m-neat ACTION PLAN TOOLKIT: VENDING OPERATIONS

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m-neat ACTION PLAN TOOLKIT: VENDING OPERATIONS BACKGROUND: Healthy vending can play an important part in encouraging healthier food choices on your installation. Vending machines are a popular vehicle for convenient snack foods and beverages for many people. This makes for an excellent opportunity to help fuel our warfighters with optimal performance-based foods and beverages. However, vending machines are often a source of less-than-healthy products. Many options are high in calories, fat, and added sugars, and are low in nutrients. Examples are candy, soft drinks, chips, cookies, and cakes. Offering nutrient dense foods, such as dried fruit or yogurt, can help individuals make better choices. NUTRITIONAL STANDARDS FOR VENDING The new Health Care Reform Law requires chain vending machine operators to clearly disclose calorie amounts for their vending items. 1 Various government agencies and some vending companies have developed nutritional guidelines to evaluate foods and beverages related to vending operations for a variety of nutrients. The m-neat Healthy 2, 3, 4 Option Criteria are based on a number of these guidelines: Nutrient Total Fat Trans Fat m-neat Healthy Option Criteria <35% calories per serving (excludes nuts and seeds without added fats or oils) <0.5 grams per serving (excludes reduced-fat cheese) Sugar <35% <35% by weight of total sugars (excludes fruits, vegetables, milk) Sodium <230 mg per serving (snack items) and <480 mg per serving (meal items) Calories <200 calories per package (snack items) or <500 calories or less (entree meal)

Table 1: FIT PICK NUTRITION GUIDELINES OPTION/DESIGNATION: FIT PICK OPTION 1 35-10-35 FIT PICK OPTION 2 BASED ON THE ALLIANCE FOR A HEALTIER GENERATION INTENDED AUDIENCE GENERAL POPULATION/SCHOOLS THAT DESIRE A MORE LIBERAL CRITERIA SCHOOLS/YOUTH ORGANIZATIONS THAT WANT A CRITERIA FOR SODIUM, CALORIES, PORTION SIZE AND/OR BEVERAGE STANDARDS SNACK CRITERIA YES YES FAT SATURATED FAT NO MORE THAN 35% OF TOTAL CALORIES (EXCLUDES NUTS, NUT BUTTERS, SEEDS) NO MORE THAN 10% OF TOTAL CALORIES NO MORE THAN 35% OF TOTAL CALORIES (EXCLUDES NUTS, NUT BUTTERS, SEEDS) NO MORE THAN 10% OF TOTAL CALORIES OR LESS THAN 1 GRAM TRANS FATS NO GUIDELINE ZERO TRANS FATS SUGAR NO MORE THAN 35% OF TOTAL PRODUC T WEIGHT NO MORE THAN 35% OF TOTAL CALORIES SODIUM NO GUIDELINE NO MORE THAN 230 MG (EXCLUDES LOW OR NON-FAT DAIRY PRODUCTS) BEVERAGE NO GUIDELINES BUT OPTION 2 GUIDELINES COULD BE ADOPTED IN CONJUNCTION WITH OPTION 1 WATER MILK: FAT- FREE MILK OR LOW-FAT REGULAR/ FLAVORED MILK WITH UP TO 150 CAL/8 OZ JUICE: 100% JUICE WITH NO ADDED SWEETENERS; UP TO 120 CAL/8 OZ & MINIIMUM 10 % RDV FOR 3 OR MORE VITAMINS AND MINERALS

