1. Healthy Vending Toolkit
Audience: teachers, administrators, post-secondary students, public health professionals, active living and recreation professionals, researchers, parents and community members, food service operators, vending operators
Presenter: Registered Dietitian or Health Promotion Coordinator
Length: 15 minutes
Location: Shaping the Future Conference
Outcomes
Materials needed/Introduction
By the end of this presentation participants will be able to:
Understand the scope of the research undertaken to develop the toolkit (ie: research objectives, methods, results and conclusions)
Understand that healthy vending helps promote a healthy eating environment
Describe what the purpose of the Healthy Vending Toolkit is, the audience it is intended for, and the contents/steps within the toolkit.
Have knowledge of some of the practical tools within the toolkit.
Know how to access and promote the toolkit through social media.
Presentation to be sent within 24 hours in advance to conference coordinators
Laptop and projector
Printed copy of notes pages
Handouts
HESH flyer with info on Healthy Vending Toolkit to be provided at conference booth.
This is general information and should not replace the advice of your health professional. Alberta Health Services is not liable in any way for actions based on the use of this information. This presentation may be not reproduced without permission. This presentation may not be changed without written permission from  Alberta Health Services (2015)
Developed by Registered Dietitians
Nutrition Services
2015

2. Outline Why Focus on Vending? Vending Research Project Toolkit
What is it? Who is it for?
What are the steps to make healthy vending a success?
Practical tools
Where can I find it?
Outcome:
Key Messages:
Facilitator Notes:
Review outline as above.

3. Why focus on vending? Vending machines are big business
Vending machines are widely available: schools, recreation centres, hospitals, and workplaces
Often available all hours of the day
Items commonly sold are high in calories but low in nutrients; not supportive to health of Albertans
Outcome: Understand that healthy vending helps promote a healthy eating environment
Key Messages: Vending machines are readily available, in many locations, at all hours. Providing healthy vending options helps support a healthy eating environment.
Facilitator Notes:
Vending machines are big business. In 2010, the average revenue from a Canadian vending business ranged from $30,000 to $5,000,000 per year.(2)
Vending machines are widely available, whether it be at school, recreation centres, hospitals, or workplaces so we have the potential to make healthy changes in all these environments.
The machines are available all hours of the day and may be the only food option available when other food operators are closed.
The items sold are typically high in calories and low in nutrients. These food can contribute to an increased energy intake (1-4) and these foods are not supportive to the health of Albertans.
References:
Wansink B, Sobal J. Mindless Eating: The 200 Daily Food Decisions We Overlook. Environ Behav [Internet] Jan 1 [cited 2014 Nov 24];39(1):106–23. Available from:
Government of Canada. Vending Machine Operators (NAICS 45421): Financial Performance Data - Canadian Industry Statistics - Industries and Business - Industry Canada [Internet]. Canadian Industry Statistics [cited 2014 Dec 15]. Available from:
Government of Canada. Body mass index, overweight or obese, self-reported, adult, by age group and sex (Percent) [Internet]. Statistics Canada [cited 2014 Dec 22]. Available from:
Government of Canada. Body mass index, overweight or obese, self-reported, youth, by sex (Percent) [Internet]. Statistics Canada [cited 2014 Dec 22]. Available from:

4. Why focus on vending? Our environment impacts the choices we make
Outcome: Understand that healthy vending helps promote a healthy eating environment
Key Messages: Our eating environment affects the choices we make. Healthy vending helps make our eating environment a healthier one.
Facilitator Notes:
Did anyone notice the picture of this creamy, rich, chocolaty, dessert on the past couple of slides? Even a small picture can influence us to want something we had no intentions of eating. In our environment we are bombarded with temptations (click)… whether it be with treats at the holidays, (click)…. cake at a work party,
(click)…. or even going down the chip or cookie aisle at the grocery store.
The average person will make over 200 food decisions a day (1), and with so many unhealthy options, it can be very difficult to choose healthy ones.
Think about the last time you bought something from a vending machine, what was it?
Now I want you to think about the vending machines at your school or workplace, or even your recreation centre. What types of options are being provided?
If we can work towards improving our eating environment, then it will help all of us in improving our personal food choices that we make every day. Healthy vending is one very important strategy to help improve our access to healthy foods and make our eating environment a healthier one.
References:
Wansink B, Sobal J. Mindless Eating: The 200 Daily Food Decisions We Overlook. Environ Behav [Internet] Jan 1 [cited 2014 Nov 24];39(1):106–23. Available from:

