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You have been chosen to participate in this research study because you are either a staff person or manager of the Special Diabetes Program, a manager or staff at one of the local stores on or near the Navajo Nation, or part of the Johns Hopkins research team -and you have contributed in some way to the implementation of the Healthy Stores Program on the Navajo Nation. At the end of the first round of program implementation, we would like to interview you about your involvement and experience in the process of adopting and implementing the Healthy Stores Program and lessons learned and challenges encountered. We will use this information to help us improve planned future rounds of the program.

If you agree to participate in this study, we will do an interview with you as soon as is convenient for you. The interview will take about 60 minutes. If you are a manager/supervisor or intervention staff of the Special Diabetes Program, the interview will be followed by a brief questionnaire. The brief questionnaire will take about 5 minutes. The interview will not be audio recorded. We have tried our best to exclude any sensitive questions. However, if you feel that any of our questions are too sensitive, please do not hesitate to let me know, and I can either move to the next question or discontinue the interview.

Your participation is voluntary and if for any reason you wish to withdraw from the study, you may do so. You do not have to answer questions that may bother you. We will be taking notes during the interview, but this information will be kept confidential.

Your name will not be mentioned in any reports we prepare. The information will be kept in a locked file cabinet in the researcher’s locked office. The researcher will be the only person with access to the data. The information will be kept for about two years, after which the paper forms will be destroyed.

There are minimal risks associated with participation in this interview. The information we collect will be used to understand the process of adoption and implementation process of the Healthy Stores Program in local organizations on the Navajo Nation and to inform next round of implementation of the Healthy Stores Program on the Navajo Nation. You will be given a small gift certificate (like a gift card to a local store, a coffee mug), in appreciation for your time.

Do you have any questions? If you do not wish to participate in this study, please feel free to say so. If you chose not to participate it will not affect your job in any way.

If you have any additional questions about your participation in this study and would like to speak with someone about this project, please feel free to contact the project coordinator, Marla Pardilla (505-272-3952 or 505-269-2548), Dr. Joel Gittelsohn, Principal Investigator (410-955-3927), Louise Joe, Navajo Nation Human Research Review Board (928-871-6650), and call the Johns Hopkins Bloomberg School of Public Health IRB office at 1-888-262-3242 or Fax (410) 502-0584.

–  –  –


Signature of Investigator ________________________________________________ CHR NO. Date ________ Date Note: Signed copies of this consent form must be a) retained on file by the Principal Investigator; b) given to the participant and c) put in the patient’s medical record (when applicable)






1. Please tell me about the role you played when your program was considering adopting the Healthy Stores Program?

2. What did you expect to happen when adopting the Healthy Stores Program?

3. In the beginning, what were some concerns or anticipated problems that you or other members of your program had about adopting the Healthy Stores Program?

4. Tell me what exactly did you do to implement the Healthy Stores intervention?

5. How was Healthy Stores intervention implemented differently from originally planned? Why?

6. How do you measure the success of the Healthy Stores intervention?



7. What were the similarities between implementing the Healthy Stores intervention and implementing your regular program activities? What were the differences?

8. What were challenges to implement the Healthy Stores intervention at the same time as you were running your regular program activities?

9. What changes or adjustments were made within your program to adapt to these challenges?

10. What changes or adjustments were made to the Healthy Stores intervention to adapt to these challenges?



11. What impact did the Healthy Stores Program have on your job?

12. What impact did the Healthy Stores Program have on your program in general?

13. What impact did the Healthy Stores program have on the community and the stores?

14. What impact did support from the Johns Hopkins University in terms of capacity building activities have on your staff and your program?


15. What major barriers did your program encounter in implementing the Healthy Stores intervention?

16. What strategies were used by your program or yourself to address these barriers?

17. Which strategies have worked well and what have not worked as well? Why?

18. What could have done better in terms of support from the Johns Hopkins University?

19. What else should I know about how your program adopted and implemented Healthy Stores intervention? Did I miss anything?

–  –  –

Capacity building  Needs for capacity building  Capacity building workshops  Impact o Practitioner level o Organizational level o Inter-organizational Program evaluation and sustainability

–  –  –

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