Background: Traditional food environment measures often focus on geographic access to food retailers but may fail to capture the complex behavioural and systems drivers influencing where, why, and how people obtain food. In-person engagement approaches may also restrict participation from rural communities and individuals with limited transport access or time availability. Map My Food (MMF) is a digitally enabled participatory mapping tool designed to support more inclusive community participation while exploring lived experiences of food access and purchasing behaviours within rural Australian communities.
Methods: Participants used the MMF platform to record food purchasing journeys, including locations visited, foods purchased, modes of transport, travel distances, and reasons for selecting particular food outlets. The tool also captured contextual influences shaping purchasing decisions, including convenience, quality, cultural preferences, and social factors. Spatial and behavioural data were analysed descriptively and interpreted using systems thinking approaches to identify interconnections and feedback mechanisms influencing food access.
Results: Over 320 people across two rural local government areas participated in MMF. Preliminary findings demonstrate substantial variability in the distances participants travelled to obtain food, with many bypassing geographically closer food retailers in favour of outlets perceived to provide better affordability, quality, or product availability. Participants frequently described trade-offs between cost, convenience, time, and food quality when making purchasing decisions. These interactions highlighted the dynamic nature of food access and demonstrated that proximity alone was insufficient to explain food purchasing behaviour.
Conclusions: MMF provides a novel systems-informed approach for understanding food access beyond traditional spatial metrics while improving opportunities for participation across geographically dispersed communities. Early findings highlight the importance of integrating behavioural, contextual, and systems-level perspectives into preventive health and food environment research. The approach offers valuable insights for local governments and policymakers seeking to design equitable and context-responsive food system interventions.

Background: Sustained government policy-driven changes to the availability and promotion of healthier food and drinks in foodservice outlets are essential to support population health over time. Limited research has explored whether, why and how healthy food retail practices become easier or more challenging to maintain over time. This study aimed to explore food retailer (managers, staff and volunteers) and implementation support practitioner (e.g., dietitians, health promotion practitioners) experiences with and perspectives on the (i) feasibility of, (ii) key determinants of, and (iii) strategies for sustaining healthy food retail practices in a range of Australian public settings.

Methods: Semi-structured interviews were conducted with seventeen participants (9 practitioners, 8 retailers) representing food outlets with experience sustaining healthy food retail practices in sport and recreation centres, schools, and healthcare facilities across six Australian jurisdictions. Interviews were thematically analysed, using primarily a deductive approach informed by the Integrated Sustainability Framework, sustainment-explicit Expert Recommendations for Implementing Change glossary and Marketing Mix theory.

Results: Key determinants of sustainment (Theme 1) were related to ‘intervention-context fit and outlet capacity’; ‘people and processes driving sustainment’; and ‘top-down leadership and systemic support’. Multiple concurrent and interconnected strategies to support sustainment (Theme 2) were identified, including ‘iterative, evaluative and adaptive strategies to support fit and fidelity’, ‘engagement and behaviour-focused strategies to build capacity and demand’, and ‘embedding healthy food retail within organisational governance and policy systems’.

Conclusions: Sustaining policy-driven healthy food retail practices in public settings is a dynamic process, requiring consistent alignment between inner and outer context, support systems and engagement with key actors. These findings can help inform more sustainable, scalable and systems-focused approaches to supporting healthy food retail policy sustainment in foodservice settings.

