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Background There is growing evidence that exposure to unhealthy urban environments increases the risk of developing non-communicable diseases (e.g. diabetes, cardiovascular disease, and respiratory illness), with marginalised communities bearing the greatest burden. However, to date, evidence alone has not been sufficient to make health a top priority in the development of urban environments. Methods The aim of this study was to develop and optimise an intervention to increase the intention to act on health and health inequalities by private sector professionals working in urban development, with a focus on consultants and developers. The ‘Changing Mindsets’ intervention was developed through an iterative co-production process using the Person-Based Approach method, drawing on evidence and a novel theoretical framework. Results Intervention development consisted of three stages. Stage 1 involved the collation of theory and evidence, which included the development of a novel theoretical framework, primary mixed methods research and stakeholder engagement. Stage 2 was the intervention modelling phase, where the findings from Stage 1 were integrated through the guiding principles and behavioural analysis tables, which informed the logic model. Stage 3 involved iterative intervention optimisation with members of the target population. The intervention was comprised of two elements: 1) An intervention session consisting of a presentation with group discussion presented by one of the two industry partners working in the private sector of urban development, and 2) A website signposting to tools and resources, networks to support prioritising and integrating health into urban development, and examples of how other organisations have done so. Conclusions We have provided insights into how complex interdisciplinary theory can be combined with evidence of the target group’s needs, issues and challenges using established methodology from the Person-Based Approach and behavioural science. Changing Mindsets is currently being evaluated for its effectiveness and acceptability in the target population. Subsequent to this, there are plans to adapt the intervention to increase the intention to act on other social issues and for other populations. Trial registration ISRCTN12310546 registered on the 30 th March 2021.

Background The built environment contributes to rising non-communicable diseases, including cancer, diabetes, respiratory illness, and poor mental health. These impacts disproportionately affect lower socio-economic groups, who experience greater exposure to harmful urban features. Evidence on these links alone has not led private-sector urban developers to prioritise health. The Changing Mindsets intervention was designed to increase intention to act on health and health inequalities among private-sector urban development professionals. This study assessed whether the intervention increased intention to act and identified predictors of change. Methods We conducted a single-arm pre-post mixed-methods evaluation of the Changing Mindsets intervention delivered at six industry events in 2024, including four in-person and two online sessions. The intervention combined an industry-partner-led presentation, peer discussion, and a supporting website. Surveys were completed immediately before (T1), immediately after (T2), and three-months after the intervention (T3). Paired analyses assessed pre-post change in intention to act. Logistic regression examined predictors of improvement from T1 to T2. Seven participants completed follow-up interviews exploring changes in thinking and actions taken. Results Of 156 attendees, 101 completed the T1 survey, 69 completed the T2 survey, and 22 completed the three-month follow-up. Immediately after the intervention, 19% of participants showed an increase in intention to act on health, while most showed no change. Paired analyses indicated a small increase in mean intention scores from T1 to T2, with limited evidence of a consistent group-level effect. Lower baseline intention and increased perceived psychological proximity to health issues were associated with improvement in intention to act. Mean intention scores remained elevated at three-months among respondents. Qualitative findings suggested that changes in thinking were linked to challenged assumptions about who can act on health. Reported actions most often involved initiating conversations and influencing others. Conclusions The Changing Mindsets intervention was associated with increased intention to act on health among a subset of urban development professionals, particularly those with lower baseline intention and greater perceived proximity to health issues. Evidence for a strong average pre-post effect was limited. However, intention remained elevated at three-month follow-up among respondents, suggesting retention of motivation over time. Trial registration ISRCTN12310546 registered on the 30th March 2021.

Large scale, multi-organisational collaborations between researchers from diverse disciplinary backgrounds are increasingly recognised as important to investigate and tackle complex real-world problems. However differing expectations, epistemologies, and preferences across these teams pose challenges to following best practice for ensuring high-quality and rigorous qualitative research, while maintaining goodwill and team cohesion across team members. This article presents critical reflections from the real-world experiences of a team navigating the challenges of collaborating on a large-scale, cross-disciplinary interview study. Based on these experiences, we extend the literature on large team qualitative collaboration by highlighting the importance of balancing autonomy and collaboration, and propose eight recommendations to support high quality research and team cohesion. We identify how this balance can be achieved at different times: when centralised decision-making should be prioritised, and autonomy can be allowed. We argue that prioritising time to develop shared understandings, build trust, and creating positive environments that accept and support differing researcher perspectives on qualitative methods is paramount. By exploring and reflecting on these differences, teams can identify how and when to support autonomy in decision-making, when to move forward collaboratively, and how to ensure that shared processes reflect the needs of the whole team. The reflexive findings, emanating from practical experience, can inform large research teams undertaking qualitative studies to explore complex issues. We make an original contribution to qualitative methods research by arguing that balancing autonomy and collaboration is the key to promoting high quality research and cohesion in large teams.

Stakeholder theory has been an incredibly powerful tool for understanding and improving organisations, and their relationship with other actors in society. That these critical ideas are now accepted within mainstream business is due in no small part to the influence of stakeholder theory. However, improvements to stakeholder engagement through stakeholder theory have tended to help stakeholders who are already somewhat powerful within organisational settings, while those who are less powerful continue to be marginalised and routinely ignored. In this paper, we argue that one possible obstacle preventing less powerful stakeholders from speaking up and/or being heard by organisations is found at the ontological level, where we have identified an 'essentialist self underpinning the stakeholder concept. By deconstructing the stakeholder concept through how it is defined, discussed and debated, and linking this back to the practical consequences of the theory for the least powerful stakeholders, we are able to make three contributions. One, through our deconstruction, it is clear that at an ontological level, stakeholder theory is underpinned by an implicit, and problematic, assumption of the 'essentialist self, where the organisation is treated as the 'natural, universal self, and anyone not closely resembling this narrow (and unrealistic) view of self is treated as 'other'. Two, we build on the work of authors such as Wicks et al. (Bus Ethics Q 4(4):475-497, 1994), who highlight the need for consideration of the self within stakeholder theory. We thus take our findings from contribution one and begin to build a more holistic view of the self within the stakeholder concept, where each self is encouraged to recognise common selves outside and inside the corporation. Third, we link the theoretical discussion to the practical by discussing some imperfect ways in which a more holistic, enriched stakeholder concept might begin to help mitigate marginalisation for some stakeholders.

