City Research Online

The role and contribution of lay community food advisor programmes to public health in Canada

Richards, L. (2018). The role and contribution of lay community food advisor programmes to public health in Canada. (Unpublished Doctoral thesis, City, University of London)


INTRODUCTION: Having members within communities as ‘natural helpers’ may ensure good understanding of local health issues and better delivery of relevant messages. Lay Community Food Advisors (LCFA) may be an effective means to increase coverage of health promotion, empower individuals and communities, help to reduce social exclusion and address the gap in nutritional inequalities. LCFAs may increase awareness of healthy eating and help people translate advice into practice thereby positively influencing patterns of behaviour. However, there is limited evidence supporting these programmes, particularly from a Canadian perspective.
Research objectives: To describe the context, drivers and (identify) strategic components of different programme models
To determine the role of programmes in addressing healthy eating behaviour (across the socio-economic spectrum)
To determine the wider role and impact of programmes in food and public health
RESEARCH DESIGN AND METHODOLOGY: A qualitative, case study approach of three key LCFA programmes in Ontario with both exploratory and explanatory aspects. Data collection included key informant interviews using semi-structured questionnaires, overt participant observation and document review. Analysis: Thematic Analysis was utilised as an overarching approach to data analysis, NVivo qualitative tool was utilised for analysis of interviews. The Health Policy Triangle and Multiple Streams Framework were both used as frameworks for policy analysis.
FINDINGS: Programme models have been shown to be able to deliver on policy priorities and enable increased capacity at multiple levels: individual, community, organisational and policy. Programmes show examples of being both universally accessible and targeted in their approach, addressing a combination of food literacy and community engagement strategies. Programmes raise tensions around lay helping and issues of access and utilisation of programmes.
DISCUSSION: Programmes play a key role in meeting public health policy priorities. Programmes address food literacy set within a social and community context, but may be more challenged to address the underlying determinants of health and raise some tension around whether they can reduce or exacerbate inequalities. However, the absence of programmes can leave a greater gap. Though they remain for the most part downstream with some midstream activity, there are opportunities for more upstream effort.
CONCLUSION: Though localised, programmes can address food and public health policy objectives beyond food skills alone. Programmes and their role need to be viewed more broadly, with connections to the wider food system and environment and how they can be both policy levers and policy influencers. As well, programmes should not be seen as the solution to a complex problem that needs more than behavioural intervention, they must complement other strategies to improve public health across the system.

Publication Type: Thesis (Doctoral)
Subjects: H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Doctoral Theses
Doctoral Theses > School of Arts and Social Sciences Doctoral Theses
School of Health & Psychological Sciences > Healthcare Services Research & Management > Food Policy
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