Assessing the Food and Beverage Environment in Denver’s Recreation Centers
1
Assessing the Food and Beverage Environment
in Denver’s Recreation Centers
Mondi Mason, PhD, MPH
Community Project Lead, City and County of Denver Department of Environmental Health
Erin Bishop, Amy Carpenter, Pamela Gould, Klaira Lerma
Graduate Students, Colorado School of Public Health
Course: Community Health Assessment, CBHS 6624
Holly Wolf, PhD, MSPH and Erin Wright, MA
Faculty Advisors, Colorado School of Public Health
May 15, 2014
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Table of Contents
Executive Summary………………………………………....…………………………………..3-6
Full Report
Background……………………………………………………………………………………...7-8
Community Background
Purpose of Project
Methods…………………………………………………………………………………..…....8-10
Literature Review
Direct observation of water access points and vending
Survey of patrons and staff
Prioritization technique
Findings…………………………………………………………………………………...….10-15
Free Drinking Water
Beverage Vending
Food Vending
Recommendations…………………………………………………………………………....15-16
Free Drinking Water
Food and Beverage Vending
Limitations……………………………………………………………………………………16-17
References………………………………………………………………………………………..18
Appendices
Appendix A: Statement of Work…………………..…………………………………………19-22
Appendix B: Team Biographies…..………………..……………...…………………………23-24
Appendix C: List of Recreation Center Food and Beverage Vending Availability……………..25
Appendix D: List of Recreation Centers Visited and Type of Assessment Completed…………26
Appendix E: State and Local Parks Beverage Drinking Water Survey and Protocol
(June 2012, PNEAT Original)………………………………………………….27-31
Appendix F: Final Recreation Center Drinking Water Survey……........……………………32-35
Appendix G: State and Local Parks Beverage Vending Survey and Protocol
(June 2012, PNEAT Original)………………………………………...………..36-37
Appendix H: Final Recreation Center Beverage Vending Survey………………..………….38-46
Appendix I: State and Local Parks Food Vending Survey and Protocol
(June 2012, PNEAT Original)……………………………………………….....47-53
Appendix J: Final Recreation Center Food Vending Survey………………..……………….54-57
Appendix K: Staff Survey: Vending Machines/Water Fountain Use in Recreation Centers...58-59
Appendix L: Patron Survey: Vending Machines/Water Fountain Use in Reaction Centers…60-62
Appendix M: Data Analysis: Drinking Water and Palatability………………..………..……63-65
Appendix N: Data Analysis: Beverage Vending……………………………………………..66-67
Appendix O: Beverage Vending Availability Findings………………..………………………...68
Appendix P: Select Photos Illustrating Existing Healthy Vending Promotional Signs……...69-70
Appendix Q: Nutrition Facts of Select Items Labeled Healthy by the Vendor………………71-74
Appendix R: Patron Survey Data Tables………………..……………………………………75-77
Appendix S: Staff Survey Data Tables………………..……………………………………...78-79
Appendix T: USDA Smart Snacks in Schools………………..……………………………...80-82
Appendix U: PowerPoint Presentation………………..……………………………………...83-87
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Executive Summary
Background and Project Context
Despite its reputation for being one of the healthiest states in the nation, Colorado is not immune
to the negative health impacts of an overweight population. Colorado is ranked 23rd in the nation
for childhood obesity, and is one of only three states with an increase in childhood obesity from
2008 to 2012 (CDC, 2013). Thirty-one percent of Denver Public School children are overweight
or obese (Denver Public School District, 2013). Additionally, just over 20% of Colorado’s adult
population is classified as obese, a number that will continue to increase if childhood obesity
continues to rise (United Health Foundation, 2013). Because the environment in which a person
lives, works, and plays influences food choices and body weight, the trends above support the
need for community initiatives to promote healthy eating. If successful, interventions to promote
a healthier weight could reduce the costs of weight-related co-morbidities such as heart disease,
diabetes and hypertension.
Denver’s Department of Parks and Recreation consists of 200 city and county parks, 5 mountain
parks, 27 recreation centers, 29 swimming pools, 100 athletic fields, and 8 municipal golf
courses. The mountain parks alone draw more than two million visitors annually (City and
County of Denver, 2013). A variety of food and beverage options are available for sale within
these settings at restaurants, vending machines, temporary kiosks, permanent kiosks and
concession vendors. Due to their considerable reach throughout Denver, and a recent policy that
allows all city youth ages 5-18 free year-around access, Denver parks and recreation settings is
an ideal place to implement healthy food and beverage strategies to reduce childhood obesity.
Though they are often overlooked as source of unhealthy food for children, recreation centers
can play an important role in the enhancement of opportunities for good nutrition among children
and families (Blanck et al., 2012).
The priority community for the current project was patrons and staff of the 27 recreation centers
in the Denver area. Among patrons, the primary focus was youth accessing these recreation
centers with their parents, as a recent Chicago Parks District study found that children under 12
(and adults with children) are the most likely to access on-site concessions, accounting for over
54% of vending machine purchases (Mason et al., 2012). Due to the time constraints of the
current project and the winter weather limitations, the current project focused on indoor
recreation centers only.
The primary purpose of this project was to assess the food and beverage environment found
within Denver’s recreation centers and, with reference to published literature on this topic, to
provide recommendations for changes based on those findings. Information gathered will act as
baseline information to allow changes to be monitored over time. The secondary purpose of the
current project was to assist the Denver Department of Environmental Health in making
recommendations to the Centers for Disease Control and Prevention (CDC) for the development
of new nutrition assessment tools to be used in recreational facilities. The State and Local Parks
Nutrition Environment Assessment Tools (PNEAT tools) served as a template for the tool used
for this project.
This project was a partnership between Denver Environmental Health (DEH) and the Colorado
School of Public Health (CSPH). Dr. Mondi Mason from DEH and faculty advisors led CSPH
graduate students through the process described below as part of their Community Health
Assessment (CBHS 6624) course.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Methods
A through literature review was completed to provide background on obesity within the target
population and vending regulations, and to inform recommendations regarding best practices.
Two intercept surveys for recreation center patrons and staff were created to gather information
about free drinking water consumption patterns, current vending purchasing behavior, opinions
about current vending choices and opinions and attitudes about healthier vending initiatives. The
questions were loosely based on a survey created by the Chicago Parks District that assessed the
vending habits and attitudes of patrons at Chicago recreation centers (Mason, 2012). The
questions were modified to meet our current project objectives and to be applicable to the target
population in Denver. Thirty patrons and sixteen staff were interviewed about their vending
purchase habits and opinions about healthier vending at 10 centers.
Quantitative CDC PNEAT surveys for assessing food vending, beverage vending and free water
access were modified for use in a recreation center environment and converted to an electronic
format that can be accessed with a tablet or smartphone to facilitate data collection, entry, and
analysis.
Drinking water was assessed at 14 centers by observing and recording data on water access,
palatability, temperature, quality, and water pressure for 41 drinking water fountains and water
refill stations. Food and beverage vending was assessed at 12 centers by observing and recording
data on vending availability, cost, promotional materials on display, existing healthy vending
initiatives, and proximity of machines to other recreation center features. Assessments were
completed for 22 beverage vending machines and 12 food vending machines.
Because food vending machines were not located at all recreation centers, each recreation centers
was called in advance to assess vending availability. Information gained was used to strategically
collect data from recreation centers that had food and beverage vending.
Key Findings
Free Drinking Water: Drinking water is widely available and centrally located at the centers
visited. All water observed was clean, odorless, colorless, and free of particulates. Eight
fountains had high streams that splashed, while three fountains had low streams that didn’t reach
a comfortable drinking height. At the centers visited, 87% of patrons and 94% of staff
interviewed indicated that they do utilize the water fountains at the recreation centers.
Promotional displays encouraging water consumption were not observed.
Food and Beverage Vending: Vending machines are centrally located, most often in the open
area or lobby near the front entrance. While beverage vending is available at 26 of 27 centers,
only 14 have a food vending machine. Beverages vended at centers include: 25% diet/noncaloric, 37% reduced-calorie, and 35% regular/sugar-sweetened. Most beverage vending
machines observed display the calorie content of items offered, accompanied by a promotional
sign encouraging a lower calorie beverage. Likewise, most food vending machines display a
promotional sign on the machine encouraging customers to look for specially labeled vending
slots containing food items that have been identified by the vendor as healthier. Overall, 27% of
food vending slots are labeled as healthier by the vendor. However, several items stocked in slots
labeled as healthy do not meet vendor’s healthy criteria. Results from the patron surveys indicate
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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that the majority of patrons interviewed have never made a vending purchase at the recreation
centers. However, among those who had made a purchase, 100% had children with them at the
time of purchase. Almost all agreed that healthy vending would be a positive change in the
recreation centers. Forty-three percent of respondents indicated that if healthier vending changes
were implemented they still would not be likely to make vending purchases. The two most
common reasons patrons reported for not currently making purchases are that they eat before or
after they visit the recreation center, or that they bring food and drink from home. Compared to
patrons interviewed, staff members were more likely to utilize both food and beverage vending.
Only 13% of staff interviewed had never used the vending machines. In addition, 93% of staff
agreed that healthier vending is a good idea, expressing a common theme regarding the
importance of supporting the recreation center’s mission to encourage a healthy lifestyle.
Limitations
The current project had several limitations. The qualitative findings of the current project cannot
be applied to the Spanish-speaking patron population because, though Spanish-speaking patrons
were present, all survey-based data collection was done in English. Additionally, social
desirability is likely to have influenced responses from patrons on their opinions toward
implementing healthy snack vending and may have caused patrons to respond in a manner that
would be viewed favorably by others.
Recommendations
Drinking Water: Free drinking water consumption could be promoted through a variety of
measures: displaying water-promoting posters, providing stools at higher drinking fountains to
make them more child accessible, and by encouraging staff to act as role models by drinking
water and using reusable bottles. Also, staff should be reminded about procedures to report need
for water fountain maintenance if the water access point at their center needs water height or
temperature adjustment.
Food and Beverage Vending: Based on our findings, a variety of initiatives can be considered for
future vending operations. We recommend initially that the Denver Parks and Recreation
department, in collaboration with the vending contractor, select which healthier vending criteria
is most appropriate, and then enforce that criteria. There is no clear consensus in the literature on
what qualifies as healthy vending criteria, but possibilities include:
• The vending contractor’s current healthy vending criteria.
• The CDC’s NEMS-V healthy vending criteria, which uses a color-coding method to label
items from healthiest to least healthy (Green=Go, Yellow=Slow, Red=Whoa). This
national criterion is more stringent than the current vendor’s standards, but some “Green”
items could be incorporated into the existing choices, allowing for a greater variety of
healthy options.
• The USDA’s “Smart Snacks in Schools” guidelines for vending. These standards are also
more stringent than the current vending contractor’s guidelines, and will soon be the
minimum requirements for the sale of vended foods in public schools. Using these
guidelines would make recreation center vending consistent with the changes that
children are seeing in their schools (USDA, 2014).
