Does policy create healthier beverage environments in small semi-rural communities?

Introduction

Consumption of sugary beverages is linked to the obesity epidemic. A focus of CA4Health was to reduce the consumption of sugary beverages in 12 small low-income counties, by implementing 4 site-specific healthy beverage standards. This study assessed beverage offerings before and after the standards were implemented.

Methods
Public Health Department staff were trained to collect data in 2012-2014.  Forty-seven settings across 9 of the 12 counties were observed at both time points. Using SPSSv21, data was analyzed using two approaches; one used ‘beverage’ as the unit of analysis and the other used ‘setting’ as the unit of analysis.

Results

Eighty-eight venues were observed at baseline and 72 at follow up; the majority were vending machines (82% and 85% at baseline and follow up, respectively). At baseline, 31% of all beverages observed (427 of 1361) adhered to the respective site-specific PHI standard; at follow up, adherence increased to 38%. The 23% increase in adherence in schools (from 33% to 56%) was mostly attributed to a sharp decline in sports drinks. At baseline, the average percent adherence across all 47 sites was 39%; at follow up, the average increased to 67%.  The change was statistically significant at p<.001 (t=6.21; df 46).

Discussion

These findings suggest that healthy beverages guidelines can have a positive impact on the healthfulness of beverages sold and/or offered in community and workplace settings. The CA4Health communities have worked collectively to create environments that will support healthy beverage choices, and ultimately reduce obesity and its related health impacts.