Stephanie Freedman Helfman, MSPH

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Vending Health:
Implementing a Healthy Vending Machine
Policy at a City Health Department
Stephanie Freedman Helfman, MSPH
Diabetes Program Coordinator
Austin/Travis County Health and Human Services Dept.
Overview
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Vending as a business
Assessing an agency’s vending culture
Obtaining support for a vending policy
Creating/choosing a healthy vending policy
Selecting products /implementation
Logistical details
Why Implement a Healthy Vending
Policy?
 Feasible in a short amount
of time
 One small step towards
offering healthier options in
the workplace
 Can be part of changing
the worksite culture
 Best in conjunction with
other policy/environmental
changes and programs to
 impact
Vending Basics
$ Sales price of vended products
- Waste (damaged, outdated product)
- Overhead (warehouse space, trucks, fuel, etc)
- Labor (route drivers, warehouse personnel)
- Commissions to vending site
= Vending Profit
If profits drop, must either adjust
 Product mix
 Pricing
 Service schedule
 Commissions
 or remove vending machines
From: Fit Pick: A Planning and Implementation Guide for Worksites and Community
Organizations. www.fitpick.org
Vending Basics
Stakeholders in the vending business
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Consumer  Variety
Department or business  Commission
Vending route driver  Commission, are
motivated to work quickly
Food distributer  Orders the product for
vending operators
From: Fit Pick: A Planning and Implementation Guide for Worksites and Community
Organizations. www.fitpick.org
Why Not Remove the Machines?
This may be an option in some businesses and
agencies, but may not be realistic due to:
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Existing contracts
Consumer demand
Need for commission as a source of funding
By increasing healthy items and maintaining the
profitability of the business, we create a winwin
Step 1: Know Your Vending Culture
 Which buildings have vending machines?
 How many machines are there?
 Is there a formal contract in place with the vendor or
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an informal agreement?
Are other departments involved in managing the
contract (i.e.- Purchasing, Building Services)?
Who is your contact person for vending?
Is your agency making a commission off of vended
items? What is this commission used for?
Can you obtain a copy of the existing contract or
scope of work, if there is a contract?
Step 2: Begin to Get Support
 Staff, Managers, and Executive Leadership
will all need to be supportive
 Online employee survey can be very useful in
obtaining support
Results of A/TCHHSD Survey
I would like additional healthy options to be added to the
beverage machine (N=79)
6%
20%
Agree/Strongly Agree
Neutral
Disagree/ Strongly
Disagree
74%
Results of A/TCHHSD Survey
I would like additional healthy options to be added
to the snack machine (N=81)
4%
15%
Agree/Strongly Agree
Neutral
Disagree/ Strongly
Disagree
81%
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Results of A/TCHHSD Survey
Healthier Options Employees Would Like in Snack Machines
(N=76)
40
40
36
35
30
20
33
31
30
29
28
27
26
25
18
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15
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0
Results of A/TCHHSD Survey
Healthier Options Employees Would Like in Beverage
Machines (N=76)
45
40
35
30
25
20
15
10
5
0
39
25
19
12
100% fruit
juice/vegetable
juice
Diet iced tea
Flavored
waters
10
Additional diet Diet lemonade
sodas
Building Support if your Agency is
Making a Commission
 Adding healthy items does not necessarily
lead to decreased profits
 Healthy items are generally more expensive
 Can  the cost of unhealthy items in order to
make up for  profit margin of healthy items
  in new users can help offset any profit loss
from healthy items
Step 3:Adapt or Create a Policy
Forming an ad-hoc workgroup around the
vending policy builds buy-in, helps in decision
making
 Multi-disciplinary
 Include those who are most impacted by the
change in vending
 Nutrition expertise
 Consider including individuals outside of your
agency- those who might want to replicate
policy
Step 3: Adapt or Create a Policy
Items to consider in a policy:
 How stringent- percentage of healthy items or
some other criteria
 What is considered “healthy” for the policy
 Requirements for product labeling
 Requirements for pricing
 Requirements for product placement
 Whether to phase in the policy
 What is realistic for the vender
Existing City/County Healthy Vending Policies
25% Healthy
Items
50% Healthy Items
75% Healthy Items
City of Brentwood, CA+
(Vending and Concession)
100% Healthy Items
Howard County,
CA
Contra Costa County, CA
Monterey County, CA
City of Los Angeles,
CA*
Los Angeles County, CA**
City of Chula Vista, CA
Santa Clara County, CA
City and County of San
Francisco (Beverages)
Solano County, CA
City of Redding Parks and Rec.
Dept., CA (Rec. Centers
and Sports Facilities)
City of San Jose, CA
San Diego County Parks and
Rec. Dept., CA (Rec.
