Product Details

Author Information

Corresponding Author
Maryann Mason
Consortium to Lower Obesity in Chicago Children (CLOCC)
225 E. Chicago, Box 157
Chicago, IL 60611
United States
p: 312-227-7026
mmason@luriechildrens.org

Authors (listed in order of authorship):
Maryann Mason
Consortium to Lower Obesity in Chicago Children

Lucy Gomez-Feliciano
Logan Square Neighborhood Association

Adam Becker
Consortium to Lower Obesity in Chicago Children

Christine Bozlak
University at Albany

Colleen Lammel-Harmon
Chicago Park District

Veronica Conti
Logan Square Neighborhood Association (intern)

Stefani Cox
Logan Square Neighborhood Association (intern)

Elizabeth Katta
Consortium to Lower Obesity in Chicago Children

Megan O'Boyle
Chicago Park District

Hatidza Zaganjor
Logan Square Neighborhood Association (intern)

Product Description and Application Narrative Submitted by Corresponding Author

What general topics does your product address?

Public Health

What specific topics does your product address?

Community health , Community organizing, Nutrition/food security, Program evaluation, Community-based participatory research

Does your product focus on a specific population(s)?

Urban

What methodological approaches were used in the development of your product, or are discussed in your product?

Case study , Community-academic partnership, Community-based participatory research , Qualitative research, Quantitative research, Survey, Interview, Participant observation

What resource type(s) best describe(s) your product?

Case study, Manual/how to guide, Reference material (i.e. annotated bibliography)

Application Narrative

1. Please provide a 1600 character abstract describing your product, its intended use and the audiences for which it would be appropriate.*

Healthier Snack Vending: The Chicago Park District Experience & Resource Guide is a "white paper" report and resource guide. It includes a detailed narrative account of the Chicago Park DIstrict's adoption of healthier snack vending practices and evaluation outcomes designed to assess staff and patrons' attitudes and perceptions of healthier vending snacks, vendor compliance and as revenue outcomes. Additionally, links to resources such as model documents to support healthy snack vending, vending nutritional guidelines and how-to tool kits for implementing healthy vending initiatives are included. The document is intended for use by policy makers, government employes charged with vending implementation and contract enforcement, public health practitioners involved with designing and evaluating healthier vending and initiatives and community organizations advocating for and supporting policy makers in the adoption of healthier vending policies.

2. What are the goals of the product?

The goals of the Case Study & Resource Guide are to share a) the experience and lessons leaned of a government entity that implemented a 100% healthy snack vending policy b) early outcomes from evaluation of these efforts including sales patterns and compliance issues and c) a variety of key resources that may provide other localities guidance in the development and implementation of healthy vending initiatives. These resources include links to descriptions of other municipalities' experiences, contract language, and evaluation outcomes that offer an opportunity to learn about issues/roadblocks encountered, solutions developed. We hope that through this learning process, product users will develop informed outcome expectations.

3. Who are the intended audiences or expected users of the product?

While the project was conducted in a park context, the information and findings in the product are applicable to a wider audience of policy makers, government employees, community organizations, and public health practitioners working in a variety of settings including schools, work sites, government offices, colleges and universities and other public spaces with snack vending machines. The product is also useful for those who are charged with implementing healthy vending policies (for example contracting departments) who are writing contract language for healthier vending initiatives and on-site employees with enforcement duties.

4. Please provide any special instructions for successful use of the product, if necessary. If your product has been previously published, please provide the appropriate citation below.

There are no special instructions for use of the document. The document has not been previously published.

5. Please describe how your product or the project that resulted in the product builds on a relevant field, discipline or prior work. You may cite the literature and provide a bibliography in the next question if appropriate.

Interest in environmental modifications to improve food environments that promote and support healthy behaviors is growing as the United States attempts to ameliorate chronic disease and obesity (1, 2). The Chicago Park DIstrict is a leader in this effort. Its efforts encompass a number of strategies for healthy food environments in Chicago parks. These strategies include use of park land for community gardens, improving the health of foods served at Park District events and implementing healthier snack vending. A recent article by Blanck et al (3) has highlighted to role parks can play in promoting healthy eating. THere is a growing recognition of this role among park districts as they consider all aspects of the food environment including catering, vending, concessions, mobile food carts and snack and beverage vending. Creating healthy food environments goes beyond parks and includes government entities of all kinds (municipal buildings, housing authorities, school districts, etc). In addition, private employers are considering these strategies for their worksites. While a variety of policies and positions are considered regarding these efforts, detailed information is limited about the process by which such policies or contracts come to be and the outcomes of policies enacted outside of interventions designed primarily for research. The white paper contributes to a gap in the literature by offering a detailed account of one government entity's experiences in enacting healthier snack vending through a competitive contracting process. It also provides early outcomes indicators regarding patron and staff reactions and sales revenue results. This document provides critical guidance within the context of real world implementation.

6. Please provide a bibliography for work cited above or in other parts of this application. Provide full references, in the order sited in the text (i.e. according to number order). .

1. Glanz K, Mullis RM. Environmental interventions to promote healthy eating: a review of models, programs, and evidence. Health Educ Q. WInter; 15(4): 395-415.
2.Parker L, Burns AC, Sanchez E, editors. Local Government Actions to Prevent Childhood Obesity. Washington (DC): National Academies Press; 2009. 125 p.
3. Blanck HM, Allen D, Bashir Z, Gordon N, Goodman A, Merriam D, et al. Let's go to the park today: the role of parks in obesity prevention and improving the public's health. Child Obes 2012; 8(5):423-8.

