Qualitative perspectives on the implementation of an intervention transforming food pantry environments

Abstract

Background

The SuperShelf intervention transformed food pantries into welcoming spaces to make the healthy choice the easier choice for clients. This qualitative study aimed to understand the transformation process and its effect on the food pantry environment and client experience.

Methods

Staff and volunteers from eight food pantries participating in a group-randomized SuperShelf evaluation were interviewed using semi-structured interview guide for a total of 32 interviews. Participants were interviewed in person before the intervention implementation in 2018 and one year later following intervention implementation.

Results

The SuperShelf approach to transforming food pantries was experienced as highly successful by food pantries undergoing these changes, and changes to the physical environment were particularly valued. The values of SuperShelf were well aligned with the changes that food pantry staff and volunteers described, especially for the values of ‘good food’ and ‘respect for all’, which led to high levels of engagement and adherence to the intervention implementation.

Conclusions

Managers and volunteers viewed the intervention as impactful, both for clients and those working in the pantries, and supportive of their vision to offer food assistance to reduce stigma and increase dignity and choice for clients.

Trial registration

ClinicalTrials.gov Identifier NCT03421106, date of registration: January 29, 2018.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-26036-2.

Background

Household food insecurity is defined as limited access to adequate food due to a lack of money and other resources [1]. In recent years, about 1 in 10 US households experienced food insecurity within a year, while 3.8% of households experienced very low food insecurity in 2021 [1]. Food insecurity is linked to a range of serious and concerning health outcomes or conditions including increased BMI in adult women and increased chronic disease among adults [2–5]. Food insecurity also impacts children, who may experience a heightened likelihood of iron deficiency anemia, as well developmental and mental health problems [3, 6–10]. Addressing household food insecurity has the potential to lead to family wide health benefits [11].

Many food insecure households rely on food pantries to obtain food. Focusing interventions for improving healthy food options in these settings has the potential to improve dietary behaviors [12–14] or other health outcomes such as glycemic control [15]. Previous pantry interventions have used strategies such as pre-selected food boxes with healthy food to participants [15], or offering cooking classes to clients that include nutrition education [16, 17]. While these interventions may lead to gains, they may also miss the opportunity to improve the experience of clients obtaining food from a food pantry, and the quality of upstream food available to food pantries. The stigma associated with obtaining food at a food pantry can serve as a barrier to obtaining food [18–20]. Moreover, food pantry staff and volunteer tend to perceive that food pantry client do not want healthy foods or lack the knowledge to cook with them [21–24] when research has consistently demonstrated the opposite [25–30].

One approach that is suited to improve the food pantry experience and maintain client choice is using behavioral economics [13, 31–33]. Behavioral economics nudges certain behaviors – for example, by changing default options, conveying behavioral norms, or offering incentives – to make the healthy choice the easiest choice [34]. At the same time, it preserves client autonomy without imposing any particular time or resource burden on the client. Notably there is a gap in the literature about the best ways to implement such interventions [35–37].

In 2013, a community initiative with stakeholders from multiple sectors led to the development of SuperShelf in Minnesota. Core partners included a food bank, food pantry, integrated health system, academic partner, and University Extension services. SuperShelf is an intervention in which the food pantry (also referred to in Minnesota as a ‘food shelf’) undergoes a consultant-guided transformation. The transformation is customized at each site based on their organizational needs and capacity, but transformations share a common process and that process is grounded in a common set of core values. The process involves two phases, the first of which is to enhance the consistent sourcing of a variety of healthy foods (i.e., increase supply) and the second of which is to physically transform the food pantry environment in a way that promotes healthy food selections (i.e., increase demand). Core values were developed by the SuperShelf community partners in 2016 and include good food, respect for all, collaborative partnerships, evidence-based practice, and systemic thinking.

A pilot study showed how the SuperShelf approach led to an improvement in the nutritional quality of food selected by food pantry clients when adherence to the intervention implementation was high [13]. This pilot study led to the development of a larger cluster-randomized trial, which commenced in 2018. An environment-level analysis has since demonstrated that the food pantries were successful in implementing SuperShelf with a high degree of fidelity, with some indicators of a healthier food supply [38]. Dozens of pantries outside the study have expressed a desire to implement SuperShelf. At the same time, implementation changes did not lead to measurable differences between intervention arms in the client-level health outcomes assessed [39]. These mixed findings leave a gap in understanding future directions for this intervention.