Centers and Sports
Facilities)
City and County of San
Francisco, CA (Food items)
City of Baldwin Park, CA
(Youth- Oriented facilities)
City of Redding Parks and Rec.
Dept., CA (Parks and Open
Spaces, Concession)
San Diego County Parks and Rec.
Dept., CA (Parks and Open
Spaces)
City of Santa Ana, CA
Marin County, CA (Health and
Human Services Dept.)
*Current goal is 25% in facilities where city-sponsored programs for preschool and school age children take place with recommended incremental increase to 100%.
**Specified a phase in period of 25%, 33%, and ultimately 50% by 2011
+ Specified that 75% of choices are items that have no more than 200 calories per portion. All snacks are limited to portion sixe of 1.25 oz; all items must meet other
standards, including portion sizes
Step 3: Adapt or Create a Policy
What have other cities/counties done?
 17 existing policies
 16 from California, 1 from NY
 San Antonio policy not ready yet
 Most based in some part on SB12 / SB 19
which regulates competitive foods in
California schools
Most common nutritional requirements
for snacks/foods
The majority of snack/food vending machine
policies follow 35-10-35:
 Not more than 35% of calories from fat
 Not more than 10% of calories from saturated fat
 Not more than 35% total weight from sugar and caloric
sweeteners
Item Labeling, Placement, Advertising
 3 polices included language requiring labeling
of healthy vs. unhealthy options
 1 policy required healthier options be placed
at eye level or in the position most likely to
sell
 3 polices stated that promotional space on
the vending machines must be used only to
promote healthy choices
ATCHHSD 50% Healthy Policy
Snacks- Requirements
 Not more than 35% of calories from fat
 Not more than 10% of calories from saturated fat
 Not more than 35% total weight from sugar and caloric sweeteners
 Items shall not contain more than 360 mg of sodium per serving
 Not more than 250 calories per individual package for snack items
 Not more 400 calories per individual package for entrée items
Snacks- Recommended
 Items shall not contain trans fats that are added during processing
 At least one (1) item must meet the FDA definition of low sodium
(less than 140 mg/serving)
ATCHHSD 50% Healthy Policy
Beverages- Requirements
At least 50% of beverages offered in each vending machine shall
be one or a combination of the following:
 Fruit-based drinks that are composed of no less than 50%
fruit juice and that have no added sweeteners
 100% fruit/vegetable juice (Maximum 12 oz; smaller serving
sizes are preferred)
 Water
 Nonfat or 1% milk (including soy milk, rice milk, and other
similar dairy or nondairy milk. No flavored milks)
 Unsweetened coffee or tea
 All other non-caloric beverages, including diet soda
ATCHHSD 50% Healthy Policy
Pricing:
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Items meeting the food or beverage nutrition
standards must be sold at a price that is equivalent
to or lower than the price of similar foods or
beverages that do not meet the nutrition standards
Labeling:
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Vendors are encouraged to utilize a labeling
system to identify items meeting the nutritional
standards
Step 4: Implementation
 Product selection
 Machine removal/placement
 Communications with staff
 Follow-up
Vending Machine at
ATCHHSD Campus
Product Selection
 Existing “healthy product” lists
 Also available through vendors
From: Fitpick http://www.fitpick.org
Step 4: Implementation
Example of product labeling
Canteen “Balanced Choices”
program
Step 4: Implementation
Communicating the change to employees
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Employee newsletter article
Memo from the Director
Product sampling or “taste tests”
Tie it back to the results of the survey
Promote choice- not taking things away but
adding variety
Step 4: Implementation
Follow-up
 Vending machine audits to adjust content,
labeling, placement
 Communication with vendor and/or
purchasing department on audit findings
 Switching out products that are not selling
well
 Talk with site managers to make sure policy
is well received
How are we doing?
 Around 35% of items in the machines are
now healthy
 Healthy snacks represent about 30% of
vended items sold since the change
 Healthy beverages represent about 26% of
vended beverages since the change
 Still need to tweak product selection to
promote sale of healthier items
Lessons from the field…
 Best to align with existing policies/programs
 Phasing in works well
 Products must be available through vending
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distributors, priced competitively, have good shelf life
Products sell better when there is more variety
The more stringent the nutritional requirements, the
less choices for stocking the machines
Healthier items often cost more
Marketing in conjunction with item labeling may
increase demand for healthier items
From: Fit Pick: A Planning and Implementation Guide for Worksites and Community Organizations. www.fitpick.org
Thank You!
Thanks to the Central Texas Diabetes Coalition
and to Kristy Hansen, ATCHHSD Program
Coordinator
Contact Information:
Stephanie Freedman Helfman, MSPH
Diabetes Program Coordinator
Austin/Travis County Health and Human Services
Dept.
[email protected]
(512) 972-6764
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