Developing Co-Creation Research in Food Retail Environments: A Descriptive Case Study of a Healthy Supermarket Initiative in Regional Victoria, Australia
- As aligned to the co-creation frameworks, at what stage did stakeholders become involved with the Eat Well, Feel Good Ballarat project?
- In what ways can the features/steps/structures/processes of phase one of the Eat Well, Feel Good Ballarat project inform co-creation frameworks?
- What is the stakeholders’ extent of participation and willingness to co-create health-enabling supermarkets?
2. Materials and Methods
2.1. Study Design
2.3. Underpinning Theory
2.4. Data Collection
2.5. Data Analysis
2.5.1. Document Analysis
2.5.2. Thematic Analysis
2.6. Analytical Filters for Data Analysis
2.6.1. Co-Creation Frameworks
2.6.2. Motivations, Opportunities, and Abilities Model
2.7. Data Reduction and Display
2.8. Research Reflexivity Statement
2.9. Ethical Considerations
3.1. Checklist Application
3.2. Stakeholders’ Stage of Involvement
3.3. Implications of Co-Creation
Intrinsic motivation: I think it’s really important to keep going, but just be mindful of what’s making an impact [within the community].(FGP)
Extrinsic motivation: […] as a business, you will always probably try and lean towards where you’re going to get the most of your sales from and the most of your profit to keep your business viable. […].(RI)
[…] nowadays, compared to the last five years, we can always see new product availability […] you can see sections of healthier food items coming up in place, you can see all supermarkets focusing on putting vegetables and fruits right in front of the stores.(HPI)
What we’re trying to change […] I guess, is that everything that we sort of make in-stores, we might have pre-cut fruit, we do our baking of healthy bread and all that stuff, is to try and get any department or positions in store and try and change that consumer shopping habit [to a healthier one].(RI)
I contacted [Retailer’s name], who manages six supermarkets in our catchment […] I just rang the general number, and I said: “can I speak to the owner of the business?” And she goes, “hang on, I’ll just put you through to [Retailer’s name],” it was so easy. I got through, and (you have that sort of elevated pitch to get his attention straight up) I spoke about the [Eat Well @IGA] project, which he knew about, and whether there was any opportunity to have some discussions with him and his managers about doing some work with them around some healthy initiatives. And he said, “yeah, sure, let’s make time now.” How lucky was that?(FGP)
I would say that I can see that if we look back over that particular store manager that really did get behind and more enthusiastic, and then others are doing it because [Retailer’s name] wants to do it. […] it’s still okay, but they might be just ticking through the motion […] they’re not personally invested in it […] It’s sort of an extra thing.(FGP)
There were quite a lot of planning meetings in the initial stages, and we went in there very cautiously because everything we [had] read was about how to maintain their profit, and of course, they do, but they were just really trying to be very helpful (FGP). I feel like it’s a new project [EWFGB], so they would want to actually put that project in the supermarket because, at the end of the day, the project means more promotion, more publicity and more people spending more time in the stores and therefore more profit.(HPI)
We [CHS and Supermarket] set it all up, we had some teams meeting to start with, and we had follow-up meetings in-store, which is great. All the point-of-sale material was presented and signed off, making sure that it was all suitable at a store level. That was a great initiative. […].(RI)
[…] if it was up to us to run it [the initiative], we probably wouldn’t do it because we just don’t physically have the time to do all this type of stuff with every other initiative we’ve got going on in the business.(RI)
The situation is that we’re constantly trying to re-connect and re-establish that relationship with the supermarket […] trying to just continue that kind of momentum, [which] it’s a little bit tricky at this end of the project.(FGP)
There was just a lot of work around working harmoniously together to get the best results for the EWFGB but also making sure that for the supermarket, it worked well with their business as well. […] it has to be some give and take because a lot of our work too; how are we going to sustain it? We’ve put so much effort into keeping the marketing collateral up; that does take a lot of resources. […] including training of staff to be included in their orientation and induction training as well. That’s what we would really love. But it hasn’t been [happening], as far as I know.(FGP)
[…] I think in the first instance, it always comes down to how much time we can actually provide or allocate to a project like this, and if you’ve got the support of Ballarat Health, they can do a lot of the groundwork, it just makes it easy for us to sign stuff off and say, “yeah, we could do it” [...] any sort of training videos that they’ve done they add on the top, so you’ve got to get people to be able to find the time to actually sit there for a five-minute session […] it can be a bit frustrating or a problem to watch something, to learn something about the healthy eating concept, that is one of the things that [is an issue] […] I think there’d be a commitment there, but it’s just that [it’s difficult]. […] I think it’d be a commitment to take it further, but it’s just the amount of time that we would have available to actually get into a deeper process or where we head with it.(RI)