5. Research objective and methods
Title: The window of opportunity for healthy vending: factors and barriers that influence adoption and implementation processes
Objective: To investigate what factors created the window of opportunity for adopting healthy vending (i.e., offering healthier choices in vending machines), and explore barriers and facilitators to the implementation process.
Outcome: Understand the scope of the research undertaken to develop the toolkit (ie: research objectives and methods)
Key Messages: This research project helped to inform the development of the healthy vending toolkit.
Facilitator Notes:
Title: The window of opportunity for healthy vending: factors and barriers that influence adoption and implementation processes
We wanted to ensure the toolkit we developed was evidenced based and reflected the needs of the target audience. To do this, we did an exploratory qualitative study. We conducted telephone interviews with key stakeholders in vending from recreation centers, school foodservices, workplaces and vending companies. The interviews were conducted by our vending working group and we used a semi-structured interview guide.
Objective: We investigated what factors created the window of opportunity for adopting healthy vending in diverse facilities (i.e., recreation centres, schools and workplaces) or by vending companies. We then explored what barriers and facilitators existed in the implementation process.
We submitted this research to be published because we noticed a lack of vending information on barriers and facilitators to healthy vending in the published literature. Research submitted to the Journal of Nutrition Education and Behavior (JNEB) in August of 2015.

6. Research objective and methods
Design: Exploratory qualitative description was used in this study. Telephone interviews were conducted using a semi-structured interview guide.
Setting: Facilities (i.e., recreation centres, schools and workplaces) and vending companies across Alberta.
Participants: Twenty-two stakeholders representing diverse settings were interviewed.
Outcome: Understand the scope of the research undertaken to develop the toolkit (ie: research objectives and methods)
Key Messages: This research project helped to inform the development of the healthy vending toolkit.
Facilitator Notes:
Design: Exploratory qualitative description was used in this study. Telephone interviews were conducted using a semi-structured interview guide.
Setting: Facilities (i.e., recreation centres, schools and workplaces) and vending companies across Alberta, Canada.
Participants: Twenty-two stakeholders representing diverse settings were interviewed.
Phenomenon of Interest: Adoption and implementation of healthy vending.
Analysis: Interviews were audio-recorded, transcribed, and inductively analyzed using qualitative content analysis.

7. Research results Barriers and facilitators
Stakeholders were personally motivated by their own health, children and families and that it was the “the right thing to do”.
Vending had to align with their organization’s mandates or nutrition policies
Implementation of healthy vending was a complex process
Implementation required balancing barriers and facilitators
Outcome: Understand the scope of the research undertaken to develop the toolkit (ie: results and conclusions)
Key Messages: This research project helped to inform the development of the healthy vending toolkit.
Facilitator Notes:
(Review a few barriers and facilitators to change)
Barriers to change included:
low availability of healthy products that fit in vending machines
have English/French label (mandatory in Canada)
procurement at a reasonable cost
stakeholders described that healthy products were often less palatable and expired faster
stakeholders reported decreased profitability in healthy vending, and increased time demanded to procure and try healthy products
more money had to be invested in new, more modern vending machines and company advertisement.
stakeholders described users’ perceptions and expectations as a barrier to implementing healthy vending (users expected to find familiar ‘treats’ in machines)
socio-ecological barrier was the food environment outside schools, recreation centers and workplaces
Facilitators to change included:
Tools and resources such as Alberta Nutrition Guidelines, Alberta Health’s Healthy U Food Checker, AHS resources (e.g., handouts, web pages)
Support (commonly referred to the guidance provided by dietitians in their area)
Engaging key stakeholders, such as users and vendors (having vendor buy in was crucial, and having users engage in taste testing helped in creating a smooth transition)
Senior administration support (ex. school principal)
Stakeholders who had adopted healthy vending commonly stated that they were personally motivated by their own health, children and families, and that it was the “the right thing to do”. Additionally, vending had to be aligned with their organization’s mandates or nutrition policies. Implementation of healthy vending was a complex process that required balancing identified barriers and facilitators.
These results impacted the development of our toolkit. Because implementation of healthy vending is such a complex process, we broke the toolkit down into easy to follow steps that highlighted key areas to focus on. We also developed many ready to use tools and checklists to keep you on track.
In our interviews, we commonly found that organizational mandate or nutrition policies were a catalyst for change that created a window of opportunity to implement healthy vending. So Step 6 in this toolkit is dedicated specifically to creating healthy eating environment policies.

