Negotiating healthy food retail initiatives: An ethnographic study of a partnership with supermarkets

BACKGROUND: The health promotion literature advocates for partnerships with private actors, but scholars have called for detailed knowledge on the development of interventions in studies using such co-approaches. This study aims to increase our understanding of how such partnerships influence intervention development and content. In 2019, researchers at the National Institute of Public Health, Denmark, established a partnership with the food retailer Salling Group and the Danish Cancer Society, which will be the case used in this study. The vision of the partnership was to develop and test healthy food retail initiatives to make the healthy choice the easy choice for customers. METHODS: We performed a focused ethnographic study from the initiation of the partnership (2019) until the feasibility test of the initiatives (2021). We used participant observation of meetings and intervention development activities, interviews with partners, and document analysis of e-mail correspondences and project materials. We analysed data abductively with inspiration from a chronological narrative analytical approach and concepts of partnerships, negotiation, and institutional logics. FINDINGS: We identified six phases of the development process, characterized by randomness, compromises, fear, conflicting logics, and unforeseen events. We show how 1) a random meeting and initial verbal agreements between a few persons affect the mindset and decision-making of the partners, 2) conflicting logics can both hinder and facilitate the development of initiatives, and 3) the process is shaped by unforeseen events i.e., Covid-19 restrictions, and organisational changes. CONCLUSIONS: This study highlights how fragile public-private partnerships are and the significance of each step taken. To succeed with effective health promotion in the retail setting partnerships may benefit from being flexible and investing time in forming a shared understanding based on discussions of different perspectives. KEY MESSAGES: • Partnerships between academics and non-academics are fragile and unpredictable. • Negotiation of healthy food retail initiatives is facilitated and hindered by differences in institutional logics.