**Background:** Food safety risks are exacerbated by shocks to food systems, including climate change, which has multifaceted impacts on food-borne disease. Multicomponent programs addressing multiple drivers of food safety risk are considered complex programs, and their success depends heavily on context. However, how evaluations consider the influence of climate change on food safety and other development programs remains understudied. This study aimed to better understand how key actors involved in food safety programs experience and respond to climate change, using a qualitative evaluation of the SafePORK program in Vietnam.
**Methods:** The study was a qualitative evaluation of SafePORK, a five-year program (2017–2022) aiming to reduce food-borne disease in informal pork markets in Vietnam. SafePORK operates in three provinces (Hung Yen, Nghe An, Hoa Binh) and includes interventions in slaughterhouses, wet markets, and Ban pig value chains. The authors developed two semi-structured interview guides—one for researchers and one for program participants—using the Consolidated Framework for Implementation Research (CFIR) with a realist-informed lens. Interviews were conducted between August and September 2021 via Microsoft Teams (researchers) and phone (program participants). A total of 30 respondents were interviewed: 7 researchers (4 men, 3 women) from public health (n=3), agricultural economics (n=3), veterinary science (n=2), and farming systems (n=1); and 23 program participants including slaughterhouse workers (n=10), retailers (n=9), local authorities (n=3), and a market manager (n=1) from Hung Yen (n=13), Nghe An (n=7), and Hoa Binh (n=3). Thematic analysis was conducted in three sequential phases of deductive coding.
**Key Results:** Four overarching themes were identified: context (environmental, organizational, socio-cultural, political) and external shocks (African swine fever, COVID-19, climate change). Climate change was found to interact with other contextual factors. Researchers noted heatwaves as a possible driver of microbial growth in pork, though could not attribute this directly to climate change versus seasonal influences. Flooding made travel to communities difficult. Because researchers considered climate change impacts minimal, they did not develop climate risk management strategies, with one researcher stating 'we have a lot of things to do' (Interviewee #3). Some SafePORK activities indirectly contributed to climate change adaptation, such as risk communication about keeping meat chilled during heatwaves. At the farm level, pigs were reported to be 'more sensitive' and 'get sick more frequently' from climate variation. Slaughterhouse workers faced challenges from drought (limited water availability) and flooding (contaminated water sources). Retailers reported that heat spoiled pork faster, with one retailer in Hung Yen explaining 'when the weather is hot, it can make your meat worse, it is not fresh and attractive anymore' (Interviewee #15). Climate change interacted with African swine fever and COVID-19 to create compounding risks. For example, slaughterhouse workers worried about both African swine fever and climate-related heat stress; retailers faced both climate and market shocks from COVID-19 preventive measures.
**Clinical Implications:** This study demonstrates that climate change is relevant to all food safety programs, regardless of whether they have a specific climate goal. The findings highlight the need to explicitly integrate climate change considerations into program planning and evaluation, even when climate action is not an explicit objective. The authors call for evaluators to explicitly consider climate change in contextual assessments, noting that current frameworks (e.g., CFIR, UK MRC/NIHR) do not explicitly name climate change as a feature of context. The study also underscores the importance of considering gender and other social dimensions, as women retailers experienced more severe disruptions from climate change compared to slaughterhouse workers. The authors recommend developing program theory on an ongoing basis, using theory-driven evaluation approaches (e.g., Outcome Mapping) to document the influence of and programmatic responses to external factors. They also suggest structured risk assessments that consider how shocks might interact to compound risks, and call for evaluations to consider how converging crises and their compounding risks are addressed in programs using an equity-focused approach.