Healthy Vending Iowa - Center TRT · Healthy Vending Iowa: Potential ... Worksite Vending Report Card ... At the end of the project period Reassess machines ...

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Tracy Dearth-Wesley

Center TRT

&

Carol Voss and Susan Klein

Iowa Department of Public Health

Healthy Vending Iowa Iowa Department of Public Health

What We Will Cover….

• Housekeeping

• Center TRT Overview

• Healthy Vending Iowa Core Elements & Public Health Impact

• How Initiative works

• Q & A

Housekeeping…

• Please type questions in the chat box and they will be answered at the end of the presentation

• All participant lines are muted

• Technical difficulties – please use the chat box

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Center TRT:

Web-Based Trainings

1. Nutrition and Health Module

– Nutrition 101

– Policy and Environmental Supports for Healthy Eating

2. Physical Activity and Health Module

3. RE-AIM

4. Nutrition and Physical Activity Self Assessment in Child Care (NAP SACC)

5. A New Leaf… Choices for Healthy Living

6. Logic Models and Evaluation Plans for Policy, Systems, and Environmental Change Initiatives

Center TRT:

Intervention Translation

• Training

• Vending Machine Assessment

• Vending Report

• Worksite Goal-Setting

• Employer Involvement

• Vendor Communications

• Employee Involvement

• Social Marketing Campaign

Healthy Vending Iowa:

Core Elements

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• Reach: High given its use by worksites and other facilities with vending machines

• Effectiveness: ↑ availability and accessibility of healthy foods and beverages

• Adoption: Used in a variety of worksite settings

• Implementation: Easy to implement at a relatively low cost

• Maintenance: Sustained worksite leadership and vendor engagement

Healthy Vending Iowa: Potential

for Public Health Impact

NUTRITION ENVIRONMENT MEASURES SURVEY – VENDING (NEMS-V)

Healthy Vending in the Work Place

Poll question #1

Are there snack and beverage vending machines in the building where you work?

Yes – snack and beverage

Beverage only

Snack only

No vending machines

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Poll question #2

About what percentage of the choices in your snack machine would you consider “healthy”

0 - 10%

11 – 30%

31 – 50%

>50%

Nutrition Environment Measures Survey Vending - NEMS-V

Developed to assess workplace vending machines

Originally based on the Institute of Medicine’s Nutrition Standards for Foods in Schools with some modifications

Criteria has been updated to match Health and Sustainability Guidelines for Federal Concessions and Vending Operations (2012).

Intended to have an easy to use coding system: red, yellow and green

Voss, C, Klein, S, Glanz, K, Clawson, M. Nutrition Environment Measures Survey–

Vending: Development, Dissemination, and Reliability. Health Promotion Practice. 2012

13: 425

NEMS-V Coding

RED food and beverages are not as healthy and fall outside the Dietary Guidelines for Americans.

YELLOW food and beverages are healthy foods that meet the Dietary Guidelines, may provide a serving of fruit, vegetable, low-fat dairy or whole grain but does not meet the strictest sodium guidelines.

GREEN food and beverages are considered the healthiest, are consistent with the Dietary Guidelines for Americans, provide a serving of fruit, vegetable, low-fat dairy or whole grain and meet the strictest sodium guidelines.

NEMS-V Coding

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Snack Criteria

≤ 200 calories per portion as packaged

No more than 35 percent of total calories from fat*

<10 percent of total calories from saturated fat*

zero trans fat

≤ 35 percent weight from total sugars

* Excludes nuts and seeds without added fats, oils or caloric sweeteners

Beverage Guidelines

Green Plain water without flavoring, additives, or carbonation

100% fruit or vegetable juice with less than or equal to 230 mg sodium per 8 oz. serving

Fat-free, 1% or 2 % unflavored milk

Yellow Flavored milk

Any other beverage with 40 calories or less per 8 oz. serving

Any beverage with between 230 mg and 400 mg sodium per 8 oz. serving

Red – whole milk; any beverage > 40 calories/8 oz. and > 400 mg

sodium per 8 oz.

