Challenges of implementing a healthy choice vending intervention

Health behavior change is very difficult without access to the appropriate tools and supports. Vending machines with healthy food and beverage options are one support for dietary behavior change. A large manufacturing company implemented a healthy choice vending intervention as a diet and nutrition component of a broader environmental behavior change program addressing obesity. Twelve sites participated in the study including nine intervention sites and three control sites. Healthy food and beverage choices were identified by calorie, fat, and sugar content, then were stocked and labeled in the sites' vending machines. The goal of the intervention was to have 25% of food items and 40% of beverage items per machine fit the healthy criteria. Despite high levels of employee awareness, participation, and dietary behavior change during the first year of the intervention, there were notable challenges in implementing the intervention. Most intervention sites implemented differential pricing for healthy versus unhealthy food and beverage items, labeling, and communications; whereas, the biggest challenges were the varying definitions of healthy foods and implementation fidelity across multiple sites. Potential improvements for the intervention that may help overcome the challenges include management of vending suppliers and garnering sufficient site-leadership support.