Abstract
Background
The World Health Organization recognizes universities as an important health-promotion
setting, including in healthy food provision. Previous research shows that healthy
food retail interventions also need to consider commercial sustainability, including
financial outcomes, and should take a holistic approach to consumer experience.
Objective
Our aim was to determine the health behavior and commercial outcomes of a multicomponent
traffic light–based healthy vending policy implemented as one part of a holistic university
food policy. The hypothesis was that purchases of less healthy “red” beverages would
decrease compared with predicted sales, that purchases of healthier “green” and “amber”
alternatives would increase, and that there would be no change in revenue.
Design
A quasi-experimental design evaluated a real-world food policy using monthly aggregated
sales data to compare pre-intervention (January 2016 to March 2018) and post-intervention
period sales (December 2018 to December 2019).
Participants/setting
Electronic sales data were collected from 51 beverage vending machines across 4 university
campuses in Victoria, Australia.
Intervention
A multicomponent policy was implemented between April and November 2018. Beverages
were classified using a voluntary state government traffic light framework. Policy
included display ≤20% red beverages and ≥50% green beverages; machine traffic light
labeling; health-promoting machine branding; review of machine placement; and recycled
bottle packaging.
Main outcome measures
Changes in red, amber, and green volume sales, and revenue compared with predicated
sales.
Statistical analyses performed
Interrupted time series analysis of sales data compared post-policy sales with predicted
sales.
Results
In the 13th month post-policy implementation, there was a 93.2% (95% CI +35.9% to +150.5%) increase
in total beverage volume sold and an 88.6% (95% CI +39.2% to +138.1%) increase in
revenue. There was no change in red beverage volume sold, but increases in green (+120.8%;
95% CI +59.0% to +182.6%) and amber (+223.2%; 95% CI +122.4% to +323.9%) volume sold.
Conclusions
Sustained behavior change and commercial outcomes suggest that holistic vending interventions
can effectively promote healthier beverage sales.
Keywords
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Biography
M. R. Blake is a research fellow, Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Biography
A. Peeters is director of the Institute for Health Transformation, and a director of the Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Biography
C. Livaditis is Hospitality Manager, Campus Services Division Deakin University, Geelong, VIC, Australia.
Biography
A. J. Cameron is an associate professor, Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Article info
Publication history
Published online: June 03, 2021
Accepted:
April 6,
2021
Received:
August 21,
2020
Footnotes
Supplementary materials: Tables 1, 2, and 3 and Figures 3, 4, 5, 7, 9, 10, and 11 are available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST All authors are employees of the university at which the intervention took place. The beverage supplier provided sales data to the authors for the purposes of the current analysis. The supplier had no role in the design, analysis, or writing of the manuscript.
FUNDING/SUPPORT M. R. Blake, A. Peeters, and C. Livaditis are funded by Deakin University. A. J. Cameron is supported by a Future Leader Fellowship (grant ID 36357) from the National Heart Foundation of Australia. He has received other funding from the Australian National Health and Medical Research Council (NHMRC), Australian Research Council, Canadian Institutes of Health Research, and the World Health Organization. M. R. Blake, A. Peeters, and A. J. Cameron are researchers within the NHMRC-funded Centre of Research Excellence in Food Retail EnvironmentS for Health (RE-FRESH) (APP1152968). The opinions, analysis, and conclusions in this article are those of the authors and should not be attributed to the NHMRC.
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© 2021 by the Academy of Nutrition and Dietetics.
