. 2024 Jul 5;24(1):1790.

doi: 10.1186/s12889-024-19277-0.

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

Julie Brimblecombe^{1

2

3}, Megan Ferguson^{4

5

6}, Emma McMahon^{4

5

6}, Bronwyn Fredericks⁷, Nicole Turner^{8

9}, Christina Pollard¹⁰, Louise Maple-Brown⁶, Joanna Batstone¹¹, Leisa McCarthy⁶, Eddie Miles^{6

12}, Khia De Silva¹³, Adam Barnes¹⁴, Mark Chatfield^{5

6}, Amanda Hill⁴, Meaghan Christian⁴, Emma van Burgel^{4

10}, Molly Fairweather⁴, Anna Murison¹⁵, Dickson Lukose¹¹, Surekha Gaikwad¹¹, Meron Lewis⁵, Rebekah Clancy¹⁶, Claire Santos¹⁷, Kora Uhlmann¹⁸, Sarah Funston¹³, Laura Baddeley¹³, Sally Tsekouras¹⁹, Jaithri Ananthapavan²⁰, Gary Sacks²¹, Amanda Lee⁵

Affiliations

¹ Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia. Julie.brimblecombe@monash.edu.
² School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia. Julie.brimblecombe@monash.edu.
³ Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia. Julie.brimblecombe@monash.edu.
⁴ Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
⁵ School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia.
⁶ Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia.
⁷ Office of the Deputy Vice-Chancellor, The University of Queensland, Herston, QLD, 4006, Australia.
⁸ Indigenous Allied Health Australia, Alia House, Napier Cl, 2600, Deakin, ACT, Australia.
⁹ Charles Perkins Centre, University of Sydney John Hopkins Dr, Camperdown, NSW, 2050, Australia.
¹⁰ Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia.
¹¹ Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia.
¹² Community First Development, 1/67 Townshend St, Phillip, ACT, 2606, Australia.
¹³ Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia.
¹⁴ NT Health, Manunda Place, 38 Cavenagh Street, Darwin, NT, 0800, Australia.
¹⁵ Outback Stores, 67 Pruen Rd, Berrimah, NT, 0828, Australia.
¹⁶ Miwatj Health Aboriginal Corporation, Lot 1425 Arnhem Road, Nhulunbuy, NT, Australia.
¹⁷ Population and Primary Health Care Outreach Team, NT Health, Casuarina Plaza, 258 Trower Road, Darwin, NT, 0810, Australia.
¹⁸ Health and Wellbeing Queensland, 139 Coronation Drive, Milton, QLD, 4064, Australia.
¹⁹ Katherine West Health Board Aboriginal Corporation, 38 First St, Katherine, NT, 0850, Australia.
²⁰ Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia.
²¹ Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia.

PMID: 38970046
PMCID: PMC11229494
DOI: 10.1186/s12889-024-19277-0

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

Julie Brimblecombe et al. BMC Public Health. 2024.

. 2024 Jul 5;24(1):1790.

doi: 10.1186/s12889-024-19277-0.

Authors

Affiliations

¹ Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia. Julie.brimblecombe@monash.edu.
² School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia. Julie.brimblecombe@monash.edu.
³ Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia. Julie.brimblecombe@monash.edu.
⁴ Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
⁵ School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia.
⁶ Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia.
⁷ Office of the Deputy Vice-Chancellor, The University of Queensland, Herston, QLD, 4006, Australia.
⁸ Indigenous Allied Health Australia, Alia House, Napier Cl, 2600, Deakin, ACT, Australia.
⁹ Charles Perkins Centre, University of Sydney John Hopkins Dr, Camperdown, NSW, 2050, Australia.
¹⁰ Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia.
¹¹ Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia.
¹² Community First Development, 1/67 Townshend St, Phillip, ACT, 2606, Australia.
¹³ Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia.
¹⁴ NT Health, Manunda Place, 38 Cavenagh Street, Darwin, NT, 0800, Australia.
¹⁵ Outback Stores, 67 Pruen Rd, Berrimah, NT, 0828, Australia.
¹⁶ Miwatj Health Aboriginal Corporation, Lot 1425 Arnhem Road, Nhulunbuy, NT, Australia.
¹⁷ Population and Primary Health Care Outreach Team, NT Health, Casuarina Plaza, 258 Trower Road, Darwin, NT, 0810, Australia.
¹⁸ Health and Wellbeing Queensland, 139 Coronation Drive, Milton, QLD, 4064, Australia.
¹⁹ Katherine West Health Board Aboriginal Corporation, 38 First St, Katherine, NT, 0850, Australia.
²⁰ Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia.
²¹ Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia.

PMID: 38970046
PMCID: PMC11229494
DOI: 10.1186/s12889-024-19277-0

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.

Keywords: Benchmarking; Continuous improvement; Diet; Health policy; Implementation strategy; Indigenous health.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
SPIRIT Participant Flow Diagram

**Fig. 3**
The benchmarking and continuous improvement cycle of assessment, feedback, action planning and implementation. Adapted from the PLAN-DO-COLLECT-LEARN cycle, Menzies School of Health Research [63]. This figure shows the four components of the cycle and the sharing of this information with store directors/owners as represented by the middle section of the figure. Artwork by Ngarrindjeri artist Jordan Lovegrove

See this image and copyright information in PMC

References

1. National Indigenous Australians Agency. House of representatives standing committee inquiry into food pricing and food security in remote indigenous communities. Submission 36. Canberra: Commonwealth of Australia; 2020.
1. The Parliament of the Commonwealth of Australia . Report on food pricing and food security in remote Indigenous communities. Commonwealth of Australia: House of Representatives Standing Committee on Indigenous Affairs. Canberra; 2020.
1. 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(2):115–119. doi: 10.1111/j.1747-0080.2011.01515.x. - DOI
1. Brimblecombe J, McMahon E, Ferguson M, De Silva K, Peeters A, Miles E, Wycherley T, Minaker L, Greenacre L, Gunther A, Chappell E, Chatfield MD, Mah CL. Effect of restricted retail merchandising of discretionary food and beverages on population diet: a pragmatic randomised controlled trial. Lancet Planet Health. 2020;4(10):e463–e473. doi: 10.1016/S2542-5196(20)30202-3. - DOI - PubMed
1. Arnhem Land Progress Aboriginal Corporation. https://www.alpa.asn.au/ [Accessed 1/07/2023]

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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

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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

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