotion of healthy choices + Customers need HS2020e - No customer need for HS2020e • Customers need/desire cold drinks, • Customers need freedom of choice | “I hope it helps with promoting more low sugar, for the community, we have a lot of diabetics, to get kids into the routine of low sugar/no sugar. Or water.” (M9, T2) |
Cosmopolitanism | Includes references to any external organisations | + Collaboration with local health services helpful + Collaboration with suppliers helpful - Collaboration with suppliers unhelpful | “An old man came up to me asked where the no sugar coke was… he also asked where the no-sugar sugar was!…the clinic started this.” (M6, T2) | |
Peer Pressure | Includes references to other stores, or lack of, in community. CFIR code refers to pressure to implement the intervention; our code refers to pressure not to do so | + No competition facilitates success - Competing stores prevent full strategy implementation + Promoting health gives competitive edge over other stores | “We have two other places we’re competing with. Supermarket and a takeaway in town, they both have Coke in the fridges, and there’s vending machines…out the front of people’s houses. Competition-wise. We’re happy to do 50:50, but taking it [SSB > 600 ml] out of the fridge, not quite ready for that yet. (M9, T2) | |
External Policies and Incentives | Nil | • Unspecified nutrition policy/regulations referenced as pre-existing before HS2020e, limiting promotion of unhealthy products | “We were told we weren’t allowed junk, we used to have lollies, chocolates at the front counter…we changed this before healthy stores started, when shop was relayed” (M9, T2) | |
Inner Setting | Structural Characteristics# | N/A | N/A | N/A |
Networks and Communications | Nil | + Remote communications between store manager and internal management/nutritionist helpful + Site visits by internal nutritionist helpful + Relationship between manager with store board helpful - Inconsistent directives from internal management unhelpful | “Having [nutritionist] there, working with her, to relay the stock. As well just to have her out to chat, previous to them coming out, they [nutritionist and area manager] both called, been very clear in why, what and how this happened. Made me feel confident to customer about why we’re doing this” (M2, T2) | |
Culture# | N/A | N/A | N/A | |
Implementation Climate | ||||
1) Tension for change | Community health/diet/ discretionary food marketing concerns of managers | + Change needed for community health/high sugar intakes, + Change needed due to customer demand + Change needed to reinforce public health messages - No tension for change | “Healthwise [HS2020e] would help them a great deal because they’re not having so much sugar, most of them are diabetic” (M5, T2) | |
2) Compatibility | Relating to specific store type, location and needs of the specific community | + HS2020e compatible to stores - HS2020e a poor fit: pre-existing healthy community/store* - HS2020e a poor fit: small store type* - 1.25L SSB strategy a poor fit: competitor store in community* | “I don’t see there’s any issues having them [HS2020e strategies] in place in any & every store.” (M10, T2) | |
3) Relative Priority | Nil | + Expected health outcomes outweigh nil store benefit + Expected health outcomes will bring long term store benefits | “Sales wise it’s a hindrance. But for the benefit of their health its needed.” (M4, T2) | |
4) Organisational Incentives and Rewards | Included incentives of increased stature or respect | • Respect lost if manager was noncompliant with HS2020e goals | “Usually discount [confectionery], but couldn’t promote products. Well it would be been frowned upon” (M6, T2) | |
5) Goals and Feedback | Included reference to goals and compliance data being communicated to store managers | + HS2020e goals clearly communicated to store manager + Manager communicated goals to store staff + Manager received goal-related feedback regarding performance • Manager desiring more goal-related feedback regarding performance | “[ALPA nutritionist] has definitely been a big help; in letting us know what was expected beforehand, good communication” (M7, T2) | |
6) Learning Climate | Included comments regarding relationship between store managers and staff, and staff members’ response to HS2020 | + Managers supervises/protects/ teaches staff in new strategies + Staff perceived as an enabler + Need for staff members’ involvement acknowledged - Need for staff members’ involvement not acknowledged* | “Keeping up, making them [staff] understand full sugar on shelf; make them read the labels… Walk with them, make sure they follow the strategy” (M6, T-mid) | |
Readiness for Implementation | ||||
1) Leadership Engagement | Included reference to store managers involvement and commitment to HS2020 | + Manager is committed and involved in HS2020e -Manager uncommitted to HS2020e | “I’m excited to see the results, we wanna try and help people not have so much sugar. The way the project has been put together is really good – we’re still selling everything I’ve just changed the set up” (M2, T2) | |