Background: Initiatives that promote healthier food choices have been implemented in food retail outlets across various public settings in Victoria. Little is known about what supports sustainment of these initiatives beyond two years. The aim was to identify and understand factors affecting long-term sustainment of health-promoting strategies for retailers.
Methods: We interviewed retail staff and supporting health-promotion practitioners from small- and medium-sized food retailers across metropolitan and regional Victorian public health, sport and recreation outlets, and private businesses. Building on the Systems Thinking for Retail Transformation (START) map, we used system dynamics modelling to build a causal loop diagram depicting key factors affecting initiative sustainment over time. Descriptions of key themes contextualised the causal loop diagram describing system patterns affecting food retailers. Findings were validated in a second round of retailer interviews.
Findings: A total 19 interviews were conducted (n = 11 retail staff and n = 8 health promotion practitioners) representing 14 retail outlets as case studies. Twenty factors influencing health-promoting strategy sustainment were grouped into four themes: the Authorising Environment (Leadership); Profitable Health-Promoting Retail (Business Acumen;); Supply-Side Limitations; and Effective Communication and Resources. Leadership support was imperative for sustainment, enabled by face-to-face communication to build initiative ownership. The biggest barrier for voluntary uptake and health-promotion champions was limited supply of healthier, appealing, and affordable products. Health-promoting food retail mandates were considered essential for sustainment.
Conclusions: The visual systems models may allow cross-sector partners to see the whole picture, identify relevant leverage points, and plan for sustainment and scalability of health-promoting business strategies. Limited healthier and profitable product supply for retailers means that enforceable mandates and contractual agreements are necessary to sustain retailer health-promoting strategies. Additionally, retailer support related to nutrition and healthier product sourcing, assessment, and development with promotional strategies prioritising improved consumer choice and value, promotes sustainment.

Background: First Nations communities across remote Queensland have long demonstrated innovation and leadership in developing local food solutions. Yet a practical gap has persisted: the absence of a structured, culturally grounded tool to assess whether conditions for local food production are appropriate before implementation begins.

Aim: Develop and validate a community-led decision-support matrix, the Local Food Production Assessment Matrix, capable of assessing readiness, feasibility, cultural authority, governance and long-term sustainability for food production initiatives across diverse First Nations contexts in Queensland.

Methodology: The project was delivered across three phases: (1) a structured evidence review of over two decades of First Nations food security strategies and investments; (2) co-design and iterative development of the Matrix through a Steering Committee with Traditional Owner representation, guided by the Five Cultural Pillars framework and Free, Prior and Informed Consent (FPIC) principles; and (3) pilot preparation through a community champion model in two discrete Far North Queensland communities.

Findings: The final matrix integrates seven domains: community readiness, infrastructure and supply chains, cultural alignment and authority, governance, food security and nutrition, economic participation, and environmental stewardship. A flexible reflective scoring model is integrated to inform project progression and/or strengthening. Community champion review from both pilot communities confirmed cultural alignment and practical applicability, affirming the matrix’s legitimacy and grounding in lived experience.

Conclusion: The Local Food Production Assessment Matrix offers a replicable, culturally grounded approach to early-stage food security decision-making that centres community strengths, authority and readiness rather than deficit. It represents a transferable model for embedding Indigenous self-determination into food system planning across remote Australia.

Aboriginal and Torres Strait Islander Governance Statement:
Conventional approaches to First Nations food security have often applied governance as an afterthought with community consultation appended to existing frameworks designed elsewhere. This project took a different position from the outset: cultural authority and community control are not procedural steps but foundational requirements, and a matrix designed without communities cannot claim legitimacy regardless of its technical merit.

Organisational leadership was vested in Nirrwara Global, a First Nations-owned company dedicated to building genuine partnerships between government, corporations, Traditional Owners and communities. This ensured Indigenous decision-making authority at the entity level before any community engagement began.

Project governance was held by a Steering Committee with direct Traditional Owner representation from both pilot communities. The Committee exercised genuine decision-making authority throughout, including formal endorsement rights at key milestones. Communities shaped the Matrix; they did not simply review it after the fact.

The matrix was underpinned by a Cultural Protocol Statement developed through Nirrwara's Five Cultural Pillars embedding cultural legitimacy, relational accountability, respect for Country and community self-determination into every phase of design and delivery. FPIC principles were embedded throughout, ensuring communities retained the right to guide, limit or withdraw from any aspect of the process.

Data sovereignty was a core design principle. Participation was voluntary, narrative insight was prioritised over data extraction, and communities retained authority over how their knowledge and context were represented within the matrix.

The Local Food Production Assessment Matrix was reviewed and supported by community champions from both pilot communities affirming the matrix’s cultural integrity, practical applicability and readiness for broader application.

