Background: Private regulation, such as contracts, can be an effective lever to implement and manage health-enabling food retail environments. However, guidance for the effective use of contracts in food retail settings is limited. The use of contracts to create healthy food vending environments is one area where policy attention has been focussed. We applied a public health regulatory framework to publicly available guidance documents on healthy vending to develop best practice recommendations for using contracts to create healthy food vending environments.
Methods: Document analysis involved i)
snowball sampling to identify eligible publicly available healthy
vending guidance documents from an identified seed paper; ii)
application of a public health regulatory framework to extract data
across three domains of form, substance and governance of healthy
vending initiatives; and iii) synthesis of data to form best
practice recommendations. Eligible documents were those aimed at
implementing healthier vending; published from 2000 onwards;
accessible online; and included recommendations beyond nutrition
standards alone, including a reference to at least one regulatory
governance process (administration, implementation, monitoring,
enforcement or review).
Results: Twelve of 92 documents identified
were eligible and all were from the United States (US). All
noted that products need to comply with nutrition standards. Other
aspects of regulatory substance (i.e., pricing, promotion,
placement, labelling and contract length) were less well considered
as were elements of regulatory governance (regulatory rules,
administration, implementation, monitoring, enforcement and
review). Our adapted framework covers three regulatory
domains with nine components, and a further 20 recommendations for
best practice application in healthy vending.
Conclusions: To be effective, contracts used
to manage healthy food vending should include more than the
nutrition standards for healthy food and drinks. Clearly stating
the regulatory objectives, operative terms and conditions, and
defining responsibilities for monitoring, review and enforcement
within the contract, in addition to the nutrition standards, will
assist practitioners in creating effective and sustained
contract-based initiatives aimed at improving the healthiness of
vending, or other food retail environments.