Stores Healthy Options Project in Remote Indigenous Communities (SHOP@RIC): a protocol of a randomised trial promoting healthy food and beverage purchases through price discounts and in-store nutrition education

BMC Public Health

Ross S Bailie⁶  Kerin O’Dea²  Cliona Ni Mhurchu⁴  Mark D Chatfield⁶  Amanda J Leach⁶  Edward Miles¹  Anne Magnus⁵  Marjory L Moodie⁵  Kylie Ball³  Selma C Liberato²  Megan Ferguson⁶  Julie Brimblecombe⁶ 

[1] Indigenous Community Volunteers Level 1, 29 Cavanagh St, Darwin, NT 0801, Australia;University of South Australia, Frome Rd, Adelaide, SA 5000, Australia;Centre for Physical Activity and Nutrition Research, Deakin University, Burwood Hwy, Burwood 3125, Australia;National Institute for Health Innovation, University of Auckland, Auckland, New Zealand;Deakin Health Economics Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood 3125, Australia;Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia

关键词: Aboriginal Australia;    Randomised multiple baseline;    Nutrition education;    Price discount;   

Others  :  1161938
DOI  :  10.1186/1471-2458-13-744

 received in 2013-06-28, accepted in 2013-07-17,  发布年份 2013

【 摘 要 】

Background

Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related. Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease. There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.

This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities.

Methods/Design

We will utilise a randomised multiple baseline (stepped wedge) design involving 20 communities in remote Indigenous Australia. The study will be conducted in partnership with two store associations and twenty Indigenous store boards. Communities will be randomised to either i) a 20% price discount on fruit, vegetables, water and diet soft-drinks; or ii) a combined price discount and in-store nutrition education strategy. These interventions will be initiated, at one of five possible time-points, spaced two-months apart. Weekly point-of-sale data will be collected from each community store before, during, and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks. Data on physical, social and economic factors influencing weekly store sales will be collected in order to identify important covariates. Intervention fidelity and mediators of behaviour change will also be assessed.

