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The performance and potential of the Australian Health Star Rating system: a four-year review using the RE-AIM framework

15 / 07 / 19

Finding: Evidence suggests the Health Star Rating (HSR) is worth continuing and strengthening to improve public health.

Summary: This study evaluated the Health Star Rating’s (HSR) performance between June 2014 and October 2018 using the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) framework. The authors analysed 33 peer-reviewed publications, 21 government and three independent reports. They found awareness and trust of the HSR was increasing, though campaign reach remained low. The HSR was present on 20-28% of products but biased to those that scored better (HSR >3.0). A review was conducted on the algorithm used to determine the HSRs and necessary stakeholders were mostly engaged. Consumers liked and could understand and use the HSR logo, although effects on purchasing are largely unknown.

The authors concluded that a substantial body of work supports the continuation and strengthening of the HSR. To improve public health impact, they suggest refinements to the HSR graphic and algorithm (eg. include added sugars, strengthen treatment of sodium, review treatment of protein, consider treatment of fresh fruit and vegetables including unpackaged), action to initiate mandatory implementation and strengthened HSR governance.

Citation:  Jones A, Thow AM, Ni Murchu C, Sacks G, Neal B. The performance and potential of the Australian Health Star Rating system: a four-year review using the RE-AIM framework. Aust NZ J Public Health 2019 May 29. 10.1111/1753-6405.12908. (free full text)