Assessing the hospital cafeteria environment and vending machines in the County of Los Angeles, 2015

Introduction: In 2014, the Los Angeles County Department of Health Services (DHS) released a Request For Proposal (RFP) requiring the selected vendor to implement healthy nutrition standards and practices (targeting cafeterias and vending machines) in all four safety-net hospitals in Los Angeles County. The resulting vendor contract is estimated to be worth more than $20 million dollars. In preparation for implementation of this institutional policy/practice change, the local health department is conducting a series of environmental scans of the hospital cafeterias and vending machines to monitor compliance and promote quality improvement activities downstream.

Approach: Two distinct environmental scan tools were developed to capture changes in nutrition standards and other healthy procurement practices in the DHS hospital cafeterias and vending machines. Baseline and subsequent follow-up assessments are being conducted using these tools. For the cafeteria setting, the internally tailored cafeteria environmental scan tool collects information on food access, nutrition, pricing, placement, promotion and nutrient information. A validated tool was adapted to assess product adherence to vending machine nutrition guidelines.

 Results: Environmental scans are in progress, aligned to the RFP process, which is ongoing. When completed, baseline data will be presented to generate a profile of hospital cafeteria and vending maching food environments, pre-launch of the DHS food service contract.

Discussion: Hospital food environments can potentially play a key role in combating obesity among hospital employees, patrons, and the surrounding community. Results to be presented from this pre-implementation assessment will inform forthcoming program improvement changes to hospital food environments.