Australian healthy retail policies in hospital settings - a policy analysis and scoping review of potential impacts on dietary behaviours.

Objectives and importance of study: This study analyses Australian healthy hospital retail policies to identify the similarities and differences in the policies and policy implementation processes. The potential impact of the different policy components on dietary behaviours were examined via a scoping review. STUDY TYPE: Policy analysis and scoping review. METHODS: Healthy retail policy documents and policy implementation guidelines were identified via a grey literature search on Department of Health websites of all Australian jurisdictions. Policy components and policy implementation processes were extracted and analysed for similarities and differences. The potential effectiveness of the different policy components on purchasing and/or dietary behaviour were identified via a scoping review of the academic literature, conducted in March 2023 across seven electronic databases and Google Scholar. The scoping review included studies reporting the impacts of healthy food retail interventions implemented in hospitals. No timeframe restriction was applied for both the grey literature search and the scoping review. RESULTS: All Australian jurisdictions, except Tasmania, have implemented jurisdiction specific healthy retail policies in public hospital settings. There are similarities and difference in the policy components and implementation design across the jurisdictions. Similarities included the policy scope, use of a traffic light system to classify the nutritional healthiness of food and beverages for sale, and the standards used to determine the mix of healthy and unhealthy food availability. These similarities allowed sharing of resources across some jurisdictions. There is limited evaluation of policy impacts on purchase and/or consumption behaviours. Twenty of 27 studies identified via the scoping literature review examined interventions similar to the Australian policies and showed that these policies could result in increased purchase of healthier products among staff and visitors. Key implementation success factors include strong support for the policy from all stakeholders, practical implementation support resources, and impacts on retailer profitability. CONCLUSIONS: The healthy hospital retail policies implemented across Australian jurisdictions could encourage healthier food and beverage purchases among staff and visitors. Evaluation of the policies could facilitate further refinement to enhance effectiveness and translation of learnings to international contexts.

Health-Oriented Marketing on Alcoholic Drinks: An Online Audit and Comparison of Nutrition Content of Australian Products.

OBJECTIVE: Marketing, label design, and product innovation strategies are being used by the alcohol industry to position some products as "healthier choices." The aim of this study was to systematically document the content and prevalence of health-oriented marketing on alcohol products on the Australian market and to compare the online availability of nutrition information and the alcohol and nutrient content between products with and without such features. METHOD: Health-oriented marketing features on all beer, cider, and ready-to-drink (RTD) premixed drinks, and selected wines on the website of the largest liquor retailer in Australia were audited using a systematic coding protocol. Nutrition information was sought from manufacturer/brand websites. RESULTS: A total of 54% of beers, ciders, and RTDs featured health-oriented marketing, the most common forms being natural imagery or descriptors, or references to fruit ingredients. Twenty-one percent of audited wines featured health-oriented marketing. The prevalence of specific features varied by product category. Online availability of nutrition information for alcohol products was poor (12% of beer, cider, and RTDs). Products with health-oriented marketing were lower in energy and alcohol content than those without but were still classed as full-strength alcohol on average. CONCLUSIONS: Health-oriented marketing is prevalent on alcohol products sold in Australia. In the absence of universal and standardized health warning and energy content information on labels, permitted health-oriented marketing has the potential to mislead consumers about product healthiness or to detract from the perceived harm associated with alcohol consumption. Research to test this proposition is now needed to guide labeling policy reform.