George Institute for Global Health, UNSW, Sydney, New South Wales.
Charles Perkins Centre, The University of Sydney, New South Wales.
Aust N Z J Public Health. 2019 Aug;43(4):355-365. doi: 10.1111/1753-6405.12908. Epub 2019 May 29.
The Health Star Rating (HSR) is a front-of-pack nutrition labelling system, implemented voluntarily in Australia and New Zealand since 2014. Our aim was to evaluate HSR's performance.
We used data from peer-reviewed publications and government-commissioned monitoring and evaluation, websites and communiqués to evaluate HSR's performance between June 2014 and October 2018 using the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) framework.
Thirty-three peer-reviewed publications, 21 government and three independent reports informed the assessment. Awareness and trust in HSR was increasing, though campaign reach remained low. Consumers liked, could understand and use the HSR logo, though effects on purchasing were largely unknown. The algorithm was the focus of a formal review. HSR was present on 20-28% of products but biased to those that scored better (HSR≥3.0). Necessary stakeholders were mostly engaged.
A substantial body of work supports continuation and strengthening of HSR. Reasonable refinements to HSR's star graphic and algorithm, action to initiate mandatory implementation, and strengthened HSR governance present the clearest opportunities for improving public health impact. Implications for public health: Development and implementation of government-led front-of-pack nutrition labelling systems have the potential to improve public health, while engaging a diverse set of stakeholders.
健康星级评级（HSR）是一种在 2014 年起在澳大利亚和新西兰自愿实施的包装营养标签系统。我们旨在评估 HSR 的表现。
我们使用了来自同行评议出版物、政府委托的监测和评估、网站和公报的数据，使用 RE-AIM（覆盖范围、效果、采用、实施和维护）框架，在 2014 年 6 月至 2018 年 10 月之间评估 HSR 的表现。
33 篇同行评议出版物、21 篇政府报告和 3 篇独立报告为评估提供了信息。对 HSR 的认识和信任度在增加，尽管宣传的覆盖范围仍然较低。消费者喜欢、能够理解和使用 HSR 标志，但对购买的影响尚不清楚。该算法是一次正式审查的重点。HSR 出现在 20-28%的产品上，但偏向于得分较高的产品（HSR≥3.0）。必要的利益相关者大多参与其中。
大量的工作支持继续和加强 HSR。对 HSR 的星级图形和算法进行合理的改进、采取行动启动强制性实施、以及加强 HSR 的治理，为提高公共卫生影响提供了最明确的机会。对公共卫生的影响：政府主导的包装营养标签系统的开发和实施有可能改善公共卫生，同时吸引了一系列不同的利益相关者。
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