Co-designing interventions to improve diets in rural communities.

By involving stakeholders to identify issues, co-design facilitates the creation of solutions aligned with the community's unique needs and values. However, genuine co-design with consumers across all stages of nutrition intervention research remains uncommon. The aim of this review was to examine notable examples of interventions to improve diets in rural settings that have been co-designed by rural communities. Six studies were identified reporting on community-based and digital interventions to improve diets in rural settings that have been co-designed by rural communities. The level of co-design used varied, with two interventions describing co-design workshops and focus groups over a period of between 6 and 11 months, and others not reporting details on the co-design process. Collectively, most interventions demonstrated positive impacts on dietary markers, including an increase in purchase of fruit and vegetable, an increase in percentage energy from nutrient dense foods and a decrease in intake of high fat meats. While these interventions show promise for improving diets in these under-served communities, it is widely recognised that there is a lack of dietary interventions genuinely co-designed with and for rural communities. Future research should build on these studies to co-design dietary interventions that integrate the benefits of both community-based and digital interventions.