Introduction
Supermarkets are the main source of food and beverage purchases in many countries [
1‐
4]. Through the use of various marketing techniques that manipulate price, placement, promotion, and product (referred to as the ‘4Ps of marketing’), supermarkets have the ability to influence people’s purchasing and consumption behaviour [
5]. As governments around the world seek to improve the healthiness of population diets [
6], supermarkets are therefore an important focus area for policy action.
Price promotions are a common and effective marketing technique used in supermarkets to increase purchases [
7], and are likely to increase the consumption of food and beverages bought on promotion [
8]. A systematic review on the healthiness of food and beverage promotions published in 2020 found that seven out of eight studies observed a higher prevalence of unhealthy, compared to healthy, price promotions in food retail outlets [
9]. A food environment that encourages the purchase of unhealthy foods and beverages is likely to contribute to the purchase and consumption of unhealthy diets.
Government policies aimed at changing the relative price of food and beverage so that unhealthy options are less financially attractive have been consistently recognised as an important part of efforts to create healthy food environments and improve population health [
10‐
14]. For example, many countries have had success in reducing the purchase and/or consumption of unhealthy products after applying taxes to unhealthy foods or beverages [
15‐
18]. However, in considering food prices and their influence on population health, the role of price promotions on unhealthy food and beverages warrants closer attention [
19].
While there have not been any ‘real-world’ studies that have investigated the public health impact of reducing price promotions on unhealthy food and beverages in supermarkets, one recent modelling study assessed the potential cost-effectiveness of a policy restricting price promotions on sugar-sweetened beverages in Australian food retail settings [
20]. That study estimated the policy was likely to reduce mean population per capita daily sugar intake, and would likely result in a reduction of mean population body weight [
20], although the authors acknowledged the limited evidence for the real-world effectiveness, feasibility, and acceptability of such policy action.
In 2020, the UK Government announced legislation to restrict large and medium retailers that sell food and drink in-store and online from offering volume-based price promotions for foods and beverages high in fat, sugar, or salt [
21]. Despite support from non-government organisations, charities, and public health bodies [
22], the policy has received criticism from food industry stakeholders. Similar to industry’s response to other government-led food regulations, key criticisms cited by the UK food industry have included the potential loss of jobs as a result of the policy; a potential increase in overall food cost for consumers; and an expectation of only a modest impact on health due to the policy [
23‐
25]. There was also concern expressed by some food industry stakeholders that a ban on promotions would be incompatible with other reformulation initiatives set by the government [
23‐
25].
Outside of the UK, little is known about the food industry’s perceptions of government-led action to restrict unhealthy food and beverage price promotions and the potential impact that could have on the implementation and effectiveness of government policies in this area. Several previous studies have explored food industry attitudes towards a range of healthy retail marketing strategies and identified their reasons for marketing ‘less healthy’ foods [
26‐
31]. Key factors included consumer demand for unhealthy foods, difficulties with storing some healthier foods, the higher cost of healthier foods relative to ‘less healthy’ foods, and incentives from manufacturers that maintain the status quo [
26‐
31]. Much of the research in this area has focused on small, independent grocery stores [
28‐
31], with participants that represent only the retailer side (without including the perspectives of food manufacturers) [
28‐
31], and have not specifically focused on price promotions [
26‐
31].
Exploring industry perspectives on government adoption and industry implementation of potential policy options can help provide an understanding of the context in which industry operates [
32]; the power and resources available to them [
33]; the likely impacts of policy action across the food system [
10]; and potential opposition from food industry stakeholders that may be a barrier to policy implementation [
10]. Furthermore, it is important to understand both food retailer and manufacturer perspectives given their joint influence on marketing decisions [
26,
33]. Therefore, the aim of this study was to gather in-depth qualitative data to better understand current price promotion practices and factors that may hinder or help implementation of a policy to improve the healthiness of food and beverage price promotions in Australian supermarkets. Specifically, this study sought perspectives from food manufacturer and supermarket stakeholders involved in setting price promotions regarding: (a) the process by which price promotions are set; (b) the acceptability of potential policy actions that modify food and beverage price promotions to encourage healthy eating; and (c) the perceived feasibility, barriers, and facilitators to implementing policy actions that target food and beverage price promotions.
