School of Public Health, The University of Queensland, 288 Herston Rd, Herston, QLD, 4029, Australia.
Nganampa Health Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia.
Nutr J. 2024 Jan 16;23(1):10. doi: 10.1186/s12937-023-00895-0.
Affordability of healthy food is a key determinant of the diet-related health of First Nations Peoples. This systematic scoping review was commissioned by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council (NPYWC) in Central Australia to identify interventions to improve economic access to healthy food in First Nations communities in selected high-income, colonised countries.
Eight databases and 22 websites were searched to identify studies of interventions and policies to improve economic access to healthy food in First Nations communities in Australia, Canada, the United States or New Zealand from 1996 to May 2022. Data from full text of articles meeting inclusion criteria were extracted to a spreadsheet. Results were collated by descriptive synthesis. Findings were examined with members of the NPYWC Anangu research team at a co-design workshop.
Thirty-five publications met criteria for inclusion, mostly set in Australia (37%) or the US (31%). Interventions (n = 21) were broadly categorised as price discounts on healthy food sold in communities (n = 7); direct subsidies to retail stores, suppliers and producers (n = 2); free healthy food and/or food vouchers provided to community members (n = 7); increased financial support to community members (n = 1); and other government strategies (n = 4). Promising initiatives were: providing a box of food and vouchers for fresh produce; prescriptions for fresh produce; provision/promotion of subsidised healthy meals and snacks in community stores; direct funds transfer for food for children; offering discounted healthy foods from a mobile van; and programs increasing access to traditional foods. Providing subsidies directly to retail stores, suppliers and producers was least effective. Identified enablers of effective programs included community co-design and empowerment; optimal promotion of the program; and targeting a wide range of healthy foods, particularly traditional foods where possible. Common barriers in the least successful programs included inadequate study duration; inadequate subsidies; lack of supporting resources and infrastructure for cooking, food preparation and storage; and imposition of the program on communities.
The review identified 21 initiatives aimed at increasing affordability of healthy foods in First Nations communities, of which six were deemed promising. Five reflected the voices and experiences of members of the NPYWC Anangu research team and will be considered by communities for trial in Central Australia. Findings also highlight potential approaches to improve economic access to healthy foods in First Nations communities in other high-income colonised countries.
PROSPERO CRD42022328326.
健康食品的可负担性是影响第一民族人群饮食相关健康的关键决定因素。本系统评价综述受澳大利亚中北部的 Ngaanyatjarra Pitjantjatjara Yankunytjatjara 妇女理事会（NPYWC）委托，旨在确定改善选定高收入、殖民国家中第一民族社区获得健康食品的经济途径的干预措施。
从 1996 年至 2022 年 5 月，我们在 8 个数据库和 22 个网站上搜索了改善澳大利亚、加拿大、美国或新西兰第一民族社区获得健康食品的经济途径的干预措施和政策的研究。从符合纳入标准的文章全文中提取数据到电子表格中。通过描述性综合方法整理结果。在 NPYWC Anangu 研究团队成员的共同设计研讨会上检查了研究结果。
有 35 篇出版物符合纳入标准，其中大部分来自澳大利亚（37%）或美国（31%）。干预措施（n=21）大致可分为以下几类：在社区销售的健康食品打折（n=7）；向零售商店、供应商和生产商直接提供补贴（n=2）；向社区成员免费提供健康食品和/或食品券（n=7）；向社区成员增加财政支持（n=1）；和其他政府策略（n=4）。有前景的举措包括：提供一箱食品和新鲜农产品优惠券；新鲜农产品处方；在社区商店提供/推广补贴的健康餐和小吃；为儿童提供食品的直接资金转移；提供打折的健康食品流动车；以及增加获得传统食品的途径。向零售商店、供应商和生产商直接提供补贴的效果最差。确定了有效项目的促成因素包括社区共同设计和赋权；最佳推广项目；并尽可能针对广泛的健康食品，特别是传统食品。在效果最差的项目中，常见的障碍包括研究持续时间不足；补贴不足；缺乏烹饪、食品准备和储存的支持资源和基础设施；以及将项目强加给社区。
本综述确定了 21 项旨在提高第一民族社区健康食品可负担性的举措，其中 6 项被认为有前景。其中五项反映了 Ngaanyatjarra Pitjantjatjara Yankunytjatjara 妇女理事会 Anangu 研究团队成员的意见和经验，将由社区考虑在澳大利亚中部试用。研究结果还突出了改善其他高收入殖民国家第一民族社区获得健康食品的经济途径的潜在方法。
PROSPERO CRD42022328326。
