Implementation of a food retail intervention to reduce purchase of unhealthy food and beverages in remote Australia: mixed-method evaluation using the consolidated framework for implementation research.

BACKGROUND: Adoption of health-enabling food retail interventions in food retail will require effective implementation strategies. To inform this, we applied an implementation framework to a novel real-world food retail intervention, the Healthy Stores 2020 strategy, to identify factors salient to intervention implementation from the perspective of the food retailer. METHODS: A convergent mixed-method design was used and data were interpreted using the Consolidated Framework for Implementation Research (CFIR). The study was conducted alongside a randomised controlled trial in partnership with the Arnhem Land Progress Aboriginal Corporation (ALPA). Adherence data were collected for the 20 consenting Healthy Stores 2020 study stores (ten intervention /ten control) in 19 communities in remote Northern Australia using photographic material and an adherence checklist. Retailer implementation experience data were collected through interviews with the primary Store Manager for each of the ten intervention stores at baseline, mid- and end-strategy. Deductive thematic analysis of interview data was conducted and informed by the CFIR. Intervention adherence scores derived for each store assisted interview data interpretation. RESULTS: Healthy Stores 2020 strategy was, for the most part, adhered to. Analysis of the 30 interviews revealed that implementation climate of the ALPA organisation, its readiness for implementation including a strong sense of social purpose, and the networks and communication between the Store Managers and other parts of ALPA, were CFIR inner and outer domains most frequently referred to as positive to strategy implementation. Store Managers were a 'make-or-break' touchstone of implementation success. The co-designed intervention and strategy characteristics and its perceived cost-benefit, combined with the inner and outer setting factors, galvanised the individual characteristics of Store Managers (e.g., optimism, adaptability and retail competency) to champion implementation. Where there was less perceived cost-benefit, Store Managers seemed less enthusiastic for the strategy. CONCLUSIONS: Factors critical to implementation (a strong sense of social purpose; structures and processes within and external to the food retail organisation and their alignment with intervention characteristics (low complexity, cost advantage); and Store Manager characteristics) can inform the design of implementation strategies for the adoption of this health-enabling food retail initiative in the remote setting. This research can help inform a shift in research focus to identify, develop and test implementation strategies for the wide adoption of health-enabling food retail initiatives into practice. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 12,618,001,588,280.

Theory is Not Enough! Experiential and Project-Based Approaches to Teaching International Social Work.

In the increasingly interconnected and interdependent world, social work education requires a more global approach to graduating better-prepared practitioners. Teaching international social work only based on classroom and second-hand experiences do not expose students to the realities, opportunities, and challenges of work in the field. While there are longer-term volunteering or internship-based field immersion programs, shorter-term collaborations mixing in-class and field learning in international social work education are practiced less. Experiential and project-based courses provide students with opportunities to learn from practitioners, while also providing the reciprocal benefit of time, human, and academic resources of their institution to their partner agencies. This model of education provides aspiring practitioners skills in and models of international collaboration, reducing the risks that learning takes place only at the expense of host communities. The key takeaways of this approach from the experience of students in the course Social Work Practice with Displaced Persons are discussed in this paper. The course provides structured instruction and exposes students to experts in the field of humanitarian response through collaborative projects, field visits, and seminars with practitioners. The analysis of the qualitative data from students' course reflections shed light on several broad themes on the value of experiential project-based education and the impact of field immersion on the development of essential skills necessary for social workers entering the field of humanitarian response and practice with displaced persons. A case for mainstreaming project-based learning in international social work education to better prepare informed, effective, and efficient practitioners and leaders is presented.