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Brimblecombe J, Ferguson M, McMahon E, Fredericks B, Turner N, Pollard C, Maple-Brown L, Batstone J, McCarthy L, Miles E, De Silva K, Barnes A, Chatfield M, Hill A, Christian M, van Burgel E, Fairweather M, Murison A, Lukose D, Gaikwad S, Lewis M, Clancy R, Santos C, Uhlmann K, Funston S, Baddeley L, Tsekouras S, Ananthapavan J, Sacks G, Lee A. Benchmarking for healthy food stores: protocol for a randomised controlled trial with remote Aboriginal and Torres Strait Islander communities in Australia to enhance adoption of health-enabling store policy and practice. BMC Public Health 2024; 24:1790. [PMID: 38970046 PMCID: PMC11229494 DOI: 10.1186/s12889-024-19277-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 06/25/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated 'audit and feedback' with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia. METHODS Study design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023. DISCUSSION We hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly. TRIAL REGISTRATION ACTRN12622000596707, Protocol version 1.
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Affiliation(s)
- Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia.
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia.
| | - Megan Ferguson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Emma McMahon
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice-Chancellor, The University of Queensland, Herston, QLD, 4006, Australia
| | - Nicole Turner
- Indigenous Allied Health Australia, Alia House, Napier Cl, 2600, Deakin, ACT, Australia
- Charles Perkins Centre, University of Sydney John Hopkins Dr, Camperdown, NSW, 2050, Australia
| | - Christina Pollard
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Joanna Batstone
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Leisa McCarthy
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Eddie Miles
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
- Community First Development, 1/67 Townshend St, Phillip, ACT, 2606, Australia
| | - Khia De Silva
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Adam Barnes
- NT Health, Manunda Place, 38 Cavenagh Street, Darwin, NT, 0800, Australia
| | - Mark Chatfield
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Amanda Hill
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Molly Fairweather
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Anna Murison
- Outback Stores, 67 Pruen Rd, Berrimah, NT, 0828, Australia
| | - Dickson Lukose
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Surekha Gaikwad
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Meron Lewis
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
| | - Rebekah Clancy
- Miwatj Health Aboriginal Corporation, Lot 1425 Arnhem Road, Nhulunbuy, NT, Australia
| | - Claire Santos
- Population and Primary Health Care Outreach Team, NT Health, Casuarina Plaza, 258 Trower Road, Darwin, NT, 0810, Australia
| | - Kora Uhlmann
- Health and Wellbeing Queensland, 139 Coronation Drive, Milton, QLD, 4064, Australia
| | - Sarah Funston
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Laura Baddeley
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Sally Tsekouras
- Katherine West Health Board Aboriginal Corporation, 38 First St, Katherine, NT, 0850, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
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Fathi LI, Yang D, Walker JL, Robinson M, Littlewood RA, Truby H. Exploring the long-term sustainability of school-based nutrition and food programs: What works, where and why? Health Promot J Austr 2024. [PMID: 38361362 DOI: 10.1002/hpja.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024] Open
Abstract
ISSUE ADDRESSED Most food and nutrition programs cease within 2 years. Understanding the determinants of program sustainability is crucial to maximise output from funding, whilst allowing sufficient time for program benefits to be achieved. This study applied the Consolidated Framework for Implementation Research (CFIR) to map the barriers and enablers of successful long-term implementation of school-based nutrition and food programs. METHODS Qualitative methods with purposive and snowball sampling were used to recruit experts who were identified as being influential in implementing and sustaining long-term (>2 years) school-based food and nutrition programs. Semi-structured interviews with global experts were conducted, transcribed verbatim and coded deductively (by applying the CFIR constructs) and inductively when required. Thematic analysis informed the development of themes. RESULTS Interviews were conducted with 11 experts including researchers, government employees, and a consultant of an international agency, from seven countries. Forty-eight deductive codes and eight inductive codes identified six main themes: (1) funding and integrity of its source; (2) political landscape; (3) nutrition policies and their monitoring; (4) involvement of community actors; (5) adaptability of the program and (6) effective program evaluation. Themes related mainly to the 'outer setting' domain of the CFIR. CONCLUSIONS The CFIR highlighted pertinent factors that influence the successful long-term implementation of school-based food and nutrition programs. SO WHAT?: The findings suggest that to sustain program implementation beyond its initial funding, relationships across government departments, local organisations and communities, need to be nurtured and prioritised from the outset.
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Affiliation(s)
- Leila I Fathi
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Danyu Yang
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Health and Wellbeing Queensland, Brisbane, Queensland, Australia
| | - Mark Robinson
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Robyn A Littlewood
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Health and Wellbeing Queensland, Brisbane, Queensland, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Rodas-Moya S, Giudici FM, Mudyahoto B, Birol E, Kodish SR, Lachat C, Abreu TC, Melse-Boonstra A, van het Hof KH, Brouwer ID, Osendarp S, Feskens EJM. Critical review of indicators, metrics, methods, and tools for monitoring and evaluation of biofortification programs at scale. Front Nutr 2022; 9:963748. [PMID: 36313073 PMCID: PMC9607891 DOI: 10.3389/fnut.2022.963748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Sound monitoring and evaluation (M&E) systems are needed to inform effective biofortification program management and implementation. Despite the existence of M&E frameworks for biofortification programs, the use of indicators, metrics, methods, and tools (IMMT) are currently not harmonized, rendering the tracking of biofortification programs difficult. We aimed to compile IMMT for M&E of existing biofortification programs and recommend a sub-set of high-level indicators (HLI) for a harmonized global M&E framework. We conducted (1) a mapping review to compile IMMT for M&E biofortification programs; (2) semi-structured interviews (SSIs) with biofortification programming experts (and other relevant stakeholders) to contextualize findings from step 1; and (3) compiled a generic biofortification program Theory of Change (ToC) to use it as an analytical framework for selecting the HLI. This study revealed diversity in seed systems and crop value chains across countries and crops, resulting in differences in M&E frameworks. Yet, sufficient commonalities between implementation pathways emerged. A set of 17 HLI for tracking critical results along the biofortification implementation pathway represented in the ToC is recommended for a harmonized global M&E framework. Further research is needed to test, revise, and develop mechanisms to harmonize the M&E framework across programs, institutions, and countries.
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Affiliation(s)
- Santiago Rodas-Moya
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands,*Correspondence: Santiago Rodas-Moya,
| | - Francesca M. Giudici
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Bho Mudyahoto
- HarvestPlus, c/o International Food Policy Research Institute, Washington, DC, United States
| | - Ekin Birol
- Edmund A. Walsh School of Foreign Service, Global Human Development Program, Washington, DC, United States
| | - Stephen R. Kodish
- Department of Nutritional Sciences and Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Taymara C. Abreu
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands,Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Karin H. van het Hof
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Inge D. Brouwer
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Saskia Osendarp
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands,The Micronutrient Forum, Washington, DC, United States
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
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