FIT PICK Healthy Vending Option FIT PICK is a national program developed by the National Automatic Merchandising Association which has also been adopted by Exchange Services world-wide. FIT PICK helps consumers by providing healthier items that are labeled according to a set of nutritional criteria based on recommendations of the American Heart Association (www.heart.org), USDA Dietary Guidelines for Americans (http://health.gov/dietaryguidelines/), and Alliance for a Healthier Generation (http://www.healthiergeneration.org/). There are two levels or options regarding nutrition guidelines: Option 1 and Option 2. The former is more liberal, while the latter includes additional guidelines for sodium, calories, portion size, and/or beverage standards and serves as a benchmark in the m-neat evaluation tool. Table 1: FIT PICK Nutrition Guidelines). A corresponding Fit Pick TM 35-10-35 Snack List is available www.fitpick.org) However, this list only identifies items that meet Option 1 criteria. FIT PICK does not currently have a snack list based on Option 2 criteria. The Center of Disease Control (in collaboration with the Government Service Administration and Department of Health and Human Services) is currently developing a tool to help vendors meet a stricter set of federal nutrition guidelines 2,3. In the meantime, you might find the Option 1 list as a good starting tool. GETTING STARTED A Sample m-neat Healthy Vending Action Plan Checklist (Attachment 1) is provided to help you begin. Garnering the most support for healthy vending on your installation will require collaboration with others, especially your Installation Commander and those that oversee all vending contracts on the base. Items on the action plan can be developed and assigned to key stakeholders and progress monitored as a part of your Installation Health Promotion Working Group meetings. Define and develop a coalition of key stakeholders. The first step is to develop a team of key stakeholders to include, most importantly, the Installation s Exchange Services Business Manager (SBM). The majority of vending contracts are usually managed by SBM. However, the National Association of Blind Merchants (http://www.blindmerchants.org) may also manage some percentage of vending machines on your installation. Other key team members may include the Health Promotion Manager, Human Resources Manager, Facilities Manager, Installation Food Service Officer, Installation Fitness Director, dietitian, Public Health Officer, and hospital Food Service Director. Include consumers to ensure their favorite products are

maintained. Determine if there are particular individuals or groups that oppose changes in vending as part of your discussion/team. Meet with your SBM and the installation s Contract Office to determine status of existing vending contracts. Determine if FIT PICK (or other healthy vending program) is in place and if so, the existing nutrition criteria and percentage of healthy vending items are currently required/offered. It may be possible to work with the existing vendor to add new product, add dedicated healthy vending machines, or work with the Exchange to identify locations that could be converted to healthy machines when contracts end. Increasing Percentage of Healthy Items While Ensuring Customer Satisfaction and Profitability. One of the most common challenges to implementing healthy vending is a perception by vendors that the items will not sell and will hurt profits. 5 This is understandable. However, research suggests otherwise. Although there may be an initial drop in sales when healthy items in a vending machine go over 25%, vendors have seen an increase in sales over time. Multiple studies have shown consumer acceptance and ability to increase the percentage of healthy items 6, 7 by up to 75% of choices 8 without negatively affecting sales. Currently, the Exchange requires that 15% of items in traditional machines meet FIT PICK Option 1 criteria. Military training sites are required to carry 50% FIT PICK products. Drastic changes may decrease consumer acceptance. Consider ways to gradually increase the percentage of healthy items over time. In order to optimize consumer purchases and product sales of healthy vending items: *Group healthy products together for easier identification. The industry recommends aligning all the healthy items on the right hand side. Use prime spots for items that you are trying to introduce. *Include as many different healthy products as possible in each machine, i.e. different varieties of chips, cookies, dried fruit, trail mix, granola bars, etc. Experience shows that two or three spirals filled with the same or similar products will not do as well as a variety of different products. *Avoid stocking the healthy version of a product in the same machine as the traditional version of the same product. Consumers tend to choose the traditional version when both are available. *Ask if the Exchange can coordinate with its vendor representatives to conduct product samplings as part of their promotional offers. *Include comment cards on the side of the machine.

