This study sought to explore how food company representatives perceive the food industry’s role in responding to and driving consumer demand for healthy and unhealthy foods.

Semi-structured interviews were conducted in 2022 by 2-3 researchers to explore food company representatives’ perspectives related to consumer demand for healthy and unhealthy food. Detailed field notes, including verbatim quotes, were recorded, and the data analysed thematically.

This study was part of a government funded 12-month intervention program to assess the impact of tailored support for food companies on company nutrition-related policies and practices.

32 food company representatives from 13 large food and beverage manufacturers in Australia.

Six themes were identified. Company representatives acknowledged that manufacturers actively shaped demand for both healthy and unhealthy foods. Healthy reformulation and aspects of nutrition labelling were constrained by anticipated consumer resistance, while demand for ‘less healthy’ products was driven by non-health attributes such as taste, comfort and affordability. Internal company marketing teams held significant influence regarding product development, promotion and labelling. Supermarkets were perceived as shaping demand via their marketing strategies. The competitive landscape, driven by pursuit of market share, was seen to fuel an ongoing cycle of promotion of ‘less healthy’ products.

Food companies acknowledge playing an active role in influencing consumer demand for healthy and unhealthy food and beverages. A whole-of-system response, including changes in government regulation and practice change by the food industry, is needed to drive stronger action and accountability from food companies to support healthier diets.

Efforts to reduce restrictive practices (RPs) in mental health care are growing internationally. Yet, inconsistent definitions and perspectives often challenge the consistent implementation and evaluation of reduction strategies. This study explored which scenarios different mental health stakeholders classify as RPs, examined the contextual factors influencing these classifications and compared classification patterns across clinicians, researchers, service users and family caregivers.

An international cross-sectional survey was conducted using a multilingual online questionnaire hosted on the Qualtrics platform. A total of 851 stakeholders participated, including clinicians (n = 517), service users (n = 80), family caregivers (n = 89) and researchers (n = 165). Participants were presented with 44 potential RP case scenarios and asked to rate whether each scenario should be classified as an RP using a four-point Likert scale (Definitely yes, Probably yes, Probably no, Definitely no). The scenarios were organized into 22 paired comparisons, each sharing the same core context but differing in specific details. Paired comparisons were analyzed one pair at a time, allowing us to identify classification patterns between the scenarios and isolate the effects of particular contextual factors using ordered logistic regression. Interaction analyses were then conducted to assess how classification patterns varied across stakeholder groups.

Substantial discrepancies exist both within and between stakeholder groups regarding whether a given action should be considered an RP or not. Physically visible actions were often identified as RPs across all groups, while less visible forms often went unrecognized. Contextual differences, such as the healthcare professional’s intention, duration of the action, methods used, presence or absence of consent, door-locking status, and the severity of anticipated harm to be prevented influenced whether a given action was classified as an RP. Service users classified more scenarios as RPs than other groups; however, their decisions were more context-sensitive, shifting notably even with minor changes in scenario details. Among the 22 paired scenarios compared, 13 (59.09%) showed significant differences (p < 0.01) within at least one stakeholder group and eight demonstrated differences between groups.

Mental health stakeholders’ interpretations of RPs were often shaped not only by the inherent coercive nature of actions but also by the context in which they occurred and the professional role of the assessors. This underscores the need for harmonized definitions and classification frameworks for RPs, co-designed with diverse stakeholders. Addressing less visible forms of RPs in policy and clinical practice is also essential.

Failure to achieve accrual goals is a common problem in health-related research. Electronic health records represent a promising resource, offering the ability to identify a precisely defined cohort of patients who meet inclusion/exclusion criteria. However, challenges associated with the recruitment process remain and institutional policies vary.

We interviewed researchers, institutional review board chairs, and primary care physicians in North Carolina and Tennessee. Questions focused on strategies for initiating contact with potentially eligible patients, as well as recruitment letters asking recipients to opt in versus opt out of further communication.

When we asked about initiating contact with prospective participants, qualitative themes included trust, credibility, and established relationships; research efficiency and validity; privacy and autonomy; the intersection between research and clinical care; and disruption to physician–researcher and physician–patient relationships. All interviewees said it was acceptable for researchers to contact patients through their physicians; most said it was acceptable for researchers to contact patients directly. Over half chose contact through physicians as more appropriate. Regarding recruitment letters, qualitative themes included the quality of the participant pool; privacy and control; research efficiency and representativeness; and patients’ opportunity to make their own decisions. All interviewees said asking recipients to opt in to further communication was acceptable; nearly all said opt out was acceptable. Similar proportions chose each approach as more appropriate.

Comparing these results to our previous research with patients reveals potential differences in stakeholder perspectives. We offer suggestions for developing balanced approaches that respect patients and facilitate the advancement of science.