Another possible avenue is to consider a cost adjustment to incentivize water and healthy snack
consumption. Research supports the implementation of either an upward cost adjustment of less
healthy items or a downward cost adjustment of more healthy items (French, 1997). A third
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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possible initiative is to consider eliminating food vending machines altogether in the 14
recreation centers that offer it, with a possible exception of limited snacks available at the front
desk for emergencies. Eliminating food vending requires further study on how significant the
impact of this loss of revenue would be for recreation centers (Han-Markey et al., 2012).
Colorado is one of three states with an increase in childhood obesity from 2008-2012 (CDC,
2013). Denver’s recreational facilities are one tool for reversing this trend, particularly because
children heavily utilize recreation centers throughout Denver. However, vending machines
located in recreational facilities give children easy access to unhealthy snack and beverage items,
which makes vending machines an appropriate point of intervention. Through the current project
we gathered a variety of baseline data, which can inform one of several potential interventions
outlined.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Full Report
Background
Community Background
Despite its reputation for being one of the healthiest states in the nation, Colorado is not immune
to the negative health impacts of an overweight population. Colorado is ranked 23rd in the nation
for childhood obesity, and was one of only three states with an increase in childhood obesity
from 2008 to 2012 (CDC, 2013). Thirty-one percent of Denver Public School children are
overweight or obese (Denver Public School District, 2013). Additionally, just over 20% of
Colorado’s adult population is classified as obese, a number that will continue to increase if
childhood obesity continues to rise (United Health Foundation, 2013). Because the environment
in which a person lives, works, and plays influences food choices and body weight, the trends
above support the need for community initiatives to promote healthy eating. If successful,
interventions to promote a healthier weight could reduce the costs of weight-related comorbidities such as heart disease, diabetes and hypertension.
Denver’s Department of Parks and Recreation consists of 200 city and county parks, 5 mountain
parks, 27 recreation centers, 29 swimming pools, 100 athletic fields, and 8 municipal golf
courses. A variety of food and beverage options, such as restaurants, vending machines,
temporary and permanent kiosks or concession vendors, are available within these facilities. The
mountain parks alone draw more than two million visitors annually (City and County of Denver,
2013). Due to their considerable reach throughout Denver, and a recent policy that allows all city
youth ages 5-18 free year-around access, Denver parks and recreation settings is an ideal place to
implement healthy food and beverage strategies to reduce childhood obesity. Though
recreational facilities are often overlooked as source of unhealthy food for children, recreation
centers can play an important role in the enhancement of opportunities for good nutrition among
children and families (Blanck et al., 2012).
The priority community for the current project was patrons and staff of the 27 recreation centers
in the Denver area. Among patrons, the primary focus was youth accessing these recreation
centers with their parents, as a recent Chicago Parks District study found that children under 12
(and adults with children) are the most likely to access on-site concessions, accounting for over
54% of vending machine purchases (Mason et al., 2012). Due to the time constraints of the
current project and the winter weather limitations, the current project focused on indoor
recreation centers only.
This work is particularly timely because of several factors:
● Mayor Hancock’s Children’s Cabinet set goal to reduce childhood overweight and
obesity in Denver by 5% by 2018.
● Denver’s Community Health Improvement Plan recommends addressing vending and
concession policies.
● The Mayor’s office is presently considering the implementation of vending changes
beginning June 2014.
● The CDC is currently piloting their State and Local Parks Nutrition Environment
Assessment Tools (PNEAT) for free drinking water access, food vending, and beverage
vending.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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This project was a partnership between Denver Environmental Health (DEH) and the Colorado
School of Public Health (CSPH). Dr. Mondi Mason, MPH, from Denver Environmental Health
(DEH), led the project in conjunction with CSPH faculty, Holly Wolf, PhD, MSPH and Erin
Wright, MA. Graduate students from the Colorado School of Public Health completed the
project as part of their Community Health Assessment course (course number CBHS 6624) at the
Colorado School of Public Health. The graduate students’ work was over seen by Dr. Mason and
advising faculty. The detailed scope of work can be found in Appendix A and biographies of
team members can be found in Appendix B.
Purpose
The purpose of the current project is to explore the food and beverage environment (food and
beverage vending, drinking water access points) found within Denver’s recreation centers and, in
doing so, gather baseline information so that any needed changes can be monitored over time.
This report outlines the findings and also reports a variety of potential recommendations for
changes to address the city’s vending and concession policies, based on the findings of the
current project and a literature review.
A secondary purpose of the current project is to inform the creation of new versions of the
Centers for Disease Control and Prevention’s State and Local Parks Nutrition Environment
Assessment Tools (PNEAT). These tools were originally designed for use in National parks, but,
with modifications, they could be used in indoor recreation centers and, though further
modifications might be needed, for smaller parks or outdoor pool facilities. We also tested the
viability of using an online version of the tool to facilitate data collection, entry, and analysis.
Methods
Literature Review
A through literature review was completed to provide background on obesity within the target
population and vending regulations, and to inform recommendations regarding best practices.
Direct Observation of Water Access Points and Vending
For the observational site assessment portion of the current project, each of recreation centers in
Denver’s system were called to inquire about the availability of food and beverage vending at
individual centers. Twelve Denver recreation centers were visited in March 2014 and detailed
assessments were made of each center’s publically available food and beverage vending
machines, as well as free drinking water sources.
For these assessments, we utilized modified versions of the CDC’s State and Local Parks
Nutrition Environment Assessment Tools (PNEAT) for water access, food vending, and
beverage vending. These PNEAT tools were themselves adapted from a survey instrument
originally developed in 2009 by Emory University called the Nutrition Environment Measures
System Vending (NEMS-V). NEMS-V is one of several quantitative tools recommended by the
CDC to measure the influence of environment on food choice (NEMS-V, 2014). The NEMS-V
survey tool provides a visual depiction of each vending machine item, classifying the food or
beverage as green, yellow, or red depending on how the items fits into federally established
guidelines for healthy vending. Green items are the most healthy (Green=Go), yellow items are
less healthy (Yellow=Slow), and items classified as Red are the least healthy (Red=Whoa). For
this project, team members watched the NEMS-V introductory tutorial to establish protocol and
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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gain familiarity with the NEMS-V healthy choices criteria (NEMS-V, 2014). Additionally, the
NEM-V healthy choices calculator was used for assessing foods observed in the machines in
terms of Green, Yellow, or Red. A summary of the NEMS-V criteria is included in Appendix I.
Both the NEMS-V and the PNEAT tools have been used in other states to assess the nutritional
content of food, beverages, and other items available in vending machines. The CDC and the
National Park Service previously used these tools to assess vending, water access, and other food
sources at 11 National Parks and also developed an Android phone application containing the
survey to facilitate data collection for use in that project. For the current project, we modified the
original PNEAT tools to simplify data entry and to improve their usability for recreation centers.
We also created online versions of each tool using Google Forms to allow data collection on any
tablet or smartphone. During each site visit, data was entered into the Google Form using a cell
phone with a cellular data plan. Data entered into the Google Form was instantly and
automatically uploaded into a Google Drive spreadsheet.
The original PNEAT tools and protocols can be found in Appendices E, G and I. A summary of
the changes that were made to the PNEAT tools to support this project can be found by viewing
the final electronic versions of each of the tools in Appendices F, H and J. Links to the editable
versions of the electronic tools are also included in these latter appendices.
Free drinking water sources, including both water fountains and water bottle refill stations, were
assessed at 13 centers. Data about each of the 41 sources was collected and includes: water
temperature, 3-ounce fill time, observable water pressure (e.g. too high or low a stream),
observable water quality (e.g. odors, colors, particulate matter), accessibility for children,
presence of promotional posters, and proximity to recreation center features.
To assess food and beverage vending availability, we first conducted a phone survey of all 27
recreation centers to inquire about availability of vending at each individual center. Beverage and
food vending was assessed at 13 centers, which included a total of 22 beverage machines and 12
food machines. Observations recorded about each vending machine include: proximity to other
recreation center features, advertising and health promotion on the machine, contents of the
machine by category, and cost of products offered.
Data from the electronic surveys were downloaded from Google Drive into Excel spreadsheets.
Each portion of the data was analyzed using descriptive statistics. Tables and charts were created
from the data (see Findings section, below).
Surveys of Patrons and Staff
Two intercept surveys were developed through a collaborative effort between the team at the
Denver Department of Environmental Health and the graduate students. The purpose of the
surveys were to assess patron and staff current usage of free drinking water access points, their
vending purchasing behavior, to gauge their opinions towards current vending choices, and to
determine their attitudes about future implementation of healthy vending. These surveys were
adapted from a survey referenced in the Chicago Parks study (Mason et al., 2012). Modifications
were made to make questions applicable to our target populations: English-speaking adults with
children who visit the Denver recreation centers, and recreation center staff members. The final
patron and staff surveys used in the current project were reviewed and approved the community
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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partner and faculty advisors, and can be found in Appendices K and L.
Ten sites were visited at non-random hours, primarily on weekdays after 3pm in attempt to
maximize the number of participants within our target group. For patrons, every third person that
entered the site was approached and asked to participate in the survey. All staff members on duty
were asked to participate in the survey.
The survey included both quantitative and qualitative questions. All data were entered into Excel
spreadsheets manually. Frequencies were identified for the quantitative data. For qualitative,
open-ended questions, two graduate students identified themes for coding. Once agreed upon,
each coder individually coded the responses for both patrons and staff. The codes were then
compared for reliability and any discrepancy was discussed and rectified. Again, frequencies
were identified among the coded qualitative responses.
A list of sites visited and types of assessments conducted at each can be found in Appendix D.
Findings
Free Drinking Water
Drinking water is widely available and centrally located at the centers visited. The number of
free drinking sources, water fountains and water refill stations ranged from 1 to 10 per center,
with an average of 4 water fountains per center. In all cases, a staff member was present to direct
us to water fountains, but maps were not provided. At the majority of centers a “No Spitting in
the Drinking Fountain” sign was displayed above the drinking fountains, but no expectorate was
observed in any fountains or refill stations.
All centers had at least one fountain close to the center lobby and, at larger centers, near
gymnasiums and exercise areas. Centers with indoor pools also had water fountains located
either in or near the poolroom. All water observed was clean, odorless, colorless, and free of
particulates. Water temperature was variable, ranging from 40 to 71 degrees Fahrenheit, with an
average temperature of 53 degrees Fahrenheit across all sources tested. The filling time required
for a 3-ounce container ranged from 2 to 10 seconds, with an average time of 4 seconds. Eight
fountains had high streams that splashed, while three fountains had low streams that didn’t reach
a comfortable drinking height. Fountains that were observed to have high or splashing streams
had a 3-ounce fill time of 3 seconds or less. Fountains with a fill time of greater than 6 seconds
were observed to have visibly low streams. At the centers visited, we did not observe water
consumption being promoted through signs or other displays. See Appendix M for detailed
information about each water access points observed, sorted by center.
