1. Healthy Hospital Food Environment: Policy & Programs in Practice CDC Weight of the Nation May 2012 Scottie Gaskins Senior Administrator Vidant Wellness, Home Health & Hospice

2. 1 Overview of Vidant Health Healthcare system serving 29 counties (1/3 of North Carolina) with a population of 1.4 million people. –1,500 beds –Ten owned, leased or managed hospitals –physician practices –home health and hospice –wellness centers Largest NC employer east of I-95 with over 11,000 employees

3. 2 MISSION VISION VALUES To enhance the quality of life for the people and communities we serve, touch and support Where incredible people provide incredible care… every day Excellence… our standard Compassion… our distinction Teamwork… our advantage Education… our investment Innovation… our future

4. 3 Wellness Culture Strategic Framework – People Pillar Leader & Board driven & supported Robust Wellness Benefits: –Three Wellness Centers –Employee Wellness Program –Disease Management & Health Coaching –Employee Health Clinic –Occupational Health Clinic –Employee Assistance Program –Employee Pharmacy –Incentives- premium credits, medications & other –Medical Plan Design Environment & Policies to support healthy behaviors

5. 4 Employee Engagement 91% employee participation in Wellscreen!

6. 5 State of Weight at Vidant Health 74% employees are overweight or obese; > local, state & national Obese employees averaged 9.4 more sick hours than healthy weight participants at a cost of $197 per person per year. Cost reduction opportunity of $809,572 to reduce the 46% of employees who are obese. Employees who were overweight or obese incurred 4.58 times more lost work hours tied to workers compensation than workers with BMI less than 25.

7. 6 Weight Reduction Programs Drop-A-Ton / Wellness Challenges Weight Watchers at Work Eat Smart, Move More, Weigh Less Group Training/ Weight Path Medical Weight Loss / Optifast Medical Nutrition Therapy Bariatric Surgery

8. 7 Healthy Food Environment Our Commitment: Make delicious, healthy foods: –Accessible –Affordable –Visible with calorie/portion size information so consumers can make informed choice Create an environment that supports the practice of healthy behaviors Still provide choice

9. 8 Policy Effective January 2012 Healthy Food Environment is the Norm, not the Exception 75% of food & beverage options at onsite food venues (eateries and vending) meet healthy criteria 60% of food & beverage options at company- sponsored events meet healthy criteria Price leverage healthy options in eateries and vending Label calories on all foods and beverages

10. 9 What is Healthy? Per serving calorie criteria as outlined below: Main dish <500 calories Side item <250 calories Meal <800 calories Soup (8 oz.)<225 calories Desserts/breads<200 calories Snacks <200 calories Condiments< 75 calories Beverages -water, sports drinks, diet sodas, juice drinks <50 cal/ 8oz -milks and coffee drinks <100 cal/ 8oz -100% juice no cal limit; 12oz max

11. 10 Spirit of Healthy Offer fruits, vegetables, whole grains, lean meats and fish, and vegetarian options; and use health- promoting food preparation techniques. The impression should be that healthy foods and beverages predominate.

12. 11 Calorie Labeling

13. 12 Price Leveraging 25% average variance Healthy Entree $2.54 Less Healthy Entree $3.44 Fried Chicken Breast $2.47 Baked Chicken Breast $1.83 Regular Bottle Soda $1.71 Diet Bottle Soda $1.39 Side Dishes reduced from $.99 to $.84 (94% healthy) Fish Entree reduced from $3.29 to $2.80 Salad Bar reduced from $.32 to $.26/ounce Whole Fruits reduced from $.70 to $.60

14. 13 Communication Cascaded by leadership Toolkits & Webinars –Vendors –Event Planners System communication channels Early adoptors & demonstration from board meetings to employee forums

15. 14 Keys to Success Leadership engagement & buy-in System-wide steering committee Specialty work groups – Finance, RD’s Written into policy Cascaded by leadership Communication Early engagement of vendors Baseline data captured to monitor impact Linkage to resources such as NC Prevention Partners Shameless plagiarism of other’s best practices

16. 15 Next Steps Consumer education Monitoring compliance until hard-wired into the culture Monitor impact –Sales –BMI

17. Acknowledgement Vidant Nutrition Initiative Healthy Food Environment Steering Committee Kathryn Kolasa PhD, RD, LDN, Vidant Nutrition Consultant May 2012 16

18. 17 Questions