Hallmark features of rural communities central to enacting change in healthy food space

Rural communities look to their own when they’re in need of help and support – so it makes sense to capitalise on local knowledge when seeking to improve health outcomes.

It’s this approach that is at the centre of a pilot project being undertaken by RE-FRESH researchers Dr Laura Alston (pictured above right) and Nikita Wheaton (pictured above left) which is studying how local health service dietitians within rural communities can be utilised to improve rural food environments.

The researchers presented on the CARE Study (Heath Service as Change Agents in Rural Food Environments) at the Western Alliance Symposium in Dunkeld in November 2022, sharing how 15 food retailers across the Colac Otway Shire, in Victoria’s south-west, will be connected to healthcare service nutrition experts to help them design tailored interventions to sell and promote healthy foods.

Participants will include several cafes, a hotel and local government-run food outlets. Adding new healthy options and identifying existing options for promotion to their customers are just two of focus area participants have identified for support.

RE-FRESH researcher Dr Alston – a Heart Foundation Fellow, the Director of Research at Colac Area Health and a member of Deakin Rural Health – said the novel idea of health services as change agents in rural food environments had come from her previous research in rural communities which looked at the types of food retailers currently sold and sought to understand enablers and barriers to selling healthy food.

“We audited 100 cafes and restaurants in seven towns across the Colac Otway Shire (1) and spoke to retailers about their current approaches and practices. We also identified 21 studies globally from rural areas (2) which highlighted different interventions. Together with recent work, this showed that its crucial for interventions to be co-designed with communities to be successful, and that businesses would love it if the local health service’s health promotions officers and dietitians could come in and give them some advice.”

“They (the food retailers) spoke about how they look to the local health service as a leader for health in the region and about how much they care about the local community’s health. We saw this as a great opportunity to bring the two together and harness the undeniably strong social fabric of rural communities to work together to enact change.”

Dr Alston said the respected position of the healthcare service and the level of community care had been clearly highlighted by the participating food retailers.

“We’ve already had the idea of some sort of health service endorsement for cafes and restaurants excelling in food retail floated, and there’s support for the health service to use its reach to promote businesses which are doing a good job, so it shows how much the health service is looked to and trusted.

“The retailers in this area said they felt a responsibility to think of the health of their community and even wanted to make sure other retailers weren’t missing out; there’s something special about rural communities where people really care about each other.”

The CARE Study is funded by the Western Alliance and Dr Alston’s Heart Foundation Fellowship.

Research referred to in this article: 

1. Alston L, Versace V, Brown E, Nichols M, Whelan J, Bolton KA, Sacks G, Needham C, Orellana L, Allender S. Understanding the healthfulness of outlets providing lunch and dinner meals: a census of a rural food retail environment in Victoria, Australia. Aust N Z J Public Health. 2021 Feb;45(1):65-70. doi: 10.1111/1753-6405.13057. Epub 2020 Dec 21. PMID: 33347675.  

2. Osborne SR, Alston LV, Bolton KA, Whelan J, Reeve E, Wong Shee A, Browne J, Walker T, Versace VL, Allender S, Nichols M, Backholer K, Goodwin N, Lewis S, Dalton H, Prael G, Curtin M, Brooks R, Verdon S, Crockett J, Hodgins G, Walsh S, Lyle DM, Thompson SC, Browne LJ, Knight S, Pit SW, Jones M, Gillam MH, Leach MJ, Gonzalez-Chica DA, Muyambi K, Eshetie T, Tran K, May E, Lieschke G, Parker V, Smith A, Hayes C, Dunlop AJ, Rajappa H, White R, Oakley P, Holliday S. Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia. Med J Aust. 2020 Dec;213 Suppl 11:S3-S32.e1. doi: 10.5694/mja2.50881. PMID: 33314144.