Impact and acceptance of a state-wide policy to remove sugar-sweetened beverages in hospitals in New South Wales, Australia

Leonie Cranney; Bradley Drayton; Margaret Thomas; Beatrice Tang; Tarli O'Connell; Michelle Crino; Megan Cobcroft; Josephine Chau; Adrian Bauman; Philayrath Phongsavan

doi:10.1002/hpja.390

Impact and acceptance of a state-wide policy to remove sugar-sweetened beverages in hospitals in New South Wales, Australia

Health Promot J Austr. 2021 Jul;32(3):444-450. doi: 10.1002/hpja.390. Epub 2020 Aug 15.

Authors

Leonie Cranney^{1

2}, Bradley Drayton¹, Margaret Thomas^{1

2}, Beatrice Tang³, Tarli O'Connell³, Michelle Crino³, Megan Cobcroft³, Josephine Chau^{1

4}, Adrian Bauman^{1

2}, Philayrath Phongsavan^{1

2}

Affiliations

¹ Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
² Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
³ Centre for Population Health, NSW Ministry of Health, North Sydney, Australia.
⁴ Department of Health Systems and Populations, Macquarie University, Sydney, Australia.

PMID: 32713051
DOI: 10.1002/hpja.390

Abstract

Issue addressed: Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support.

Methods: A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ² analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed.

Results: The proportion of outlets that removed SSBs increased from 58.0% to 96.3% (P < .001). The majority (79.5%) of the 2394 surveyed supported SSB removal, with nearly half (48.4%) reporting it would improve people's health. A minority (13.4%) did not support SSB removal, more than half (61.4%) of those said individuals should have free choice. More staff than visitors were aware of the change (61.9% vs 31.2%; P < .0001).

Conclusions: Availability of SSBs in NSW hospitals was significantly reduced after implementation of a policy to remove them from sale. There was strong staff and visitor support for the initiative. SO WHAT?: This study provides clear evidence that a policy designed to provide a healthy hospital retail drink environment can be successfully implemented at scale with high levels of support from staff and visitors.

Summary: A state-wide policy initiative to remove SSBs from sale in NSW hospital food outlets in 2017 was successfully implemented, with a sample of outlets having nearly 100% compliance. The majority of staff and visitors (80%) supported the removal of SSBs, mostly because they believed it would improve individual and population health.

Keywords: health policy; healthy environments; nutrition; obesity.

MeSH terms

Beverages
Hospitals
Humans
New South Wales
Policy
Sugar-Sweetened Beverages*