Minaker 2016.
| Methods |
Design: ITS Timing: Retrospective Allocation to group: N/A (ITS without control group) Number of clusters or sites: 1 pharmacy (in which the intervention was implemented) and 2 further stores selling SSB Number of individuals: N/A (the study is based on routinely‐collected sales data not linked to individual customers) Length of intervention: 8 months |
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| Participants |
General description of participants: Residents and visitors of Baddeck, a small rural community on Cape Breton Island, Nova Scotia, Canada Age: All ages Inclusion criteria: N/A Exclusion criteria: N/A Recruitment: N/A Weight status at baseline: N/R SSB consumption at baseline: N/R Equity considerations: Quote: "Baddeck is a rural small town (population approximately 800 year‐round residents) on Cape Breton Island in Nova Scotia. Baddeck is a popular tourist destination in the summer months, and throughout the year functions as a service center for the surrounding, sparsely populated county. The nearest urban municipality is Sydney, Nova Scotia (population 31,597), 80 km away (about an hour’s drive). The community nutrition environment in Baddeck includes twelve restaurants (several of which are only open seasonally), and three food stores including the pharmacy" |
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| Interventions |
Intervention: Removal of SSB from 1 out of 3 stores selling SSB in a small, remote community. (Quote: "This study examines an intriguing example of a recent retailer‐led restrictive RFE [retail food environment] intervention in the province of Nova Scotia, Canada. In September 2014, a pharmacist made national and regional news by removing all sweet beverages from his pharmacy’s shelves. When questioned about his objectives, the pharmacist commented, ‘It made no sense to me. Just in good conscience, we just couldn’t continue selling’") Behavioural co‐intervention: None reported Control: No intervention |
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| Outcomes |
Measures of SSB intake: Weekly community‐wide sales of SSB in Canadian dollars, assessed continuously throughout the study period with routinely‐collected sales data Measures of intake of alternatives to SSB: N/R Anthropometric measures: N/R Adverse outcomes: The study does not report how data on adverse outcomes were collected, and if adverse outcomes were observed or not (but community‐wide sales of SSB are assessed as a measure of switching behaviour among stores within the community) Other outcomes: None included in this review |
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| Context and implementation |
Setting: A rural community pharmacy Sector: Retailing Country: Canada Year(s) when implemented: 2014 Mode of implementation: Pilot trial by researchers in co‐operation with a private pharmacy Level of implementation: Setting‐based intervention |
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| Declarations |
COI: "Competing interests: LMM, NN, SA, CLM, BEC, and DLO have no financial disclosures and no competing interests to declare. GM is employed by Atlantic Pharmasave" Funding: "LMM, NN, and SA acknowledge the support of the Canadian Cancer Society Research Institute [Major Program Grant #701019] to the Propel Centre for Population Health Impact, which funded the study. CLM holds a Canadian Institute of Health Research Grant. DLO is supported by a Canadian Institutes of Health Research Fellowship" Trial registration: N/R Protocol availability: N/R |
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| Notes | We report results from the ARIMA model, as this model is described as the most‐adjusted one by the study authors. Quote: "Although several analytical options exist to analyse time series data, our interrupted time series data were most appropriately analysed using autoregressive integrated moving average (ARIMA) models. These models attempt to account for all aspects of data series autocorrelation, and are appropriate for repeated measures data assessed at equal intervals" | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | The outcome data were routinely‐, automatically‐collected sales data, so it is likely that they are close to complete |
| Blinding (performance and detection bias) Objective outcomes | Low risk | Participants were not blinded, but outcomes are objective, and outcome data were collected independently of the intervention and study |
| Selective reporting (reporting bias) | Low risk | All outcomes mentioned in the Methods section are reported in the Results section, and based on how data collection and assessment are described it seems likely that SSB sales were indeed the only outcome which was assessed |
| Independence of the intervention from other changes (performance bias) | Unclear risk | The paper notes that the composition of the customer base of the 3 stores in Baddeck (the intervention community) is fluctuating seasonally (e.g. permanent residents versus visitors), which could potentially affect the observed effect sizes. Quote: "In addition, the relatively short follow‐up time precluded an analysis of CSD [carbonated soft drinks] during a summer peak in which the policy was in place, when a different type of consumer (namely tourists) would have comprised a greater proportion of people purchasing CSD [carbonated soft drinks]" |
| Pre‐specification of the intervention effect (detection bias) | Low risk | The point of analysis is the point of intervention |
| Intervention effects on data collection (detection bias) | Low risk | Data were collected routinely and independently of the intervention and the study. It is unlikely that the intervention affected data collection |
| Other bias | Low risk | No other concerns |