Food and beverage price discounts to improve health in remote Aboriginal communities: mixed method evaluation of a natural experiment

Abstract Objective: Retrospectively evaluate food price discounts in remote Aboriginal community stores. Methods: Four price discount strategies of 10% were designed in 2010, aiming to influence grocery, fruit, vegetables and diet soft‐drink sales. This natural experiment across a group of stores was evaluated using an explanatory, sequential mixed method design through analysis of store point‐of‐sale, document, observation and interview data. The outcome was measured by change in: 1) percentage of grocery sales to total food and beverage; 2) fruit and vegetable sales; and 3) diet soft‐drink sales. Qualitative data enabled the interpretation of outcomes through understanding perceived success and benefits, and enablers and barriers to implementation. Results: Eighteen community stores and 54 informants participated. While targeted price discounts were considered important to improving health, no discernible effect was evident, due to inadequate design and communication of discount promotion, and probably inadequate magnitude of discount. Conclusions: Strategy impact on food and beverage sales was limited by promotion and magnitude of discount. Implication for Public Health: This study demonstrates key factors and commitment required to design, communicate, implement and monitor strategies to improve health in this challenging remote retail context. Evaluation of natural experiments can contribute evidence to policy‐making.