There’s a lot of stuff they wanted to do this year that they couldn’t do because we had some trading terms agreements with certain suppliers […], and they [CHS] wanted to get fresher products in certain positions in the store, and we weren’t able to do that because of […] those terms that we had to some key supplies which makes it really difficult to sort of implement everything that needed to be implemented.(RI)
4.1. Strengths and Limitations
4.2. Implication for Research and Practice
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Motivations||The force that directs individuals towards goals. It reflects readiness and interest to engage in an activity .||Essential condition to co-create more health-enabling strategies in food retail. The goals are not restricted to the initiative’s short- and long-term objectives but could extend to the organizational motivations to achieve change in the food outlet.|
|Opportunities||Relevant constraints that enable the desired outcome . Opportunities could extend to situational and operational factors that support or serve as barriers to performing an activity .||Circumstances that enabled the EWFGB project could lead to its long-term sustainability. The opportunity could reflect actions/strategies/structures that increase the means or reduce barriers to co-create health-enabling strategies in food retail outlets.|
|Abilities||The necessary resource level and the extent of these resources to achieve the desired goal . For co-creation, this relates to the stakeholders’ skills or knowledge to engage in co-creation (e.g., platforms and skills to interact with others and capabilities to exchange value propositions) .||Type of resources (e.g., cognitive, social, financial, physical) the stakeholders enable the co-creation of health-enabling strategies in food retail outlets.|
|Task||Application of the|
Eat Well, Feel Good Ballarat Project
|Stakeholder engagement, evidence collection and governance||Identify||Identify the governance/management arrangements and organizational structure supporting, influencing, and resourcing relevant to the issue of interest||CHS is the principal organization that has closely partnered with the Supermarket since 2019 . |
Partners: Supermarket and CHS.
A supermarket owner is highly engaged and has an altruistic motivation to help the community .
A Supermarket in Ballarat has agreed to partner with CHS on the pilot .
|Identify and analyze motivation for change||Results from a community consultation .|
Ongoing work in a Supermarket in Bendigo .
|Identify any existing tools to measure and assess change in the food environment (consider if these are appropriately validated and reliable)||Store Scout was used to audit the three supermarkets before implementing the project .|
|Analyze||Analyze stakeholder network and role agreement||Supporters: Table 3|
|Analyze key area(s) of concern identified by stakeholders||Customers wanted more support from supermarkets to help them make healthier food and drink choices .|
Barriers to making healthy choices in supermarkets relate to the low cost of unhealthy foods, misleading and hard-to-understand labelling, and the layout of the stores .
|Identify any relevant implementation frameworks/strategies to be considered||The EWFGB project was modelled on key elements of Eat Well @ IGA .|
|Define||Prioritize problems and possible solutions||Increase the ease for customers to identify and select healthier food and drink products using interventions within the supermarket environment that promote healthier food and drink options .|
The Australian Government’s HSR system helps customers identify the healthiest food and drink options while shopping at the supermarket .
|Communication, policy alignment & development||Identify any government/internal policy that needs to be implemented, aligned to or to be developed||The intervention sits within a broader movement of health promotion strategies .|
|Ensure effective communication and information sharing among stakeholders (consider channels that enable continually feedback between stakeholders)||Regular meetings occur during the definition of actions and initiative development.|
The Supermarket had a direct communication line to report any issues with the materials.
|Identify and consider any relevant initiative dissemination strategies that benefit or enhance the initiative (e.g., communication targeted to communities)||Local newspapers and TV channels promoted the project to the community, social media, and CHS website .|
|Ensure any privacy and/or ethics considerations (if relevant)||Privacy was ensured according to CHS guidelines. |
All participants in the evaluation provided informed consent.
|Co-design of evidence-informed action and implementation planning||Design||Use methods to develop a shared understanding of the drivers of the issue and potential solutions to this issue (e.g., Group Model Building or other participatory methods)||NA|
|Ensure that the prioritization of action/strategies was collaboratively defined||CHS developed insights from the literature and pilot studies.|
The included strategies were selected in agreement with the store manager.
The supermarket provided additional input on the type of promotional materials.
CHS adapted designs and evaluated the feasibility of implementation.
|Prepare a specific plan for the implementation of strategies (consider processes and timeline)||Categorization of key products by HSR|
Initial Store Scout audit.
