A process evaluation of the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial

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dc.contributor.author Olstad, D en
dc.contributor.author Ball, K en
dc.contributor.author Abbott, G en
dc.contributor.author McNaughton, S en
dc.contributor.author Le, HND en
dc.contributor.author Ni Mhurchu, Cliona en
dc.contributor.author Pollard, C en
dc.contributor.author Crawford, DA en
dc.date.accessioned 2017-11-16T03:28:53Z en
dc.date.issued 2016-02-24 en
dc.identifier.citation International Journal of Behavioral Nutrition and Physical Activity 13:15 pages Article number 27 24 Feb 2016 en
dc.identifier.issn 1479-5868 en
dc.identifier.uri http://hdl.handle.net/2292/36441 en
dc.description.abstract Background Supermarket Healthy Eating for Life (SHELf) was a randomized controlled trial that operationalized a socioecological approach to population-level dietary behaviour change in a real-world supermarket setting. SHELf tested the impact of individual (skill-building), environmental (20 % price reductions), and combined (skill-building + 20 % price reductions) interventions on women’s purchasing and consumption of fruits, vegetables, low-calorie carbonated beverages and water. This process evaluation investigated the reach, effectiveness, implementation, and maintenance of the SHELf interventions. Methods RE-AIM provided a conceptual framework to examine the processes underlying the impact of the interventions using data from participant surveys and objective sales data collected at baseline, post-intervention (3 months) and 6-months post-intervention. Fisher’s exact, χ 2 and t-tests assessed differences in quantitative survey responses among groups. Adjusted linear regression examined the impact of self-reported intervention dose on food purchasing and consumption outcomes. Thematic analysis identified key themes within qualitative survey responses. Results Reach of the SHELf interventions to disadvantaged groups, and beyond study participants themselves, was moderate. Just over one-third of intervention participants indicated that the interventions were effective in changing the way they bought, cooked or consumed food (p < 0.001 compared to control), with no differences among intervention groups. Improvements in purchasing and consumption outcomes were greatest among those who received a higher intervention dose. Most notably, participants who said they accessed price reductions on fruits and vegetables purchased (519 g/week) and consumed (0.5 servings/day) more vegetables. The majority of participants said they accessed (82 %) and appreciated discounts on fruits and vegetables, while there was limited use (40 %) and appreciation of discounts on low-calorie carbonated beverages and water. Overall reported satisfaction with, use, and impact of the skill-building resources was moderate. Maintenance of newly acquired behaviours was limited, with less than half of participants making changes or using study-provided resources during the 6-month post-intervention period. Conclusions SHELf’s reach and perceived effectiveness were moderate. The interventions were more effective among those reporting greater engagement with them (an implementation-related construct). Maintenance of newly acquired behaviours proved challenging. Trial registration Current controlled trials ISRCTN39432901. en
dc.publisher BioMed Central en
dc.relation.ispartofseries International Journal of Behavioral Nutrition and Physical Activity en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1479-5868/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title A process evaluation of the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12966-016-0352-3 en
pubs.volume 13 en
dc.description.version VoR - Version of Record en
dc.rights.holder Copyright: The author en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Article en
pubs.elements-id 546019 en
pubs.org-id Faculty of Medical & Hlth Sci en
pubs.org-id Population Health en
pubs.org-id Pacific Health en
pubs.number 27 en
pubs.record-created-at-source-date 2016-11-15 en


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