Defeat the Sweet: Reduction of sugar sweetened beverages in rural Western Victoria
Led by Wimmera Health Care Group (WHCG), seven health services across rural Western Victoria came together, over a six month period, to accelerate the reduction of sugar sweetened beverages (SSBs) across their retail, vending and catering as part of the Healthy choices: policy guidelines for hospitals and health services.
The health services aimed to replace any RED (limit) items with GREEN (best choices) or AMBER (choose carefully) items.
To encourage collaboration, WHCG’s CEO engaged CEOs from existing alliances which created authorisation for change for all health services. A steering committee was established, and regularly met to increase collaboration between health services.
Peer rural partnerships
The steering committee was made up of representatives from health promotion, dietetics and quality management.
As organisations were at different stages of reducing SSBs, a collaborative approach assisted organisations to reach their aim.
The steering committee shared learnings, set goals, and provided solutions when barriers were encountered. They engaged with senior management and implementation staff early in the process as well as at regular points throughout the project to ensure a whole of organisation approach.
- The Healthy Eating Advisory Service (HEAS) provided resources and tailored advice for each health service. Their FoodChecker tool was used to assess the percentage of GREEN, AMBER and RED foods and drinks available.
- Alfred Health assisted in ways to engage food outlets and stakeholders and help to embed change.
- This initiative was supported by the Victorian Government.
What we hoped to achieve?
- “Food and drinks on offer can have a large impact on the health of team members, visitors and the broader community” – Rural Northwest Health (Warracknabeal).
- “It’s an opportunity to set a good example to the community” – East Grampians Health Service (Ararat).
- “From our customer survey, kiosk customers reported the traffic light system significantly influenced their purchasing choices” – West Wimmera Health Service (Nhill).
What was achieved?
- Executive engagement from all seven health services was attained. All hospitals involved are now committed to implementing the Healthy Choices guidelines.
- The region presented as a united front to approach food and drink suppliers and advocate for increased access to healthier foods and drinks.
- On average, the provision of GREEN drinks increased and RED drinks decreased in health service’s vending machines and retail drink fridges.
- Change in drink availability across rural Western Victoria
Critical success factors for implementing healthy change
A collaborative approach
The steering committee provided strength in numbers and an open forum to share learnings, overcome barriers and maintain open dialogue.
It was important to keep food service and health service team members informed from the outset. We recommend developing a communication plan early to explain the reasons for change before the process has commenced. Communication of changes should be ongoing throughout the process.
Challenges unique to rural settings
Food supply and logistics
Product recommendations were made to stockists and vendors early. In cases where there were significant delays with supply the steering committee decided to remove the vending machines entirely.
Three health services decided to remove their vending machines because the supplier would not service the area or update the internal machine configurations to fit healthier drinks.
Due to poor tasting water quality, the population in the region are reluctant to drink tap water. At some sites, water fountains were installed prior to the removal of vending machines.
Resistance from staff
In most organisations there was some staff resistance to change and perceived reduced choice. Most health services found that this resistance subsided after a couple of weeks. A targeted communication plan and an organisation wide approach helped to improve staff acceptance of these changes.
Project time and resources
The steering committee found it was difficult to elicit change in a timely manner. It took some vendors up to 3 months to re-stock vending machines or implement change.
Perceived loss of profit
Resistance came from retailers and suppliers prior to the change occurring as they believed that profits would decrease. While the impact on sales was not measured in this project, one site has reported an increase in sales since removing sugary drinks.
Where to from here?
- Continue working on providing 50% GREEN foods and less than 20% RED foods across all health service’s retail outlets, as per the Healthy Choices guidelines.
- Start working towards providing over 50% GREEN foods and no RED foods for internal catering
- Ensure vending machines remain compliant through regular communication and auditing of vending.
- Maintain the established steering committee which will work together to continue building demand for healthy supply options.