在澳大利亚医疗服务中做出更健康的选择：一项干预措施的前后评估，旨在提高自动售货机和食品销售点食品和饮料的营养价值。
Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets.
机构信息
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia.
出版信息
BMC Health Serv Res. 2013 Nov 25;13:492. doi: 10.1186/1472-6963-13-492.
BACKGROUND
Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale.
METHODS
Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green).
RESULTS
Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets.
CONCLUSIONS
Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines.
背景
医疗机构内的自动售货机和商店是员工、访客和门诊病人购买食品和饮料的来源，它们有可能促进健康食品和饮料的选择。本文描述了澳大利亚医疗机构内食品销售点的家长和管理人员对更健康食品选择的供应和标签以及医疗机构内销售的食品和饮料的看法。它还描述了一项改善更健康食品和饮料销售供应和标签的干预措施的影响。
方法
对家长（n=168）和食品销售点经理（n=17）进行了调查。对新南威尔士州亨特新英格兰地区卫生服务机构运营的食品销售点（n=5）和售货机（n=90）中销售的食品和饮料进行了审核，在引入增加更健康选择供应的政策和相关支持之前（2007 年）和之后（2010/11 年）进行了审核。使用红绿灯系统对食物进行分类，从最不健康的（红色）到最健康的（绿色）。
结果
几乎所有（95%）家长和大多数（65%）食品销售点经理都认为卫生服务站点的食品销售点应该有明确显示健康选择的标志。家长（90%）还认为与 47%的管理人员相比，所有卫生服务站点的食品销售点都应该提供主要的健康食品。自动售货机中更健康饮料插槽的比例从 29%增加到 51%，而标记更健康饮料的机器比例从 0 增加到 26%。与干预后 4 个中的 5 个相比，没有销售点在基线时标记更健康的物品。在自动售货机中，没有观察到更健康食品的供应或标签变化，也没有观察到食品销售点更健康食品或饮料的供应变化。
结论
尽管得到了家长和销售点管理人员的支持，但医疗机构内销售的更健康食品和饮料选择的供应和标签在基线时很差。干预措施鼓励改善自动售货机中更健康饮料的供应和标签，但对食品没有影响。
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