Sodium Guidelines

Sodium – unless otherwise specified on the specific category

Green = < 230 mg (roasted and salted pistachios with

160 mg sodium, Low-sodium V- 8 juice)

Yellow = >230 mg < 400 mg (smoked almonds with 380 mg sodium)

Red = > 400 mg (V-8 juice)

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Sugar Guidelines

Green = 2%, 1% or fat-free yogurt with no added sweeteners; fat-free, 1% or 2 % unsweetened milk with < 13 gm sugar per 8 oz. serving

Yellow = 2%, 1% or fat-free yogurt with added sweeteners; fat-free, 1% or 2 % flavored milk with more than 13 gm sugar per 8 oz. serving and/or artificial sweeteners

Red = Regular yogurt; whole milk

NEMS-V Website Features

NEMS-V Tools Tutorial: 15 minute online demonstration on how to complete a NEMS-V assessment

NEMS-V Healthy Choices Calculator and phone applications: Used to determine green, yellow, or red color-coding for food/beverage choices

NEMS-V Healthy Choices Calculator Tutorial: 5 minute online demonstration on how to use the Healthy Choices Calculator

www.nems-v.com

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www.nems-v.com – click on blue “Healthy Choices Calculator” button

Polling question # 3

Which of the following vending machines is more likely to have at least 50% green and yellow options at pre-assessment?

Snack

Beverage

Refrigerated

Nearly 6 in 10 respondents thought message worked best to communicate the snack rating system clearly.

Respondents liked that it illustrated examples of foods, which made the color coding system very clear.

The main message was focused on encouraging people to choose better snacks at least some of the time.

Many noted they had never seen vending machines with healthy options stocked in them.

Message Selected

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Focus Group Findings

White collar workers don't expect to find healthy choices in vending machines;

they are more likely to pay attention to the nutrition facts; and

they rationalize eating unhealthy snacks if they have eaten well or exercised that day.

Blue collar workers focus on the enjoyment of eating a snack;

not very likely to look at nutrition labels, however, are willing to change their eating habits if tasty, healthy choices are available

Rest area visitors more likely to adopt an “on the road” mentality - let go of everyday

healthy eating habits to have a treat / indulgence

: Resources for Worksites, Rest Areas, Parks

Worksite Promotional Signage (Blue Collar and White Collar)

•Table Tents

•Bathroom Signs

•Pledge Cards

•Snack Tracking Calendars

•Paystub Stuffers

•E-mail Messages

•Bi-monthly Newsletters - print-ready and editable

Resources (continued)

Vending machine clings, signs, banners and floor clings

Videos - worksite video (10 min.); vendor video (5 min.)

NEMS-V Report Card and Certificate

New beverage poster

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Use of Social Marketing Resources

Highest usage Vending machine topper – 87%

Color-coded vending machine “pushers”- 81%

Brochures – 81%

MIX IT UP poster – 81%

Snack cling – 75%

Newsletter – 62%

Beverage cling – 50%

Lowest usage Floor cling; pledge card; pocket-size snack calendar

Iowa Healthy Vending Initiative

Ultimate Goal: Project will lead to having a policy in place for state facilities to provide a minimum of 25% of food and 50% of beverage choices in vending machines as healthy options (green or yellow) based on NEMS-V criteria

NEMS-V Recognition Levels Bronze (30% food or 55% beverage choices are yellow and green);

Silver (40% food or 65% beverage choices are yellow and green);

Gold (50% food or 75% beverage choices are yellow and green and no red foods are advertised).

Project will serve as a model for other businesses across the state.

Healthy Vending Iowa Implementation Mini-grant opportunities – 2010 through 2013

Taste-testing

Incentives

NEMS-V assessments

Reporting to key decision makers/wellness committee for action plan

Ideal model – 13 worksites in 2012-2013

Funds to use as above

Longer implementation time – 6 months

Social marketing resources

Environment or policy change

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Core Strategies

NEMS-V assessment

Worksite Vending Report Card

Worksite Wellness Committee

Vendor Communications

Employee Involvement

Social Marketing Campaign

Follow-up NEMS-V Assessment

13 Worksites Model

Application The project coordinator must have attended The Healthy Iowa

Worksites Conference

Completed NEMS-V assessment in worksite with at least one beverage and one snack machine

Signature of worksite CEO/vending machine decision maker

Commit to:

Contact the worksite vendor

Make arrangements to do product tastings ($100)

Develop a plan to market healthy vending machine options (provided Mix it Up resources)

Provide incentives to employees ($150)

At the end of the project period Reassess machines

Submit minutes/results from meeting with worksite wellness committee/CEO

Submit a copy of a worksite resolution/policy or a list of proposed or completed action(s) towards policy implementation

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Maintenance

Sustained worksite leadership

Vendor engagement

Worksite policy or resolution

Monitoring for compliance

Polling question #4

Do you purchase healthy options from your worksite vending machines?