Implementation science is the study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies, into health care and public health settings. Implementation science is key to understanding barriers and enablers of establishing and reproducing a successful intervention [40]. Frameworks such as the Diffusion of Innovation (DOI) Theory [41, 42] offer insights on the implementation of interventions. DOI has highlighted the importance of establishing the relative advantage of a change in practice, particularly if new policies or practices will be viewed as better than current practice. DOI also considers the intervention complexity, how well the intervention changes can be observed and measured, the impact on social relationships, and the perceived time commitment to undertake the intervention [36]. However, there has been little application of such frameworks to interventions in food pantry settings.

The aim of this study was to interview SuperShelf managers and volunteers in intervention and control food pantries, and through the use of implementation science frameworks, to understand the process of transformation of these food pantries and its effect on the food pantry environment. These perspectives provide evidence of impacts of the transformation that may not have been not quantifiable using other evaluation instruments, and explain the steadfast interest among Minnesota food pantries in undergoing SuperShelf transformations.

Methods

Setting

This qualitative study was part of an evaluation of the SuperShelf intervention in Minnesota, USA. This study randomized food pantries to an intervention condition (SuperShelf) and control condition (which offered a delayed intervention following the completion of all study data). The study was carried out in two waves: wave one (2018–2019) and wave two (2019–2020). The overall intervention assessed changes in client health as measured with a primary outcome of diet quality (measured by the HEI-2015) [43], food selection (measured by HEI-2015, secondary outcome), and cardiovascular health as measured by Life’s Simple 7 [44], (secondary outcome). The full study protocol is reported elsewhere [39].

Participants

Participants consisted of eight managers and eight volunteers from the eight food pantry sites that agreed to participate in the study in wave one. These groups were recruited as they had direct experience in delivering food pantry services and being able to speak knowledgeably about how the pantry is organized and functions. Four pantries had been randomly assigned to the intervention arm and four matched pantries had been randomly assigned to the intervention condition. Participants were interviewed in person before the intervention implementation in 2018 and one year later following intervention implementation (or in the same month as a matched pantry for control condition pantries) for a total of 32 interviews.

Data collection

A semi-structured interview guide was developed by the study investigators. The guide included questions that aimed to understand the organization, from the perspective of the participant. Questions addressed the client population, the overall client experience, general functioning of the food pantry, organizational struggles, work styles, organization values, and what the organization hoped to achieve from the SuperShelf intervention. Constructs from DOI were used to guide the development of the interview guide [41, 42]. Interviews were audio recorded and transcribed verbatim.

Intervention

The intervention was implemented by SuperShelf consultants who underwent a formal 1.5 day training with ongoing scaffolding by a study Community Outreach Coordinator and bi-weekly meetings for all SuperShelf consultants. In phase one of the intervention, consultants worked with food pantry staff to increase the quantity and variety of healthy and culturally appropriate food (i.e., reflecting the value ‘good food’) using a variety of strategies, including analyzing reports of current food procurement by the pantry, making changes to food bank orders, and building the pantry’s network of food procurement to include more retail rescue and produce distributors (i.e., collaborative partnerships). They also trained volunteers about the goals of the intervention, bringing attention to the issue of reducing stigma for clients and promoting skills to recognize those in different positionality from themselves (i.e., systemic thinking). When possible, food pantries modified their operations to reduce wait times and encourage positive interactions between staff and clients (i.e., respect for all).

In the second phase, new shelving, unique produce displays, bright paint, and signage with positive messaging in relevant languages made the food pantry a welcoming place (i.e., respect for all). Consultants reorganized the pantry into major food group categories with fruits and vegetables first; grains, proteins, dairy, cooking, and baking items in the middle; and highly processed food last (i.e., good food). Behavioral economics strategies were used to make the healthiest choice the easiest choice for clients (i.e., evidence-based practices). Fruit and vegetables were placed on appealing central displayed, whole grains were placed at eye level, and healthy foods were bundled on end caps with other ingredients to make a meal. In addition, weight limits on client food selection were removed, while the selection of fresh fruits and vegetables was made unlimited (i.e., reflecting the values ‘good food’ and ‘respect for all’). Clients could still take unhealthy items, but these items competed with one another on the pantry’s shopping list (e.g., all snack foods were consolidated onto one shelf, where clients could “pick any two.”).

Each transformation took place over approximately two months. Intervention food pantries were reimbursed up to $4000 to make physical changes to their food pantry (e.g., new displays, shelves, paint). They also received up to $1000 for SuperShelf branded signage.