2) Available Resources | Included comments regarding planograms and other resources | + Planograms helpful, -Planograms initially unhelpful + Fridge signage informing customers helpful + HS2020e summary guide helpful with manager turnover | “Have a read through about how it all worked. It was useful knowing what you guys targeted, what to look for with what’s got sugar” (M9, T2) | |
3) Access to Knowledge and Information | Included comments regarding SSDd | + Adequate access to SSDd - Inadequate access to SSDd to affirm HS2020e effectiveness - Inadequate access to SSDd Initially, to adjust ordering | “Obviously full sugar, heavy sugar items went down – Coke 1.25, most of the full sugar 1.25 drinks…no sugar and diet definitely went up. and not as much as full sugar went down. Judged this from sales reports from previous months, you can see what’s going on.” (M6, T2) “It’s probably a month to catch sales data, work out what’s up what’s down.” (M2, T2) | |
Characteristics of Individuals | Knowledge and Beliefs about the Intervention | Including opinions on general efficacy of strategy, attitudes and beliefs | + Belief: HS2020e benefits community + Belief: HS2020e is easy to implement + Belief: HS2020e 1.25L SSB strategy is effective - Belief: biscuits/sugar/ signage strategies ineffective + Belief: HS2020e is overall effective and valuable - Belief: HS2020e is overall ineffective/unnecessary*, • Neutral belief in HS2020e efficacy + Belief: no profit loss to store HS2020e - Belief: profit loss to store with HS2020e + Knowledge: managers familiar with HS2020e principles/facts - Knowledge: managers unfamiliar with HS2020e principles/facts | “… helps the community consuming less sugar, should help dramatically” (M1, T2) “The soft drink sales have certainly gone down. The 1.25. They’re buying the smaller ones. They want something cold.” (M4, T-mid) “I don’t think we’ve been successful in reducing the amount of biscuits or sugar, the stripping hasn’t been effective…” (M7, T-mid) |
Self-efficacy | Included comments regarding managers' confidence in implementing HS2020e | + High confidence in maintaining strategies for study period + High confidence in maintaining strategies post-study period + Managers’ retailing skills are transferrable to HS2020e | “[The strategies are] not any harder than [selling] any other product, just normal retail business. Just no sugar instead" (M5, T2) | |
Individual Stage of Change# | N/A | N/A | N/A | |
Individual Identification with Organisation# | N/A | N/A | N/A | |
Other Personal Attributes | Nil | + Pragmatism + Optimism + Adaptability and resilience + Marketing and retail competency + Knowledgeable in current sales and local purchasing patterns - Not knowledgeable in local language | “Oh absolutely [can continue post-strategy period]. [You mentioned that customers are still asking about the 1.25 s they are just used to it now anyway. They just deal with it, eventually it will run its course, I haven’t given them an end date.” (M3, T2) | |
Process | Planning# | N/A | N/A | N/A |
Engaging | ||||
1) Opinion Leaders | Nil Combined from CFIR codes: opinion leaders, formally appointed internal implementation leaders, and champions. This refers to leading/influential store managers or store board members | + Leading managers motivated and supported staff + Leading managers extended strategies post-intervention + Store board motivated store workers | … just learning where everything goes. And I guess understanding why. We walked around the store with our staff and had a staff meeting. If the manager was engaged we could make sure the staff understood why, if we weren’t engaged it would be been very confusing for the staff as they need to understand why (M4, T2) | |
2) Formally Appointed Internal Implementation Leaders | ||||
3) Champions | ||||
4) External Change Agents# | N/A | N/A | N/A | |
Executing | Adherence | + All implemented fully - Short term unintentional noncompliance with drinks layout - Noncompliance after study period | “All of it is there, stayed the same and now is normal routines.” (M5, T-mid) | |
Reflecting and Evaluating | Included comments regarding team debriefing with their staff, or the value of phone calls to debrief/reflect | + Phone calls/support from research staff helpful | “Your [research assistant] calling, your support, calling in and not letting me go…[was most helpful]” (M6, T-mid) | |
Additional code* | Customer Response: Actual responses to the strategies seen or heard by managers | • No customer response heard • Neutral verbal response only -Negative verbal response + Positive verbal response • Changed purchasing pattern seen • No comment/observing of signs/stickers, + Noticed customer looking at signs/stickers | “Surprisingly we haven’t had much negative response at all, I’m very surprised about that. A few questions about why it’s being done” (M4, T2) | |
Additional code* | Suggested Strategies: Suggestions offered by managers to improve healthy food and drink merchandising in their store | • Improve store floorplan, Improve placement of additional low sugar products • Focus on healthy product promotion • Adaptations of existing merchandising material • Scale up of HS2020e across ALPA, • High-impact campaign to target table sugar • Other | “Yes but good to know now that it’s [HS2020e] over I can change a couple of things, we’re swapping the nuts and lollies so you get to the nuts first, and the water should be in the first door of the fridge and now it’s the last.” (M2, T2) |