We found that the majority of patrons (87%) and staff (94%) interviewed utilized the water
fountains at the recreation center. Furthermore, when asked staff whether or not their employer
encourages the use of reusable water bottles, 40% reported that it was encouraged, as shown in
Figure 1.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Figure 1. Response to question about employer encouraging use of reusable water
bottles. n=16
Beverage Vending
Twenty-six of the 27 Denver Recreation Centers have at least one beverage vending machine.
Platt Park Senior Center is the only center in the system that reported, via phone, that no
beverage vending is offered. Of the 13 centers assessed, 6 had only one soda machine that also
contained sports drinks. Six centers had a dedicated Coke machine and a Powerade machine;
while 2 centers had a Coke machine, a Powerade machine, and one additional machine.
Drink machines offered a variety of beverages:
 25% were non-caloric, including 14% water and 10% diet soda
 37% were low- or reduced-calorie, including 35% Powerade and 2% Vitamin Water
 36% were regular soda
 3% were sweetened ice tea.
Calorie information was generally provided on or next each drink machine button. Three
machines did not have calorie information listed next to selections, including two Powerade
machines and one machine, unique among the centers visited, with a clear viewing window
allowing customers to see drinks displayed (like a food vending machine). “Calories Count”
signs (see photo in Appendix P) were displayed on at least one of the drink machines at 9 of 13
centers.
Vended beverage pricing was similar at most centers observed. Costs were:
• Water $1.50
• Soda, Ice Tea $1.50
• Powerade $1.75
• Vitamin Water $2.00
However, a few centers had pricing that was different than other observed centers. Water at
Harvey Park was $1.75. At Montbello, sports drinks were $1.75 and Vitamin Water was $1.50.
A breakdown of beverage vending data sorted by center can be found in Appendix N and types
of beverages available at centers can be found in Appendix O.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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The majority of patrons, 60%, did not purchase beverages from the vending machines on site and
only 3% reported purchasing a beverage one time per week or more. This indicates that patrons
are either not purchasing beverages or are purchasing only sporadically. Conversely, staff are
purchasing more frequently. Only 25% of staff interviewed reported that they had never
purchased a beverage, and 56% indicated they had purchased one time per month or more
frequently.
Food Vending
Fourteen of the Denver Recreation Centers have at least one food vending machine. See
Appendix C for a list of centers that do not offer food vending. Of the 11 centers assessed with
food vending, only one had more than one machine (Montbello). Food vending machines were
observed to be centrally located near the front desk area, and clustered with the beverage vending
machines. The current vending contractor is Canteen vending services. Canteen offers a variety
of Wellness Solutions for vending, according to their website. We observed 91% of food vending
machines assessed have signs on display promoting healthier food vending choices according to
Canteen’s own healthy vending criteria. Only one food vending machine had no healthy vending
promotional material on display. Two different criteria were observed on display via promotional
posters, usually on the outside front of the machine: “Choice Plus Snacks” (sign observed on one
machine) and “Balanced Choices” (sign observed on nine machines). The Choice Plus Snacks
criteria is advertised on the Canteen vending website (Canteen, 2014). We could not locate the
Balanced Choices criteria on the vendor’s website, but were able to obtain the criteria directly
from the promotional sign on the vending machine (see Table 1 below).
Table 1. Canteen Vending Services: Healthful Vending Options Criteria
Balanced Choices Criteria:
260 calories or less
7 g of fat or less
Choice Plus Snack Criteria*:
250 calories or less
10 g of fat or less
3 g of saturated fat or less
0g of trans fat
230 mg sodium or less
20 g of sugar or less
In order for customers to identify which vending items meet healthier criteria, individual vending
slots inside the machines are labeled with a green tag, indicating the item stocked there is a
healthier vending item. Based on our observations, 27% of all food vending slots are labeled as
healthier by the vendor. However, many items stocked in slots labeled as healthy do not meet the
vendor’s own healthy criteria. Also, when comparing the nutrition facts of the labeled healthy
snacks to the national healthy vending criteria according to NEMS-V, none of the items would
fall into the Green category; most items would be categorized as Yellow, and several would be
categorized as Red.
Table 2 summarizes the food types that were labeled or mislabeled as healthier according to the
vendor’s healthy criteria and compared to NEMS-V criteria. For further information, see
Appendix Q for pictures of select food items that were labeled as healthier by the vendor and
their nutritional content.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Table 2: Summary of Food Vending Items Labeled as Healthier By the Vendor
SNACK TYPE
Total
Count
# Centers
Meets Vendor’s
Healthy
Criteria?
1. Granola/Protein Bar
18
8
Some items
2. Nuts/trail mix
13
9
Some items
3. Baked chips (assorted)
4. Crackers (assorted)
13
11
7
9
Yes
Some items
fat-free 9
8
Yes
8
8
Yes
7. Kettle Cooked Chips 7
(assorted)
8. Jerky (not low 6
sodium)
5
9. Sun Chips (assorted)
5
No
6
Yes
5
Yes
10. Fruit Snacks
4
4
Yes
11. Popcorn (cheese)
4
4
No
12. Pastries/donuts
2
2
No
13. Rice Krispie Treats
2
2
Yes
14. Regular Chips
1
1
No
15. Snack mix
1
1
Yes
5.
Candy,
(assorted)
6. Pretzels
National
Healthy
Criteria*?
Note: *Compares food item to healthy vending criteria using NEMS-V to categorize foods.
GREEN, (healthiest), YELLOW, (less healthy) and RED (not healthy).
13
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
14
Similar to beverage vending, 71% of patrons interviewed have never made a purchase from the
food vending machines (see Figure 2, below). None of the patrons without children who were
interviewed reported having ever made a food purchase. Six of the patrons interviewed were
members of recreation centers that didn’t offer snack vending. Only 9% reported making
purchases one time a week or more. As was reported regarding vended food purchases, patrons
are either not purchasing vended beverages or, when they do, they do so sporadically. Of those
making purchases, however, 82% stated they were either purchasing for their child or their child
and themselves.
Figure 2. Reported purchases of vended foods by patrons, n=24. Note: six patrons were
interviewed at a recreation center where a food vending was not available.
When asked why patrons are not making purchases, the most common response was that they
either eat before or after they visit the recreation center or that they bring snacks from home. A
few patrons commented that they didn’t think the machines provided enough healthy choices.
Despite their current purchasing behavior, patrons overwhelming agreed that implementation of
healthy vending was a good idea; although 43% indicated that they would be either somewhat
unlikely or very unlikely to make a purchase after the changes.
One patron stated, “Healthier options would be great; the site doesn't offer snack vending and
currently provides free snacks and meals, but occasionally healthy vending would be a good
supplement.” In many recreation centers with a high volume of children, a free snack and meal
program called the Snack Support Program was already in place offering healthy snacks year
round and healthy meals during the summer.
Conversely to patrons, staff members make snack purchases more frequently (see Figure 3
below). In fact, only one staff member reported never making a purchase. Thirty-seven percent
of staff made purchases one time a week or more frequently. In general, the results of this survey
indicate that staff members are utilizing the vending machines more frequently than patrons,
possibly because staff members are at the recreation centers for longer periods of time and on a
more consistent basis than patrons. In agreement with patron responses, staff overwhelmingly
agreed that implementation of healthy vending would be welcomed; 15 out of 16 interviewed
indicated that it was a good idea. One theme that emerged was that healthy vending is in line
with the recreation center’s mission to support a healthy lifestyle. See Appendices R and S for
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
15
patron and staff responses to all questions asked on the survey.
Figure 3. Reported frequency of staff purchases from vending machines, n=14. Note:
Two staff members that never made a purchase were employed at recreation centers
without food vending and were not included in this chart.
Recommendations
Free Drinking Water
Free drinking water consumption could be promoted through a variety of measures: displaying
water-promoting posters, providing stools at higher drinking fountains to make them more child
accessible, and by encouraging staff to act as role models by drinking water and using reusable
bottles. We recommend the continued use of the “No Spitting in the Drinking Fountain” signs
because these signs appear to be effective, according to our observations. Also, staff should have
access to the proper maintenance contact information if the water access point at their center
needs water height or temperature adjustment.
If the same or a similar assessment tool for drinking water access points is used in the future,
observations of 3-ounce fill time could be replaced with observations of stream height, since a
correlation was observed between observation of stream height and seconds measured for the 3ounce fill time. Likewise, tasting the water provided an excellent proxy for temperature.
Eliminating the need to utilize equipment (specifically, a water thermometer and beaker) to make
these observations would allow recreation center staff to easily report functionality of their water
fountains, particularly if the electronic survey tool is used.
Food and Beverage Vending
Based on our findings, a variety of initiatives can be considered for future vending operations.
We recommend initially that the Denver Parks and Recreation department, in collaboration with
the vending contractor, select which healthier vending criteria is most appropriate, and then
enforce that criteria. We used a strategy grid prioritization technique in developing and reporting
these recommendations, assessing feasibility and impact. There is no clear consensus in the
literature on what qualifies as healthy vending criteria, but possibilities with higher feasibility
and impact include:
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
•
•
•
16
Consistent implementation of the current vendor’s healthy vending criteria, “Choice Plus
Snacks.” or “Balanced Choices.” The Balanced Choices criteria are the less restrictive of
the two, establishing limits for only calories and fat grams. Using this more liberal
criteria would allow food items that are high in sugar and/or sodium to be labeled as
healthier, such as fat-free candy, which may mislead the customer and confound the
initiative. We consider this recommendation to have high feasibility, but lower impact
compared to other recommendations.
Incorporating some items that meet the CDC’s NEMS-V healthy vending criteria,
specifically “Green” choices. This national criteria is more stringent than the current
vendor’s standards, making it potentially less feasible to implement, but some “Green”
items could be incorporated into the existing choices, allowing for a greater variety of
healthy options. We consider this recommendation to have medium feasibility and high
impact compared to other recommendations.
Consider the use USDA’s “Smart Snacks in Schools” guidelines for minimum
requirements for the sale of vended foods in schools. These standards are also more
stringent than the current vending contractor’s guidelines. Using these guidelines would
make recreation center vending consistent with the changes that children are seeing in
their schools, and will be familiar to vending contractors. A summary of the USDA’s
vending criteria is provided in Appendix T, as well as link to their website (USDA,
2014). We consider this recommendation to have medium to high feasibility and high
impact compared to other recommendations.
Another possible avenue for vending is to consider a cost adjustment to incentivize water and
healthy snack consumption. Research supports the implementation of either an upward cost
adjustment of less healthy items or a downward cost adjustment of more healthy items (French,
1997). We consider this recommendation to have high feasibility and high impact.
A third possible initiative is to consider eliminating food vending machines altogether in the 14
recreation centers that offer it, with a provision to have limited snacks available at the front desk
for emergencies. We understand that this third initiative requires further study on how significant
the impact of the loss of revenue would be for recreation centers. However, since almost half of
all Denver recreation centers do not currently offer food vending, and the results of our patron
surveys indicate that the majority of patrons rarely or infrequently make food vending purchases,
the elimination of food vending in recreation centers may be a logical next step (Han-Markey et
al., 2012). Depending somewhat on the significance of the revenue loss, we consider this option
to have low feasibility and high impact.
