*3.1. Model Context*

The participating grocery store chain offered a large, busy store that was located in a demographically diverse neighborhood. This store was chosen because of the diverse employee and customer demographics, as well as the store manager, who was enthusiastic about the program. After the initiation of the program, this store manager was transferred to another store; the replacement manager was not as invested in the study. During the project planning phase, store management agreed to adjust work schedules of design team members so they would be scheduled to work on meeting days, and could attend meetings immediately before or after their scheduled shift; this did not always happen over the course of the program. Store management provided a space for the design team to meet on site, although it was not always private due to limited space options in the store.

The selected store employed approximately 159 workers, roughly 40% of whom were full-time employees. We obtained baseline surveys from 120 workers (75% response rate); their demographics are presented in Table 1. The majority of the workforce was unionized and represented by one of five different unions/locals within the store.


**Table 1.** Demographics of the Baseline Survey Respondents.

#### *3.2. Model Inputs*

We used all of the IDEAS Tool worksheets, but simplified some of the language to make them more understandable to the design team members. The design team reported that although they understood the program materials when the facilitator guided the process, the worksheets were not intuitive to complete on their own. Thus, the facilitator was a critical part of the team's success in

completing the steps of the IDEAS Tool. The facilitator devoted considerable time over the course of the program to prep, plan, and facilitate team meetings. The majority of the facilitator's time was spent between meetings, combing through the design team's materials to condense and simplify the information to help move the team through the program (Table 2). The criteria for recruitment for the design team and steering committee were met. However, store management was not able to consistently schedule team members to work on the day of the meeting as planned so not all team members were able to attend the weekly meetings. Seven workers were initially recruited, but one was unable to regularly attend the meetings. The final design team consisted of six workers with racial and gender diversity. The team was representative of the line-level workers in terms of age, seniority, union membership, and self-reported weight. We recruited a volunteer from six of the store's largest departments. The six departments with design team volunteers represented 52% of the store's workforce.




**Table 2.** *Cont.*

Note: HWPP: Healthy Workplace Participatory Program, IDEAS: Intervention Design and Analysis Scorecard.

#### *3.3. Model Activities*

Fidelity to the IDEAS process was met and Steps 1–6 were completed by the design team or steering committee (Table 2). Step 7 (evaluation) was not completed by the design team or steering committee, as formative and follow-up survey data collection was completed by the research team. Design team members were highly engaged during the meetings and attendance was consistent; no design team member missed more than two meetings and they often attended meetings on their days off work. While the level of participation during meetings varied by person, all team members contributed to the discussion and offered new ideas. The members of the design team were not consistent with completing assigned 'homework' tasks outside of meetings, but they did report talking to each other about the program between meetings. Scheduling conflicts and other priorities prevented greater time for discussion and completion of homework activities.

Overall, design team members had positive perceptions of the program. They reported that the program met their expectations and positively influenced their health (i.e., drinking more water, purchasing healthier food options). Five of the six team members felt that the participatory process created opportunities for more open dialogue with management, although they did not feel confident that management would follow-through on implementing proposed activities. In addition, a few design team members were frustrated with being scheduled to work at the time of the team meetings, however they were able to work with their immediate supervisor to attend. Early in the process (Step 1), the design team participated in two rounds of brainstorming which generated a total of 65 ideas grouped into four themes (diet, physical activity, stress, and health awareness). The team referred to these ideas and themes in Step 2 to identify their goal ("Reduce Stress at Work"), develop three objectives ("Improve Diet at Work," "Improve Store Communication," and "Increase Health Awareness"), and create 15 specific activities related to the three objectives. The design team rated these activities during Steps 3 and 4 with the understanding that they would have to "sell" the ideas to management. The team presented their top rated ideas to the steering committee. The steering

committee took approximately 7 months to respond to the design team's proposal; they approved five activities without edit; approved two activities with small changes based on current store logistics; requested more information on four activities; and did not approve four activities (Table 3).