Materials and methods
Study design and theoretical framework
In-depth semi-structured interviews were conducted with a range of people with expertise on price promotions based on their first-hand experience working with Australian (1) food manufacturing companies and/or (2) supermarkets.
This analytical framework for the study drew on Lewin’s theories of organisational change. Lewin was a prominent researcher in the field of social psychology and developed several theories, to be used in conjunction with one another, to facilitate organisational change [
34]. Lewin’s theories of organisational change have been widely applied in a range of fields including health promotion [
35], health care [
36‐
38], and business management [
39,
40]. According to Lewin’s theories, before making change it is important to understand and map the ‘field’ (the group/organisational environment) and the ‘forces’ (driving and restraining) that influence the status quo [
41].
Ethical approval was granted by the Deakin University Human Ethics Advisory Group (HEAG-H 131_2020). Participants received and returned a signed consent form prior to the interview. Additional verbal consent to audio-record the interviews was gained prior to each interview.
Sample selection and recruitment
People with influence, experience and/or in-depth knowledge of the Australian supermarket setting and price promotion practices were purposively sampled. In the first instance, a range of current employees (from major supermarket chains and consultancy firms) known to the authors were contacted. The majority declined to participate, citing concerns around Australian regulations prohibiting collusion on price setting. Next, additional employees and ex-employees of relevant organisations were identified and invited to participate based on known contacts, Google searches, and the social media platform, LinkedIn. LinkedIn was searched by entering a relevant job title e.g., “promotions manager” into the search function and filtering by country (i.e., Australia) and industry (e.g., food and beverage). Snowball searching was used to find similar contacts (primarily using the function “People also viewed” on the LinkedIn platform). Additionally, key food and beverage company LinkedIn profiles were searched to identify employees.
Seven current and former employees of food and beverage retailers, suppliers and manufacturers in Australia were identified through LinkedIn. Three people known to the research team who have experience in Australian supermarket settings and price promotions were also recruited. An additional two participants were identified through snowball sampling. Recruitment was ceased once no new themes emerged and data saturation was reached (
n = 12) [
42].
Data collection
Semi-structured in-depth interviews were conducted with the aid of a pre-developed interview guide. The interview guide was based on concepts from Lewin’s organisational change theories [
41]. Key concepts from Lewin’s theories that were incorporated into the interview guide included: the current processes of the organisation (including operating procedures, the way decisions are made, and relevant stakeholders involved); identifying the perceived need for change and/or what it would take to trigger a perceived need; the ‘forces’ (internal or external to the organisation) that influence decision making; which ‘forces’ might help drive change and which might restrain change (including understanding any concerns); and identifying a variety of solutions to the perceived restraining forces [
34,
41] (see Additional file
1).
Due to restrictions related to the Covid-19 pandemic, interviews were conducted on a one-to-one basis via the video calling platform Zoom. Interviews took an average time of 44 min (range: 33–59 min). Interviews were conducted by LGD over a six-month period (September 2020 - February 2021).
Analysis
All interviews were recorded and transcribed. Transcripts were emailed to interviewees for review and to offer the opportunity to remove content deemed commercially sensitive.
Transcripts were imported into NVivo 12 for data analysis. Coding of themes was completed in two stages: a deductive approach using preliminary codes based on Lewin’s theories and previous research, followed by an inductive approach where codes were added or removed. Utilising a constant comparative method, analysis was performed alongside recruitment and data collection in order to refine and focus future interviews and to monitor data saturation [
42]. Codes were organised into categories and sub-categories and iteratively reviewed to identify themes. A randomly selected transcript was coded by a second researcher to check agreement between coding. The overall coding of data and themes was reviewed by one of the research team (GS).
