Online Program

Does policy create healthier beverage environments in small semi-rural communities?

Tuesday, November 3, 2015 : 9:10 a.m. - 9:30 a.m.

Sallie Yoshida, DrPH, RD, The Sarah Samuels Center for Public Health Research & Evaluation, Oakland, CA
Soledad Drago-Ferguson, MPH, The Sarah Samuels Center for Public Health Research & Evaluation, Oakland, CA
Heidi Skolnik, PhD, MA, The Sarah Samuels Center for Public Health Research & Evaluation, Oakland, CA

Consumption of sugary beverages is linked to the obesity epidemic. A focus of CA4Health was to reduce the consumption of sugary beverages in 12 small low-income counties, by implementing 4 site-specific healthy beverage standards. This study assessed beverage offerings before and after the standards were implemented.

Public Health Department staff were trained to collect data in 2012-2014.  Forty-seven settings across 9 of the 12 counties were observed at both time points. Using SPSSv21, data was analyzed using two approaches; one used ‘beverage’ as the unit of analysis and the other used ‘setting’ as the unit of analysis.


Eighty-eight venues were observed at baseline and 72 at follow up; the majority were vending machines (82% and 85% at baseline and follow up, respectively). At baseline, 31% of all beverages observed (427 of 1361) adhered to the respective site-specific PHI standard; at follow up, adherence increased to 38%. The 23% increase in adherence in schools (from 33% to 56%) was mostly attributed to a sharp decline in sports drinks. At baseline, the average percent adherence across all 47 sites was 39%; at follow up, the average increased to 67%.  The change was statistically significant at p<.001 (t=6.21; df 46).


These findings suggest that healthy beverages guidelines can have a positive impact on the healthfulness of beverages sold and/or offered in community and workplace settings. The CA4Health communities have worked collectively to create environments that will support healthy beverage choices, and ultimately reduce obesity and its related health impacts.

Learning Areas:

Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the importance of healthy beverage policies in creating healthier food environments Compare the level of adherence of beverages to the standards from baseline to follow up in various settings. Explain the increase in adherence to the beverage standards in various settings.

Keyword(s): Policy/Policy Development, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on this research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.