Impact and acceptance of a state‐wide policy to remove sugar‐sweetened beverages in hospitals in New South Wales, Australia

Abstract

Issue addressed: Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support.Methods: A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ 2 analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed.

Towards healthier food choices for hospital staff and visitors: impacts of a healthy food and drink policy implemented at scale in Australia

“…This is one of the first evaluations of an at-scale policy intervention targeting the food environment in health facilities, to assess changes in staff and visitor's levels of awareness, support and food purchasing behaviours, and the differences amongst sociodemographic groups. The findings are promising, showing that consumers are increasingly aware of the changes introduced under the Framework, and that they are well supported by both staff and visitors in NSW hospitals, consistent with our previous study examining the removal of SSB in this setting (21) . The level of support found for offering more healthy and fewer unhealthy foods for sale was higher than for removing SSB, in these facilities (21) and other hospital food outlets (23) , and for increasing the price of SSB (24) .…”

“…The findings are promising, showing that consumers are increasingly aware of the changes introduced under the Framework, and that they are well supported by both staff and visitors in NSW hospitals, consistent with our previous study examining the removal of SSB in this setting (21) . The level of support found for offering more healthy and fewer unhealthy foods for sale was higher than for removing SSB, in these facilities (21) and other hospital food outlets (23) , and for increasing the price of SSB (24) . Significant difference between groups are indicated in bold; there was significant variation between hospitals for awareness (random intercept SD 0.42; P = 0•003) and between hospital outlets for everyday food items purchased (random intercept SD 0.50; P = 0•0001).…”

“…Café/cafeteria customers were eligible if they had purchased food or cold drink items within the outlet and were approached just after they completed their purchase, however, this study reports on food purchases only. Data on drinks purchased was analysed separately and has been published previously (21) .…”

“…The Framework applies to food outlets where foods and drink are available to staff and visitors in NSW health facilities. The first target as outlined in the Framework was the removal of pre-packaged SSB from sale by 31 December 2017, which was largely achieved (21) . The second target was to achieve all other fifty-three Framework practices by 31 December 2018.…”

“…The adjusted odds of purchasing 'Everyday' food items were: 22 % lower in visitors relative to staff; 29 % lower in younger adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) relative to older (55þ); 29 % lower in non-tertiary educated relative to tertiary-educated and 52 % higher in those that spoke a language other than English at home relative to English speaking. There was a significant interaction between age group and education level (P = 0•005), with non-tertiary-educated participants significantly less likely to purchase 'Everyday' foods than tertiary-educated among younger age groups only (Fig.…”