Background: Adolescent e-cigarette use (vaping) is a growing public health concern and is associated with adverse health outcomes and increased risk of future tobacco use. Schools play a key role in influencing adolescent behaviours, including vaping. Previous research has focused on discrete vaping prevention components (e.g. education and school policies). In this study we examine the provision of vaping-related activities in Australian secondary schools using the Health Promoting Schools (HPS) framework.

Methods: An online cross-sectional survey was completed by Australian secondary school staff (n=131). Participants reported on the presence of school vaping policies and vaping prevention and cessation activities delivered in their role over the previous 12 months. Activities were categorised across the HPS domains: Curriculum & Learning, Ethos & Environment, and Partnerships & Services.

Results: Most staff (87%) reported encountering students in possession of vapes. While 54% indicated their school had a vaping policy, 36% were unsure. Most staff (93%) reported delivering at least one activity to address vaping within their school in the past 12 months. Activities were more commonly delivered within the Curriculum & Learning and Ethos & Environment domains (87% and 81% of staff reporting at least one activity in that domain, respectively). The most frequently reported activities were informal conversation with students around vaping (79%) and communicating with students about the schools vaping policy (62%). Less engagement was observed in the Community & Partnerships domain (40%). Provision of cessation supports, including referring students to vaping support services (21%) and delivering brief cessation advice (8%), were less common.

Conclusions: Although most Australian secondary school staff are taking action to address student vaping, the support provided varied considerably. Common activities were primarily mediated through informal, relationship-based interactions, and gaps in policy awareness and cessation support were identified.

Background: Healthy food retail policies aim to support population health by improving the nutritional quality of foods and drinks available for purchase in public settings. However, evidence on the resources required to sustain policy-driven changes in product offerings is limited. This study sought to explore retailer and implementation support practitioner perspectives on the resources required to sustain healthy food retail practices in Australian public settings.

Methods: A qualitative study using semi-structured interviews was conducted with eight retailers (including managers and staff) and nine implementation support practitioners (e.g., health promotion practitioners) from six Australian jurisdictions involved in sustaining healthy food retail practices. Participants represented multiple public settings (schools, healthcare facilities, and sport and recreation centres) in both metropolitan and regional areas. Interviews were analysed deductively using a framework analysis approach guided by concepts from implementation science, health economics, and healthy food retail.

Results: Sustaining healthier product offerings was described as relying primarily on human resources, especially practitioner and retailer time and expertise. Resource requirements were perceived often highest during the initial establishment of sustainment processes (e.g., developing monitoring systems or training staff). Recurrent sustainment activities (e.g., ongoing monitoring) were generally described as requiring fewer resources but still depended on retailer and/or practitioner time and skills. Volunteer support and unpaid in-kind contributions were common in some contexts, indicating differences in sustainment resource sufficiency.

Conclusions: Improved understanding of sustainment-specific resource requirements can strengthen future economic evaluations, support selection of most appropriate sustainment strategies, and identify where additional resourcing is needed to maintain healthier food environments over time. These findings can help inform more scalable approaches to supporting healthy food retail policy implementation and sustainment in Australian public settings.

Background and Aim
Active travel (AT) - such as walking and cycling - has multiple environmental and public health benefits. Although knowledge abounds on interventions to increase the use of AT modes, policy action to implement this evidence varies across institutional, environmental, and socio-cultural settings. This study aims to examine the contextual factors shaping institutional approaches to AT planning in Australia, with a view to examining institutional influence on the success or failure of implementation outcomes.

Methods
This study used a realist evaluation approach, drawing on empirical evidence from 15 semi-structured online interviews and a subsequent stakeholder workshop used to refine and validate themes. Participants were all stakeholders in the AT policy process, representing transport and public health agencies, local government organisations, advocacy groups, consultancies and research entities. Interviews informed the development of realist theory-based recommendations, as well as challenges and opportunities in integrating public health considerations into AT planning.

Preliminary findings
AT policy implementation is influenced by regulative, cultural-political, financial, organisational, environmental and social factors. Key barriers include institutional silos, car-centric social norms, and limited financial and organisational capacity to support AT projects. Tailored responses include strategic and inclusive policy design, interagency collaboration, people-centred interventions, organisational capacity building, and improved communication and public engagement. Public health considerations are not explicitly or consistently embedded in transport planning due to siloed governance structures, misaligned sectoral priorities, and weak translation of health evidence into policy and practice. Strengthening cross-sector collaboration requires better use of health evidence and economic modelling of co-benefits to demonstrate the value of AT.

