Search

Background The issue of food security is complex and requires capacity for often-unrelated groups to work together. We sought to assess the relevance and meaning of a commonly used set of community capacity development constructs in the context of remote Indigenous Australia and through this propose a model to support capacity. Methods The assessment was conducted with four communities and took place over five steps that involved: (i) test of clarity of construct meaning; (ii) inductive derivation of community capacity constructs; (iii) application of these constructs to the capacity of community multi-sector food-interest groups; (iv) a cross-check of these constructs and their meanings to literature-derived constructs, and; (v) achieving consensus on tool constructs. Data were collected over a three-year period (2010–2012) that involved two on-site visits to one community, and two urban-based workshops. These data were augmented by food-interest group meeting minutes and reports. Results Eleven community capacity development constructs were included in the proposed model: community ownership, building on strengths, strong leadership and voice, making decisions together, strong partnerships, opportunities for learning and skill development, way of working, getting together the things you need, good strong communication, sharing the true story, and continuing the process and passing on to the next generation. The constructs derived from the literature and commonly used to appraise community capacity development were well accepted and could be used to identify areas needing strengthening. The specifics of each construct however differed from those derived from the literature yet were similar across the four communities and had particular meaning for those involved. The involvement of elders and communication with the wider community seemed paramount to forming a solid foundation on which capacity could be further developed. Conclusion This study explored an approach for ascribing context specific meanings to a set of capacity development constructs and an effective visual appraisal tool. An approach to tackling food security in the remote Indigenous context where community capacity goals are considered in parallel with outcome goals, or at least as incremental goals along the way, may well help to lay a more solid foundation for improved service practice and program sustainability. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-914) contains supplementary material, which is available to authorized users.

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

Background Although communities have long been exhorted to make efforts to enhance their own health, such approaches have often floundered and resulted in little or no health benefits when the capacity of the community has not been adequately strengthened. Thus being able to assess the capacity building process is paramount in facilitating action in communities for social and health improvement. The current review aims to i) identify all domains used in systematically documented frameworks developed by other authors to assess community capacity building; and ii) to identify the dimensions and attributes of each of the domains as ascribed by these authors and reassemble them into a comprehensive compilation. Methods Relevant published articles were identified through systematic electronic searches of selected databases and the examination of the bibliographies of retrieved articles. Studies assessing capacity building or community development or community participation were selected and assessed for methodological quality, and quality in relation to the development and application of domains which were identified as constituents of community capacity building. Data extraction and analysis were undertaken using a realist synthesis approach. Results Eighteen articles met the criteria for this review. The various domains to assess community capacity building were identified and reassembled into nine comprehensive domains: "learning opportunities and skills development", "resource mobilization", "partnership/linkages/networking", "leadership", "participatory decision-making", "assets-based approach", "sense of community", "communication", and "development pathway". Six sub-domains were also identified: "shared vision and clear goals", "community needs assessment", "process and outcome monitoring", "sustainability", "commitment to action" and "dissemination". Conclusions The set of domains compiled in this review serve as a foundation for community-based work by those in the field seeking to support and nurture the development of competent communities. Further research is required to examine the robustness of capacity domains over time and to examine capacity development in association with health or other social outcomes.

Background Point-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting. Methods Records from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome. Results The search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions. Conclusions A range of intervention types have been used at point-of-sale to encourage healthy purchasing and/or intake of healthier food options and to improve health outcomes. There is a need for more well designed studies on the effectiveness of a range of point-of-sale interventions to encourage healthier eating and improve health outcomes, and of the mediating factors that might impact these interventions. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-919) contains supplementary material, which is available to authorized users.