|Strategies to improve the nutritional quality of foods in vending machines and food outlets in the Hunter New England Local Health District (HNELHD)|
|Vending machines||Food outlets|
|Building leadership and consensus||LHD Advisory Committee||LHD Advisory Committee|
|Memos from HNELHD executive to site managers to encourage support||Memos from HNELHD executive to site managers to encourage support|
|Engagement of HNELHD contracts manager|
|Resources, tools, information; incorporation into systems/procedures||Development of HNELHD Vending Policy Compliance Procedure*||Development of HNELHD Outlets Policy Compliance Procedure*|
|Healthier Choices requirements built into tender and contract processes for supply of vending machine services||Healthier Choices Guide and resources disseminated during site visits: logo and signage for products; posters; classification of product table; taste testing kit;% calculation tool|
|HNELHD vending contract Nov 2008 included Healthier Choices conditions|
|Contractor provided with: Healthier Choices logo for vending machines; and classification system resource||Healthier Choices fact sheets circulated to outlets each year|
|Offer of revised menu board with green and amber items labelled|
|Training||Invitation to outlet managers to attend Healthy Canteen expo|
|Follow up support||Reactive- dietitian advice on request†||Proactive - dietitian support|
|Site visits - two per year|
|Telephone support calls|
|Reactive – dietitian advice available on request via email or phone|
|Monitoring and feedback||Reactive feedback to contractor on planograms for planned stock†||Audit monitoring and feedback - tailored written reports to outlet managers|
*The Policy Compliance Procedure outlined that requirements be built into tender or contract processes. There was minimal capacity for this for outlets within this intervention period; however Healthier Choices requirements were built into tender and contract processes for one private outlet contract enacted during 2010. This outlet is not included in this evaluation as it had not been set up at follow up audit. Policy Compliance Procedures also included a communication strategy that included presentations to key stakeholders including health service managers and dieticians.
†Feedback provided twice for planned drinks machines and once for planned snack machines, other advice on Healthier Choices was not sought.
Bell et al.
Bell et al. BMC Health Services Research 2013 13:492 doi:10.1186/1472-6963-13-492