Yes

No

No vending machines available

Our color-coded path…..

Worksite Model Capitol Complex

Successes and lessons learned

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Vending Could Be a Good Place to Start

“The NEMS-V initiative provided Stream with a foundation to start a health initiative. Without this opportunity their vending products would not have received the much needed product makeover. This was the first wellness initiative that this company has implemented. “

Souixland Health Department

Pinecrest County Building 225 Employees

“Our vendor said that the healthy options moved much faster than any of her other sites.”

Blackhawk County Health Department

Vendor Support is Crucial

Unexpected Barriers

“It was difficult getting the worksite to use

the materials because they have a policy to

not allow materials produced by others to be

placed in the facility. Eventually we were

able to use some of the smaller items but it

took some convincing.”

Ringgold County Hospitals and Clinics

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Sioux City Foundry 1200 Employees

Strategy: Replace Unpopular Red Items

No Matter How Hard You Try…..

“Some great comments have come out of

the changes but some employees are

disgruntled about spending time and money

on promoting healthy eating. We try to keep

it as positive as possible.”

Mills County Public Health

R A N D O L P H - S H E P PA R D A C T

Our Work with Blind Vendors

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Need Support and Time…….

October 12th, 2010

Dear Director Newton;

We are pleased to write this letter in support of Iowa Department of Public Health’s

efforts to improve access to healthier choices in vending machines in state-owned

buildings, rest areas and state parks. We would like to specifically extend our

support to your policy of offering at least 30% of food and beverage choices as

healthy options. …….

……..We support providing our customers choices that include healthful foods and

beverages. We also understand and recognize this initiative is about creating a

healthful environment and not specific products………

Sincerely,

Roger G. Erpelding Kevin Szcodronski Ed Holland

Dept. for the Blind Dept. for Natural Resources Dept. of Administrative Services

Vendor Support is Crucial

Your Timing May Not Coincide with Vendors

I have not given out one incentive and don’t think there are any green items in our machine (at least not the last time I looked).

Thanks –

Leighann

I hate to be a pest but thought you might like to know that the Jessie Parker building vending machines still do not have the colored flags inside the machines.

Carlene

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Getting Employees Onboard

How come IWD has only 9 yellow selections and no green selections

in our vending machines?

Jim

I was just down at our vending machines and they still have not been

marked. I have been telling all of my staff about the neat prizes and

they keep bugging me as to when they will be labeled. Do you have

any idea when that will be?

Thank you,

Ashley

Engage Worksite Wellness Champions

…..our NEMS-V stuff went up last week. One of the yellow

foods was a 280 calorie bag of Cheez-its. So, being the

person that I am, I sent a friendly email to Carol. When I went

to use the restroom this afternoon, there was Carol, and

Monty, and a blind guy in a suit, and one or two more

people. I can’t wait to check our green and yellow foods

tomorrow. Hopefully, chili cheese fritos will be green.

Sheryl, DAS

Persistence Pays Off

Wow! There have been some nice additions to the machines this

week and I have been busy dishing our prizes! Business is picking

up! Thanks for all your work to make healthy options available for DE

employees.

Take care-

Carrie

which vendor has the grimes building? Just wondering because it is

an awesome selection. And I like the "mix it up" scheme.

Keri

Transition Vocational Rehabilitation Counselor Iowa Department for

the Blind

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NAMA – Industry Support

"People are more conscious about health and wellness and are making more concerted efforts to have a balanced diet," said Jackie Clark, National Automatic Merchandising Association spokeswoman. There's evidence that shows that sales go up when healthier items replace traditional vending options. "This is a trend that's here to stay."

Questions

Contact Information

Carol Voss, Nutrition Coordinator

515-242-5566

[email protected]

Susan Klein, Consultant

515-240-0368

[email protected]