Developing and implementing specific in-store messaging (signage, planograms, recipe, weekly specials, etc.)
Development and implementation of shelf signage to promote 4.5 and above.
Development and delivery of staff training.
Develop key communication messages.
|Construct a resource and asset allocation for the implementation of actions||CHS—EWFGB project management.|
Victorian State Government Department—Funding.
University partners: information and provision of support.
Volunteers: data collection.
Supermarket—Planning and implementation support.
|Develop an initiative evaluation plan before starting the implementation||Evaluation process: surveys, interviews, and final Store Scout audit, sales data.|
|Realize||Implement and monitor the initiative, identify trends and adapt if/when needed||Pre-intervention Store Scout analysis was undertaken between the 19th and 23rd of April 2021. Post-intervention Store Scout analysis was undertaken between the 17th and 21st of May 2021 .|
The eight-week pilot was planned for each store, but this was extended to nine after a two-week state-wide lockdown between the 28th of May and 10th of June 2021 impacted store monitoring and the commencement of customer surveying. The launch had a staggered start (of one week) between stores so that process evaluation of the implementation could guide each subsequent launch .
|Identify Momentum continuous quality improvement (CQI) cycle||Evaluate||Assess if/to what extent the proposed outcomes were met||EWFGB project demonstrated the capacity of the supermarket environment to support consumers in making healthier food and drink choices. More detail in the evaluation report .|
|Identify the critical area (s) of concern (consider if a new concern/ problem has emerged)||CHS staff, volunteers, and interviewees were concerned that it might be hard to sustain the materials once this assistance is taken away. |
Managers noted that the duration of any marketing intervention requires careful consideration describing how customers can get “store blind” if promotional materials are used for an extended period.
|Identify encountered barriers that limited the implementation and/or stakeholder collaboration||Limited supermarket staff engagement due to staff capacity limitations, timing, and preparedness before scheduled implementation. |
HSR ratings of Supermarket products assessment were done in early 2020 but were used until early/mid-2021 (many products and ratings may have changed due to introducing new products, discontinuing products, and product reformulation).
COVID-19 restrictions limited the ability to meet staff and hold meetings in person.
|Identify enablers that supported or enhanced the implementation and/or stakeholder collaboration||Visually attractive materials which help customers reflect on nutrition.|
Recipe cards were the most popular promotional material.
The supermarket commitment to the trial and provision of the space and sales data.
|Learnings from the diverse stakeholders||Supermarket: The senior managers strongly supported the EWFGB project continuing in the future, recommending sustainability of the promotional materials as a consideration.|
Support from CHS staff and volunteers throughout the project was critical to the success of the project.
|Identification of new stakeholders||NA|
|COACH||Stakeholder Engagement, Evidence Collection, and Governance||Co-Design of Evidence-Informed Action and Implementation Planning||Momentum and CQI|
|Communication Policy Alignment & Development|
|Community Health Service||✓||✓||✓||✓||✓||✓|
|Regional Health Service||✓||✓||✓||✓|
|Primary Care Partnership||✓||✓||✓|
|Victorian State Government Department||✓||✓||✓|
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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Vargas, C.; Whelan, J.; Feery, L.; Greenslade, D.; Farrington, M.; Brimblecombe, J.; Thuruthikattu, F.; Allender, S. Developing Co-Creation Research in Food Retail Environments: A Descriptive Case Study of a Healthy Supermarket Initiative in Regional Victoria, Australia. Int. J. Environ. Res. Public Health 2023, 20, 6077. https://doi.org/10.3390/ijerph20126077
Vargas C, Whelan J, Feery L, Greenslade D, Farrington M, Brimblecombe J, Thuruthikattu F, Allender S. Developing Co-Creation Research in Food Retail Environments: A Descriptive Case Study of a Healthy Supermarket Initiative in Regional Victoria, Australia. International Journal of Environmental Research and Public Health. 2023; 20(12):6077. https://doi.org/10.3390/ijerph20126077Chicago/Turabian Style
Vargas, Carmen, Jillian Whelan, Louise Feery, Deborah Greenslade, Melissa Farrington, Julie Brimblecombe, Freddy Thuruthikattu, and Steven Allender. 2023. "Developing Co-Creation Research in Food Retail Environments: A Descriptive Case Study of a Healthy Supermarket Initiative in Regional Victoria, Australia" International Journal of Environmental Research and Public Health 20, no. 12: 6077. https://doi.org/10.3390/ijerph20126077