Using a competition model to help rural communities become healthier: lessons from the NSW Healthy Town Challenge quality assurance process

The New South Wales (NSW) Healthy Towns Challenge (HTC), an initiative to encourage small rural communities in NSW develop strategies to be healthier, was designed by combining multi-level approach to health promotion with a competition-based model. Applications were invited from towns with a population between 1000 and 15 000 in the 2011 Census outside the Sydney metropolitan area. Towns could team up with adjacent towns and satellite townships if theywere too small or shared local services such as health facilities. Of the 12 towns that applied, five were selected competitively to participate due to available funding for grant awards.