Data analysis

The qualitative data were analyzed using NVivo 11 [45]; two members of the research team double-coded the data to ensure consistency. The research team used the social constructivist approach to identify themes and subthemes in the data [46, 47]. This approach allows for the consideration of pre-existing literature or theory alongside the emerging themes. The findings are presented to provide insights into the period before and after the transformation. In this analysis, the themes were organized and described in relation to the intervention values (see Table 1). Only participants from food pantries that had undergone a transformation are included in the analysis of the transformation process. Discussions with members of the research team on the emerging analysis further validated the rigor of the qualitative analysis. A consensus-building approach was used to resolve any differences in the emerging themes. To achieve consensus members of the analytic team met frequently to review and discuss emergent codes, allowing for detailed discussion of differences, allowing for the team to build a common and agreed upon thematic framework.

Table 1.

SuperShelf intervention values

SuperShelf Values		Examples of transformation activities and promoted practices that reflect values
Good Food	We believe reliable access to healthy, appealing and culturally appropriate food will promote overall health in our communities	• Emphasize appealing displays of healthy food • Include culturally specific food in stocking standards
Respect for All	We believe client-centered, welcoming, and positive approaches create dignified experiences that further equity in our communities.	• Train volunteers to allow clients to choose food for themselves • Eliminate “pound limits” on food for clients at their visit
Collaborative Partnerships	We believe mutual trust and fully-engaged partners build strong, connected communities working toward sustainable systems change.	• Build a network of new food suppliers of healthy food • Communicate with food bank about food needs
Evidence-based Practices	We believe excellence comes from thoughtful, rigorous evaluations, and replicable solutions.	• Ground intervention activities in behavioral theory and previous research • Integrate data from statewide client surveys into practice
Systemic Thinking	The food system is complex, interconnected and dynamic; We believe action at all levels is critical for transformational change.	• Approach food issues from those in a positionality different from oneself • Consider how the transformation could have “ripple effects” (e.g., less food waste, different foods available at food bank)

Human subjects

The study was approved by the University of Minnesota Institutional Review Board (Study Number 1612S02201).

Findings

Here we present the findings, organized as main themes and sub-themes with illustrative quotes (see Table 2). Food pantries are often referred to as “food shelves” in Minnesota, but outside of direct quotations, the term “food pantry” is used in these findings to describe the setting the participants worked or volunteered in since that is the term most commonly used in the U.S.

Table 2.

