Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores

Protocol for a randomized controlled trial

Julie Brimblecombe, Megan Ferguson, Emma McMahon, Anna Peeters, Edward Miles, Thomas Wycherley, Leia M. Minaker, Khia De Silva, Luke Greenacre, Catherine Mah

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    Abstract

    Background: Discretionary food and beverages (products high in saturated fat, added sugars, and salt) are detrimental to a healthy diet. Nevertheless, they provide 42% of total energy and account for 53% of food and beverage expenditure for remote living Aboriginal and Torres Strait Islander Australians, contributing to the excessive burden of chronic diseases experienced by this population group.

    Objective: The aim of this study is to test an intervention to reduce sales of discretionary products, in collaboration with the Arnhem Land Progress Aboriginal Corporation (ALPA), which operates 25 stores in very remote Australia, by reducing their merchandising and substituting with core products in remote Australian communities.

    Methods: We will use a community-level randomized controlled pragmatic trial design. Stores randomized to the intervention group will be supported by ALPA to reduce merchandising of 4 food categories (sugar, sugar-sweetened beverages, sweet biscuits, and confectionery) that together provide 64% of energy from discretionary foods and 87% of total free sugars in very remote community stores. The remaining stores (50% of total) will serve as controls and conduct business as usual. Electronic store sales data will be collected at baseline, 12-weeks intervention, and 24-weeks postintervention to objectively assess the primary outcome of percent change in purchases of free sugars (g/megajoule) and secondary business- and diet-related outcomes. Critical to ensuring translation to improved store policies and healthier diets in remote Indigenous Australia, we will conduct (1) an in-depth implementation evaluation to assess fidelity, (2) a customer intercept survey to investigate the relationship between customer characteristics and discretionary food purchasing, and (3) a qualitative study to identify policy supports for scale-up of health-enabling policy action in stores.

    Results: As of August 2018, 20 stores consented to participate and were randomized to receive the intervention or continue usual business. The 12-week strategy ended in December 2018. The 24-week postintervention follow-up will occur in May 2019. Trial results are expected for 2019.

    Conclusions: Novel pragmatic research approaches are needed to inform policy for healthy retail food environments. This research will greatly advance our understanding of how the retail food environment can be used to improve population-level diet in the remote Australian Aboriginal and Torres Strait Islander context and retail settings globally.

    Original languageEnglish
    Article numbere12646
    Pages (from-to)1-12
    Number of pages12
    JournalJournal of Medical Internet Research
    Volume21
    Issue number3
    DOIs
    Publication statusPublished - 29 Mar 2019

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    Food and Beverages
    Randomized Controlled Trials
    Food
    Pragmatic Clinical Trials
    Diet
    Beverages
    Health Expenditures
    Health Policy
    Population Groups
    Research
    Chronic Disease
    Salts
    Fats
    Population

    Cite this

    Brimblecombe, Julie ; Ferguson, Megan ; McMahon, Emma ; Peeters, Anna ; Miles, Edward ; Wycherley, Thomas ; Minaker, Leia M. ; De Silva, Khia ; Greenacre, Luke ; Mah, Catherine. / Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores : Protocol for a randomized controlled trial. In: Journal of Medical Internet Research. 2019 ; Vol. 21, No. 3. pp. 1-12.
    @article{e88d592d34fe4ed7a867331c5c59ce89,
    title = "Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores: Protocol for a randomized controlled trial",
    abstract = "Background: Discretionary food and beverages (products high in saturated fat, added sugars, and salt) are detrimental to a healthy diet. Nevertheless, they provide 42{\%} of total energy and account for 53{\%} of food and beverage expenditure for remote living Aboriginal and Torres Strait Islander Australians, contributing to the excessive burden of chronic diseases experienced by this population group. Objective: The aim of this study is to test an intervention to reduce sales of discretionary products, in collaboration with the Arnhem Land Progress Aboriginal Corporation (ALPA), which operates 25 stores in very remote Australia, by reducing their merchandising and substituting with core products in remote Australian communities. Methods: We will use a community-level randomized controlled pragmatic trial design. Stores randomized to the intervention group will be supported by ALPA to reduce merchandising of 4 food categories (sugar, sugar-sweetened beverages, sweet biscuits, and confectionery) that together provide 64{\%} of energy from discretionary foods and 87{\%} of total free sugars in very remote community stores. The remaining stores (50{\%} of total) will serve as controls and conduct business as usual. Electronic store sales data will be collected at baseline, 12-weeks intervention, and 24-weeks postintervention to objectively assess the primary outcome of percent change in purchases of free sugars (g/megajoule) and secondary business- and diet-related outcomes. Critical to ensuring translation to improved store policies and healthier diets in remote Indigenous Australia, we will conduct (1) an in-depth implementation evaluation to assess fidelity, (2) a customer intercept survey to investigate the relationship between customer characteristics and discretionary food purchasing, and (3) a qualitative study to identify policy supports for scale-up of health-enabling policy action in stores. Results: As of August 2018, 20 stores consented to participate and were randomized to receive the intervention or continue usual business. The 12-week strategy ended in December 2018. The 24-week postintervention follow-up will occur in May 2019. Trial results are expected for 2019. Conclusions: Novel pragmatic research approaches are needed to inform policy for healthy retail food environments. This research will greatly advance our understanding of how the retail food environment can be used to improve population-level diet in the remote Australian Aboriginal and Torres Strait Islander context and retail settings globally.",
    keywords = "Diet, Food supply, Indigenous population, Randomized controlled trial",
    author = "Julie Brimblecombe and Megan Ferguson and Emma McMahon and Anna Peeters and Edward Miles and Thomas Wycherley and Minaker, {Leia M.} and {De Silva}, Khia and Luke Greenacre and Catherine Mah",
    year = "2019",
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    Brimblecombe, J, Ferguson, M, McMahon, E, Peeters, A, Miles, E, Wycherley, T, Minaker, LM, De Silva, K, Greenacre, L & Mah, C 2019, 'Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores: Protocol for a randomized controlled trial', Journal of Medical Internet Research, vol. 21, no. 3, e12646, pp. 1-12. https://doi.org/10.2196/12646

    Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores : Protocol for a randomized controlled trial. / Brimblecombe, Julie; Ferguson, Megan; McMahon, Emma; Peeters, Anna; Miles, Edward; Wycherley, Thomas; Minaker, Leia M.; De Silva, Khia; Greenacre, Luke; Mah, Catherine.

