Summary: Food retail strategies to improve the healthiness of food and beverage options may increase purchasing of healthier options and improve diets. Consumer demand for healthier options is an important determinant of the successful implementation and maintenance of healthy food retail interventions. A systematic review of peer‐reviewed literature was undertaken to explore whether consumers are willing to pay more for healthier foods and to determine the key factors that influence willingness to pay. Fifteen studies reported the results of 26 experiments providing willingness to pay estimates for healthier food products across a range of food retail environments. Twenty three out of the 26 experiments included in this review (88.5%) found consumers would pay a 5.6% to 91.5% (mean 30.7%) price premium for healthier foods. Studies consistently found a positive willingness to pay for foods with reduced fat and wholegrains with additional fruit and vegetables, while willingness to pay for foods with reduced salt or a combination of low fat and sugar, or salt showed mixed results. Adults over 60 years, females, those living with obesity, and consumers who aim to maintain a healthy lifestyle were more likely to pay a price premium for healthier food, whereas younger consumers, consumers with healthy weight, and consumers with higher levels of education were less likely to pay higher prices. The results of this review contribute to our understanding of consumer preferences for healthier products and provide information to retailers on consumer surplus (benefits) associated with the provision of healthier food alternatives.

Summary: Background: Childhood obesity prevention initiatives are complex interventions that aim to improve children's obesity‐related behaviors and provide health promoting environments. These interventions often impact individuals, communities, and outcomes not primarily targeted by the intervention or policy. To accurately capture the effectiveness and cost‐effectiveness of childhood obesity prevention interventions, an understanding of the broader impacts (or spillover effects) is required. This systematic review aims to assess the spillover effects of childhood obesity prevention interventions. Methods: Six academic databases and two trial registries were searched (2007–2023) to identify studies reporting quantifiable obesity‐related and other outcomes in individuals or communities not primarily targeted by an obesity prevention intervention. Critical appraisal was undertaken for studies that reported statistically significant findings, and a narrative synthesis of the data was undertaken. Results: Twenty academic studies and 41 trial records were included in the synthesis. The most commonly reported spillovers were diet or nutrition‐related, followed by BMI and physical activity/sedentary behavior. Spillovers were mostly reported in parents/caregivers followed by other family members. Nine of the 20 academic studies reported statistically significant spillover effects. Conclusion: Limited evidence indicates that positive spillover effects of childhood obesity prevention interventions can be observed in parents/caregivers and families of targeted participants.

Purpose To systematically summarise the recent literature on the cost and cost effectiveness of interventions implemented to reduce violence against women (VAW) and decision frameworks guiding resource allocation. Method A scoping review of scholarly and grey literature on the cost-effectiveness and/or resource allocation for interventions addressing intimate partner violence (IPV), dating violence and non-partner sexual violence perpetrated against women aged 15 years and over. All settings and contexts were eligible, with papers published in English between 2010 and March 2023 included. Results Nineteen papers fulfilled the inclusion criteria reporting the cost, cost savings and/or cost effectiveness of 24 interventions to prevent IPV and to a lesser extent, other forms of interpersonal violence. Among the 16 economic evaluation studies reviewed, four types of interventions were cost effective in multiple settings or studies, including community activism (Uganda, Ghana), gender transformative interventions with couples and individuals (Ethiopia, Rwanda), specific justice and law enforcement measures (USA) and a combined personnel training, support, and referral programme in General Practice in the UK. Other interventions were cost effective in a single study or had conflicting evidence. Three remaining papers conducted a partial evaluation or cost appraisal providing limited information on the cost or cost-savings of other implemented interventions. No frameworks on resource allocation for the prevention of VAW were identified. Conclusion While there is some evidence of cost effectiveness emerging for interventions implemented in specific contexts, overall, we find the recent evidence on costs and cost effectiveness of interventions for the prevention of VAW to be limited. Embedding economic evaluation in future effectiveness trials will build critical evidence needed to inform policy and resource allocation decisions based on the value-for-money of interventions. Modelling the benefits and costs of interventions to better understand the societal impacts of programmes at scale is a further research opportunity.