Overall themes, sub-themes and illustrative quotes

Theme	Sub-theme	Illustrative Quotes
Anticipating the SuperShelf transformation		I look at it like everything can be improved, so bigger improvement like that would be great. Make people feel a little better you know when they do come here because some people don’t like going to the food shelf, and, and, then when you know so they can get to experience like you know like just come to like a grocery store, but again in the day there is no, out of your pocket. You know what I’m saying. That’s a good thing. That’s a good thing. (Volunteer) I think even just being able to have more choices and have more free options certainly um so I think it’s exciting to have SuperShelf come in and to be able to not only look at the space, look at the budget, be able to fill that gap and also do that kinda deeper analysis of how, how is this working, not only for staff but um volunteers and for clients. (Volunteer)
SuperShelf transformation process	Good Food	We’re doing more produce, and that’s really nice. And got rid of a lot of things cause we were doing like canned spaghetti and things like that and getting away from a lot of that more processed food, and trying to get more towards the more, greener down to earth, back to earth food, you know? And that makes a huge difference. And the produce is just, it’s been super nice. (Volunteer) We are better connected with um, like the, the vendors, like they have, we can get, we get better produce now. Um we were getting stuff that we, my boss would order, and it wasn’t really, it was good but like part of it was bad cause it was rescued. It’s all rescued food. But um, you know, so he’s just able to get fresher stuff and um, you know, cause if you spend any money on something that, you know you’re, you’re planning on putting out, you don’t want to spend money on stuff that’s half, you know, ready to go [bad]. Even though that was the case and we knew that going into it, um by doing this we have, we just have more options and where to order from and how much to order, but um the results have been good. (Manager)
	Respect for All	Our main mission is obviously to serve food, but also with dignity to the community. And I think every step of the process uh with Supershelf has maintained the dignity of our clients. So, I think it definitely has aligned really well. (Manager) I think the customer service has improved, I mean you can’t give away good stuff and have a bad attitude when you do it. I mean it’s just, I think it’s improved that you know, the way that we look at it as more of a grocery store instead of a food shelf really. That’s the way I look at it, I look at it as a grocery store and people are coming here to grocery shop, so you treat them well. (Manager)
	Collaborative Partnerships	Supershelf was really engaged with the partner organizations um and really made it very seamless and easy to go through the process. I think, it could be scary for, you know, smaller food shelves because I think Supershelf is really needed in those like smaller food shelves that really could see the more drastic change um and for them they might not have the capacity to take on a big project like this. (Manager) Some people don’t realize that the food shelf is here or that there is a need, really. And so it’s nice to be able to showcase what we’re able to offer and make them aware there is a need in town. Cause a lot of people don’t see that here, and then like I was saying earlier, we’re working with the food banks and things like that. And so we’ve developed some great relationships with them to try to you know get what we need for our clients as well. And that’s, they’ve been really receptive to the change you know as well as, just trying to figure out how to get sourcing that they need to provide us as well. (Manager)
	Evidence-based Practice	I mean I think that overall it is a positive change, I mean when they come in here it’s a more dignified experience you know for them. And I think that we’re able to nudge them into you know trying something maybe they haven’t tried before that’s maybe a healthier option than what they might’ve gotten in the past or you know things like that. (Manager) I think that overall it was good. But I think one of the biggest things for me personally that I had my hands involved with was making out the new shopping list. Going through that and trying to consolidate the categories, what might work, where to put things, and things like that. They’re very helpful as far as what they’ve done before, how I could make that work here, and what would also be best for our clients based on the surveys they’d done before and things like that. (Manager)
	Systemic Thinking	Our board is going through the process of updating our values. And, because we have made so many great changes with SuperShelf, we have been able to update those, and align them more with creating a welcoming environment and putting health as a priority. So, yeah, I think SuperShelf has helped us look at our missions and values and our mission statement, and make it stronger because of the changes that we’ve made. (Manager) I think we already made a lot of changes in the last year, really positive ones definitely we’re going to work on maintaining. In the future, I would really would like to see some sort of nutrition policy as well as we serve (the) county, which is quite large. Um, somehow figuring out how to bring food to people, um, but also still have that based on choices, too. I think that’s the direction we’re going next, is looking into the access that people have to the food shelf and how we can improve that. (Manager)
Impact of Changes	Impact on client experience	I think when they walk in, especially so, we, not Supershelf related, but um we just got a new front desk um, that white one, before we just had like (thumps on the desk) a desk like this like a wooden one. Um and people have also been commenting on that of like “Oh wow! This place looks so professional” and not that we want to be this like, business you know, but I think with the transformation it’s really improved people’s perception of who we are as an organization and that we’re a friendly community safe place. (Manager) We have people coming in every day who say that they feel like they’re at a grocery store. They don’t feel bad for coming in. They’re really happy that we have fresh fruits and vegetables, which we’ve had, but we’ve never displayed them as nicely as we have,, as well as, um, having an abundance of things for people to choose from. (Manager)
	Impact on staff and volunteers	I’m so glad that we were able to do this. Thankful, very very very very thankful. You know, because it makes a huge difference. It really does. You know? I mean before we had it the way it was before and to what it is now, it’s like a total different, total different place. You know? And um, I’m just happy. (laughs) (Volunteer) My gosh! It was just like *ping*! And we were all getting so excited cause everything, even the coat of paint, oh my gosh a coat of paint is so welcome because it’s like it brightens everything up, you know. And uh I was really happy with the whole transformation. (Volunteer)
	Challenges	And, I mean it was a lot to change over to the new system for us, for the computer. You know because people, it was a real learning curve. You know, but I think all that kind of stuff, it just, it helps so much more, you know I think you’re better to be, to be tracking things and so forth for the, for the managers and directors and all. (Volunteer) It was kinda, it was hectic, it was hectic. Just based on the time frame that we had to do it in, so it was frantic at some points trying to get everything done but anticipating it looking a lot like a grocery store, was worth it. (Manager)
	Future plans	The last results that we received, uh, was really beneficial to us in seeing the food items that our clients are most, um, in need of. Or, you know, the items that they need most. So yeah, we’re using that and we’re also hoping to do, um, next summer a survey similar to that. Put together information to see what we can change here as well. (Manager) I feel like we’re going into really good stages with this last year focused on inside the building. And now we need to start branching out to figure out how we can start to serve people more efficiently (Manager)

Anticipating the SuperShelf transformation

Participants generally viewed their upcoming SuperShelf transformation with excitement because of the potential to better serve their clients. Some participants expressed feelings of anxiety and apprehension in regard to how volunteers or clients might react to the change to their food pantry. Some shared that change could feel daunting, and their hopes that SuperShelf would be able to be implemented well in their individual setting.