Themes were synthesised narratively and conceptualised into a Force Field Analysis Model, a visual representation of the identified forces restraining from, and driving towards, change. In this case, the desired change is healthier price promotion practices in Australian supermarkets. According to Lewin, plotting the driving and restraining ‘forces’ can facilitate the process of change by helping stakeholders to understand the ‘forces’ that require strengthening and/or reducing [
34].
Discussion
In this study, twelve interviews were conducted with food and beverage industry stakeholders to understand the process by which price promotions are set, and the acceptability and feasibility of implementing policy actions that modify the healthiness of food and beverage price promotions in Australian supermarkets.
From the interviews, it was identified that current price promotions are highly lucrative for retailers and their suppliers. Therefore, a policy that restricts price promotions for unhealthy foods would likely be strongly opposed by many food industry stakeholders. This is consistent with industry responses observed to other policies designed to improve population diets. For example, industry opposition to the original price promotion consultation in the UK (2018) [
43] may have contributed to the weakening of the policy design. The initial proposal of a restriction on all unhealthy food and beverage price promotions was watered down to a policy that restricts only on volume-based price promotions (e.g., two-for-one), meaning temporary price reductions are still allowed under the proposed law [
19]. Lobbying from the food industry has been identified as a key barrier to implementing healthy eating policies, leading organisations such as the WHO to advocate for nutrition policy to be developed by governments and to be safeguarded against influences from the food industry [
44].
Interviewees agreed that if a mandatory policy to reduce price promotions on unhealthy foods was implemented, industry would likely promote their unhealthy products in alternate ways (e.g., lowering their permanent price, or promoting through placement strategies). Interviewees also identified the importance of having clear definitions of healthy and unhealthy foods, and monitoring compliance. Industry responses to the UK consultation on restricting promotions revealed a similar sentiment, requesting clear and detailed guidance on the scope of the restrictions and the enforcement regime from the government. This is echoed by academics who have recommended that industry initiatives require clear targets for implementation; objective and transparent monitoring and evaluation; and meaningful sanctions for non-compliance [
45‐
47]. Alternate promotion and/or pricing strategies and the implication on the healthiness of foods sold at supermarkets should be closely monitored when the UK policy comes into force.
In considering the potential impact of policies to restrict price promotions on unhealthy foods, the study indicated that policy action may incentivise increased product development or reformulation in favour of healthy products. Giving suppliers time to adapt and/or phasing in the regulation with stepped targets may facilitate such reformulation or product development. Reformulation following mandatory nutrition-related policies has been seen elsewhere, for example, an evaluation of the UK sugar-sweetened beverage tax found that the tax resulted in manufacturers reformulating products which substantially reduced the sugar content [
48]. More generally, many large food manufacturers operating in Australia already have diverse product portfolios, consisting of a range of both healthy and unhealthy products [
49]. In many cases, these manufacturers would likely have multiple opportunities to shift towards adopting price promotions on their healthier products within each category. However, their willingness to do that, the likely response from supermarkets, and the corresponding impact on population diets need to be explored in more detail.
This study indicated that a policy to restrict price promotions on unhealthy foods was likely to be most effective if it was mandatory, with voluntary action unlikely to be widely adopted due to the current “promotional cycle” and competitive dynamics. Similarly, responses from the consultation process in the UK’s proposal to ban promotions revealed that a voluntary initiative was unlikely to work as there would need to be a level playing field across the retail sector [
22]. The likely benefit of mandated public health policies in the area of nutrition is evident from previous voluntary initiatives that have fallen short of their public health objectives [
50]. For example, a review of the Health Star Rating (HSR), a voluntary front-of-pack labelling scheme for packaged foods used in Australia, found that although there has been substantial uptake of the policy by some manufacturers, the overall uptake is still considered to be sub-optimal (only around 40% of eligible products had a HSR, most of which were on products with higher i.e., healthier, HSRs) [
51,
52].
