{
  "abstract": "Introduction Food retail outlets in sports and recreation facilities often fail to support healthy eating, despite aligning with healthy lifestyles and goals of local governments (LGs) that often own or manage them. LGs face barriers to implementing facility changes including inadequate staffing, training and incentives. The Promoting CHANGE initiative was co-designed to support LGs in improving and sustaining healthier food and drink offerings in these settings.Methods and analysis A 3-year, type 2 effectiveness-implementation hybrid cluster randomised controlled trial will evaluate the Promoting CHANGE capacity-building and support package in three Intervention and four Control LGs in Victoria, Australia (August 2023–July 2026). The co-designed initiative includes human resource support, training, tools, technical assistance, community-of-practice groups, feedback based on food outlet audit and sales data and small grant incentives. Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework, the trial’s co-primary outcomes are the percentage of least healthiest food and drinks (1) displayed (implementation) and (2) sold weekly (effectiveness). Key secondary outcomes are effectiveness (sales and revenue); facility-level adoption, implementation, maintenance of healthy changes; cost-effectiveness (within-trial modelled economic evaluation). Findings will provide evidence of the initiative’s effectiveness and scalability, informing recommendations for advancing healthier food environments in over 6000 community-based food outlets across 500 Australian LGs, with implications globally.Ethics and dissemination This study has received approval from the Deakin University Human Research Ethics Committee (reference number HEAG-H 92_2023). The results will be published in scientific peer-reviewed journals along with plain language summaries for participants.Trial registration number ACTRN12621001120864.",
  "authors": [
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Neha Lalchandani"
    },
    {
      "affiliations": [
        "Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria, Australia",
        "School of Public Health, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Helena Romaniuk"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Adrian Cameron"
    },
    {
      "affiliations": [
        "Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Liliana Orellana"
    },
    {
      "affiliations": [
        "Deakin Health Economics, Deakin University, Burwood, Victoria, Australia"
      ],
      "name": "Jaithri Ananthapavan"
    },
    {
      "affiliations": [
        "Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "A Peeters"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Bettina Backman"
    },
    {
      "affiliations": [
        "School of Exercise and Nutrition Sciences, Deakin University Faculty of Health, Burwood, Victoria, Australia"
      ],
      "name": "Megan Adam"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Steven Allender"
    },
    {
      "affiliations": [
        "Deakin Health Economics, Deakin University, Burwood, Victoria, Australia"
      ],
      "name": "Phuong Nguyen"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Gary Sacks"
    },
    {
      "affiliations": [
        "Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Julie Kay Brimblecombe"
    },
    {
      "affiliations": [
        "Wellbeing and Preventable Chronic Disease Division, Charles Darwin University, Menzies School of Health Research, Darwin, Australian Capital Territory, Australia"
      ],
      "name": "Emma McMahon"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Miranda Blake"
    }
  ],
  "title": "Promoting CHANGE cluster randomised controlled trial to improve food outlet healthiness in Australian sport and recreation facilities: protocol",
  "uid": "f47d2d81-75d6-53f7-9e8d-d2e2d6232953"
}