Oral Presentation ANZOS-ASLM-ICCR 2019

A healthy environment translates to healthy consumer purchasing behaviours: Evaluation of a healthier environment intervention. (#56)

Renae Earle 1 , Robyn Littlewood 1 2 , Jacki Walker 1 2 , Ayala Rogany 1 2 , Oliver Canfell 1 2 , Clare Dix 1
  1. School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
  2. Children's Health Queensland, Centre for Children's Health Research, South Brisbane, QUEENSLAND, Australia

Objective: The purpose of this study was to evaluate a healthier environment intervention in a public paediatric hospital.

Study Design: The intervention was implemented at the facility’s 24 vending machines, and 5 retail outlets. Food and drink products were classified according to a traffic light system, based on nutritional quality. The intervention aimed to limit red foods to 20% of total food displayed, and red drinks to 0% of total drinks displayed. Remaining food and drink displays were aiming for 50% green and 50% amber. Perceptions regarding implementation were qualitatively assessed in vending and retail stakeholders.

Methods: Audits were used to determine intervention adherence. The intervention was assessed quantitatively using monthly case-mix sales data, which was collected for a period of 12 months, representing eight months pre- and four months post-implementation for drinks, and mid-implementation for food. Data was sub-grouped based on its origin (vending or retail) and type (food or drink). Independent T-tests and non-parametric equivalents were used to determine percentage change in each traffic light category, and in total sales for each sub-group. For qualitative data, five managerial representatives participated in semi-structured interviews, which were thematically analysed.

Results: Sales of red food and drinks decreased by 26% (33, 18) (p=<0.0001) post-implementation. This coincided with a decline in overall sales by 18% (24, 12) (p=<0.0001). From qualitative analysis three major themes emerged; implementation barriers, facilitators and future direction, financial feasibility and consumer behaviour.

Conclusions: A healthier environment intervention reduced the purchasing of red food and drinks. Changes in purchasing behaviours coincided with an overall decline in sales. Future research that assesses the impact of healthy environment interventions on health outcomes and comprehensively analyses financial feasibility is highly recommended to inform future interventions of this nature, and health policy.