Conclusion
The success of AT policy implementation depends on complex interactions between institutional, environmental and social factors, as well as targeted government responses and investment. Integrating existing public health evidence into transport decision-making can enhance cross-sectoral collaboration, align priorities and improve AT policy effectiveness.

Better Bites Gippsland

Background

Gippsland reports lower adherence to dietary guidelines than Victorian averages. Improving health in Gippsland and other regional communities requires reshaping food environments so healthier choices are easier and more appealing. Member-based dining venues provide an opportunity to do this; however, they often offer large portions and energy-dense meals, with limited focus on nutrition. Evidence on effective approaches to improving menu healthfulness in these settings remains limited. Better Bites Gippsland aimed to support venues to improve menu quality and dining environments to increase availability and appeal of healthier options.

Methods

Better Bites Gippsland used a mixed-methods approach, working collaboratively with chefs (n=3) and staff (n=3) across three member-based dining venues in Gippsland to implement food-environment changes through recipe reformulation, improved side dishes and promotion of healthier options. Data collection included venue and menu audits, patron surveys (n=81) and semi-structured interviews with managers and chefs (n=7).

Results and discussion

The project supported three member-based dining venues in Gippsland to improve menu quality and dining environments increasing the availability and uptake of healthier options. It found that nutritional improvements could be achieved through subtle, low-cost modifications embedded within existing food service systems. Changes to top-selling meals including portion reduction, lowering added salt, ingredient substitutions and increased vegetable content reduced total fat, saturated fat, sodium and sugar by up to 36%, 46%, 43% and 34% respectively in participating venues. Venue staff strongly preferred subtle changes over visibly branded “healthy” menu items. Patron surveys indicated taste and monetary value remained the primary drivers of meal choice, with health considerations secondary.

Conclusion and implications

Simple, practical changes to popular menu items can improve nutritional quality without compromising taste or value. Future work should explore strategies to support venues to implement simple, minimally disruptive changes that maintain profitability while improving population health.

Purpose: Decades of research has explored whether community-based interventions (CBIs) for obesity prevention are effective, feasible and acceptable to stakeholders. However, evidence on their economic credentials remains limited and often fails to capture the full range of benefits arising from intervention. An objective of the Precision Evidence for Childhood Obesity Prevention Interventions (PRECIS) study was to identify and quantify these broader impacts to strengthen the business case for community-based prevention.

Methods: A mixed-methods approach was adopted. A systematic review summarised evidence on the cost-effectiveness of CBIs, while a scoping review identified the breadth of outcomes evaluated in CBI studies. Semi-structured interviews with stakeholders explored the perceived broader benefits and relevant indicators. Four studies explored potential environmental benefits. Finally, pooled results were modelled using a validated economic model to estimate potential health gains and healthcare cost-savings.

Results: The systematic review identified 17 studies, including five economic evaluations incorporating a narrow range of benefits. The scoping review identified 140 outcomes across 18 outcome domains, reflecting the multidimensional nature of community-based prevention. Stakeholders identified community networks as critical, yet under-recognised, benefits. Actions addressing both obesity and climate change (“double-duty actions”) were evident but were not incorporated into existing economic evaluations. Modelling using pooled effectiveness estimates indicated the potential value-for-money of CBIs (50,886 health-adjusted life years saved (95% UI 44,019-58,729); AUD$496M in healthcare savings (AUD$421M-$574M) over the lifetime of the Australian population aged 5-18 years).

Conclusions: This program of work demonstrated that CBIs can have broad social, economic and environmental benefits that extend beyond traditional health outcomes. Expanding economic evaluation frameworks to include wider impacts could provide a more comprehensive assessment of value. However, achieving this requires overcoming significant challenges, including the lack of standardised methods and data to capture non-health benefits, and the complexity of aligning accountability and investment across multiple sectors.