Target Behavior: Healthy Eating
Intervention Type: PSE Change
Intervention Reach and Adoption
As an institutional policy, the procurement motion specifically targets County employees (100,000 + individuals); patrons who purchase food and beverages at County venues, and populations whose meals are provided by County of Los Angeles food venues and programs. The County distributes meals to youth, seniors, patients, and incarcerated individuals; populations who are at greater risk for obesity and poverty. Once the institutional policy is fully implemented, DPH estimates that it will impact the nutritional quality of nearly 37 million meals offered/sold in various County settings per year.
Setting: Community, Retail, Worksite
Target Audience: Preschool (<5 years old), Elementary School, Middle School, High School, Pregnant/Breastfeeding Women, Parents/Mothers/Fathers, Adults , Older Adults
- Institutional policy should include evidence-based nutrition standards, as well as other healthy food procurement strategies that promote selection/consumption of healthy foods and beverages.
- Institutional policy should designate an organization or formal group to coordinate implementation of new nutrition standards and other promotion strategies.
- The coordinating organization should consult with stakeholders whom the institutional policy will impact, such as food service vendors and department leadership in charge of food service contracts. This step must precede policy implementation.
- The coordinating organization should have adequate resources to oversee institutional policy implementation, including sufficient resources to offer ongoing technical assistance and evaluation.
- An organization or formal group should be authorized to evaluate and monitor the institutional policy or system change. In Los Angeles County, the coordinating organization (Los Angeles County Department of Public Health) also serves as the entity that evaluates and monitors policy implementation.
- Model policy– Healthy Food Promotion in LA County Food Service Contracts
- “Creating Healthy Food Environments” policy brief
- Model memo from the Department of Public Health’s Health Officer to all the County Departments informing them of the Board of Supervisors’ motion and its implications
- Sample Food Service Requirements for Concession Operations at a County of Los Angeles Cafeteria, 2011
- Nutrition Standards Implementation Guides (available for vending machine beverages and snacks, and a sodium reduction plan)
- Case study on the vending machine program
- Policy brief on working with public and private hospitals
The initial assessment involved an extensive survey of the settings (e.g., cafeterias, vending machines, and concessions), practices (current nutrition standards, dietary accommodations), and challenges anticipated by each County department. Since 2011, DPH has partnered with 7 County departments including the Probation Department, Department of Public Works, Department of Health Services, Department of Children and Family Services, Department of Parks and Recreation, Department of Beaches and Harbors, and the Chief Executive Office. DPH provided technical assistance to each department, conducted site visits and menu reviews, recommended nutrition standards to be integrated into their contract solicitation processes, and established a monitoring and compliance system.
An adapted version of the validated Nutrition Environment Measures Survey for Vending Machines (NEMS-V) tool and an internally developed environmental scan tool for cafeterias were used to collect baseline data on the food and beverage options offered in vending machines and cafeterias at selected facility locations. To date, we have collected baseline data on food and beverages that are offered in 5 hospitals and multiple worksite cafeterias.
In addition, vendor quarterly sales (revenue), food production records, and nutritional information of vending machine snacks and beverages have been collected to examine the level of adherence to a 100% healthy vending policy at a large urban agency in Los Angeles County, as well as its impact. In terms of the latter, DPH assessed changes in the product line nutrients and revenues as a result of the vending policy for a timeframe of nearly 2 years (November 2013 to September 2015). Results suggest that policy adherence increased for snacks and beverages sold by the vending machines, 28% and 49%, respectively. Average snack and beverage revenues appeared to decrease by $137.30 and $93.87 per month, respectively, during the sampled period. However, based on a vending machine environmental scan sub-assessment, DPH found that large price increases occurred shortly after the implementation of the 100% healthy vending machine policy; this may, to some extent, explain the decreases in snack and beverage revenue.
DPH plans to conduct further impact evaluation and continue technical assistance through the dissemination of healthy food procurement toolkits, and promotion of model procurement guidelines for a variety of venues and institutions. The DPH evaluation team has published several articles pertaining to healthy food procurement work, and has several manuscripts in development that document the challenges and successes of creating healthier food environments. Contribution to this evidence base provides valuable information for informing similar efforts in other sectors (e.g., cities, private companies, community-based organizations with food services).
|Readiness and Capacity – Short Term (ST)||Changes – Medium Term (MT)||Effectiveness and Maintenance – Long Term (LT)||Population Results (R)|
|Sectors of Influence||MT7|
Michelle Wood, MPP
Program Manager, Food Procurement and Policy
Choose Health LA
Division of Chronic Disease and Injury Prevention
Los Angeles County Department of Public Health
3530 Wilshire Blvd., 8th Floor
Los Angeles, CA 90010
Phone: (213) 351-7809