While some industry representatives included in this study indicated that restrictions of price promotions on unhealthy foods were likely to be effective, other participants indicated that policy action in this area was unlikely to curb consumer demand for unhealthy foods and stressed a preference for consumer education instead. This view is comparable to previous research exploring retailers’ perspectives of healthy eating initiatives, where the primary reason for stocking and/or promoting unhealthier foods is cited as customer demand [
28‐
31]. Food industry arguments about the need for consumer education (rather than industry regulation) to address unhealthy diets have frequently been identified [
53‐
55]. A strong body of evidence has noted that this narrative is designed to deflect the need for industry action to improve population health and maximise industry profits (often at the expense of public health) [
56‐
59]. Furthermore, education interventions alone have been shown to be ineffective without greater action to alter food environments to support healthier choices [
12,
13,
60]. Interestingly, a recent shopper survey from the Republic of Ireland found that over 90% of participants wanted to see more promotions on fruits and vegetables and the majority wanted less on products such as cakes, biscuits, soft drinks, and confectionery [
27]. Additional research is needed to understand the effects of altering the proportion of unhealthy to healthy price promotions on purchase behaviour and consumer views on such policies.
Strengths and limitations
To our knowledge, outside of information gleaned from the recent UK government consultation on price promotion policy, this is the first study to explore both food retailers’ and suppliers’ reflections on policy actions that target price promotions to encourage healthy dietary behaviours. Furthermore, this study included participants with substantial expertise in the food industry, providing rich, in-depth data on food and beverage price promotions in Australia.
However, there were several limitations to this study. Firstly, a number of current food industry employees in Australia declined participation in the study, and the included participants were primarily identified through LinkedIn, potentially biasing the sample toward those active on this social media platform and ex-employees of food companies. Nevertheless, the included participants had extensive experience in the food industry and were able to offer deep insights into food and beverage price promotion strategies in Australian supermarkets, both from retailer and supplier perspectives. Secondly, the personal experiences and beliefs of the researcher (a public health PhD student) will have influenced the interpretations of the findings. To reduce potential bias from the researcher’s own experiences and assumptions, reflexivity was practiced throughout the data collection and analysis. Additionally, themes and a transcript were cross checked by another researcher.
Lastly, this study was only conducted with industry stakeholders based in Australia. The supermarket landscape and marketing tactics in Australia are context specific and are likely to differ across countries. For example, Australia is dominated by two main supermarket retailers [
61], Australians have been found to be some of the most price sensitive grocery shoppers [
62], and the proportion of grocery sales purchased while on price promotions in Australia is one of the highest in the world [
63]. It is likely that these contextual differences will be reflected in the barriers and enablers to a policy on price promotions observed in this study. While the use of well-established theories of organisational change in analysing the study results is likely to increase the generalisability of the findings (especially in other high-income countries with similar regulatory systems to Australia), relevant stakeholder perspectives from other countries and contexts should be explored.
Implications for public health policy
Unhealthy diets are a leading contributor to ill health in Australia and globally [
64]. Accordingly, governments are actively seeking strategies to improve population diets [
6,
65,
66]. As price promotions on unhealthy foods and beverages are likely a contributing factor to unhealthy diets, governments need to actively consider ways to address their impact as part of a comprehensive approach.
This study, along with other research, suggests that for a policy to reduce price promotions on unhealthy foods to be successful, the policy would need to be comprehensive (clearly defining healthy and unhealthy products, applying to a range of settings, and including broader in-store promotional activities such as placement strategies); be mandatory; include extensive compliance monitoring (including the monitoring of broader marketing tactics to ensure there is not an increase in compensatory marketing strategies); incentivise the promotion of healthy products; and consider phasing in targets to shift the proportion of healthy and unhealthy price promotions. Moreover, to counter likely industry responses, it would be critical that policy action to restrict price promotions be embedded within a comprehensive nutrition policy (including taxes, consumer education, advertising and online marketing restrictions, etc.) targeting multiple marketing strategies and techniques. The findings from this study strongly imply that industry will resist a policy that limits price promotions and provides insights into the arguments they will use to defend their position. To counter these industry arguments, it is important for researchers and public health advocates to generate evidence on the impacts a policy to restrict price promotions on unhealthy foods will have on purchasing behaviour, diet quality, financial cost to the public, and the public’s perception of a policy.
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