I think it’s going to better us. We need to do anything that you can do to improve what you’re doing right now is for the better of the clients. … Anything we can do to make them feel more at ease, more you know, we’re here for them. (Volunteer, pre-implementation)

The manager participants primarily anticipated that any resistance to change would come from volunteers, specifically long-term volunteers. The managers emphasized the need to educate volunteers and staff (other paid employees at the food pantry) on the reasoning for change, encourage them to think positively about the change, and hold space to listen to and address any concerns. Participants mentioned particular areas of improvement or change at the food pantry they felt were most important for meeting client needs, and these included, wanting more healthy and fresh food at their food pantry, improving the aesthetics of the space and to increasing the efficiency of the food pantry.

SuperShelf transformation process

Participants were asked to describe the process of the SuperShelf transformation, and most described the process as collaborative and supportive, with good relationships and communication between the SuperShelf transformation consultants and their sites. Participants overwhelmingly described their experience with the SuperShelf team to be very positive and easier than anticipated. The transformation – while customized to the needs and capacity of each food pantry – had a similar process at each site and was rooted in five common key values. To organize the findings of the post-intervention interviews, participant experiences of the transformation are presented for each of the five values; good food, respect for all, collaborative partnerships, evidence-based practices, and systemic thinking (see Table 1).

Good food

The value of providing good food related to the ways in which the transformation worked to change food sourcing, stocking standards, food selection practices and focus on maximizing nutritional quality. Participants shared a great deal of enthusiasm for aspects of the transformation relating to the value of good food and described how they applied this value to their pantry. The majority of the food pantries thought the most significant change was to the food category/shopping list, with an increasing emphasis on healthier foods. In addition, this led to changes in how the fruits and vegetables were displayed within the food pantry, giving them the most prominent location in the pantry. Participants also described serving diverse populations, including Caribbean, East Asian, Somali, Latino and Russian families. The transformation process was seen as helpful in supporting the food pantries to address the needs of these diverse clients, particularly in regard to providing culturally-specific foods or translating culturally-tailored shopping lists into a variety of languages.

Participants described that some of the most noticeable changes was the transition to having more fresh produce available. This was commented on by both manager and volunteer participants. Participants felt this was a very important part of the transformation, and they were pleased that clients, including families and individuals, could benefit from this improved selection. Participants also felt they did not have to limit the selection of fresh fruits and vegetables, and that this was a change directly stemming from the transformation. Participants felt that offering healthier food was a way to also demonstrate their intention to provide healthy, caring, and equitable services. Additionally, by increasing healthier foods, such as fresh produce, the transformation was credited with visibly decreasing the prominence of sugar, salty and processed foods. Participants shared how clients had noticed these changes and were feeling very positive about them.

One guy that actually came through today, and we talk, and he was just really happy, because he’s been making better choices, and there’s a lot more better choices to be made than there was before. So especially with the produce, you know? I mean that makes a huge, people need that produce. Really need the produce. (Volunteer, post-implementation)

Respect for all

The transformation of the physical space of the food pantry, while only one part of the SuperShelf intervention, was a highly anticipated part of the transformation process. Overall, there was a positive association between the physical appearance, resources (such as refrigeration and computers), and changes of the food pantry. In general, participants depicted their post-transformation food pantry as brighter, cleaner, and running much more smoothly and efficiently. They attributed it to the optimized use of space, leading to improved organization. With much appreciation, participants described the food pantry post-transformation as a better place to visit for clients and to work or volunteer in.

I think sometimes our building looks like a warehouse, um or like a mechanic like an autoshop from the outside. So I think when they come in, they’re like pleasantly surprised of how like warm and welcoming the space is from the transformation. And like I said, just going back to you know, having the pictures of fresh produce on the walls and you know it’s showing that we’re caring about them in a way. (Manager, post-implementation)

Participants welcomed the transformation emphasis of improving accessibility for clients at the food pantry. The redesign of existing spaces led to wider and organized walkways to allow more efficient functionality. Accessibility was also enhanced through having new computer systems, which allowed them to enter and find family households quickly and efficiently, or not have to deal with hard copies of paper for families to sign. Overall, the accessibility and functionality of the food pantry was mentioned as being a positive change for clients.

Participants enthusiastically described how the physical changes to the space brightened everything up and created a more welcoming and cheerful atmosphere for the staff, volunteers and their clients alike. Participants discussed noticing a difference in people’s moods and demeanor, specifically smiles and laughs around the food pantry. Some participants described feeling that their food pantry evolved from being dark and lifeless to something families could feel comfortable and proud to shop in. This change was highly valued by participants, as it conveyed the message to clients that they were welcome and respected at the food pantry.

