A spatial, systems and solution focused approach to understanding food environment factors that influence dietary risks of Australians living in rural and remote areas

Australians in rural and remote areas live shorter lives and experience higher rates of diet-related disease compared to those living in cities. Poor diet is a major, preventable contributor to this inequality in morbidity and mortality making improving the diet of rural and remote communities a critical priority. Food environments drive dietary practice, and rural and remote areas experience less access to healthy food retailers than urban areas. Little is known about how rural and remote Australians experience food environments, how these experiences shape dietary choices and how this could be adapted to drive healthier diet choices. Participatory research is needed to engage retailers, consumers and food suppliers so we can understand how environments drive
behaviours and what changes would be both effective and acceptable to improve diet quality. Participatory approaches drawn from systems and social science have been effective in exploring the causes and consequences of complex problems and potential evidence-informed interventions. Our group has pioneered the use of these and demonstrated effectiveness in co-designing effective interventions for obesity, physical inactivity, and unhealthy food behaviours. However, the commonly used in-person facilitation of these participatory approaches limits community participation, particularly for rural and remote communities. We propose to co-develop and feasibility test a web-based application of an innovative participatory approach to engage rural and remote communities. In doing this we will better understand these communities lived experience of the food environment and how this influences dietary behaviours. A second outcome will be providing the opportunity to co-design interventions to address diet-related health and associated health-care costs in rural areas.