Discussion

This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12613000694718

【 授权许可】

   
2013 Brimblecombe et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 1 .

【 参考文献 】

• [1]Vos T, Barker B, Begg S, Stanley L, Lopez AD: Burden of disease and injury in aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. Int J Epidemiol 2009, 38:470-477.
• [2]Australian Institute of Health and Welfare: The health and welfare of Australia's Aboriginal and Torres Strait Islander people, an overview 2011. Cat no: IHW 42. Canberra: AIHW; 2011. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737418955&libID=10737418954 webcite
• [3]Brimblecombe JK, Ferguson MM, Liberato SC, O'Dea K: Characteristics of the community-level diet of aboriginal people in remote northern Australia. Med J Aust 2013, 198:380-384.
• [4]Lock K, Pomerleau J, Causer L, McKee M: Low fruit and vegetable consumption. In Comparative quantification of health risks:global and regional burden of disease attributable to selected major risk factors. Edited by Ezzati M, Lopez A, Rodgers A, Murray C. Geneva: Wolrd Health Organisation; 2004:597.
• [5]SIGNAL and the National Vegetables and Fruit Coalition: Eat more vegetables and fruit: The case for a five-year campaign to increase vegetable and fruit consumption in Australia. Part 1: Business Case. Canberra: SIGNAL; 2002.
• [6]Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, et al.: Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004, 292:927-934.
• [7]Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, et al.: Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Am J Clin Nutr 2009, 89:1299-1306.
• [8]Laville M, Nazare JA: Diabetes, insulin resistance and sugars. Obes Rev 2009, 10(Suppl 1):24-33.
• [9]Rowley KG, Iser DM, Best JD, O'Dea K, Leonard D, McDermott R: Albuminuria in Australian aboriginal people: prevalence and associations with components of the metabolic syndrome. Diabetologia 2000, 43:1397-1403.
• [10]Maple-Brown L, Cunningham J, Celermajer DS, O'Dea K: Increased carotid intima-media thickness in remote and urban indigenous Australians: impact of diabetes and components of the metabolic syndrome. Clin Endocrinol (Oxf) 2007, 66:419-425.
• [11]An R, Patel D, Segal D, Sturm R: Eating better for less: a national discount program for healthy food purchases in South Africa. Am J Health Behav 2013, 37:56-61.
• [12]Eyles H, Ni Mhurchu C, Nghiem N, Blakely T: Food pricing strategies, population diets, and non-communicable disease: a systematic review of simulation studies. PLoS Med 2012, 9:e1001353.
• [13]Ni Mhurchu C, Blakely T, Jiang Y, Eyles HC, Rodgers A: Effects of price discounts and tailored nutrition education on supermarket purchases: a randomized controlled trial. Am J Clin Nutr 2010, 91:736-747.
• [14]An R: Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments. Public Health Nutr 2013, 16:1215-1228.
• [15]Black AP, Brimblecombe J, Eyles H, Morris P, Vally H, Dea O: Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review. BMC Publ Health 2012, 12:1099. BioMed Central Full Text
• [16]Waterlander WE, de Boer MR, Schuit AJ, Seidell JC, Steenhuis IH: Price discounts significantly enhance fruit and vegetable purchases when combined with nutrition education: a randomized controlled supermarket trial. Am J Clin Nutr 2013, 97:886-895.
• [17]Blakely T, Ni Mhurchu C, Jiang Y, Matoe L, Funaki-Tahifote M, Eyles HC, et al.: Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomised, controlled trial. J Epidemiol Community Health 2011, 65(10):902-908. http://jech.bmj.com/content/65/10/902.abstract webcite. Epub 2011 Feb 4
• [18]Ball K, McNaughton S, Ni Mhurchu C, Andrianopoulos A, Inglis V, McNeilly B, et al.: Supermarket Healthy Eating for Life (SHELf): protocol of a randomised controlled trial promoting healthy food and beverage consumption through price reduction and skill-building strategies. BMC Publ Health 2011, 11:715. BioMed Central Full Text
• [19]Jensen R, Miller N: Do consumer price subsidies really improve nutrition?. Cambridge: National Bureau of Economic Research. NBER working paper series; 2010:1-43.
• [20]Glanz K, Eriksen MP: Individual and community models for dietary behavior change. J Nutr Educ 1993, 25:80.
• [21]Glanz K, Basil M, Maibach E, Goldberg J, Snyder D: Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption. J Am Diet Assoc 1998, 98:1118-1126.
• [22]National Health and Medical Research Council: Nutrition in Aboriginal and Torres Strait Islander Peoples: An Information Paper. Canberra: Commonwealth of Australia; 2000:1-267. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n26.pdf webcite
• [23]Council of Australian Governments: National strategy for food security in remote Indigenous communities. Canberra: Council of Australian Governments; 2009. [http://www.coag.gov.au/sites/default/files/nat_strat_food_security.pdf webcite]
• [24]Lee AJ, Smith A, Bryce S, O'Dea K, Rutishauser IH, Mathews JD: Measuring dietary intake in remote Australian aboriginal communities. Ecol Food Nutr 1995, 34:19-31.
