Table 1 Summary of included studies

Abbott et al. 2010 [51]

Urban, New South Wales

Qualitative evaluation, in-depth interviews

(Moderate)

23 (19 female; 4 male)

100%

19-72

Key influences on diet included family; social and cultural importance of communal eating; cost of food; personal preference.

Adams et al. 2012 [52]

Urban, Victoria

Action research, photovoice

(High)

10 (9 female; 1 male)

100%

Majority

20-39

Key factors influencing food choice included collectivism, creation of family harmony; concerns for hungry children, low vegetable intake. Aboriginal co-operative policy regarding healthy food provision at events

Brimblecombe et al. 2014 [53]

Remote, Northern Territory

Ethnographic- Semi-structured interviews, group discussions

(Moderate)

46 (interviews with 16: 8 female; 8 male)

100%

35-60

Factors influencing food choice include transition from traditional to Western foods, lack of confidence in Western food system; food insecurity- low incomes, high food/living costs; reliance on cheap, energy-dense foods; inadequate food storage/refrigeration facilitates.

Bryce et al. 2020 [54]

Remote, South Australia

Indigenist and ethnographic: observations, conversation and reflections.

(High)

14

100%

Unstated

Key factors influencing diet include high food prices; low income; overcrowded housing; availability of food storage/preparation/cooking facilities/equipment; reliance on take-away food; sharing resources enabled resilience

Colles et al. 2014 [55]

Remote, Northern Territory

Qualitative semi-structured interviews

(Low)

30 (21 female; 9 male)

100%

18-60+

Inadequate supply of quality food, poor household infrastructure. Freedom of choice valued. Desire for practical food literacy/cooking skills. Preference for inter-personal education rather than pamphlets/flipcharts.

Cubillo et al. 2020 [56]

Urban, Northern Territory

Hermeneutic phenomenological approach, semi-structured interviews

(Moderate)

12 (8 female; 4 male)

100%

18+

Traditional foods important for health and wellbeing. Concerns for loss of culture among younger generations. Access, availability, mobility, and local knowledge, social support networks influence traditional food consumption.

Cuesta-Briand et al. 2011 [57]

Urban, Western Australia

Qualitative descriptive study, focus groups, in-depth interviews

(Low)

38 (28 female; 10 male)

47% (n = 18)

25-75+

Dependence on relatives for food provision/meal preparation. Food insecurity- high cost of food, low income, healthier food considered more expensive

Ferguson et al. 2017 [9]

Remote, Northern Territory and Western Australia

Mixed methods: interviews, observation, document review

(Low)

54 (28 female; 26 male)

78%

<35(n = 6);

>35(n = 48)

Strong support for food pricing policy to improve affordability of fruit and vegetables. Promotion and magnitude of discount key to effectiveness

Foley 2010 [58]

Urban, Queensland

Ethnographic: in-depth interviews, participant observation, group discussion.

(Low)

31 (24 female; 7 male)

100%

18+

Key concerns included food affordability, lack of cooking ideas, keeping family members satisfied, access to nutrition information, extra work involved in healthy cooking. Cooking workshops provided opportunities to experiment with new recipes in a relaxed, social environment.

Lawrence 2015 [59]

Urban, New South Wales

Grounded theory: focus groups

(Low)

40 (30 female; 10 male)

100%

16-66

Factors influencing food choice included nutrition knowledge; access to quality food; family perceptions of appropriate food and body weight, stress/depression. Supermarkets stocked with processed foods. Traditional food associated with food, identity, culture, wellbeing.

Lowell et al. 2018 [60]

Remote, Northern Territory

Ethnography: in-depth interviews, participant observation.

(High)

36

100%

2 mo-2(n = 6);

18-70(n = 30)

Key challenges included housing insecurity/overcrowding; food insecurity: running out of money/going without food; reliance on takeaway food when unable to store food at home or unable to share with household.

McCarthy et al. 2018 [61]

Urban, Northern Territory

Qualitative inductive approach: initial interviews followed by in-depth interviews

(Low)

30 (27 female; 3 male)

100%

17-58

Food security issues: food affordability, low income, high cost of living, limited supermarket access, inadequate housing infrastructure, social problems (e.g. gambling, alcohol). Family support provides safety net.

Mellor et al. 2016 [62]

Remote, rural and urban Western Australia and Victoria

Participatory action research: Semi-structured interviews, focus groups

(Moderate)

150 (male)

100%

18-35

Barriers to healthy eating included disconnection from land, culture and traditional foods; food cost, nutrition knowledge/cooking skills; availability of fast food, discrimination/racism, lack of Aboriginal-specific services.

Murtha 2012 [63]

Remote, Queensland

Policy development consultation

(Moderate)

Unstated

Unstated

Unstated

Four key priorities: 1. Healthy and strong Aboriginal and Torres Strait Islander People. 2. Adequate food supply, availability and access. 3. Keep track of nutrition indicators. 4. Build nutrition capacity.

Myers et al. 2014 [48];

VACCHO 2012 [49]

Urban and rural Victoria

Qualitative needs assessment: focus groups

(Moderate)

35 (22 female; 13 male)

100%

18 +

Key issues included fussy easting in children, demand for sweet drinks,/junk foods; poor oral health, overweight, access to information.

Nilson et al, 2015 [64]

Rural, Western Australia

Ethnographic: participant observation, yarning groups, individual yarning sessions.

(High)

17 (female)

100%

18-60

Key factors influencing nutrition included loss of traditional foods/cultural knowledge; shame caused by social inequity/racism; junk food advertising, cost of healthy food, easy access to fast food, family pressure.

Seear et al. 2020 [65]

Remote, Western Australia

Community directed participatory action research: focus groups

(High)

32 (24 female; 8 male)

100%

16-17 (n = 15);

18-25 (n = 4);

45 (n = 13)

Key issues included availability/marketing of unhealthy food and sugary drinks; high cost/poor quality of fresh food in remote stores; inaccurate nutrition information.

Street et al. 2018 [66]

Remote, South Australia

Community deliberative forum, co-design using storyboard

(Moderate)

14 (7 female; 7 male)

100%

18-34 (33%); 35-54 (33%);

55+ (33%)

Key issues included food cost and racism. Priority actions: teaching Aboriginal history in school; parenting classes; youth programs, improve school food environment, improve food literacy, cooking skills, food labelling

Thorpe and Browne 2009 [67]

Urban and rural, Victoria

Policy development consultation

(High)

Unstated (consultations in 27 sites)

Unstated

Unstated

Action areas included: Increase Aboriginal nutrition workforce; access to affordable, nutritious and culturally appropriate food; policies to support healthy eating in key settings; funding for community nutrition programs; culturally appropriate health information/social marketing

Thurber et al. 2016 [68]

Remote and urban (11 sites around Australia)

Mixed methods: cross-sectional surveys/interviews, focus group

(Low)

1230 (carer interviews)

12 (focus group)

100%

Unstated

Barriers to fruit and vegetable intake included access, financial status, resource status, housing, crowding and infrastructure, availability of produce in rural/remote area, children’s dislike, wasting money on uneaten food

Waterworth et al. 2016 [69]

Urban and rural, Western Australia

Participatory action research and constructivist grounded theory: focus groups

(Moderate)

120

Urban: 70% female, Rural: 40% female,

100%

15->54 years

Key factors included living between two cultures; impact of colonisation; protective effect of culture; low income; inadequate housing; racism; mistrust of government/non-Indigenous programs/services). Personal choice important.