Limitations
There were several limitations. First, with regard to the patron intercept survey responses, we
had a small sample size and found it challenging to find patrons with children available to
participate in the survey. Thus, we included 10 patrons who did not have children and who
reported different purchasing behavior compared to patrons with children. We also found that
many of the recreation centers had a high volume of children patrons; however, parents did not
often accompany these children. Since we limited our target population to adults, we may have
excluded a significant population of children who independently utilize the recreation centers
and the vending machines. Furthermore, Spanish-speaking patrons were excluded from the
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
17
survey due to a lack of resources to develop a survey in Spanish and have a translator available.
In addition, sites were visited at non-random times to maximize respondent participation.
Purchasing behavior could vary with seasonality and our data simply provides a snapshot of one
point in time. Finally, it is likely that social desirability bias could have played a role in
participants’ responses. Because interviews were conducted in a recreation center, a location
associated with the promotion healthy lifestyle choices, respondents may have answered in a way
that they thought would be in line with the recreation center’s mission or interviewers’ opinions,
ultimately skewing their responses.
Additionally, direct observations of vending machine contents were conducted at non-random
times without regard to refill schedule, which could partially account for lack of consistency in
how vending machines are stocked. Furthermore, drinking fountains were only assessed once,
without regard to time of day, level of building occupancy, or maintenance schedule. Any of
these factors could have affected water temperature, pressure, or water fountain cleanliness.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
18
References
Blanck, H.M., Allen D., Bashir, Z., Gordon, N., Goodman, A., Merriam, D., & Rutt, C. (2012).
Let's go to the park today: The role of parks in obesity prevention and improving the
public's health. Childhood Obesity, 8(5), 423-428.
Canteen Wellness Solutions: Better-For-You Options. Retrieved from
http://www.canteen.com/Pages/Canteen.aspx?ItemID=43
Centers for Disease Control and Prevention (CDC). (2013). Vital Signs. National center for
chronic disease prevention and health promotion: Division of nutrition, physical activity
and obesity. Retrieved from http://www.cdc.gov/vitalsigns/childhoodobesity/
City and County of Denver. (2013). Parks and recreation: City parks. Retrieved from
http://www.denvergov.org/parksandrecreation/ParksandRecreation/Parks/CityParks/tabid
/443559/Default.aspx
Denver Public School District. (2013). Preliminary weight status report. Retrieved from
http//www.denvergov.org/Portals/771/documents/DPS%2520BMI%2520initial%2520fin
dings%25208%252022%25202013%2520APPROVED.pdf
French, S.A., Jeffery, R.W., Story, M., Hannan, & Snyder, P. (1997). A pricing strategy to
promote low-fat snack choices through vending machines. American Journal of Public
Health, 87(5), 849–851.
Han-Markey, T.L., Wang, L., Schlotterbeck, S., Jackson, E., Gurm, R., Leidal, A., & Eagle, K.
(2012). A public school district's vending machine policy and changes over a 4-year
period: Implementation of a national wellness policy. Public Health, 126 (4).
Mason, M.,Gomez-Feliciano, L., Becker, A., Bozlak, C., Lammel-Harmon, C., Conti, V., Cox,
S., Katta, E., O’Boyle, M., & Zaganjor, H. (2012). Healthy snack vending: The Chicago
parks district experience and resource guide (PDF). City of Chicago, Parks District.
Retrieved from: http://www.healthycommunitieshealthyfuture.org/wpcontent/uploads/2013/04/Healthier-Snack-Vending-The-Chicago-Park-DistrictExperience-Resource-.pdf
Nutritional Environmental Measures Survey (NEMS-V). (2014). Vending machines in the
workplace. Retrieved from http://www.nems-v.com/
United Health Foundation. (2013). America’s health rankings: 2013 annual report. Retrieved
from http://www.americashealthrankings.org/
U.S. Department of Agriculture, Food and Nutrition Service (USDA). (2014). Smart snacks in
schools. Retrieved from http://www.fns.usda.gov/school-meals/smart-snacks-school
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
19
Appendix A: Statement of Work
“Assessing the Food and Beverage Environment in Denver’s Recreation Centers”
CBHS 6624 Community Health Assessment
Spring 2014
Colorado School of Public Health
University of Colorado, Denver
Community Information:
Despite its reputation for being one of the healthiest states in the nation, Colorado is not
immune to the negative health impacts of an overweight population. Colorado is ranked 23rd in
the nation for childhood obesity, and is one of only three states with an increase in childhood
obesity from 2008 to 2012 (CDC, 2013). Thirty-one percent of Denver Public School children
are overweight or obese (Denver Public School District, 2013). Additionally, just over 20% of
Colorado’s adult population is classified as obese, a number that will continue to increase if this
trend in childhood obesity is not reversed (United Health Foundation, 2013). These data support
the need for community initiatives to promote healthier eating in support of weight gain
prevention in both children and adults. Early intervention to promote a healthier weight among
the population will reduce the costs of weight-related co-morbidities such as heart disease,
diabetes and hypertension.
The priority community for this project will be the patrons who visit the 27 recreation
centers in the Denver area. We intend to focus on the youth who are accessing these recreation
centers, as a recent Chicago Parks District study found that children under 12 (and adults with
children) are the most likely to access on-site concessions, accounting for over 54% of vending
machine purchases (Mason et al., 2012). Due to the time constraints of this project and the winter
weather limitations, we are limiting our scope to indoor recreation centers only.
Project Background and Context:
(Attribution: parts of this section were reprinted from a 2013 grant proposal submitted to the
Johns Hopkins Global Center on Childhood Obesity from the Denver Environmental Health
Department)
Denver’s Department of Parks and Recreation encompasses 200 city and county parks, 5
mountain parks, 27 recreation centers, 29 swimming pools, 100 athletic fields, and 8 municipal
golf courses. The 27 recreational centers include larger, regional facilities, local facilities and
small-scale neighborhood facilities (see map:
http://www.denvergov.org/dpr/DenverParksandRecreation/RecreationCentersPools/FindaRecCe
nter/tabid/443596/Default.aspx).
A variety of food and beverage options are available within each type of recreation
setting (restaurants, vending machines, kiosks and concession vendors). While parks and
recreation settings are a valuable resource for children and adults to maintain and improve their
health through exercise and recreation, the high-calorie, low-nutrient-dense foods often served
can quickly negate the benefits of physical activity. Parks and recreation departments can play an
important role in the enhancement of opportunities for good nutrition among children and
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
20
families (Blanck et al., 2012). Due to their considerable reach throughout Denver, and a recent
policy that allows all Denver youth ages 5 to 18 free year-around access, Denver parks and
recreation settings are an ideal place to begin to assess and inform city-wide healthy food and
beverage strategies to impact childhood obesity.
Project Timeliness
This project is timely because of the following:
· Mayor Hancock’s Children’s Cabinet recently recommended reducing childhood overweight
and obesity 5% by 2018.
· Denver’s Community Health Improvement Plan recommends addressing the City’s vending
and concession policies as a means to provide healthier choices to patrons and impact the
increasing prevalence of childhood overweight and obesity.
· The Mayor’s office is considering the implementation of vending changes beginning June
2014.
· Denver Department of Environmental Health, Denver Public Health, and Denver Parks and
Recreation are partnering with the Centers for Disease Control and Prevention (CDC) to pilot
and inform the development of new park nutrition environment assessment tools.
Project Objectives:
● Establish a baseline for the current state of the food and beverage environment of 24 of
Denver’s recreation centers utilizing a standardized nutrition environment assessment
tool
● Interview staff and patrons regarding opinions of current vending options and water
access within the recreation centers, as well as concerns about any proposed changes
● Provide recommendations to address the city’s vending and concession policies in
preparation for the Mayor’s vending changes beginning in June 2014.
● Inform the development of the park and recreation nutrition environment assessment
tools created and utilized by the Centers for Disease Control and Prevention
Community Client:
Mondi Mason, PhD, MPH
City and County of Denver, Department of Environmental Health
Telephone: 720-865-5463
Email: mondi.mason@denvergov.org
Community Client Roles and Responsibilities:
● Meet with students twice a month
● Provide the following, as available: background information, City and County of Denver
policies related to food/beverage or other related health/wellness policies, any preferred
assessment tools, relevant literature
● Guide student prioritization of scope of work and deliverables
● Guide timeline based on constraints in working with Department of Environmental
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
●
●
●
●
●
21
Health, Denver Parks and Recreation (e.g. special events, closures, high use due to school
holidays and drivers), and client project goals or needs
Provide training for utilization of the nutrition assessment tools
Guide student’s cultural and political understandings of stakeholders and recreation
facility users in order to:
○ Improve both student interactions with stakeholders and recreation users
○ Improve data collection
○ Enhance viability of eventual recommendations
Facilitate access to stakeholders and facilities for interviews and data collection,
including facilitation of any needed background checks or permissions to collect data
from patrons, if applicable
Read and provide feedback on deliverables
Arrange presentation time and location for presenting findings to Denver stakeholders to
further inform policy and nutrition environment changes
Project Deliverables:
Phase One: Survey/Tool Development, due 2/24 (draft to Mondi prior to 2/24)
Phase Two: Data Collection, due 3/31
Phase Three: Data Analysis, due 4/7
Phase Four: Report, due 5/7
Recreation Sites Vending Assessment: Utilizing CDC assessment tools, vending and water
access points will be assessed in a sample of at least 50% of recreation centers in the Denver
area, including regional, local and neighborhood centers. The vending tool will assess the
available products in food and beverage vending machines. The water tool will assess the
availability of water, how difficult the water is to find, the functionality of the water fountain (or
other device) and the palatability of the water itself.
Patron Intercept Surveys: Utilizing what resources are already available, a survey will be
developed for patrons accessing the vending and water in recreation centers. 10 recreation
centers will be chosen; 3-5 surveys will be conducted at each of these 10 sites.
Recreation Center Staff Surveys: Utilizing what resources are already available, a survey will
be developed for staff of the recreation centers with access to the vending and water in their
place of work. Surveys will be conducted at 10 recreation centers; 3-5 surveys will be conducted
at each of these 10 sites.
Report: A 10-page report will be written and submitted to partners of the City and County of
Denver’s Department of Environmental Health. This report will include a miniature literature
review to provide background for why assessing food and beverage sites within parks and
recreation centers is important. Pending reports, to be requested by Mondi as needed, include a
policy brief and a presentation to the partners on findings. At this time, only a 10-page report has
been requested.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
22
References:
Blanck HM, Allen D, Bashir Z, Gordon N, Goodman A, Merriam D, Rutt C. (2012). Let's go to
the park today: the role of parks in obesity prevention and improving the public's health.
Childhood Obesity; 8(5):423-428.
