Abstract
Implementing Sustainable Business Model Innovation (SBMI) in prevention-centred contexts requires firms to develop dual value propositions that balance commercial viability with delivering long-term health benefits to consumers through disease prevention. Yet consumer responses can generate socio-economic tensions that challenge adoption, delay trust formation, and intensify legitimacy pressures. This paper examines how firms experience and navigate these tensions during SBMI implementation. Through a longitudinal case study of a nutrition company developing a functional food for cardiovascular disease prevention, we analyse two SBMI iterations using interviews and archival documents. Preliminary findings identify three interrelated tension dimensions – value adoption, intertemporal, and legitimacy – that become knotted together during implementation. This knotting shapes shifts in the firm's response logic across iterations, offering new insight into how organisations evolve their navigation of socio-economic tensions in prevention-led innovation.