• [25]Brimblecombe J, Mackerras D, Clifford P, O'Dea K: Does the store-turnover method still provide a useful guide to food intakes in aboriginal communities? Aust NZ J Public Health 2006, 30:444-447.
• [26]The Parliament of the Commonwealth of Australia. House of Representatives: Aboriginal and Torres Strait Islander Affairs Committee: Everybody's Business: remote aboriginal and Torres strait islander community stores. Canberra: Commonwealth of Australia; 2009. [http://www.aph.gov.au/Parliamentary_Business/Committees/House_of_Representatives_Committees?url=/atsia/communitystores/report.htm webcite]
• [27]Northern Territory Government: Northern territory market basket survey. Darwin: Department of health, Northern Territory; 2012. [http://digitallibrary.health.nt.gov.au/prodjspui/bitstream/10137/560/2/NT%20MBS%20Report.pdf webcite]
• [28]Torzillo PJ, Pholeros P, Rainow S, Barker G, Sowerbutts T, Short T, et al.: The state of health hardware in aboriginal communities in rural and remote Australia. Aust N Z J Public Health 2008, 32:7-11.
• [29]Rowley KG, Daniel M, Skinner K, Skinner M, White GA, O'Dea K: Effectiveness of a community-directed 'healthy lifestyle' program in a remote Australian aboriginal community. Aust NZ J Public Health 2000, 24:136-144.
• [30]Lee AJ, Bonson AP, Yarmirr D, O'Dea K, Mathews JD: Sustainability of a successful health and nutrition program in a remote aboriginal community. Med J Aust 1995, 162:632-635.
• [31]Butler R, Tapsell L, Lyons-Wall P: Trends in purchasing patterns of sugar-sweetened water-based beverages in a remote aboriginal community store following the implementation of a community-developed store nutrition policy. Nutr Diet 2011, 68:115-119.
• [32]Australian Government: Stronger futures in the northern territory policy statement november 2011. Canberra: Australian government. Department of Families, Housing, Community Services and Indigenous Affairs; 2011:1-11. [http://www.fahcsia.gov.au/our-responsibilities/indigenous-australians/programs-services/stronger-futures-in-the-northern-territory-0 webcite]
• [33]ALPA - The Arnhem Land Progress Aboriginal Corporation ALPA; 2013. [http://www.alpa.asn.au/ webcite]
• [34]OUTBACK Stores. OBS 2013. [http://www.outbackstores.com.au/ webcite]
• [35]Brimblecombe J, Liddle R, O'Dea K: Use of point-of-sale data to assess food and nutrient quality in remote stores. Public Health Nutr 2013, 16(7):1159-1167. http://www.ncbi.nlm.nih.gov/pubmed/23009766 webcite, http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8927689 webcite. Epub 2012 Sep 25
• [36]Australian Bureau of Statistics: 2076.0 - Census of population and housing: characteristics of aboriginal and Torres strait islander Australians, 2011. Canberra; 2010. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2076.0main+features1102011 webcite
• [37]Australian Bureau of Statistics: Information paper: ABS views on remoteness. ABS Cat. No. 1244.0. Canberra: Commonwealth of Australia; 2001. [http://www.ausstats.abs.gov.au/ausstats/free.nsf/0/FCC8158C85424727CA256C0F00003575/$File/12440_2001.pdf webcite]
• [38]Australian Bureau of Statistics: 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA). Australia: ABS; 2011. 4-4-2013. 8-4-2013. [http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa?opendocument&navpos=260 webcite]
• [39]Brown CA, Lilford RJ: The stepped wedge trial design: a systematic review. BMC Med Res Methodol 2006, 6:54. BioMed Central Full Text
• [40]Hussey MA, Hughes JP: Design and analysis of stepped wedge cluster randomized trials. Contemp Clin Trials 2007, 28:182-191.
• [41]Stokols D: Translating social ecological theory into guidelines for community health promotion. Am J Health Promot 1996, 10:282-298.
• [42]Bandura A: Social foundations of thought and action: a social cognitive theory. Prentice-Hall, INC: Englewood Cliffs, NJ, US; 1985.
• [43]Food Standards Australia New Zealand (FSANZ): AUSNUT 2007 Database Files. FSANZ; [http://www.foodstandards.gov.au/science/monitoringnutrients/ausnut/pages/ausnut2007databasefi4061.aspx webcite]
• [44]Brimblecombe J: Keeping track of healthy foods: towards improving the nutritional quality of foods sold in community stores in remote Australia. Darwin, NT: Menzies School of Health Research; 2008. http://www.menzies.edu.au/page/Research/Projects/Nutrition/Remote_Indigenous_Stores_and_Takeaways_RIST_Keeping_Track_of_Healthy_Foods_Tool_Development/ webcite
• [45]Food Standards Australia New Zealand (FSANZ): NUTTAB. FSANZ; [http://www.foodstandards.gov.au/science/monitoringnutrients/nutrientables/pages/default.aspx webcite]
• [46]Australian Bureau of Statistics: 2011 Census quick stats. Canberra: Commonwealth of Australia; 2012. [http://www.abs.gov.au/websitedbs/censushome.nsf/home/quickstats?opendocument&navpos webcite]
• [47]Cerin E, Mackinnon DP: A commentary on current practice in mediating variable analyses in behavioural nutrition and physical activity. Public Health Nutr 2009, 12:1182-1188.
• [48]Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N: Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med 2008, 5:e12.