Centers for Disease Control and Prevention (August 2013). Vital Signs. National Center for
Chronic Disease Prevention and Health Promotion. Division of Nutrition, Physical
Activity and Obesity. Retrieved from http://www.cdc.gov/vitalsigns/childhoodobesity/
City and County of Denver (2013). Parks and Recreation: City Parks. Retrieved from:
http://www.denvergov.org/parksandrecreation/ParksandRecreation/Parks/CityParks/tabid
/443559/Default.aspx
Denver Public School District (August 2013). Preliminary Weight Status Report (PDF).
Retrieved from:
http//www.denvergov.org/Portals/771/documents/DPS%2520BMI%2520initial%2520fin
dings%25208%252022%25202013%2520APPROVED.pdf
Mason, M.,Gomez-Feliciano, L., Becker, A., Bozlak, C., Lammel-Harmon C., Conti, V., Cox, S.,
Katta, E., O’Boyle, M., Zaganjor, H. (2012, November). Healthy Snack Vending: The
Chicago Parks District Experience and Resource Guide (PDF). City of Chicago, Parks
District. Retrieved from: http://www.healthycommunitieshealthyfuture.org/wpcontent/uploads/2013/04/Healthier-Snack-Vending-The-Chicago-Park-DistrictExperience-Resource-.pdf
United Health Foundation (2013). America’s Health Rankings: 2013 Annual Report. Retrieved
from: http://www.americashealthrankings.org/
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
23
Appendix B: Team Biographies
Erin Bishop
503.803.9212
Erin.bishop@ucdenver.edu
Biographical Info: Erin is an MPH candidate with a concentration in
Community and Behavioral Health at the Colorado School of Public
Health. She received her bachelor’s of science in Human Nutrition and
Food Science while working as a research assistant on the Healthy
Babies Study with a focus on breast feeding and infant nutrition. In
addition, she provided general support to CSU Extension office of SNAP-ed and FNEP in the
areas of data collection and data entry. Currently, Erin works as a research assistant on the
Influential Factors and Healthy Living Study (IFHL) with the Community Epidemiology and
Program Evaluation Group (CEPEG) in collaboration with Colorado Department of Public
Health and Environment. Erin plans to pursue a career within the public health arena focusing on
nutrition as it relates to chronic disease prevention.
Amy Carpenter
757.268.5801
amy.carpenter@ucdenver.edu
Biographical Info: Amy is in her first year of the doctoral program at
CSPH, with a focus area of Community and Behavioral Health. Amy is a
Registered Dietitian, with a Master of Science in Nutrition. She is also an
active-duty Lieutenant Colonel in the US Air Force, having worked for 15
years as a military officer practicing clinical dietetics and health
promotion at military bases around the country. Most recently Amy
served as an Assistant Professor of Biology at the U.S. Air Force
Academy in Colorado Springs.
Pamela Gould
864.985.2097
pamela.gould@ucdenver.com
Biographical Info: Pamela will finish her MPH this semester in
Community and Behavioral Health. Her focus area is creating and
evaluating programs for improving children’s eating behaviors and food
choices. She serves as a Golden city councilor and a commissioner on
the Golden Urban Renewal Board. She is also on the statewide healthy
eating active living (HEAL) Advisory Board through LiveWell. A former teacher, she has also
served as a school coordinator in LiveWell’s Healthy Schools Program and as a member of
Jefferson County Schools Health Education Advisory Board.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
24
Klaira Lerma
608.408.6858
klaira.lerma@ucdenver.edu
Biographical Info: Klaira is a Masters of Public Health (MPH)
candidate in the Community and Behavioral Health department at the
Colorado School of Public Health. Klaira received her bachelor’s
degree in Psychology and Biopsychosocial Health and Wellness at the
University of Wisconsin, where she worked as a health educator. She
currently is working as a contraceptive counselor at the
Comprehensive Women's Health Center and is a Graduate Public Health Intern in the Adolescent
Medicine department of Colorado Children's Hospital.
Faculty Support:
Holly J. Wolf, PhD, MSPH
303.724.1273
holly.wolf@ucdenver.edu
Biographical Info: Holly Wolf is an assistant professor in Community
and Behavioral Health and Epidemiology in the Colorado School of
Public Health and teaches community health assessment, program
evaluation and project management. She is interested in public health
and health reform, especially as it relates to chronic disease prevention
and control and community mobilization. She directs the Colorado
Colorectal Screening Program for the medical underserved and is
principal investigator, project epidemiologist and/or project manager for several research and
public health service programs focused on cancer prevention and control including several
assessments around cancer screening and delivery of care. She is an active member of state and
national coalitions, including the Colorado Cancer Coalition, serving as past Chair and executive
committee member, as well as the National Colorectal Cancer Roundtable steering committee
and Co-Chair of the Policy Task force.
Erin Wright, MA
319.721.6001
erin.wright@ucdenver.edu
Biographical Info: Erin Wright manages chronic disease prevention
programs at Denver Public Health, which aim to improve population
health through policy and system changes in schools, clinics, and
communities. Previously, she worked on programs locally and
internationally to improve health and wellbeing of underserved and
marginalized communities. She received her Masters in Medical Anthropology from the
University of Colorado Denver and her Bachelors in Cultural Studies from Wartburg College.
She is currently a student in the Doctor of Public Health program in Community and Behavioral
Health at the Colorado School of Public Health.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Appendix C: List of Denver Recreation Center Food and Beverage Vending Availability
Recreation Centers with Both Food and Beverage Vending:
Athmar Recreation Center
Ashland Recreation Center
Aztlan Recreation Center
Central Park Recreation Center
Cook Park Recreation Center
Glenarm Recreation Center
Harvard Gulch Recreation Center
Harvey Park Recreation Center
Hiawatha Davis Jr Recreation Center
La Familia Recreation Center
Martin Luther King Jr Rec Center
Montbello Recreation Center
Montclair Recreation Center
Washington Park Recreation Center
2680 W. Mexico Ave, 80219
2475 W Dunkeld Pl, 80211
4435 Navajo St, 80211
9651 E. MLK Jr. Blvd., 80238
7100 Cherry Creek Dr. S., 80224
2800 Glenarm Pl, 80205
550 E. Iliff Ave., 80211
2120 S. Tennyson Way, 80219
3334 Holly St, 80207
65 S. Elati St., 80223
3880 Newport St., 80207
15555 E. 53rd Ave., 80239
729 Ulster Way, 80230
701 S. Franklin St., 80201
Phone: (303) 937-4600
Phone: (720) 865-0510
Phone: (303) 458-4899
Phone: (720) 865-0750
Phone: (720) 865-0610
Phone: (720) 865-3380
Phone: (720) 865-0905
Phone: (720) 865-0550
Phone: (720) 865-0590
Phone: (303) 698-4995
Phone: (720) 865-0530
Phone: (720) 865-0580
Phone: (720) 865-0560
Phone: (720) 865-3400
Recreation Centers without Food Vending (Beverage Vending Only):
Barnum Recreation Center
Eisenhower Recreation Center
Green Valley Ranch Recreation Center
Highland senior Recreation Center
La Alma Recreation Center
Rude Recreation Center
Scheitler Recreation Center
Southwest Recreation Center
St Charles Recreation Center
Stapleton Recreation Center
Swansea Recreation Center
Twentieth Street Recreation Center
360 Hooker St, 80219
4300 Dartmouth Ave., 80222
4890 Argonne Way, 80249
2880 Osceola St., 80212
1325 W. 11th Ave., 80204
2855 W. Holden Pl., 80204
5031 W. 46th Ave., 80212
9200 W. Saratoga Pl., 80123
3777 Lafayette St., 80205
5090 Broadway, 80216
2650 E. 49th Ave., 80216
1011 20th St., 80202
Phone: (303) 937-4659
Phone: (720) 865-0730
Phone: (303) 375-3857
Phone: (303) 458-4868
Phone: (303) 572-4790
Phone: (720) 865-0570
Phone: (720) 865-0640
Phone: (720) 865-0670
Phone: (303) 295-4462
Phone: (303) 295-4482
Phone: (720) 865-0540
Phone: (720) 865-0520
Recreation Centers with No Food or Beverage Vending:
Platt Park Senior Center
1500 S. Grant St., 80210
Phone: (720) 865-0630
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
26
Appendix D: List of Denver Recreation Centers Visited and Type of Assessment
Name of Center
Drinking Water
Assessment
Vending Assessment
20th Street
x
Ashland
X
Ashland Pool
X
Athmar
X
Aztlan
x
x
x
x
Central Park
x
Cook Park
X
x
Glenarm
X
x
Harvard Gulch
X
x
Harvey Park
X
x
Highland
X
X (no food)
La Alma
La Familia
Interviews
x
x
X
x
MLK
x
Montbello
X
x
x
Montclair
X
x
x
St. Charles
X
Stapleton
X
X (no food)
Washington Park
X
x
Total Food Vending Assessments: 12
Total Drinking Water Assessments: 41
Total Patron Interviews: 30
Total Staff interviews: 16
Total Beverage Vending Assessments: 22
x
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
27
Appendix E: State and Local Parks Drinking Water Survey and Protocol
(June 2012, PNEAT Original)
These measures are designed to rate access, availability, and certain aspects of quality for free
plain drinking water in state and local parks. This includes plain drinking water that comes from
water coolers, fountains, spigots, and filtration devices. For the State and Local Parks survey, all
drinking water that is delivered in restaurants, stores, concession stands/snack shops or vending
machines are excluded.
Definitions:
Water fountain – A stand-alone device that dispenses water for immediate consumption or into a
water vessel
Water cooler – A water jug visible on top of a water dispenser
Water bottle refill station – A spigot attached to a larger backboard for refilling water bottles
Water spigot – A stand-alone water faucet that dispenses drinking water
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
28
In these protocol instructions, each section of the survey is shown, followed by instructions for
completing that section.
Water Access Policies and Promotion
Complete this page at the end of your day in the park to ensure that you have a good sense of
what is available/ accessible in the park.
1. Mark whether water consumption (in general) is promoted via signs, displays, advertisements,
radio/audio messages or videos. Water may be promoted by the park or park service, by vendors
such as Aramark (choose Yes, by vendors) or by manufacturers such as Coca-Cola or Poland
Spring (choose yes, by manufacturers). You may pick all that apply (among the yes choices).
2. Mark whether water consumption is promoted as a “healthy choice” via signs, displays,
advertisements, radio/audio messages or videos.
Examples:
“Hydrate for health”
“Water – the smart choice!”
“Pure clean drinking water – the zero-calorie thirst quencher!”
Water may be promoted as healthy by the park (choose Yes, by parks) by vendors such as
Aramark (choose “Yes, by vendors”) or by manufacturers such as Coca-Cola or Poland Spring
(choose “Yes, by manufacturers”). You may pick all that apply (among the yes choices).
3. Mark whether the park has water containers available for free or for sale near (within
approximately 100 feet, or 1/3 of a football-field) water fountains or dispensers. Water
containers may include disposable or reusable cups, bottles or bladders. Water containers can be
available for free or sale in a visitor center, gift shop, concession booth or another venue. If
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
29
water containers (of any type) are available for sale, choose “Yes, for sale” and/or if available for
free, choose “Yes, for free”. You may pick all that apply (among the yes choices).