Machine Placement. Meet with your SBM and Installation Food Service Officer to determine the best placement for machines. Lessons learned from installations who have paved the way are that squadron common rooms, PAX terminals, education buildings, and libraries are prime locations for vending machines. Additional locations to consider are the Temporary Lodging Facility (TLF), bowling alley, and MTF for those without midnight meals, etc. The Installation Medical Treatment Facility or Fitness Center serve as excellent locations to consider implementing dedicated healthful machines in addition to areas where individuals are working 2 nd or 3 rd shifts but do not have access to healthful meals. Pricing Strategies. One vending strategy to improve consumer selection of healthier items is to lower the cost of healthier items, increase the price of less healthy items, or a combination of both. A number of studies show that this strategy is effective and that vending profits are not negatively affected. 5,9 Current DoD policy, however, may limit the ability to adjust pricing to the degree necessary to observe a significant effect on consumer purchase behavior. Alternately, you might note whether the healthier snacks are priced higher than traditional versions of snack. Discuss possible pricing strategies with your SBM. Remember to include favorites which can be at a lower cost, such as graham crackers. Promoting Healthy Vending. Suboptimal marketing may cause an initial decrease in vending revenue. Work with your SBM to help promote your healthy vending program: *Implement signage, promote on payroll stuffer, and/or publish a series of articles in newsletters. *Conduct a product sampling event *Ask leaders to announce the healthy vending program at staff meetings or commanders calls Provide baskets of sample healthy vending products for break rooms or at staff meetings

ATTACHMENT 1: Sample m-neat Healthy Vending Action Plan Checklist This sample checklist is intended to help you get started and can also be included in your Installation Health Promotion Working Group (HPWG) meeting minutes. Suggested Action Items and Points of Contact can be modified as needed according to the needs of the installation and resources available. The FIT PICK Implementation Guide (FPIG at www.fitipick.org) also contains valuable guidance and tools. Suggested Action Items Define and Develop a List of Key Stakeholders Assess Current Vending Status See FPIG pp. 13-18: Step by Step Guide Contact Exchange Business Manager Contact Installation Contract Office re: Additional Vending Contracts i.e. National Association of Blind Merchants Suggested Point of Contact Officer Officer Status/Considerations Address the following: a. Current m-neat Vending Score/ Areas of Improvement b. Current Healthy Vending Contract/% Required Healthy Items Option 1 vs. Option 2 Requirements, Current Contract Expiration Date c. SBM/Vendor Concerns Expected Completion Date Conduct Healthy Vending Survey See Sample Worksite Vending Survey (Attachment 2) Conduct Taste Test IAW Current Vending Contract Agreement See FPIG pg. 47 Develop Grand Launch Establish new contract or modify IAW AAFES/contracting requirements See FPIG Launch Worksheet & Checklist pg. 61 Officer Officer Oversight Exchange Service SBM w/installation HPWG Officer Consider using an electronic survey tool or conducting a focus group Some vending operators may be reluctant to participate in sampling since this is not that common in the industry. The local Exchange may be able to coordinate and assist IAW the contract agreement. Choose a few pilot sites first before full implementation to assess compliance with standards, acceptance, and sales. Launch Items to include: Machine Stickers Exchange Service

Plan-o-grams Machine Set-Up Training to route drivers Press Release- See FPIG for Sample Press Release Appendix I pg. 51 Radio PSA, See FPIG Sample PSA Script, pg. 53 Monitoring See Sample Comment Card FPIG pg. 59 Marketing strategies See Sample Articles, FPIG pp. 54-55 Develop ongoing education campaign Collect, Track & Report Evaluation Measures 1. m-neat Vending Operations scores 2. Customer Satisfaction (See Sample Comment Card, FPIG, pg. 59) 3. Request Vendor Sales Reports comparing healthy vs. traditional products (if available) SBM Vendor Exchange Service SBM/Vendor Exchange Service SBM/Vendor Officer Officer Exchange Service SBM/Vendor IHPWG/Exchange SBM IHWPG Officer IHPWG Officer/Exchange SBM Ensure healthy items are stocked and priced appropriately. Document lessons learned. Note: It is not a requirement for vendors to share their customer satisfaction data or sales reports. It might help to focus on developing a good relationship with your SBM and vendor reps first and foremost.

