Co-designing retail strategies with people with lived experience of obesity and food insecurity

The role of public and patient involvement (PPI) groups in the FIO Food project
Woman food shopping from selection of fried snacks

Overview

The Food Insecurity in people living with Obesity (FIO Food) project aimed to co-design supermarket-based interventions that support people living with obesity and food insecurity to make healthier and more sustainable food choices. The project team worked collaboratively to co-develop retail strategies that address dietary inequalities through an in-depth understanding of the experiences of people living with obesity and food insecurity (Lonnie et al., 2023). 
Public and patient involvement (PPI) groups played a key role in FIO Food, ensuring that research addressed the most relevant issues, that study materials and interventions were acceptable to participants, and that research findings were presented in accessible formats. The overall aim was to give people with lived experience of obesity and food insecurity a voice, and to communicate their voices to policymakers, retail partners and the research team.

People involved 

A multidisciplinary team of researchers from nutritional and social sciences, applied health, obesity, and data science collaborated with a range of organisations, including retail (Sainsbury’s plc), nutritionists, third-sector organisations and policy makers.
Three public and patient involvement (PPI) groups were created to work closely with researchers, actively contributing to the development, delivery, and dissemination of all work within FIO Food work packages: 
  • FIO Food Ambassadors: recruited through the Food Foundation. This group included people with lived experience of food insecurity.
  • Community advisors’ group: based locally in Aberdeen. This group included representatives from the Aberdeen City Council, third sector and community organisations, as well as people with lived experience of food insecurity and obesity. 
  • PPI advocates: recruited through a national weight management provider. This group included people with lived experience of obesity based in England.
The project steering group also included a member with lived experience of obesity.
Man food shopping for honey
Woman food shopping for juice
 
 

Key project activities

Public and patient involvement (PPI) groups were involved throughout the research process and across all project work packages.
For example, in Work Package 1 (Understanding the lived experience of people living with obesity and food insecurity), an online survey, interviews and focus groups were used to capture food shopping experiences of people living with obesity and food insecurity, identifying the main barriers and facilitators to purchasing healthier and more sustainable foods. This knowledge was used to co-design retail-based interventions. To support this research, the PPI groups worked with the research team to:
Co-produce interview and focus group topic guides, screening questionnaires, and recruitment processes.
Discuss and interpret key findings before publication, and wider dissemination.
Provide feedback on dissemination materials (e.g., infographics that visually depict the results gathered in WP1).
Actively disseminate project findings (e.g., video interviews with PPI group members were shared at a parliamentary event to share lived experiences of people with obesity and food insecurity).
Provide feedback on Sainsbury's communications and marketing materials of real-world interventions.
Conduct action-mapping workshops: PPI members from the Food Foundation's Veg Advocates, Obesity Voices, and Nourish Scotland took part in two in-person workshops alongside academics, representatives from government and local authorities, industry, health and nutrition-focused charities, and healthcare professionals. These workshops aimed to identify solutions to support people living with food insecurity and obesity to make healthier and more sustainable food choices. Referring to the workshops, a PPI participant noted that it was "very lovely to feel heard and feel like our contribution is meaningful and being taken forward" (PPI participant, FIO Food).

Co-production principles

Relationships 

The research team met regularly with the different public and patient involvement (PPI) groups either online or in-person. Members of the PPI groups were remunerated for their contributions with an hourly rate paid in vouchers.  

Knowledge 

Capturing the lived experience of a range of different people living with obesity and food insecurity was the cornerstone of the FIO Food project, and the team strove to do this through the three PPI groups, using these insights to co-develop solutions and strategies to support sustainable and healthier food choices, and address dietary inequalities.
PPI members also highlighted why the involvement of people with lived experience was so important for the research: 
"[those with lived experience] know better than anyone else the challenges and issues of the project and the solutions to mitigating the issues… I wanted any questionnaires that were being used to be non-stigmatising and easy to read, and have a dignified approach."

Inclusivity 

The research team, PPI groups and other project partners engaged in discussions on how to best recruit PPI members and research participants from a diverse range of backgrounds, regional localities, and ethnicities. 
Project partner Sainsbury’s noted that the project has facilitated learning from groups "that we would struggle to reach out to otherwise, on our own, so it's been extremely valuable in that sense."
PPI group members had the option to meet researchers individually or in a group and provided their feedback on documents according to their preference (by email or to chat about any comments).
 

Find out more about this project

Related references

FIO Food. 'How to form and maintain fruitful academic partnerships with Public Involvement Advocates', https://abdn.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=782255cb-0f76-44a5-b791-b13e0118bf99&start=7.467337
ICFConsulting Services Limited and Technopolis (2025) ‘Transforming UK Food Systems (TUKFS) Programme Interim Impact Evaluation Annex’, Accessed 8 October 2025. https://www.ukri.org/wp-content/uploads/2025/08/BBSRC-060825-TUKFS-interim-impact-evaluation.-Annex.pdf  
Lonnie, M., E. Hunter, R. A. Stone, M. Dineva, M. Aggreh, H. Greatwood, A. M. Johnstone, and F. I. O. Food team (2023). 'Food insecurity in people living with obesity: Improving sustainable and healthier food choices in the retail food environment-the FIO Food project', Nutrition Bulletin, 48: 390–99. https://doi.org/10.1111/nbu.12626
Lonnie, M., Crabtree, D. R. and Johnstone, A. M. on behalf of the FIO Food Team (2024). 'Tackling dietary inequalities in the UK food system: An exploration of stakeholders' experiences to deliver national recommendations for policy and health care practitioners (a framework for action)'. https://doi.org/10.31219/osf.io/evc9y
TUKFS (2023). 'Food Insecurity in people living with Obesity (FIO Food)', Accessed 16 October 2023. https://ukfoodsystems.ukri.org/research-projects-training-reports/fio-food/