8. Research conclusions
Nutrition policies and organizational mandate play a vital role in the implementation of healthy vending
These policies and mandates are important in promoting the health of individuals, communities and populations.
This study is expected to inform groups and organizations interested in adopting healthy vending.
Outcome: Understand the scope of the research undertaken to develop the toolkit (ie: results and conclusions)
Key Messages: This research project helped to inform the development of the healthy vending toolkit.
Facilitator Notes:
Conclusions and Implications: Nutrition policies and organizational mandate play a vital role in the adoption and implementation of healthy vending, stressing their importance in promoting the health of individuals, communities and populations. This study is expected to inform groups and organizations interested in adopting healthy vending.
And of course…the barriers and facilitators identified in this study helped to inform the development of a Healthy Vending Toolkit.
Keywords: vending machines, healthy vending, nutrition guidelines, nutrition policies, schools, recreation centres, workplaces.

9. Healthy Vending Toolkit
Purpose: The Healthy Vending Toolkit will help you offer healthier foods and drinks in vending machines.
Audience: For recreation centres, schools, workplaces, community groups and vending machine businesses
Provides a step by step process to implement healthy vending
Provides evidence-based strategies and practical tools throughout
Outcome: Describe what the purpose of the Vending Toolkit is and the audience it is intended for.
Key Messages: The healthy vending toolkit will help you offer healthier foods and drinks in vending machines. This resource is for recreation centres, schools, workplaces, community groups and vending machine businesses.
Facilitator Notes:
Review notes as on slide.

10. Healthy Vending Toolkit Overview
Introduction
Healthy Eating
Steps to make healthy vending a success (Steps 1-8)
Additional tools and resources
Appendix- User friendly forms and tools
Outcome: Participants to be able to describe content of toolkit.
Key Messages:
Facilitator Notes:
A. Introduction
Healthy Vending is a Vital Part of a Healthy Eating Environment
Once upon a “Healthy Eating Environment”…
B. Healthy Eating
What is Healthy Eating?
Eating Well with Canada’s Food Guide
Portions vs. Servings
Label Reading
Alberta Nutrition Guidelines
Healthy Eating Starts Here
C. Steps to Make Your Healthy Vending a Success
Getting Started
Overview: Steps to Make your Healthy Vending a Success!
Healthy Vending Checklist
Steps 1-8
D. Additional Tools and Resources
E. References
F. Appendices
1: Healthy U Food Checker Example
2: Sample Patron Letter to Support Healthy Vending
3: Vending Inventory Tool
4: Vending Environment Scanning Tool
5: Creating a Healthy Vending Action Plan
6: Vending Communication Plan
7: Healthy Vending Customer Pre-Change Survey
8: Healthy Vending Customer Post-Change Survey
9: Request for Proposal (RFP) for Vending - Healthy Product Specifications
10: Mapping Out Your Vending Machine
11: Food Safety in Vending Machines
12: Sample Healthy Vending Machine Guideline
13: Working with your Vendor
14: Customized Order Form
15: Sales and Trends Tracking Tool