    In: Journal of Medical Internet Research, Vol. 21, No. 3, e12646, 29.03.2019, p. 1-12.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Reducing retail merchandising of discretionary food and beverages in remote indigenous community stores

    T2 - Protocol for a randomized controlled trial

    AU - Brimblecombe, Julie

    AU - Ferguson, Megan

    AU - McMahon, Emma

    AU - Peeters, Anna

    AU - Miles, Edward

    AU - Wycherley, Thomas

    AU - Minaker, Leia M.

    AU - De Silva, Khia

    AU - Greenacre, Luke

    AU - Mah, Catherine

    PY - 2019/3/29

    Y1 - 2019/3/29

    N2 - Background: Discretionary food and beverages (products high in saturated fat, added sugars, and salt) are detrimental to a healthy diet. Nevertheless, they provide 42% of total energy and account for 53% of food and beverage expenditure for remote living Aboriginal and Torres Strait Islander Australians, contributing to the excessive burden of chronic diseases experienced by this population group. Objective: The aim of this study is to test an intervention to reduce sales of discretionary products, in collaboration with the Arnhem Land Progress Aboriginal Corporation (ALPA), which operates 25 stores in very remote Australia, by reducing their merchandising and substituting with core products in remote Australian communities. Methods: We will use a community-level randomized controlled pragmatic trial design. Stores randomized to the intervention group will be supported by ALPA to reduce merchandising of 4 food categories (sugar, sugar-sweetened beverages, sweet biscuits, and confectionery) that together provide 64% of energy from discretionary foods and 87% of total free sugars in very remote community stores. The remaining stores (50% of total) will serve as controls and conduct business as usual. Electronic store sales data will be collected at baseline, 12-weeks intervention, and 24-weeks postintervention to objectively assess the primary outcome of percent change in purchases of free sugars (g/megajoule) and secondary business- and diet-related outcomes. Critical to ensuring translation to improved store policies and healthier diets in remote Indigenous Australia, we will conduct (1) an in-depth implementation evaluation to assess fidelity, (2) a customer intercept survey to investigate the relationship between customer characteristics and discretionary food purchasing, and (3) a qualitative study to identify policy supports for scale-up of health-enabling policy action in stores. Results: As of August 2018, 20 stores consented to participate and were randomized to receive the intervention or continue usual business. The 12-week strategy ended in December 2018. The 24-week postintervention follow-up will occur in May 2019. Trial results are expected for 2019. Conclusions: Novel pragmatic research approaches are needed to inform policy for healthy retail food environments. This research will greatly advance our understanding of how the retail food environment can be used to improve population-level diet in the remote Australian Aboriginal and Torres Strait Islander context and retail settings globally.

    AB - Background: Discretionary food and beverages (products high in saturated fat, added sugars, and salt) are detrimental to a healthy diet. Nevertheless, they provide 42% of total energy and account for 53% of food and beverage expenditure for remote living Aboriginal and Torres Strait Islander Australians, contributing to the excessive burden of chronic diseases experienced by this population group. Objective: The aim of this study is to test an intervention to reduce sales of discretionary products, in collaboration with the Arnhem Land Progress Aboriginal Corporation (ALPA), which operates 25 stores in very remote Australia, by reducing their merchandising and substituting with core products in remote Australian communities. Methods: We will use a community-level randomized controlled pragmatic trial design. Stores randomized to the intervention group will be supported by ALPA to reduce merchandising of 4 food categories (sugar, sugar-sweetened beverages, sweet biscuits, and confectionery) that together provide 64% of energy from discretionary foods and 87% of total free sugars in very remote community stores. The remaining stores (50% of total) will serve as controls and conduct business as usual. Electronic store sales data will be collected at baseline, 12-weeks intervention, and 24-weeks postintervention to objectively assess the primary outcome of percent change in purchases of free sugars (g/megajoule) and secondary business- and diet-related outcomes. Critical to ensuring translation to improved store policies and healthier diets in remote Indigenous Australia, we will conduct (1) an in-depth implementation evaluation to assess fidelity, (2) a customer intercept survey to investigate the relationship between customer characteristics and discretionary food purchasing, and (3) a qualitative study to identify policy supports for scale-up of health-enabling policy action in stores. Results: As of August 2018, 20 stores consented to participate and were randomized to receive the intervention or continue usual business. The 12-week strategy ended in December 2018. The 24-week postintervention follow-up will occur in May 2019. Trial results are expected for 2019. Conclusions: Novel pragmatic research approaches are needed to inform policy for healthy retail food environments. This research will greatly advance our understanding of how the retail food environment can be used to improve population-level diet in the remote Australian Aboriginal and Torres Strait Islander context and retail settings globally.

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    KW - Food supply

    KW - Indigenous population

    KW - Randomized controlled trial

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    JF - Journal of Medical Internet Research

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