Local food environment interventions to improve healthy food choice in adults: a systematic review and realist synthesis protocol.
BACKGROUND
Local food environments have been linked with dietary intake and obesity in adults. However, overall evidence remains mixed with calls for increased theoretical and conceptual clarity related to how availability of neighbourhood food outlets, and within-outlet food options, influence food purchasing and consumption. The purpose of this work is to develop a programme theory of food availability, supported by empirical evidence from a range of local food environment interventions.


METHODS
A systematic search of the literature will be followed by duplicate screening and quality assessment (using the Effective Public Health Practice Project tool). Realist synthesis will then be conducted according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards, including transparent appraisal, synthesis and drawing conclusions via consensus.


RESULTS
The final synthesis will propose an evidence-based programme theory of food availability, including evidence mapping to demonstrate contextual factors, pathways of influence and potential mechanisms. With the paucity of empirically supported programme theories used in current local food environment interventions to improve food availability, this synthesis may be used to understand how and why interventions work, and thus inform the development of theory-driven, evidence-based interventions to improve healthy food choice and future empirical work.


BACKGROUND
PROSPERO CRD42014009808.
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Tarra L
TL
Penney
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Helen Elizabeth
HE
Brown
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Eva R
ER
Maguire
Medical Library, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
Isla
I
Kuhn
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Pablo
P
Monsivais
D002755:Choice Behavior; D004032:Diet; D004777:Environment; D005247:Feeding Behavior; D005523:Food Supply; D006801:Humans; D009765:Obesity; D000078202:Systematic Reviews as Topic
PREVENTIVE MEDICINE; PUBLIC HEALTH; QUALITATIVE RESEARCH