I think that you know the renovation as a whole, the you know, fresh, the fresh look, the way that things are, you know laid out, the signs, that are, you know showing off the produce and the food and um you know those positive changes like that just make it feel good you know when you walk in and I think that you know it would’ve been a lot harder for us to pull off something like that in such a short time without the Supershelf coming in and making that impact for us. (Manager, post-implementation)

Participants described the transformed food pantry as looking like a grocery store or supermarket, and felt this was a significant improvement for the pantry. In particular, it was mentioned as important for reducing, or even removing the stigma associated with getting food from a food pantry. Participants reported this physical transformation having a positive impact on the families they serve. This was viewed as consistent with the goal of providing services with dignity. Participants felt this had contributed to improved relationships between clients and staff in the food pantry.

It just makes a huge difference in, in the whole atmosphere and that makes a huge difference for people that are working there and the clients that come in also. You know because it makes them happier. They feel like they’re shopping in a grocery store instead of shopping at, because there’s always that stigma of having to go to the food shelf you know? But it’s like, this doesn’t seem as much like a food shelf as it seems like more of a small market. (Volunteer, post-transformation)

Collaborative partnerships

Sites varied in the range of current partnerships they had and, in general, sites that conducted more outreach or additional services (e.g., health navigation, etc.), had a wider range of partnerships. The transformation process was described as helping to build new partnerships, such as accessing resources at a local university, remodelers who helped with the physical transformation, and connections to local businesses who were able to donate food or contribute to food rescue. Some sites had existing partnerships with the county, community and local grocery stores who donate food to them, and both manager and volunteer participants described the transformation as helping to strengthen relationships with other food shelves who were also increasing access to fresh produce/food options.

We just have more options and where to order from and how much to order, but um the results have been good. (Manager, post-implementation)

Evidence-based practice

The SuperShelf transformation emphasized the value and importance of integrating evidence-based practices into the food pantry environment. The participants reflected on their appreciation of the SuperShelf transformation itself being evidence-based and many participants felt that the transformation went very smoothly for that reason. The transformation encouraged sites to set up ways to assess the client experience of the food pantry, and collect data on food pantry usage, such as monitoring what food is selected. Food selection at the pantry level was influenced by using evidence-based practices such as reviewing data on what food was being chosen.

We weren’t going to spend our money on [whole grain items, brown rice] because people don’t like those anyways. Which is not true from what we’re finding. (Manager, post-implementation)

Gathering and incorporating client feedback was helpful for seeing what is being utilized and how clients are experiencing the services at the food pantry.

We really make sure that when we’re ordering we’re thinking about the participants and what their needs are, rather than what we like. We’re not shopping for ourselves. We’re making sure that we listen to what they want on the shelves and what the most useful for them. (Manager, post-implementation)

Systemic thinking

The value of systemic thinking involves encouraging the food pantry to see themselves as part of a larger, dynamic food relief system that is working towards systemic solutions, connections or change. These changes might be downstream, when foods offered to clients are based on “what their needs are, rather than what we [the pantry] likes”, which is likely to have positive effects on the food system, including reducing food waste. Upstream, the transformation helped to strengthen the food pantry relationship with their food bank, which in turn was useful for ensuring certain product availability, such as culturally-specific foods, whole grains, as well as spices, condiments, and baking items for clients to be able to cook at home.

When we first started this process which is really cool for me to see, uh, our food bank created a list for us, with kind of a percentage of maybe snack items that are buying at this percentage, fruits and vegetables this percentage, um, so that was really cool to see what we’ve been spending our money on previously, Um, to kind of tweak that and do better going into the future. But I feel like our food bank has been really good. And I also, and I don’t know if this is a coincidence or not, um, I feel like our food bank is being mindful of the items that we have committed to being put on our shelves at SuperShelf. (Manager, post-transformation)

A key feature of systemic change occurs when one action comes back through feedback loops, sometimes in surprising ways. In this case, attending to client requests at the pantry sparked changes at the food bank.

Impact of changes

Impact on client experience

Participants spoke of their dedication to serving their clients and communities with high quality food and dignity. For many participants it felt too early to say if the transformation had led to improved relationships with clients, but a number of examples were given that illustrated improved client experiences. In general, participants shared that clients seemed very happy to see the changes in the food pantry post-transformation. Participants reported that clients were adjusting to the new shopping lists and food pantry organization. Others noted that clients seemed to describe the food pantry as looking more like a grocery store.

