This study aims to bridge the gap between the potential and realized spatial access to food outlets in rural areas of Québec, Canada. By assessing both aspects, this research aims to provide a comprehensive understanding of the challenges faced by rural communities in accessing food resources and the effectiveness of existing interventions in addressing these challenges. A mixed methods approach was adopted to collect and analyze data, combining GIS-based spatial analysis with community-based surveys. The spatial analysis allowed for the quantification of the potential access metrics, while the community surveys provided valuable information on travel behaviors, preferences, and barriers experienced by residents when accessing food outlets. The results of the distance measurement calculations showed that for both the potential and realized distance measurements, convenience stores are more easily accessible than grocery stores and supermarkets. Thus, workers seem to have a strategy for minimizing the impact of long distances by combining work and grocery shopping. These results are measured for the realized accessibility to grocery stores and supermarkets and the principal retailer used. Finally, the results of the analyses show that there is a socio-economic gradient in the potential geographical accessibility from home to the food outlets. The importance of developing and strengthening the local food environment to make it favourable to healthy eating and supportive of food security is discussed.

Background: Local food environments are recognized by experts as a determinant of healthy eating. Food cooperatives (coop) can promote the accessibility to healthier foods and thus improve the health of the population, particularly in remote rural communities. Objective: To measure the effects of implementing a food coop in a disadvantaged community with poor access to food. We have two main research questions: (1). Does the establishment of a food coop in rural areas described as food deserts have an impact on accessibility, frequency of use, food consumption, food quality, and ultimately the health of individuals? (2). Does the establishment of a food coop in rural areas described as food deserts have an impact on food security and community vitality? Design: A natural experiment with a mixed pre/post method will be used. The sample is composed of households that came from geographically isolated communities (population: 215 to 885 inhabitants) which qualified as food deserts and located in rural areas of Quebec (Canada). All communities plan to open a food coop (in the years 2022–2023), and as their opening will be staggered over time, participants from communities with a new food coop (intervention) will be compared to communities awaiting the opening of their food coop (control). Data collection was carried out at three time points: (1) before; (2) 1 to 5 months after; and (3) 13 to 17 months after the opening of the coop. Questionnaires were used to measure sociodemographic variables, dietary intake, residents’ health, and community vitality. Semi-structured interviews were conducted with community stakeholders. Results: Few natural experiments have been conducted regarding the impact of implementing food coops. Gathering concrete data on the effectiveness and processes surrounding these interventions through natural experiments will help to quantify their impact and guide knowledge users and policymakers to make more informed decisions.