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Table 2 Arbitrary decisions made by key stakeholders at the national Healthy Diets ASAP Forum

From: Healthy diets ASAP – Australian Standardised Affordability and Pricing methods protocol

Decision Point Forum decision- standard protocol Rationale/other comments
Household structure
1. Number of household structures for which results are reported? (5 different structures were developed in the pilot study) • Report and compare results for one household structure only • Simpler to interpret and communicate results for only one (common) household structure. Less analysis, and therefore resources, required to access diet prices, therefore the protocol is more likely to be used
2. Composition of household structure? • 2 adults and 2 children:
-adult male 31–50 yrs. old
-adult female 31–50 yrs. old
-boy 14 yrs. old
-girl 8 yrs. old
• Publish quantities of food to be included for a range of individuals (age/gender), in addition to those to be included in the selected household structure
• Most commonly used household structures in Australian studies are 6 and 4 person households
• Of these household structures, use 4 as it is closest to the median Australian household size of 3 persons
• Those interested in reporting results for other household structures (e.g. single parent or pensioners) could perform additional analysis post data collection
Data collection
3. Which products should be included?
 a) Branded?
 b) Generic?
 c) Cheapest?
 d) Sales items?
 e) Bulk deals?
 f) How should any optional data collected be identified on the data collection forms?
a) Include most common market share branded products (Australia wide)
b) Include generic products only if branded items are not available (but exclude ALDI supermarket which tend to stock generic products). However, consider supporting optional inclusion of cheapest generic item, including the special/sale price (also applies to inclusion of ALDI)
c) Don’t specifically seek to include cheapest item. However, consider supporting optional inclusion of cheapest item, including the special/sale price (also applies to inclusion of ALDI)
d) Exclude sales items (as above)
e) Exclude bulk deals (i.e. two for the price of one deals)
Consider adding tick box in end column of data collection form to record if costing generic/special/sale price items as optional extras
a) Include the most popular items reported in the Australian Health Survey (AHS) 2011–13 as current diet
b) Inclusion of generic items has potential to bias, affect comparability and distort results over time- but could be included ifconsumption data continues to suggestincreasing intake.
c) Cheapest price could also be collected to answer an optional additional question, but inclusion of cheapest price, including of sales or generic items, has potential to bias, affect comparability and distort results over time.
d) As above
e) As above. If optionally, collecting the cheapest price, could use multi buy price by dividing to obtain single price
f) May need to use multiple data collection forms for each store or add additional data collection column if collecting optional prices
4: Unhealthy (current) diet pricing tool
a) Adjust for known under-reporting in AHS 2011–12? No adjustment; report as ‘best case scenario’ There are no robust data on which to base adjustment factor, so could introduce error. Analysis is not adjusted for any other reasons.
b) Confirm coding for five food group and discretionary foods? • Tinned meat and vegetables- code as ½ veg and ½ meat
• Tinned fruit – code as fruit
• Ham salad sandwich- (replace with chicken salad sandwich) and code as 1/3 bread, 1/3 veg, 1/3 chicken meat
• Choc-chip Muesli bar – code as discretionary
• Flavoured milk – code as non-discretionary (decision consistent with ABS classification)
• Processed meats (e.g. ham) – code as discretionary
• Water – include ½ reported water intake as bottled water (costed) and ½ as tap water (not costed)
• Decisions should be consistent with coding used by the ABS in the AHS 2011–12
• Revisit decisions reassessed when the Australian Dietary Guidelines (ADGs) are reviewed (i.e. in 5 years’ time)
5. Healthy (recommended) diet pricing tool
Should any extra healthy foods be included? Such as more convenience options, bottled water? Is the healthy diet unrealistic without inclusion of some discretionary foods or drinks, such as alcohol? • Water – include ½ reported water intake as bottled water
• Convenience items- confirmed inclusion of roasted chicken and sandwich– no further inclusions
• Alcohol – do not include
Use the ADG Modelled Foundation diets based on rationale that:
−63% Australian adults are overweight/obese
-There was no adjustment for underreporting in current diet
-Most Australians are not expending enough energy to allow for additional energy intake from any discretionary foods or drinks
- The healthy diet should be aspirational, and reflect that associated with optimal health outcomes
6: Income data
Should mean or median income be used?
What assumptions should be used to determine indicative low income?
• Include both median household (HH) income from published data and calculated low (minimum) disposable income household (HH) income (confirmed assumptions used in pilot calculations)
• Also consider reporting results against the Australian poverty line
• Median HH income is specific to location, but is pre-tax i.e. not disposable income
• Low income HH calculation is not specific to location apart from rent (which is set low so rarely changes)
• Poverty line is lower than 50% of the Australian median HH income
• Median household income and indicative low (minimum) vs disposable household income are not comparable
7: Sampling framework
Sampling frameworks: which areas, stores, distances (e.g. 7 km radius of centre of SA2 area) should be included? • Sampling approach SA2 stratified by Index of Relative Socio-Economic Disadvantage for Areas (SEIFA) and including all stores within a specific radius confirmed (ALDI excluded in initial methods as above)
• Requested further work to determine calculating distance away from centre for inclusion of stores
• Methods of randomisation trialled is appropriate and feasible
• 7 km radius of inclusion may not be appropriate for all locations, particularly in rural areas
8: Data collection protocols
Prioritisation of sizes and branding for pricing, as proposed on data collection sheet • Proposed detailed methods confirmed e.g. size prescribed but if not available take next larger size first • Detailed methods proposed are appropriate
• Reflect common current practice in most locations; clear and concise; easy to follow
9: Definition of affordability
Should affordability level be set at 25% or 30% of disposable HH income? • May need to assess both (post hoc) but initially use 30% pending further review of the literature and international consultation • Based on most commonly used definition in international literature from high incomecountries