{
  "abstract": "Background Community food organisations (CF0s) are playing an increasingly important role in addressing food insecurity. These settings also provide opportunities for improving the healthiness of users’ diets; however, it is important to understand these unique contexts before implementing interventions. In this study, we present initial reflections on findings from one complete and one ongoing process evaluation of two RCTs conducted in CFOs in England. We explore the practicalities of implementing healthy and sustainable food interventions within these settings from the perspectives of their users.Methods We purposively recruited 51 intervention recipients (CFO users) across two CFOs: an independent food bank operating from a single location and a nationwide social supermarket with multiple sites. Semi-structured interviews, lasting up to 45 minutes, were conducted either in person at the CFO or online and followed topic guides informed by the principles of realist evaluation. Data were analysed using thematic analysis.Results Participants were generally supportive of health and sustainability interventions but emphasised the importance of recognising CFOs as distinct retail settings by addressing the specific needs of users. They described that users are more likely to experience socioeconomic disadvantage and food insecurity and require accessible support and advice services. Price was identified as the primary factor influencing purchasing decisions, with participants expressing greater acceptance of interventions that reduced prices across all products rather than exclusively on healthier and more sustainable options.Given the disadvantage faced by many CFO users, participants emphasised the importance of freedom of choice. Access to less healthy foods was often seen as a valuable treat, that might not be readily available elsewhere. As a result, interventions which restricted access to these less healthy convenience foods were likely to be seen as taking away the right to choice and be less acceptable to participants.Participants also highlighted CFOs’ operational, financial, and staffing constraints, noting that interventions should not impose an additional burden at the expense of their ability to support users.Conclusion The findings reveal the unique challenges of implementing food interventions in CFOs and highlight the need for tailored approaches that align with the realities of these settings. Successful interventions must balance affordability, user autonomy, and operational feasibility while promoting healthier choices.The findings also draw attention to the importance of understanding the interplay between CFO use and the broader retail landscape. Future analyses will integrate interviews with CFO staff and quantitative data to better understand intervention effectiveness and feasibility.",
  "authors": [
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Bea Savory"
    },
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Lily Barnett"
    },
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Steven Cummins"
    },
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Greg Hartwell"
    },
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Suzan Hassan"
    },
    {
      "affiliations": [
        "Public Health, Environments and Society, The London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Oliver Huse"
    },
    {
      "affiliations": [
        "Health and Social Work, University of Hertfordshire, Hatfield, UK"
      ],
      "name": "Claire Thompson"
    }
  ],
  "title": "P09 The practicalities of healthy and sustainable food interventions in community food settings: reflections from two process evaluations",
  "uid": "9c23a0b3-3425-5d0e-a7f5-325043e6f16c"
}