11. your Healthy Vending a Success!
Steps to Make
your Healthy Vending a Success!
Outcome: Participants to be able to describe content of toolkit.
Key Messages: There are 8 steps outlined in the toolkit to help you implement healthy vending at your site.
Facilitator Notes:
Step 1: Build an Action Team made of individuals who support the changes.
Step 2: Assess your Vending Environment and identify priority areas for your site using tools such as the customer pre change survey.
Step 3: Develop an Action Plan and Set Goals Use the inventory, scan and survey to choose action areas and set goals.
Step 4: Create a Communication Plan Promote changes to customers, community, and local media.
Step 5: Create Vending Machine Guidelines to outline your plan.
Starting Your Guidelines
Types of Vending Machines
Percentage of Healthy Options
Recommended Percentages
Phase in Your Changes
Stocking Patterns
Types of Products
Portion Size of Products
Example Vending Machine Guidelines
Planograms
Working with Your Vendor: Contract Negotiation and Request for Proposal
Step 6: Create a Healthy Eating Environment Policy so all foods and drinks offered at your site follow the same standards.
Healthy Eating Environment Example Policies
Step 7: Take Action
Market and Promote Healthy Options.
Step 8: Evaluate and Celebrate Success
Reflect
Measure Progress
Make Your Healthy Changes Last
Celebrate Success
Success Stories

12. Step 5: Create Vending Machine Guidelines
Finding Healthier Options
Compare the product’s nutrition information to the ANG to find out what category it falls into.
Use the Healthy U Food Checker to classify products.
Non Refrigerated Options
Granola bars
Fruit bars
Energy bars
Trail mix
Pretzels
Cereal
Baked chips
Crackers
Cereal bars
Fruit cups
Squares
Tuna/cracker snack pack
Outcome: Participants to be able to describe content of toolkit.
Key Messages: You can determine if an option is healthy by using the ANGCY, these are good options to stock your vending machine with.
Facilitator Notes:
Since we do not have time to review all the steps, we will focus on what products to stock your vending machine with, and how to market and promote your healthy vending initiative (steps 5 and 7).
Step 5 will help you Create Vending Machine Guidelines that outline the types of foods to stock your vending machine with. We recommend using the Alberta Nutrition Guidelines for Children and Youth to determine what foods are healthier options to put into your vending machine. These guidelines use a 3 categories to classify food into either, “Choose Most Often, Choose Sometimes, or Choose Least Often”. The proportion of these three categories in your vending machine is up to your site. These examples may be healthier options:
Granola or fruit bars
Trail Mix
Cereal
Baked Chips
Crackers
Fruit Cups
Tuna
The type of vending machine used will impact the types of food and drinks that can be offered. All of these examples are non-refrigerated options.
You can also use the Healthy U Food checker to classify products…(next page)

13. Step 5: Create Vending Machine Guidelines
Granola Bar
Outcome: Participants to be able to describe content of toolkit.
Key Messages: The healthy U food checker will help you classify items into “Choose Most Often”, “Choose Sometimes”, “Choose Least Often”
Facilitator Notes:
The healthy U food checker is an easy tool to use online or on your smartphone, that will help you classify items into “Choose Most Often”, “Choose Sometimes”, “Choose Least Often”.
This tool will guide you through a few questions on the product. First you determine what food group the product belongs in. Then, you choose the correct food from the drop down categories, and then you enter in the nutritional information and the checker will automatically categorize the food item for you. If the item does not meet the “Choose Most Often” or “Choose Sometimes” categories, the checker will provide you with an explanation why. For example, it might say, sodium did not fall below 500mg.