I think they look at us differently, um I don’t think they look at us as a, as a food shelf. I think they think it’s more like a grocery store and they feel that way cause that’s how we treat them. It evolved from a food shelf that just had canned goods to now having produce and frozen things and dairy, meat, and all that.(Manager, post-transformation).

Others provided accounts of improved interactions with clients, which they attributed to the transformation. One participant shared that prior to the transformation there were sometimes difficult interactions with clients, with clients being upset an angry with the staff and volunteers, including experiencing threats or actual violence, and that following the transformation there had been no negative client experiences. Another described the post-transformation environment as being more inclusive, in that it was easier to see and interact with clients as they visited the site, and that allowed for better relationships and interactions.

Participants noted that one of the biggest changes to the food pantry was promoting expanded client choice, such as having the choice to shop by themselves at the food pantry or to have the support of a volunteer if they wanted. Some learned that clients often had a negative perception of volunteers to walking with them through the food pantry, even though it was intended to be helpful. Offering a choice about how to walk through the food pantry was seen as a positive change among sites where, previously, clients had been directed to walk through the pantry on a required route.

Overall, the transformation was seen to reduce stigma and increase dignity and choice for clients. Efforts had been made to make the food pantry more family friendly and inclusive. These changes were perceived to lead to clients being more forthcoming about the challenges they were facing, and thus provided an opportunity for better connection with clients. They felt like they were providing an inclusive, welcoming, and dignified experience for the community.

“I mean when they come in here it’s a more dignified experience you know for them. And I think that we’re able to nudge them into you know trying something maybe they haven’t tried before that’s maybe a healthier option than what they might’ve gotten in the past.”(Manager, post-transformation).

Impact on staff and volunteers

In the initial interviews, there was some concern among participants about trying to get all the volunteers on board with the transformation, particularly in sites with larger number of volunteers (one food pantry had 170 volunteers). However, post-transformation, participants described the volunteers as being supportive of the changes. In some cases, additional volunteers that joined only to help with the transformation ended up staying on to keep volunteering with the food pantry.

Participants described that, following the SuperShelf transformation, volunteers and staff alike were noticeably happier and more comfortable with their new environment and that working conditions had improved. Participants noted a positive shift in attitudes from staff and volunteers, and that they felt supported and had the resources they needed to do their job effectively. Participants observed that increased client choice with food selections had led to staff and volunteers feeling they could better serve the families now.

Well personally of course (laughs), it was just much more comfortable, the working conditions were much more pleasant. Um but I do think the emphasis on healthier food and displaying it so that it was appealing to people, I can’t imagine people walking by colorful produce and not wanting to take it (chuckles). (Volunteer, post-transformation)

Challenges

Participants were asked to reflect on the challenges they had encountered in the SuperShelf transformation process. The most significant challenge was that participants often described their desire for a larger physical space, whereas the SuperShelf intervention focused on transformation of the current space. In addition, participants shared there was a learning curve in getting used to new systems, the SuperShelf food categories, and getting all the volunteers and staff on board with the process. Preparing and cleaning the food pantry for the transformation at times felt hectic, especially if a site needing to be deep cleaned. An additional challenge in the transformation process was working with all staff and volunteers, both to communicate about all changes consistently, and to provide training when there is a high rate of volunteer turnover, or sporadic volunteer hours.

For many participants, they also described that insufficient funding was another serious ongoing challenge that they encountered in relation to providing all the services they would like. Having more funds would translate to more outreach opportunities within their community. One participant mentioned that their food pantry used to have funds to assist clients with bus tokens and housing, but had to cut this assistance because of limited funds. Changes that were very well aligned with current practices or values were seen as not complex at all, such as creating more welcoming environments or client choice-based practices. Some changes were more complex, such as fostering increased systemic thinking, particularly in connecting to the greater charitable food context.

Future plans

Overall, the majority of the participants described a desire to continue to provide services consistent with their SuperShelf transformation, including continuing to improve and provide items that their community needs. Some expressed an interest in continuing to find ways to improve their services through doing surveys to assess clients need, work on their outreach program and either start a mobile food pantry distribution or provide transportation for clients to their food pantry.

“You know I think SuperShelf has really taken us to the next level of experience, but we shouldn’t just stay complacent with where we are now and [we should] keep asking how we can improve”(Manager, post-transformation).

