Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia.
The University of Sydney Law School, Sydney, Australia.
BMC Public Health. 2024 Nov 20;24(1):3219. doi: 10.1186/s12889-024-20771-8.
Contracts can be an effective lever to implement and manage health-enabling food retail environments. However, guidance for the effective use of contracts in food retail settings is limited. The use of contracts to create healthy food vending environments is one area where policy attention has been focussed in high income countries. We applied a public health regulatory framework to publicly available guidance documents on healthy vending to develop best practice recommendations for using contracts to create healthy food vending environments.
Document analysis involved i) snowball sampling to identify eligible publicly available healthy vending guidance documents from an identified seed paper; ii) application of a public health regulatory framework to extract data across three domains of form, substance and governance of healthy vending initiatives; and iii) synthesis of data to form best practice recommendations. Eligible documents were those aimed at implementing healthier vending; published from 2000 onwards; accessible online; and included recommendations beyond nutrition standards alone, including a reference to at least one regulatory governance process (administration, implementation, monitoring, enforcement or review).
Twelve of 92 documents identified were eligible and all were from the United States (US). All noted that products need to comply with nutrition standards. Other aspects of regulatory substance (i.e., pricing, promotion, placement, labelling and contract length) were less well considered as were elements of regulatory governance (regulatory rules, administration, implementation, monitoring, enforcement and review). Our adapted framework covers three regulatory domains with nine components, and a further 20 recommendations for best practice application in healthy vending.
To be effective, contracts used to manage healthy food vending should include more than the nutrition standards for healthy food and drinks. Clearly stating the contract objectives, operative terms and conditions, and defining responsibilities for monitoring, review and enforcement within the contract, in addition to the nutrition standards, will assist practitioners in creating effective and sustained contract-based initiatives aimed at improving the healthiness of vending, or potentially other food retail environments.
合同可以成为实施和管理有利于健康的食品零售环境的有效手段。然而，关于在食品零售环境中有效使用合同的指导有限。在高收入国家，政策关注的一个重点领域是利用合同创造健康的食品售货环境。我们应用公共卫生监管框架对可公开获取的关于健康售货的指导文件进行分析，以制定最佳实践建议，用于利用合同创造健康的食品售货环境。
文件分析包括：i）滚雪球抽样，从已确定的基础文件中确定有资格的可公开获取的健康售货指导文件；ii）应用公共卫生监管框架，从三个方面提取健康售货计划的形式、实质和治理数据；iii）综合数据形成最佳实践建议。符合条件的文件是指旨在实施更健康售货的文件；2000 年以后出版；可在线获取；并包括营养标准以外的建议，至少参考一个监管治理过程（管理、实施、监测、执行或审查）。
从 92 份文件中确定了 12 份符合条件的文件，均来自美国。所有文件都指出，产品需要符合营养标准。监管实质的其他方面（即定价、促销、位置、标签和合同期限）考虑较少，监管治理方面的要素（监管规则、管理、实施、监测、执行和审查）也是如此。我们的改编框架涵盖了三个监管领域，有九个组成部分，并为健康售货提出了 20 项最佳实践应用建议。
为了有效，用于管理健康食品售货的合同应不仅包括健康食品和饮料的营养标准。除了营养标准外，还应明确说明合同目标、操作条款和条件，并在合同中定义监测、审查和执行的责任，这将有助于从业者制定有效的、可持续的基于合同的倡议，旨在提高售货的健康水平，或可能改善其他食品零售环境。