Background: Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures. Methods: Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society, public office and global governance organisations. Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map. Results: The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policymaking: 1) direct access to public sector decision-makers; 2) creation of confusion and doubt about policy decisions; 3) corporate prioritisation of commercial profits and growth; 4) industry leveraging the legal and dispute settlement processes; and 5) industry leveraging policymaking, norms, rules, and processes. Conclusion: UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions future work.

This article investigates corporate social responsibility (CSR) as an institution within UK multinational corporations (MNCs). In the context of the literature on the institutionalization of CSR and on critical CSR, it presents two main findings. First, it contributes to the CSR mainstream literature by confirming that CSR has not only become institutionalized in society but that a form of this institution is also present within MNCs. Secondly, it contributes to the critical CSR literature by suggesting that unlike broader notions of CSR shared between multiple stakeholders, MNCs practise a form of CSR that undermines the broader stakeholder concept. By increasingly focusing on strategic forms of CSR activity, MNCs are moving away from a societal understanding of CSR that focuses on redressing the impacts of their operations through stakeholder concerns, back to any activity that supports traditional business imperatives. The implications of this shift are considered using institutional theory to evaluate macro-institutional pressures for CSR activity and the agency of powerful incumbents in the contested field of CSR.

Background: Interventions are needed to prevent and mitigate unhealthy commodity industry (UCI) influence on public health policy. Whilst literature on interventions is emerging, current conceptualisations remain incomplete as they lack considerations of the wider systemic complexities surrounding UCI influence, which may limit intervention effectiveness. This study applies systems thinking as a theoretical lens to help identify and explore how possible interventions relate to one another in the systems in which they are embedded. Related challenges to addressing UCI influence on policy, and actions to support interventions, were also explored. Methods: Online participatory workshops were conducted with stakeholders with expertise in UCIs. A systems map, depicting five pathways to UCI influence, and the Action Scales Model were used to help participants identify interventions and guide discussions. Codebook thematic analysis was used to analyse the data. Results: Fifty-two stakeholders participated in 23 workshops. Participants identified 27 diverse, interconnected and interdependent interventions corresponding to the systems map’s pathways that reduce the ability of UCIs to influence policy, e.g., reform policy financing; regulate public-private partnerships; reform science governance and funding; frame and reframe the narrative, challenge neoliberalism and GDP growth; leverage human rights; change practices on multistakeholder governance; and reform policy consultation and deliberation processes. Participants also identified four potential key challenges to interventions (i.e., difficult to implement or achieve; partially formulated; exploited or misused; requires tailoring for context), and four key actions to help support intervention delivery (i.e., coordinate and cooperate with stakeholders; invest in civil society; create a social movement; nurture leadership). Conclusion: A systems thinking lens revealed the theoretical interdependence between disparate and heterogenous interventions. This suggests that to be effective, interventions need to align, work collectively, and be applied to different parts of the system synchronously. Importantly, these interventions need to be supported by intermediary actions to be achieved. Urgent action is now required to strengthen healthy alliances and implement interventions.

Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors—notably the largest transnational corporations—are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.

Purpose Although current literature assumes positive outcomes for stakeholders resulting from an increase in power associated with CSR, this research suggests that this increase can lead to conflict within organizations, resulting in almost complete inactivity on CSR. Methods A Single in-depth case study, focusing on power as an embedded concept. Results Empirical evidence is used to demonstrate how some actors use CSR to improve their own positions within an organization. Resource dependence theory is used to highlight why this may be a more significant concern for CSR. Conclusions Increasing power for CSR has the potential to offer actors associated with it increased personal power, and thus can attract opportunistic actors with little interest in realizing the benefits of CSR for the company and its stakeholders. Thus power can be an impediment to furthering CSR strategy and activities at the individual and organizational level.

Addressing increasingly urgent global challenges requires the rapid mobilisation of new research groups that are large in scale, co-produced and focussed explicitly on investigating root causes at a systemic level. This requires new ways of operationalising and funding research programmes to better support effective interdisciplinary and transdisciplinary (ID/TD) partnerships between a wide range of academic disciplines and stakeholder groups. Understanding the challenges and approaches that teams can follow to overcome them can come through critical reflection on experiences initiating new research programmes of this nature and sharing of these reflections. We aimed to offer a framework for critical reflection and an overview of how we developed it and to share our reflections on operationalising a newly formed large-scale ID/TD research programme. We present a framework of 10 areas for critical reflection: systems, unknowns and imperfection, ID/TD understanding, values, societal impact, context and stakeholder knowledge, project understanding and direction, team cohesion, decision-making, communications and method development. We reflect on our experience of operationalising the research programme in these areas. Based on this critical examination of our experiences and the processes we adopted, we make recommendations for teams seeking to tackle important and highly complex global challenges, and for those who fund or support such research groups. Our reflections point to an overarching challenge of the structural and institutional barriers to cross-disciplinary research of this nature.