Discussion

The SuperShelf intervention was described as being successfully implemented, with enthusiastic participation by managers and volunteers, and with a perceived positive impact on clients, managers, and volunteers. The Diffusions of Innovation framework can help guide the interpretation of the findings in this study, particularly in relation to its domains of relative advantage, complexity, observability, impact on social relations and time or resource commitments [41, 42].

Food pantry volunteers and managers saw the SuperShelf transformation process as offering clear relative advantage compared to their pre-transformed state. Of particular note, the physical transformation was highly valued and seen as a way to create a space that matched the values of the organization, be more client centered and challenge stigma. Other comparative advantages also reported included: changes in how food was sourced and supplied, improved quality of food supplied, and the healthiness of choices made by clients.

Another key aspect of DOI is the complexity of the intervention, and in this case the response from participants was mixed. The strong positive response to the transformation of the physical space also appeared to be a conduit to engaging in more complex choices. These differences in complexity also impacts the DOI domain of observability, or the ability to assess the changes resulting from the intervention. SuperShelf appears to have impacts in a range of ways, and some are easier to observe than others. Participants were clear about the impact on the quality of the space, food, and perception that clients were accessing healthier food. However, the changes at a systemic level may not be directly perceptible in daily operations, as opposed to impacting leadership or structural issues, such as supply chains. Future research could consider how the characteristics of food pantries may impact systemic level changes.

The impact on social relations aspect of DOI, or the way in which the intervention impacts the social environment, was particularly evident with the SuperShelf intervention. The values-based components and the commitment to address stigma associated with using a food pantry, was highly resonant with the current aspirations among food pantries. This concordance opens a pathway for the intervention to gain solid traction in the implementation environment and the changes that supported the respect for all and good food values, leading to changes that the food pantries valued very highly. The final DOI construct of time and resource commitment shows that the technical support and additional resources provided by SuperShelf to address changes were much needed by the food pantries. As often in resource-scarce environments, it was key to have an external team create changes that the pantries might not be able to afford themselves. However, other changes, particularly in relation to food sourcing, stocking standards, and new client choice-based practices were readily adopted and, while supported by technical assistance, were not burdensome to adopt for the pantries.

SuperShelf transformations have currently been completed in over 40 food pantries with approximately 20 more underway [48]. Despite findings of no measurable changes in the client health outcomes assessed in the larger evaluation, food pantries have expressed enthusiastic interest in the SuperShelf intervention. Results of the current study help to explain the reasons for this continued interest. Results support the notion that environmental improvements garnered positive effects beyond those that outcomes that were formally measured as part of the randomized evaluation. These positive effects included appreciation for a more comfortable physical space, improved interpersonal interactions between clients and staff, and reduced stigma for those visiting the food pantry. The importance of these factors is consistent with findings from other qualitative research with food pantry staff and clients [18, 19].

Limitations

This study has several notable limitations. First, this work was based in the upper Midwest and as such may not generalize to other geographic areas. It is also a fairly small sample size, although both managers and volunteers were able to be included, the sample size limited our ability to make comparisons between these groups. In addition, participants may have been influenced by social desirability bias in sharing their views. In order to mitigate this potential bias, a researcher who was not part of the implementation team led and conducted all interviews. Additionally, these participants were reflecting on their perception of how the SuperShelf intervention impacted food pantry clients, but we did not ask those clients for their views directly.

Conclusion

The SuperShelf approach to transforming food pantries was experienced as highly successful by food pantries undergoing these changes. The values of the SuperShelf were well aligned with the changes that food pantry staff and volunteers described, especially for the values of ‘good food’ and ‘respect for all’, which led to high levels of engagement and adherence to the intervention implementation. Managers and volunteers viewed the intervention as impactful, both for clients and those working in the pantries, and supportive of their vision to offer food assistance to support improved health and reduce stigma.

Abbreviation

DOI

Diffusion of Innovation Theory

Authors’ contributions

CC and RP conceived and planned the research, as well as supervised the project. RP designed the analytical plan. CBB and RP performed the data analysis, and CC, NG, MC, and HP provided input throughout the analysis. RP and CC wrote the manuscript in consultation with CBB, NG, MC, and HP. All authors approved the manuscript.

Funding

This research was supported by the National Institute of Heart, Lung, and Blood Institute of the National Institutes of Health (C.C, 1R01HL136640); NIH grant UL1TR002494 from the National Center for Advancing Translational Sciences (NCATS) supported data management.

Data availability

Data will be made available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The trial was granted ethics approval by the University of Minnesota (UMN) Institutional Review Board (code: 1612S02201). All participants provided their informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.