STUDY: Evaluation of efforts to reduce sodium & ensure access to healthier beverages in four healthcare settings in Massachusetts

Vending machine full of junk foodA new study describes the evaluation process and outcomes of intervention strategies to reduce sodium in foods and sugar in beverages as part of a collaborative partnership between state public health, academic, community, and healthcare partners in Massachusetts, US.

Lower sodium diets and lower levels of sugar-sweetened beverage consumption are linked to better health outcomes. However, the majority of adults and children in the US continue to consume high sodium diets, and 61% of children and 50% of adults still drink a sugar-sweetened beverage daily. Strategies that limit sodium in commercially prepared and processed foods and promote healthy beverage consumption in community and worksite settings, like healthcare settings, may improve health outcomes for consumers and employees.

In 2014, the Massachusetts Department of Public Health received funding to support local community-clinical collaborations to prevent obesity, diabetes, heart disease, and stroke in four communities in Massachusetts. This study describes the intervention process and evaluation outcomes of strategies to reduce sodium in foods and sugar in beverages as part of this partnership between state public health, academic, community, and healthcare partners in Massachusetts.

The strategies were based on prior studies of strategies to reduce sodium in packaged foods in vending machines and menu items in cafeterias, and to improve access to non-sugar sweetened beverages in vending machines and cafeterias in community settings. The four community partnerships that were created as part of the project included a healthcare setting and a mix of local community-based organizations, public health agency collaborators, healthcare setting administrators, and foodservice management.

Intervention activities in each setting included initial data collection to develop:

  1. A tailored feedback report with recommendations for reducing sodium in foods and sugar in beverages,
  2. A collaborative action planning process
  3. Individually-tailored technical assistance
  4. Materials and supports for communication and implementation of nutrition standards for sodium and beverage sugar content
  5. Marketing and promotional materials to educate consumers, and
  6. A follow-up tailored feedback report created by the academic partners.

Findings from this study suggest that strategies within healthcare setting foodservice operations and management systems can be used to encourage a healthier food and beverage environment. In addition, cafeteria and vending machine settings may need different types of implementation supports to be successful.

This study highlights both the promises and challenges of a multi-sector and collaborative approach where local community partners worked with healthcare settings to improve the food and beverage environment in the places serving both patients and staff.

Citation:

Cradock AL, Barrett JL, Daly JG, Mozaffarian RS, Stoddard J, Her M, Etingoff K, Lee RM. Evaluation of efforts to reduce sodium and ensure access to healthier beverages in four healthcare settings in Massachusetts, US 2016–2018Prev Med Rep. 2022 Apr;27. Online ahead of print. doi:10.1016/j.pmedr.2022.101788