14. Step 7: Take Action Promote Healthy Options Offer variety
Make healthy options appealing
Spread the word
Track sales to find hot sellers
Outcome: Participants to be able to describe content of toolkit.
Key Messages: Promoting and marketing your healthy vending initiative will help to make it successful.
Facilitator Notes:
To make you healthy vending initiative a success, it is important to promote and market your healthy options.
Promote Healthy options by:
Offering variety! The more healthy foods and drinks choices you offer, the more you will sell.
Make healthy options as appealing as possible. You can change the images on the front of the machines to ones that support a healthy lifestyle. You can choose healthy foods that have bright packaging and are convenient to eat. You can also offer feature items or new items regularly.
Conduct taste tests for new healthy foods and drinks
Spread the word and inform everyone at your site about the positive changes through:
Social Media
Newsletters
PA announcements
Memos, s or listservs
Newspapers
Bulletin boards
Posted on your website or online community bulletin
Regularly keep track of sales and find similar items to the hot sale items. Use the Sales and Trends Tracking Tool .
Having a coin machine next to the healthy vending machine may also make it easier for people to purchase the items.

15. Step 7: Take Action Use Pricing Strategies
Decrease the price of healthy options and increase price of unhealthy items
Offer promotional prices to build familiarity
Did you know?
Profits may increase long-term through:
People are more likely to choose healthy options, if choices are available, priced right, and taste good.
Outcome:Participants to be able to describe content of toolkit.
Key Messages: Potential loss of sales due to implementing healthy vending can help be offset with pricing strategies and alternative revenue sources.
Facilitator Notes:
When the idea of providing healthy vending options is brought to the table, one of the first questions typically asked is, “What impact will this have on sales and our profits?”. Often times, vending machines can be a large revenue source for sites so this is a very valid concern.
One strategy to help to help offset the potential loss in sales is to use pricing strategies.
Adjust for potential revenue impacts by pricing healthy items 10% to 50% less than unhealthy items. At the same time, increase the price of unhealthy items to offset any smaller profit margins on healthy foods or drinks. Offering a promotional price on one healthy feature item may increase its sales and build familiarity of that product among customers for repeat purchases in the future.
When schools calculated the revenue earned per vending machine customer, it was less than $4 per student (1). This amount could be easily generated by other revenue streams. In fact, sales from healthy foods in canteens have made up for vending losses in some facilities.(2)
It is also important to remember that some long term profits may not be accounted for in the short term.
Profits may increase long-term through:
Increased corporate profits
More loyal, healthier and productive employees
Healthier students or clients
Being a leader and role model for health
People are more likely to choose healthy options, if choices are available, priced right, and taste good.
References:
Center for Science in the Public Interest. The economic impact of national school nutrition standards on schools and the beverage industry. [Internet] [cited 2014 Dec 22]. Available from:
Wharton CM, Long M, Schwartz MB. Changing nutrition standards in schools: the emerging impact on school revenue. J Sch Health [Internet] May [cited 2014 Dec 22];78(5):245–51. Available from:
Healthier students or clients
Increased corporate profits
Being a leader and role model for health
More loyal, healthier and productive employees

16. Unhealthy products (CLO)
Revenue and Marketing
Make healthy choices visible
Healthy products
(CMO and CS)
Unhealthy products (CLO)
Place healthy food and drinks front and centre at eye level where they can be easily seen.
Outcome:Participants to be able to describe content of toolkit.
Key Messages: Ensure your healthy vending options are easy to identify and access.
Facilitator Notes:
It is important to make sure your healthy choices are visible. Where an item is placed in a vending machine can affect what a customer will choose. Place healthy food and drinks front and center at eye level where they can be easily seen. This picture also shows you how your vending machine might look in regards to the proportion of CMO/CS/CLO options provided.
This is an example of a vending machine with coloured sticker dots on each vending slot to show what category the item is in (Choose Most Often/Healthy Choice, Choose Sometimes or Choose Least Often). This makes it very easy for the customer do identify healthy options.
Where the machine is located is also a factor on what customers will choose. Customers often make purchases that are the easiest choice. Move the healthy vending machines to high traffic areas so they are more visible and easier to access.
Label foods and drinks that are healthy choices with a sticker or icon.

