Local Environment Action on Food project: impact of a community-based food environment intervention in Canada.

Children are exposed to food environments that make nutrient-poor, energy-dense food cheap, readily available and heavily marketed; all conditions with potential negative impacts on diet and health. While the need for programmes and policies that improve the status of food environments is clear, greater public support is needed for governments to act. The purpose of this qualitative collective case study was to examine if community engagement in the Local Environment Action on Food (LEAF) project, a community-based food environment intervention in Alberta, Canada, could build public support and create action to promote healthy food environments. Semi-structured interviews with a purposeful sample of 26 stakeholders from 7 communities explored LEAF's impact and stakeholder experiences creating change. Data collection and analysis were iterative, following Charmaz's constant comparative analysis strategy. Participants reported environmental and community impacts from LEAF. Notably, LEAF created a context-specific tool, a Mini Nutrition Report Card, that communities used to promote and support food environment action. Further, analysis outlined perceived barriers and facilitators to creating community-level food environment action, including level of engagement in LEAF, perceived controllability, community priorities, policy enforcement and resources. Findings from this study suggest that community-based interventions, such as LEAF, can help build community capacity and reduce existing barriers to community-level food environment action. Thus, they can provide an effective method to build public awareness, demand and action for healthier food environments.