ATTACHMENT 2: Worksite Vending Survey 1. Please tell us about yourself by indicating your rank/grade. E1-E4 E5-6 E7-E9 01-03 04-06 07 & Above Gov t Civil Service: Indicate Grade: Gov t Contractor Family Member/Retired Other: 2. How many times per week do you buy snack foods from the vending machine on your military installation while at work? (check from list) Less than once per week 1-2 times per week 3-4 times per week 5-6 times per week 7 or more times per week If you use the vending machine less than once per week, skip to question 14. Please answer the questions below if you use the vending machines 1 or more times per week. When making a choice at a vending machine, how important is: (MARK ONE BOX FOR EACH ITEM) 3 Trying a snack I ve never had before: 4 Snack taste: 5 Snack price: 6 Number of calories in a snack: 7 Amount of fat in a snack: 8 Amount of carbohydrates in a snack: 9 How healthy a snack is: 10 Watching my weight: 11 Value for my Not at all important Somewhat important Very important

money: 12 Buying my usual snack: 13 How hungry I am: 14. Where do you usually get your food for work? (CHECK ALL BOXES THAT APPLY) bring from home buy from nearby store and eat at work buy from worksite vending machines don t eat anything at work eat away from work 15. I would like healthy options in the snack food vending machine at work and on my military installation. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 16. If there were a variety of healthy snack food choices, I would use the snack food vending machine more often than I currently do. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree 17. On average, how much do you spend per week on the snack food vending machine? $0-$2.00 $2.00-$4.00 $4.00-$6.00 More than $6.00 per week SURVEY COMPLETE. THANK YOU FOR YOUR RESPONSES!

ADDITIONAL RESOURCES & REFERENCES FIT PICK Developed by the National Automated Merchandising Association (NAMA), Fit Pick helps consumers locate vending machine choices that support a healthy lifestyle. It is a simple, ready-to-use system of vending machine stickers that identify vended products which meet a standardized set of nutrition guidelines. Its comprehensive implementation toolkit includes an implementation guide, healthy product list, and marketing tools (stickers, clings, posters). www.fitpick.org. Centers for Disease Control and Prevention. Health and Sustainable Food Guidelines for Federal Concessions and Vending Operations. http://www.cdc.gov/chronicdisease/resources/guidelines/food-service-guidelines.htm. National Automated Merchandising Association (NAMA). NAMA is the national trade association of the food and refreshment vending, coffee service and foodservice management industries including on-site, commissary, catering and mobile. Its membership is comprised of service companies, equipment manufacturers and suppliers of products and services to operating service companies. The basic mission of the association is to collectively advance and promote the automatic merchandising and coffee service industries. http://www.vending.org. Alliance for a Healthier Generation is a partnership between the American Heart Association and the William J. Clinton Foundation as a response to the growing rate of childhood obesity. www.healthiergeneration.org 1 New Menu and Vending Machines Labeling Requirements. US Food and Drug Administration. http://www.fda.gov/food/labelingnutrition/ucm217762.htm. Accessed 1/19/2013. 2 HHS/GSA Healthy and Sustainable Food Guidelines (Federal Concessions and Vending Operations): http://www.gsa.gov/graphics/pbs/guidelines_for_federal_;concessions_and _Vending_Operations.pdf 3 Health and Sustainability Guidelines for Federal Concessions and Vending Operations: Q & A for HHS Employees: http://www.cdc.gov/chronicdisease/pdf/qa-foro-employees.pdf. 4 FIT PICK Toolkit: www.fitpick.org. 5 Healthy Vending Toolkit: Guide for Federal Healthy Vending Options. Centers for Disease Control/Dept. of Health & Human Services/Government Service Administration. 6 Gorton D., Carter J., Cvjetan B.; Ni Mhurchu C. Healthier Vending Machines in Workplaces: Both Possible and Effective. N A Med J. 2010 Mar 19; 123 (1311): 43-52. 7 French S.A., Jeffery R.W.., Story M., Breitlow K.K., Baxter J.S., Hannan P., Snyder M.P. Pricing and Promotion Effects on Low-Fat Vending Snack Purchases: the CHIPS Study. 8 Kimmons J., Wood M., Villarante, J.C., Lederer A. Adopting Healthy and Sustainable Food Service Guidelines: Emerging Evidence from Implementation at the United States Federal Government, New York City, Los Angeles County, and Kaiser Permanente. American Society for Nutrition. Adv. Nutr. 3: 746-748, 2012; doi:10.3945/1n.112.002642. 9 French S.A.., Hannan, P.J., Harnack L.J., Mitchell N.R., Toomey T.L., Gerlach A. J. Occup Environ Med 2010 Jan;52 Suppl 1:S29-33.