4. Mark whether there are any Park Service staff or volunteers in the main visitors center who
can direct you to multiple free plain drinking water access points (e.g. fountains).
5. Mark if there are maps available in the main visitor center that depict water access points
(typically marked with an icon of a small drinking cup).
6. Please list ANY names/locations of major sights or structures that do NOT have any
functioning drinking water access. These may be scenic vistas, trailheads, bathrooms, or
anywhere else that you think having drinking water would be helpful.
Sources of Free Drinking Water in Parks
This section involves taking objective measures of free drinking water access in the parks (again,
not in restaurants, stores, or snack shops/concessions stands). These may include water
fountains, water coolers, filtration devices, bottle refill stations, spigots, etc.
In smaller parks, a census of all drinking water sources may be possible (and is preferred).
In larger state parks a census of free drinking water sources may not be possible.
The following sampling strategy should be used:
1. Rate all drinking water access points near (visible from) restaurants, stores, snack
shops/concession stands and vending machines that are already being rated.
2. Obtain a park map that depicts the locations of bathrooms, visitor centers, and other physical
structures
3. Determine the feasible distance that the rater can travel from the arrival point at the park
(example: 20 miles by car from the parking lot/main visitor center)
4. Seek out all major physical structures within the feasible distance, including visitors center,
museums, bathrooms, exhibits and look for/rate drinking water access points.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
30
5. Seek out trail heads, shuttle stops, and scenic vistas and look for/rate drinking water access
points.
6. Rate all drinking water access points labeled on the map (typically with a small drinking cup)
that are within the feasible distance.
Rating Water Sources:
Circle type of source:
Water fountain (WF), water bottle refill station (WB), water spigot (WS), or water cooler (WC)
* Please do NOT evaluate water from bathroom or other sinks
Date of evaluation: Please write the date that the rater completes the evaluation (ex: 9/10/2012)
Time of evaluation: Please write the time, including am/pm that the rater starts the measurement
(e.g. 1:00pm, 10:15am)
Operating: Please circle yes if the source is functioning at the time of rating, or no if the source is
not functioning (i.e. water comes out of the source when button/switch pressed)
3-ounce filling time: Please indicate the amount of time (in seconds) it takes to fill a 3-ounce
cup. If a 3-ounce cup is not available, please use a graduated cup with a 3-ounce hash
mark. For this measure, it helps to have two people (one timer, and one cup filler) –
though possible with one person. Please round up/down to the nearest whole number,
as appropriate.
Temperature: Using a thermometer, preferable digital (please note, a human thermometer will
not work because it does not measure below 94○ Fahrenheit), measure the
temperature of the water that is in the 3-ounce cup, immediately after filling it. As
much as possible, do NOT let the water run for some period of time to let it “cool
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
31
down”. This measure is meant to reflect the water temperature if a NPS visitor just
turns on the water and drinks it.
Photo: Check the box if a photograph (time and date stamped) was taken. If your camera cannot
time/date stamp – then please take a photo of a watch/clock/phone displaying time
and date immediately before taking the photo of the water source.
Appearance of device: Circle the responses that best describe the appearance of the drinking
water device (e.g. water fountain). If the appearance is satisfactory, circle that
response only. If the appearance is unsatisfactory, circle any of the following that
apply: Visible dirt/rust, Not draining, or Otherwise unappealing (ex: filled with
garbage or moldy).
Relative Accessibility: Assess whether the water source is near (within 100 feet or 1/3 of a
football field) any of the following, then circle whether any of the following apply:
Campground, Trail, Scenic Vista, Picnic area or Other populous area (where visitors
frequent).
Proximity: Circle whether the water source is within 30 feet of: Vending machines, Bathrooms,
another Building (any type) or None of the above (N/A)
Comments: Please write the GPS coordinates, if possible, and any comments about the function,
location, accessibility or performance of this water source
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix F: Final Recreation Center Drinking Water Survey
(Modified from the June 2012 State and Local Parks Drinking Water Survey shown in Appendix E)
32
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
33
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34
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
35
Link to original drinking water tool as an electronic document, before modifications:
https://docs.google.com/forms/d/1hO1kl3ick__r1TzBleavLKC2UpKBonoSkQctV7QUccU/view
form
Link to final drinking water electronic document, after modifications:
https://docs.google.com/forms/d/1majy_ORmbX6gVda_y34Xt_UQBHRpAuNsr6Z3SaONr0U/v
iewform
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix G: State and Local Parks Beverage Vending Survey and Protocol
(June 2012, PNEAT Original)
BEVERAGE VENDING MACHINES
Record the following at the top of the form:
1. Rater Initials
2. Park Name
3. Vending machine ID
4. Today’s date
Questions 1-9: Please see food vending protocol above (pages 1-3)
Question 10:
10. Count the number of slots, the bottle/can size, and the price for each of the items
listed.
o If more than one size of any item exists, always pick the smallest size. If
more than one variety of any item exists (e.g. Diet Coke & Diet Pepsi), pick
the item with the lowest price. If more than one variety has the same price,
36
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
37
then pick the item for which the first letter of the name comes closest to A in
the alphabet (e.g. if Coke and Pepsi are the same price, choose Coke)
o If there is none of a particular item, mark N/A
-Definitions:
-Water: plain drinking water (may be carbonated or still, may not have flavor)
-Artificially sweetened water drink: flavored water sweetened artificially with <10 cals/8
ounces (e.g. Propel)
-100% fruit juice: may not have less than 100% juice
-Juice-flavored drink: fruit or juice flavored drink with less than 100% juice (e.g. fruit
punch, cranberry juice)
-Diet soda: soda sweetened with artificial sweeteners (not with sugar)
-Non-diet soda: regular, sugar-sweetened soda
-Diet sports drink: thirst-quenching, artificially-sweetened beverages such as G2
Gatorade
-Sports drink: thirst-quenching, sugar-sweetened beverages such as powerade
-Diet energy drink: caffeinated, artificially-sweetened drinks such as Diet Rockstar
-Energy drink: caffeinated, sugar-sweetened drinks such as Monster
-Non-diet tea drink: drink make primarily with tea sweetened with sugar (e.g. Snapple)
-Diet tea drink: drink made primarily with tea sweetened artificially (e.g. Diet Sobe)
-Skim/1% unflavored cow’s milk: unflavored skim or 1% milk
11. Indicate whether nutritional information is posted on or near the vending machine for
beverage items (MUST include calories).
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
38
Appendix H: Final Recreation Center Beverage Vending Survey
(Modified from the June 2012 State and Local Parks Beverage Vending Survey shown in Appendix G)
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
39
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
40
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
41
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42
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43
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44
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
45
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
46
Link to original beverage vending tool as an electronic document, before modifications:
https://docs.google.com/forms/d/1oFi4BOCbvNydXiCdy_2RSnYN7NU6i5nEdoMmY6NEjAI/v
iewform
Link to final beverage vending electronic document, after modifications:
https://docs.google.com/forms/d/1rd3ZhX5YM0wrIPHrgOKbPo82w6gPnzZTJkRljRd7cg/viewform
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
47
Appendix I: State and Local Parks Food Vending Survey and Protocol
(June 2012, PNEAT Original)
FOOD VENDING MACHINES
These measures are designed to rate the nutrition available in vending machines that serve snacks or
beverages. Restaurants, snack shops and stores should be captured by RESTAURANTS, SNACK
SHOPS, and STORES tools respectively. Vending machines serving frozen foods (e.g. ice cream or
microwave meals) are excluded.
In these protocol instructions, each section of the survey is shown, followed by instructions for
completing that section.
FOOD VENDING MACHINES
Record the following at the top of the form:
1. Rater Initials
2. Park Name
3. Vending machine ID
4. Today’s date
1. Location Information
a. Fill in GPS coordinates, if available, for the location of the vending machine, and
give a brief description of the machine location
a. For example, “Machine located 20 feet from main visitors center, next to bathroom,
under awning” or “machine in remote location on hiking trail near bathroom”
b. Mark if the machine is located near a visitor center, at a defined scenic vista (e.g. marked
with signs by the park as a scenic overlook), along a walking trail, near a recreational area
(e.g. sports field or playground), near a designated picnic area, or near bathrooms (near
defined as <100 feet or 1/3 football field).
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
2. Please indicate whether the machine is working (operational) at the time of the survey
3. Please indicate whether this machine is in a cluster of other vending machines (i.e. beverage
machine next to a food machine, or beverage machine next to another beverage machines)
4. Please indicate whether the machine features a credit card reader, a robotic arm that delivers
the items from the shelf to the dispenser, or refrigeration
5. What less healthy options are depicted on the exterior of the machine (e.g. pictures of potato
chips, candy bars, or sugar drinks)? Select all choices that apply.
o
Definitions:
-Regular chips: non-baked chips
-Non-diet soda: regular, sugar-sweetened soda
-Flavored milk: milk flavored with chocolate, vanilla, strawberry or other sugars
-Sports drink: thirst-quenching, sugar-sweetened beverages such as powerade
-Energy drink: caffeinated, sugar-sweetened drinks such as Monster
-Dairy dessert: creamy, dairy desserts such as ice creams
-Grain desserts: flour or grain-based dessert like cookies or cakes
If unsure about whether an item counts as less healthy, please refer to nutritional
guidelines in Appendix A&B below.
6. What healthier options are depicted on the exterior of the machine (e.g. pictures of fruit,
vegetables, water or 100% fruit juice)? Select all choices that apply.
48
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
49
Definitions:
-Low-fat unflavored milk: Skim or 1% cow/soy milk not flavored with sugar
-Low-calorie sports drink: thirst-quenching drinks (e.g. Powerade), <10cals/8oz
7. Indicate whether the vending machine has signs or displays (e.g. screens) that encourage
healthy food or drink choices. Fill in comments about what is displayed or phrases used.
o Signage may relate to nutritional value/type of food
 Example: “Try a low-fat option like dried fruit”
 Example: “Eat healthy: Try our whole grain granola bars”
8. Do signs or displays encourage unhealthy food or drink choices?
o It can be related to nutritional value/type of food (promoting sweets or chips)
o Example: “Try our candy bars: Perfect for your sweet tooth”
o Example: Posters featuring pictures of high-fat foods
o Example: Logos or pictures of sugar drinks or sugar drink companies (i.e. CocaCola, Pepsi-co)
9. Are healthy items in the food machine labeled or identified with icons or displays (either by
the item or the button)?
o Example: heart healthy items marked with a heart
o Example: light or low-calorie items identified as such
10. Use the chart in Appendix A to determine whether an option is considered Green (healthy),
Yellow (healthy in limited quantities) or Red (eat only occasionally). Count the number of slots
filled by items that are classified as Green, Yellow or Red. Items that cannot be classified or are
non-nutritive (e.g. chewing gum) should be quantified in the Other/Non-nutritive category.
Empty slots should be counted and listed in the Empty category. List total number of slots in
machine (should equal sum of other columns)
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
50
11. Count the number of slots filled with particular healthy items, and list the price (per item).
Record the number of slots occupied by each healthy items (add # from a to h).
If an item is not present, check the box for N/A.
Definitions:
-Fresh Fruit: fresh such as bananas, apples or pears.
-Vegetables: fresh vegetables such as baby carrots or celery sticks
-Dried fruit: no-sugar/toppings added, such as apricots, raisons or cranberries
-Nuts: single or mixed variety of nuts, plain or with spices (must meet nutrition criteria in
Appendix B).
-Seeds: sunflower seeds or other seeds with no sauce/flavor added (salted ok)
-Jerky: low-sodium dried beef, pork or other meat jerky
-Animal/ Graham Crackers: low-fat. must meet nutrition criteria in Appendix B
-Low-calorie snack packs: must meet nutrition criteria in Appendix B
-Fruit cup in fruit juice- single serving of fruit, such as pears, peaches, grapefruit, or mixed fruit
packaged in fruit juice with no additional sugar.
-Rice cakes: puffed rice snacks either regular size or miniature and can be flavored, but must
meet nutrition criteria in Appendix B
-Soy crisps- baked soy crisps (chips) or thins, can be flavored, but must meet nutrition criteria in
Appendix B
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
51
*If unsure of whether a particular item counts as healthy or not, you can write down the name of
the item and then check nutritional information when back at your desk.
12 &13. Record package size (in ounces or grams) and price (per package) of baked chips,
regular chips, granola/energy bars, and candy bars. Mark N/A if item is not available. Circle
whether granola or energy bar was rated
Definition: Energy bars include Clif, PowerBar, Luna, Kashi, etc.
If more than one variety of chips or bars are available, pick the least expensive item to rate. If
more than one items are the same price, pick the item for which the first letter of the item’s name
is closest to A in the alphabet (e.g. if Fritos and Cheetos are the same price, you would pick
Cheetos).
14. Indicate whether nutritional information is posted on or near the vending machine for all food
items, only for healthy items, or no items (MUST include calories)
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
52
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
53
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix J: Final Recreation Center Food Vending Survey
(Modified from the June 2012 State and Local Parks Food Vending Survey shown in Appendix I)
54
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55
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56
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
57
Link to original food vending tool as an electronic document, before modifications:
https://docs.google.com/forms/d/1fLQwtgbWh6daX9zFpBxsSmCcFLxGTy0Det_pxxqq5g/viewform
Link to final food vending electronic document, after modifications:
https://docs.google.com/forms/d/1DBo0MtFeHREkvXAOo2RCepBjckBjwDpL1PbhNtREK1M/
viewform
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
58
Appendix K: Staff Survey: Vending Machines/Water Fountain Use in Recreation Centers
Date: ___________
Location: ___________
Interviewer: ____________
Hello, I am a graduate student working with Denver Parks and Recreation on a project trying to
better understand how recreation center staff is using food and beverage vending machines and
the water fountains. Would you be willing to answer a few questions about the vending options
and water fountains at this recreation center? The survey should take less than 5 minutes to
complete, it is voluntary and all the information you provide will be kept confidential and will
not be shared with your employer.
___Yes
___No (Thank for time and end interview).
Have you ever purchased a snack from the vending machine(s) in this recreation center?
___Yes
___No
Have you ever purchased a beverage from the vending machine in this recreation center?
___Yes
___No
IF YES
How often do you purchase food from the vending machine in this recreation center?
______________________________________________________________________________
__________________________________________________________________________
How often do you purchase sweetened beverages (such as regular soda or energy drinks) from
the vending machine in this recreation center?
______________________________________________________________________________
__________________________________________________
What do you typically purchase from the vending machines? Please list your top three items.
1._____________________
2._____________________
3._____________
What influences your vending purchases? (can select more than one and rank by order of
importance)
a. Taste/Cravings
b. Price
c. Habit
d. Health choice
e Other (please explain):________________________________
What would you like to see available in the vending machines that is not already there?
____________________________________________________________________________
IF NO
What is your main reason for not purchasing from the vending machines?
______________________________________________________________________________
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
59
__________________________________________________
What would you like to see available in the vending machines that you would be interested in
purchasing?
______________________________________________________________________________
__________________________________________________
ALL
beverages (such as water, 100% fruit juice, unsweetened tea) being offered in recreation center
vending machines?
a. Good idea (please explain):____________________________________
b. Bad idea (please explain):_____________________________________
c. No opinion
How likely would you be to make a healthy snack or beverage purchase from a vending
machine?
a. Very likely
b. Somewhat likely
c. Somewhat unlikely
d. Very unlikely
Do you use the water fountains at the recreation center? ___ Yes
___No
IF NO What keeps you from using the water fountain?
(Prompt, if needed: taste, distance
from workout area, safety issues, other)
______________________________________________________________________________
__________________________________________________
ALL Does your employer encourage you to use a reusable water bottle and use the water on
site? ___Yes
___No
Comments/Questions:
______________________________________________________________________________
__________________________________________________
Thank you for your time; your input is very valuable to this project.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
60
Appendix L: Patron Survey: Vending Machines/Water Fountain Use in Recreation Centers
Date: ___________
Location: ___________
Interviewer: ____________
Hello, I am a graduate student working with Denver Parks and Recreation on a project trying to
better understand how recreation center patrons are using food and beverage vending machines
and the water fountains. Would you be willing to answer a few questions about the vending
options and water fountains at this recreation center? The survey should take less than 5 minutes
to complete, it is voluntary and all the information you provide will be kept confidential – your
responses will never be connected directly to you.
___Yes
___No (Thank for time and end interview).
We are only interviewing people over 18 years of age today. What year were you born?
Year born ______________ (End interview if born after 1996.)
How often do you come to this recreation center?
a. Daily
b. 2-3 times/week
c. Once a week
d. 2-3 times a month
e. Once a month
Do you have children (under 18) who participate in recreation center activities?
___Yes, How many? __________
___No
Have you ever purchased a snack from the vending machine(s) in this recreation center?
___Yes
___No
Have you ever purchased a beverage from the vending machine in this recreation center?
___Yes
___No
IF YES
How often do you purchase food from the vending machine in this recreation center?
______________________________________________________________________________
______________________________________________________________________________
____________
How often do you purchase beverages such as regular soda or energy drinks from the vending
machine in this recreation center?
______________________________________________________________________________
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
61
______________________________________________________________________________
____________
What do you typically purchase from the vending machines? Please list your top three items.
1._____________________
2._____________________
3._____________________
Who do you normally purchase for?
a. You
b. Your child
c. Both you and your child equally
d. Someone else
What influences your vending purchases? a. Taste/Cravings
b. Price
c. Habit
d. Health choice
e. Other (please explain):________________________________
What would you like to see available in the vending machines that is not already there?
______________________________________________________________________________
______________________________________________________________________________
____________
IF NO
What is your main reason for not purchasing from the vending machines?
______________________________________________________________________________
______________________________________________________________________________
____________
What would you like to see available in the vending machines that you would be interested in
purchasing?
______________________________________________________________________________
______________________________________________________________________________
____________
ALL
beverages (such as water, 100% fruit juice, unsweetened ice tea) being offered in recreation
center vending machines?
a. Good idea (please explain):____________________________________
b. Bad idea (please explain):_____________________________________
c. No opinion
How likely would you be to make a healthy snack or beverage purchase from a vending
machine? a. Very likely
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
62
b. Somewhat likely
c. Somewhat unlikely
d. Very unlikely
Do you use the water fountains at the recreation center? ___ Yes
___No
IF NO
What keeps you from using the water fountain?
(Prompt, if needed: taste, distance from workout area, safety issues, other)
Comments/Questions:
______________________________________________________________________________
______________________________________________________________________________
____________
Thank you for your time; your input is very valuable to this project.
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
63
Bathroom, Gymnasium / courts,
Vending machines
Bathroom
49
71
Harvey
1
Bathroom, Exercise / weight room or
cardio equipment, Gymnasium /
courts, Vending machines
40
Harvard
Gulch
5
Bathroom, Lobby / front desk,
Meeting rooms / classrooms /
offices, Vending machines
Vending machines
51
Wash park
7
Water pressure
weak
51
Bathroom, Exercise / weight room or
cardio equipment
Bathroom, Exercise / weight room or
cardio equipment
Bathroom, Exercise / weight room or
cardio equipment, Lobby / front desk
Exercise / weight room or cardio
equipment
Exercise / weight room or cardio
equipment
Exercise / weight room or cardio
equipment
52
Gymnasium / courts, Lobby / front
desk
Gymnasium / courts, Lobby / front
desk
Step stool
provided;
additional fountain
recommended in
exercise room
Step stool provided
48.2
Gymnasium / courts
Pool / sauna
Ease of Access
for Children:
[Water outlet is
36" or less from
floor]
Temperature
Problems with
water source
2
Proximity
# drinking water
sources
Athmar
Type of Water
Source
Center Name:
Appendix M: Data Analysis: Drinking Water Access and Palatability
48
54
Water pressure
high
Water pressure
high
Visible
Dirt/Rust;
Water pressure
high
57
Visible
Dirt/Rust
56
57
51
67
67
>36” from ground
Ashland
4
Ashland
(pool)
Glenarm
Montbello
2
10
Bathroom, Exercise / weight room or
cardio equipment, Gymnasium /
courts
Bathroom, Gymnasium / courts,
Lobby / front desk
Bathroom, Exercise / weight room or
cardio equipment, Lobby / front
desk, Meeting rooms / classrooms /
offices, Vending machines, Pool
table
Bathroom, Gymnasium / courts
Visible
Dirt/Rust
67
Dirty
mouthpiece,
residue in drain
43
Water spout
broken off
47
50
Locker room or changing area
47
Locker room or changing area
48
Exercise / dance or aerobics room,
Gymnasium / courts, Lobby / front
desk, Pool / sauna
Exercise / weight room or cardio
equipment, Meeting rooms /
classrooms / offices
Bathroom, Gymnasium / courts
48
Bathroom, Gymnasium / courts,
Lobby / front desk
Gymnasium / courts
Meeting rooms / classrooms / offices
Meeting rooms / classrooms / offices
44
47
>36” from ground
Out of order
47
Cracked buttons
on the front
Water pressure
high
Water pressure
high
Gymnasium / courts
Exercise / dance or aerobics room
>36” from ground
44
Meeting rooms / classrooms / offices
Gymnasium / courts, Lobby / front
desk
64
Ease of Access
for Children:
[Water outlet is
36" or less from
floor]
Temperature
Problems with
water source
2
Proximity
# drinking water
sources
La Familia
Type of Water
Source
Center Name:
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
51
47
47
51
Water pressure
high
49
>36” from ground
Exercise / dance or aerobics room
Pool / sauna
Cook Park
Montclair
3
6
Water pressure
high
Water pressure
weak
48
54
Pool / sauna
52
Exercise / weight room or cardio
equipment
Exercise / weight room or cardio
equipment
65
Bathroom, Gymnasium / courts,
Lobby / front desk
Bathroom, Meeting rooms /
classrooms / offices, Vending
machines
Bathroom, Meeting rooms /
classrooms / offices, Vending
machines
Bathroom, Exercise / weight room or
cardio equipment, Locker room or
changing area, Lobby / front desk
Bathroom, Exercise / weight room or
cardio equipment, Locker room or
changing area, Lobby / front desk
Bathroom, Exercise / weight room or
cardio equipment, Locker room or
changing area, Lobby / front desk
Water pressure
weak
65
Ease of Access
for Children:
[Water outlet is
36" or less from
floor]
Temperature
Problems with
water source
Proximity
Type of Water
Source
# drinking water
sources
Center Name:
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
64
Out of order
61
61
61
61
61
>36” from ground
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
66
Appendix N: Data Analysis: Beverage Vending
Recreation
Center
Name:
Athmar
Harvey Park
Harvard
Gulch
Washington
Park
La Familia
Ashland
Ashland
pool
Glenarm
Montbello
Cook Park
Montclair
Stapleton
Aztlan
Total
calories
count sign
y/n
y
y
calories
listed for
all choices
y
y
8
y
y
27
18
18
y
y
n
y
y
y
9
18
9
18
65
18
7
233
n
n
y
y
y
n
y
y
n
y
y
n
n
y
Total Slot Spaces
in Machine
9
9
Water (plain)
Athmar
Harvey Park
Harvard
Gulch
Washington
Park
La familia
Ashland
Ashland
pool
Glenarm
Montbello
Cool Park
Montclair
Stapleton
Aztlan
Total
1
1
% total
11%
11%
Price
$1.50
$1.75
1
13%
4
2
1
1
1
1
2
15
3
1
34
Diet soda
(<10cals/8
oz)
1
0
% total
11%
0%
Price
$1.50
$1.50
2
25%
$1.50
15%
11%
6%
$1.50
$1.50
$1.50
3
3
0
11%
17%
0%
$1.50
$1.50
11%
6%
11%
11%
23%
17%
14%
$1.50
$1.50
$1.50
$1.50
$1.50
$1.50
$1.50
2
2
0
2
5
2
1
23
22%
11%
0%
11%
8%
11%
14%
Sold out
$1.50
$1.50
$1.50
$1.50
$1.50
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Athmar
Harvey Park
Harvard
Gulch
Washington
Park
La familia
Ashland
Ashland
pool
building
Glenarm
Montbello
Cool Park
Montclair
Stapleton
Aztlan
Total
Sports drink (e.g.
Gatorade,
Powerade)
2
8
%total
22%
89%
Price
$1.75
$1.75
Artificially
sweetened
water
(<10cals/8
oz)
0
0
2
25%
$1.75
0
0%
9
9
9
33%
50%
50%
$1.75
$1.75
$1.75
0
0
2
0%
0%
11%
0
8
7
9
12
7
0
82
0%
44%
78%
50%
18%
39%
0%
$1.75
$1.50
$1.75
$1.75
$1.75
0
1
1
0
0
0
0
4
0%
6%
11%
0%
0%
0%
0%
Reg soda
sweetened
carbonated
beverage
Athmar
Harvey Park
Harvard
Gulch
Washington
Park
La familia
Ashland
Ashland
pool
building
Glenarm
Montbello
Cool Park
Montclair
Stapleton
Aztlan
Total
%total
0%
0%
4
0
% Total
44%
0%
Price
$1.50
Sweetened
iced tea
1
0
% Total
11%
0%
3
38%
$1.50
0
0%
10
4
6
37%
22%
33%
$1.50
$1.50
$1.50
1
0
1
4%
0%
6%
6
6
0
5
30
5
6
67%
33%
0%
28%
46%
28%
86%
Sold out
$1.50
0
0
0
0
3
1
0
0%
0%
0%
0%
5%
6%
0%
$1.50
$1.50
$1.50
$1.50
67
Price
$2.00
$2.00
$1.50
Price
$1.50
$1.50
$1.50
$1.50
$1.50
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix O: Beverage Vending Availability Findings
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Appendix P: Select Photos Illustrating Existing Healthy Vending Promotional Signs
Figure 1: "Choice Plus" Promotional Sign
Figure 2: "Balanced Choices" Promotional Sign
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Figure 4: Beverage Button Labeling
Figure 3: Healthy Beverage Vending
Promotional Sign
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix Q: Nutrition Facts of Select Items Labeled Healthy By the Vendor
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Appendix R: Patron Survey Data Tables
Patrons With Children Under 18
Patrons Without Children Under 18
n=30
20 (67%)
10 (23%)
Patron: How often do you come to this recreation center?
Daily
5 (17%)
2-3x Week
14 (46%)
1x Week
5 (17%)
1-2x Month
6 (20%)
n=30
Patron: Have you ever purchased a snack from the vending machine(s) in this recreation center?
Yes
6 (10%)
No
18 (90%)
n=24
**6 patrons interviewed did not have snack vending available
** None of the patrons without children (0/10) reported making a purchase
Patron: Have you ever purchased a beverage from the vending machine(s) in this recreation center?
Yes
11 (38%)
No
18 (62%)
n=29
Patron: How frequently do you purchase beverages from the vending machine in this recreation center?
1x per Week
2 (7%)
1-2x per Month
6 (20%)
Less than 1x per Month
3 (10%)
Never Purchased
19 (63%)
n=30
Patron: How frequently do you purchase snacks from the vending machine in this recreation center?
1x per Week
2 (9%)
2-3x per Week
1 (4%)
1-2x per Month
2 (8%)
Less than 1x per Month
2 (8%)
Never Purchased
17 (71%)
n=24
**6 patrons interviewed did not have snack vending available
Patron: What do you typically purchase from the vending machines? Please list your top three items.
Hot Cheetos
Soda
Popcorn
Root Beer
Orange Soda
Snickers
Beef Jerky
Doughnuts
Smart Food Popcorn
Water
Trail Mix with M&Ms
Diet Coke
Gummy Worms
Chips
Gatorade
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Patron: Who do you normally purchase for?
You
Your Child
Both You and Your Child Equally
Someone Else
3 (27%)
6 (55%)
2 (18%)
0 (0%)
n=11
** This is data from patrons with children; patrons without children that made purchases (2/2) indicated they only
made purchases for themselves.
Patron: What influences your vending purchases?
Taste/Craving
Hunger
Availability
Thirst
5 (39%)
2 (15%)
1 (8%)
5 (38%)
n=13
Patron: What would you like to see available in the vending machines that is not already there?
Candy/Pastries/Higher Fat-Sugar Items
2 (14%)
Healthier Option
10 (72%)
Gluten Free
1 (7%)
Energy/Protein Bars
1 (7%)
n=14
Patron: What is your main reason for not purchasing from the vending machines?
Machines Do Not Provide Desirable Options
Machines Do Not Provide Healthy Options
Brings Own Snacks
Eats Food Before or After Visiting
n=17
3 (18%)
3 (18%)
5 (29%)
6 (35%)
Patron: How would you feel about healthier snacks (such as fruits, nuts, and baked chips) or beverages (such as
water, 100% fruit juice, unsweetened ice tea) being offered in recreation center vending machines?
Good Idea
29 (97%)
Bad Idea
1 (3%)
n=30
Subsets of Good Idea:
Would Help with Personal Goals to Eat Healthier
1
Not Likely to Use
2
Fits with Recreation Center’s Mission to Promote Health
2
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Patron: How likely would you be to make a healthy snack or beverage purchase from a vending machine?
Very Likely
7 (24%)
Somewhat Likely
10 (34%)
Somewhat Unlikely
8 (28%)
Very Unlikely
4 (14%)
n=29
Patron: Do you use the water fountains at the recreation center?
Yes
26 (87%)
No
4 (13%)
n=30
** The 4 patrons that indicated they did not use the water fountain explained they brought their own bottles due
to sanitary issues or only drink bottled water.
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix S: Staff Survey Data Tables
Staff Over the Age of 18
16
Staff: Have you ever purchased a snack from the vending machine(s) in this recreation center?
Yes
13 (93%)
No
1 (7%)
n=14
**2 staff members interviewed did not have snack vending available
Staff: Have you ever purchased a beverage from the vending machine(s) in this recreation center?
Yes
12 (75%)
No
4 (25%)
n=14
Staff: How frequently do you purchase snacks from the vending machine in this recreation center?
1x per Week
2 (12%)
2-3x per Week
4 (25%)
1-2x per Month
6 (37%)
Less than 1x per Month
2 (13%)
n=14
**2 patrons interviewed did not have snack vending available
Patron: How frequently do you purchase beverages from the vending machine in this recreation center?
1x per Week
1 (6%)
2-3x per Week
2 (12%)
1-2x per Month
6 (38%)
Less than 1x per Month
3 (19%)
Never Purchased
4 (25%)
n=16
Staff: What do you typically purchase from the vending machines? Please list your top three items.
Snickers
Powerade
Root Beer
Candy Bar
Protein Bars
Soda
Chips
Donuts
Pop Tarts
Gummy Worms
Reeses
Popcorn
Fritos
Cheetos
Twix
Twizzlers
M&Ms
Fiber Bar
Doritos
Beef Jerky
Staff: What influences your vending purchases?
Taste/Craving
Hunger
Availability
Thirst
Price
9 (65%)
2 (14%)
1 (7%)
1 (7%)
1 (7%)
n=14
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
79
Staff: What would you like to see available in the vending machines that is not already there?
Candy/Pastries/Higher Fat-Sugar Items
5 (38%)
Healthier Option
4 (31%)
Gluten Free
1 (7%)
Energy/Protein Bars
1 (8%)
Food Vending
1 (8%)
Lower Prices
1 (8%)
n=13
Staff: How would you feel about healthier snacks (such as fruits, nuts, and baked chips) or beverages (such as water,
100% fruit juice, unsweetened ice tea) being offered in recreation center vending machines?
Good Idea
15 (94%)
Bad Idea
1 (6%)
n=16
Staff: How likely would you be to make a healthy snack or beverage purchase from a vending machine?
Very Likely
7 (44%)
Somewhat Likely
7 (44%)
Somewhat Unlikely
1 (6%)
Very Unlikely
1 (6%)
n=16
Staff: Do you use the water fountains at the recreation center?
Yes
15 (94%)
No
1 (6%)
n=16
** The staff member that indicated they didn’t use the water fountains at the recreation center explained that
employees of the center have access to the fridge in the employee lounge, which supplies water.
Staff: Do you use the water fountains at the recreation center?
Yes
No
No Comment
n=16
6 (40%)
5 (33%)
4 (27%)
Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix T: USDA Smart Snacks in School
Retrieved from: http://fns.dpi.wi.gov/files/fns/pdf/afsis.pdf
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
Appendix U: PowerPoint Presentation
83
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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Assessing the Food and Beverage Environment in Denver’s Recreation Centers
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