17. Practical Tools Sample Patron Letter to support healthy vending
Healthy Vending Customer Pre-Change and Post- Change Survey
Mapping out Your Vending Machine
Outcome: Participants to gain knowledge of some of the practical tools within the toolkit.
Key Messages: There are many practical tools within the toolkit to help you implement healthy vending.
Facilitator Notes:
To gain support for your healthy vending project we have a sample patron letter which could also be which can be adapted to provide to facility managers and vendors.
It is important to do an assessment before you implement healthy vending. Knowing how your customers feel about healthy vending can help you tailor your changes to best meet their needs. The pre- change survey can tell you what foods and drinks your customers will buy and what price points they will be comfortable with. The post- change survey will help you determine how well the changes are going and what areas need improvement.
It may be helpful to phase in healthy vending to promote a smooth transition for the site and to allow machine users more time to adapt to the changes. Plan to increase the percentage of healthy options each year. Use the Mapping Out Your Vending Machine tool to plan the percentage of healthy options for your site.
Does anyone know what a vending planogram is? (Allow for a few answers)….

18. Sample Planogram
Outcome: Participants to gain knowledge of some of the practical tools within the toolkit.
Key Messages: Planograms will help make healthier options more visible to consumers and it will provide a guide for the vendor to follow.
Facilitator Notes:
This is an example of a planogram. A planogram is a visual diagram that gives guidance about where to place food and drinks within a vending machine. It can be useful to help decide where to place your products and for vendors or employee to follow when stocking vending machines. A well thought-out planogram that considers where to place healthier options within the machine will make healthy products more visible to consumers and the first items they see.
Label the planogram with specific products and their category (CMO, CS, and CLO). It is important to monitor machines to ensure they are stocked according to specifications provided.
Include specific brands, flavours and item size in the planogram so that the vendor will know what products to put in the machine. Consider appropriate substitutes that the vendor can use if a product runs out.  
Please see below for an example healthy vending planogram for a non-refrigerated snack machine. This planogram contains 100% healthy choices, with all foods from the CMO and CS categories.
Refer to the Sample Planograms (Appendix 10) for examples of planograms with targets of 100%, 75%, or 50% healthy choices and the Build-Your-Own Planogram Tool (Appendix 10).

19. Practical Tools Food Safety Sample Vending Machine Guidelines
Working with your Vendor
Customized Order Form
Sales and Trends Tracking Tool
Outcome: Participants to gain knowledge of some of the practical tools within the toolkit.
Key Messages:
Facilitator Notes:
Food safety is always an important concern to ensure that customers are provided with safe food.
Vending machine guidelines are important because they contain the information and plan for your healthy vending initiative. We have included a sample vending machine guideline to assist you in developing a guideline for your site.
The working with your vendor list will help you identify important topics to discuss with your vendor such as goals, healthy choices to stock the machine, stocking patterns, pricing, and contracts.
Your vendor may wish to use the customized order form to help make the ordering process simpler.
The sales and trend tracking tool makes it easy to track and compare sales over time.

20. Key Points to Remember
The Healthy Vending Toolkit provides evidence based tools to help you adopt healthy vending programs at your site
Offers consistent and current nutrition information, strategies, and tools in one complete resource
Healthy vending can help make the healthy choice the easy choice
Outcome:
Key Messages:
Facilitator Notes:
Review key points as on slide:
The Healthy Vending Toolkit provides evidence based tools to help you adopt healthy vending programs at your site
Offers consistent and current nutrition information, strategies, and tools in one complete resource
Healthy vending can help make the healthy choice the easy choice

21. Where can I find the toolkit?
Outcome: Participants to understand how to access the toolkit.
Key Messages: Healthy vending toolkit is available on HESH website.
Facilitator Notes:
Direct audience through website and show where to locate Healthy Vending Toolkit on HESH website.

22. Questions Email your questions to: healthychildrenandyouth@ahs.ca
Outcome: Participants will have the opportunity to ask questions and understand how to promote the toolkit through social media.
Key Messages: Encourage participants to tweet about toolkit and follow AHS_behealthy.
Facilitator Notes:
Thank audience for their attention
Ask audience to follow us on
Ask audience to tweet about the healthy vending toolkit with the hashtag “HealthyVendingAB”
Additional questions can be directed
Follow us on Twitter
@AHS _behealthy
and Tweet us using:
#HealthyVendingAB
your questions to: