Case Study Qualitative Inquiry of Healthy Food Retailing in Rural Newfoundland and Labrador

Multilevel, multicomponent interventions are recognized approaches to promote public health and prevent disease. Our study focused on diet and its determinants to understand factors impacting healthy food retailing in rural Newfoundland and Labrador (NL), Canada, using a case study approach with community-engaged system-based processes. In three case study communities, we conducted two qualitative data generating processes (storeowner interviews and community focus groups), to inform the design and implementation of a healthy retailing intervention. We identified five key themes from describing the micro, meso, exo, and macro system of factors that impact healthy food retailing in rural NL communities: (1) consumers drive retailer behavior; (2) independence increases the stores’ capacity to serve the community; (3) “everything comes down to price, for us and the customers”; (4) the store is less about food, and more about the community; (5) frustrating conventional food systems are juxtaposed against aspirations of obtaining food locally. We reveal the important relationships between consumers and retailers, the value of independence in store ownership, the dominating challenge of food prices, and imperfect local and conventional food systems impacting healthy food retailing in small stores in rural NL. Our system of themes highlights the economic and social landscape in which the stores operate. Food retailers strategically balance this complex system of layered, interconnected factors, continuously seeking ways to support the wellbeing of their communities. Future research will explore the feasibility and impact of healthy food retailing interventions, informed by this research, within rural NL food stores and communities

Focus group · Food systems · Healthy food · Psychological intervention · Public health · Qualitative research · Rural area · Food Security and Health in Diverse Populations · Obesity, Physical Activity, Diet · Organic Food and Agriculture