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Objective: Determine how very-remote Indigenous community (RIC) food and beverage (F&B) turnover quantities and associated dietary intake estimates derived from only stores, compare with values derived from all community F&B providers. Methods: F&B turnover quantity and associated dietary intake estimates (energy, micro/macronutrients and major contributing food types) were derived from 12-months transaction data of all F&B providers in three RICs (NT, Australia). F&B turnover quantities and dietary intake estimates from only stores (plus only the primary store in multiple-store communities) were expressed as a proportion of complete F&B provider turnover values. Food types and macronutrient distribution (%E) estimates were quantitatively compared. Results: Combined stores F&B turnover accounted for the majority of F&B quantity (98.1%) and absolute dietary intake estimates (energy [97.8%], macronutrients [≥96.7%] and micronutrients [≥83.8%]). Macronutrient distribution estimates from combined stores and only the primary store closely aligned complete provider estimates (≤0.9% absolute). Food types were similar using combined stores, primary store or complete provider turnover. Conclusions and implications: Evaluating combined stores F&B turnover represents an efficient method to estimate total F&B turnover quantity and associated dietary intake in RICs. In multiple-store communities, evaluating only primary store F&B turnover provides an efficient estimate of macronutrient distribution and major food types. Refereed/Peer-reviewed

Objective: Retrospectively evaluate food price discounts in remote Aboriginal community stores. Methods: Four price discount strategies of 10% were designed in 2010, aiming to influence grocery, fruit, vegetables and diet soft-drink sales. This natural experiment across a group of stores was evaluated using an explanatory, sequential mixed method design through analysis of store point-of-sale, document, observation and interview data. The outcome was measured by change in: 1) percentage of grocery sales to total food and beverage; 2) fruit and vegetable sales; and 3) diet soft-drink sales. Qualitative data enabled the interpretation of outcomes through understanding perceived success and benefits, and enablers and barriers to implementation. Results: Eighteen community stores and 54 informants participated. While targeted price discounts were considered important to improving health, no discernible effect was evident, due to inadequate design and communication of discount promotion, and probably inadequate magnitude of discount. Conclusions: Strategy impact on food and beverage sales was limited by promotion and magnitude of discount. Implication for Public Health: This study demonstrates key factors and commitment required to design, communicate, implement and monitor strategies to improve health in this challenging remote retail context. Evaluation of natural experiments can contribute evidence to policy-making. Refereed/Peer-reviewed

Objective: To estimate the cost-effectiveness of fiscal measures applied in remote community food stores for Aboriginal Australians. Methods: Six price discount strategies on fruit, vegetables, diet drinks and water were modelled. Baseline diet was measured as 12 months' actual food sales data in three remote Aboriginal communities. Discount-induced changes in food purchases were based on published price elasticity data while the weight of the daily diet was assumed constant. Dietary change was converted to change in sodium and energy intake, and body mass index (BMI) over a 12-month period. Improved lifetime health outcomes, modelled for the remote population of Aboriginal and Torres Strait Islanders, were converted to disability adjusted life years (DALYs) saved using a proportional multistate lifetable model populated with diet-related disease risks and Aboriginal and Torres Strait Islander rates of disease. Results: While dietary change was small, five of the six price discount strategies were estimated as cost-effective, below a $50,000/DALY threshold. Conclusion: Stakeholders are committed to finding ways to reduce important inequalities in health status between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Price discounts offer potential to improve Aboriginal and Torres Strait Islander health. Verification of these results by trial-based research coupled with consideration of factors important to all stakeholders is needed. Refereed/Peer-reviewed