Background: Supermarkets are businesses, and any voluntary changes to increase the healthiness of their food offerings must align with retailers’ commercial needs. Business outcomes of healthy food retail strategies are important non-health factors that may influence retailers’ decisions to implement these strategies. Although there is growing evidence on the significance of various business outcomes, such as net profit and customer satisfaction, it remains unclear how retailers value and trade-off these outcomes against each other. This study aimed to determine retailer preferences and measure their marginal willingness to pay for key business outcomes.Methods: A Discrete Choice Experiment (DCE) survey recruited current or former owners or managers of supermarkets or grocery stores in Australia. It included 12 choice tasks for two hypothetical scenarios (A or B) that the retailer could implement in their store, along with an option to maintain the current situation (opt-out option). The survey included six attributes (net profit, healthy items sold, customer and retailer satisfaction, ease and costs of implementation) with 3–4 levels each. A multinomial logit model was used to estimate preferences and calculate marginal rates of substitution and marginal willingness to pay.Results: Sixty-one respondents completed the DCE, resulting in a 72% response rate. Retailers identified customer satisfaction as the highest ranked business outcome when deciding to implement healthy food retail strategies. This was followed by the percentage of healthy items sold, supplier satisfaction, net profit, implementation cost, and ease of implementation. The marginal willingness to pay for different attribute levels varied from A$650 per year per store for a strategy that increases net profit by 3% to A$32,136 for a strategy leading to “very satisfied” levels of customer satisfaction compared to the base level.Conclusion: The results could be used to guide the implementation of healthy food retail strategies that also meet the needs of retailers.

Summary: Increasing the healthiness of food retail environments is an identified mechanism to help halt rising rates of diet‐related non‐communicable diseases. Previous studies on healthy food environment adoption report that retailers' perceptions of loss of profitability and higher food costs are often barriers to change. Despite this, actual changes to profitability and food costs have not been fully explored. This study aimed to systematically scope the evidence relating to changes to food costs or profitability when changes are made to increase the healthiness of food and drinks sold by food service retailers. Nine databases were searched, with studies included from settings that sold ready‐to‐consume items, with interventions to increase the healthiness of menus, and reporting food environment/nutrition outcomes, and cost/profit outcomes. Of the 12 studies included, the majority were conducted in the United States and in school settings. Most studies indicated that increasing the healthiness of food service retail environments resulted in neutral or favorable financial outcomes. Food costs and/or profit changes were most often monitored via simple accounting measures. While further research is needed to strengthen the evidence on financial outcomes of healthier food provision, this review indicates that some perceived barriers to change may not be warranted.

The purpose of this study is to evaluate the technical efficiency, productivity, and determinants of technical inefficiency in local hospitals in Oman, which are facing increasing resource constraints. Effective utilization of hospital resources is crucial for improving service delivery, ensuring equitable access, and maintaining the quality of healthcare. The study employs an input-oriented Data Envelopment Analysis (DEA) approach to assess the technical efficiency of 29 local hospitals under constant returns to scale (CRS), variable returns to scale (VRS), and scale efficiency (SE) using data from 2018. Additionally, a Tobit regression model is used to identify the determinants of hospital inefficiency, and the DEA-based Malmquist Productivity Index (MPI) is applied to panel data from 2015 to 2018 to measure Total Factor Productivity Change (TFPCH). The findings reveal that 75.8% of the local hospitals were technically efficient under VRS and SE assumptions, while 79.3% achieved technical efficiency under the CRS assumption. The average technical efficiency scores under CRS, VRS, and SE were 96%, 97%, and 99%, respectively. The Tobit model indicates that the number of physicians and pharmacists negatively impacts the VRS efficiency score, while the number of outpatient visits has a positive effect. Productivity growth of 18.1% was observed over the study period, mainly driven by a 42.6% increase in technological change. The study concludes that while most local hospitals in Oman are technically efficient, there is still room for improvement. The findings imply that targeted interventions, such as optimizing the allocation of human resources and leveraging technological advancements, could enhance the overall efficiency and productivity of the healthcare system in Oman.