Community pharmacy as a setting for public health nutrition action: Australian nutritionists' perspectives.

OBJECTIVE: To explore public health nutritionists' perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition. DESIGN: Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation. SETTING: Queensland, Australia. SUBJECTS: Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience. RESULTS: Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners' perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes. CONCLUSIONS: Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are 'for the good' of mothers and infants.

Understanding community pharmacy intervention practice: lessons from intervention researchers.

BACKGROUND: Community pharmacy (CP) is a setting with health promotion and public health potential which could include strategies with a nutrition promotion focus. Research embedded in this setting has explored and produced evidence to inform practice change to develop this potential. The experience of undertaking research in this setting may provide insight into the challenges and key features of intervention research practice. Exploring experienced-based knowledge presents as a productive area of research, extending what can be known beyond the bounds of what is measurable. OBJECTIVES: This study aimed to understand the experience of intervention research in CP with a focus on nutrition and to develop guidance for future research practice (intervention design and implementation) in CP based on interventionists' reflections and practice wisdom. METHODS: Semi-structured interviews were conducted with 9 researchers with experience in undertaking intervention research in CP with a nutrition component. Content analysis, constant comparison and interpretive description were used in the analysis and interpretation of interview data. RESULTS: Five key lessons were identified - 1) utilize existing capacity; 2) navigate and utilize social power and interests; 3) personalize engagement and recruitment; 4) consider the logistics and 5) intervention type considerations. Key challenges for translating research into practice and sustaining change included financial sustainability, physical constraints, logistics, collaboration, and practice change enablers. Personal reflections on research practice identified qualities, such as determination and skills in networking, as key for researching in CP. CONCLUSIONS: CP-embedded research is challenging given the complexity of the practice environment. The social context of CP appears central to intervention research and a nuanced understanding of the social context needs to be the basis for intervention design to inform successful implementation. Experience-based and insider knowledge is useful and needed for nuanced design and development of intervention research in CP.