7. Please describe the project or body of work from which the submitted product developed. Describe the ways that community and academic/institutional expertise contributed to the project. Pay particular attention to demonstrating the quality or rigor of the work:

• For research-related work, describe (if relevant) study aims, design, sample, measurement instruments, and analysis and interpretation. Discuss how you verified the accuracy of your data.
• For education-related work, describe (if relevant) any needs assessment conducted, learning objectives, educational strategies incorporated, and evaluation of learning.
• For other types of work, discuss how the project was developed and reasons for the methodological choices made.

This project grew out of a Healthy Kids, Healthy Communities (HKHC) project funded by the Robert Wood Johnson Foundation and received additional support from a Community Based Participatory Research seed grant from the Alliance for Research in Chicago Communities (ARCC) a program of the Northwestern Clinical and Translational Sciences Award (CTSA). The Chicago HKHC supported implementation of healthier snack vending and other environmental change policies at Chicago Park District parks. The ARCC seed grant supported evaluation work for the project.
The evaluation was lead by a community Principal Investigator (Lucy Gomez-Feliciano, lead health organizer for the Logan Square Community Association) and academic Principal Investigator Maryann Mason (Evaluation and Community Research Director for the Consortium to Lower Obesity in Chicago Children). Evaluation implementation assistance was provided by a research assistants (RA)(Veronica Conti, Stefani Cox, and Hatidza Zaganjor, interns at the Logan Square Neighborhood Association) and Elizabeth Katta, an intern who was later hired as a CLOCC RA. An advisory group made up of Chicago Park District staff (Colleen Lammel-Harmon and Megan O'Boyle), CLOCC's executive director (Adam Becker) and policy and advocacy manager (Christine Bozlak), and representatives from COMPASS (the Chicago Park District snack vendor) guided the evaluation project. The Team (Co-PIs and advisory group) guided the development of evaluation questions, methods and interpretation of findings. Gomez-Feliciano played a lead role in developing and refining the evaluation questions. The evaluation questions are:
1. What are patron and staff reactions to the healthier snack vending items?
2. How have healthier snack vending sales changed during the course of the healthier snack vending contract?
3. What, if any, compliance issues have arisen and how have they been dealt with?
Mason led the evaluation design, incorporating quantitative and qualitative data. RAs (Conti, Cox, Katta and Zaganjor) collected all data. Qualitative data include: Semi- structured interviews with park staff at 10 CPD parks (out of a total of 106) with a snack vending machine located at their respective field house–1 staff member per park was eligible to participate. Participants were recruited from a sign-up list posted at each park. Questions included attitudes toward healthier snack vending, snack vending purchasing behaviors, observations of snack vending machine issues (stocking and functioning), and interactions with park patrons around snack choices. Each interview lasted between 20 to 60 minutes.
Observations of snack vending purchases from 10 parks were included to learn more about patron demographics and purchasing behaviors. Observations were conducted by RAs and were varied by day of the week and time of day to capture variation in purchasing behaviors. Observations noted: item(s) purchased and characteristics of the purchaser including age status; child, teen, young adult, adult; gender; whether the purchaser was alone, with child(ren) or with others such as teens, young adults, adults; and whether the purchased item was consumed immediately, given to another for immediate consumption, or moved away from the observation site before consumption. Observations were collected in the spring and summer of 2012.

Observations of machine condition (stocking), functioning, and vendor compliance to the nutritional guidelines of the policy were conducted by RAs and CPD management-level staff at a sub-sample of 4parks in the evaluation sample. Observations were collected periodically from the fall of 2011 to summer of 2012.
Quantitative data included a 16 question patron interviewer-administered survey fielded at 10 parks. Surveys were administered by RAs in English with persons 18 years of age or older.
Mason, with assistance from RAs analyzed data. The advisory group led discussions around findings interpretation.

8. Please describe the process of developing the product, including the ways that community and academic/institutional expertise were integrated in the development of this product.

The report was collaboratively developed through a project advisory committee. Co-Prinicipal Investigators Lucy Gomez-Feliciano (Lead Health Organizer, Logan Square Neighborhood Association) and Maryann Mason (Community and Evaluation Research Director, Consoritum to Lower Obesity in Chicago Children --CLOCC) took the lead in project design and authorship. Other members of the committee contributed information including recollections of events and issues, reviewed drafts and approved the final documents. Members of the committee include: Maryann Mason , Lucy Gomez-Feliciano, Colleen Lammel (Wellness Unit Manager at the Chicago Park District), Megan O'Boyle (Wellness Unit staff, Chicago Park District), Adam Becker (Executive Director, CLOCC), Christine Bozlak (formerly Policy and Advoacy Manager, CLOCC). The committee met throughout the project, on average on a quarterly basis to discuss project implemenation, research question development, data collection and analysis and report writing. Several major revisions during the course of the research were agreed upon by the advisory committee. These included the addition of data collection efforts (such as patron surveys) as well as analysis methods (different ways to present the data).

In addition, Q Dhang from ChangLab Solutions provided expert review. Several research assistant interns also contributed to the project, providing data collection, data entry and preliminary data analysis. These interns include: Veronica Conti, Research Assistant, Project Intern/LSNA; Stefani Cox, Research Assistant, Project Intern/LSNA
Elizabeth Katta, MPH, (began as an intern and later hired as a Research Assistant), Project Intern/CLOCC and Hatidza Zaganjor, MPH, Research Assistant, Project Intern/LSNA.

9. Please discuss the significance and impact of your product. In your response, discuss ways your product has added to existing knowledge and benefited the community; ways others may have utilized your product; and any relevant evaluation data about impact, if available. If the impact of the product is not yet known, discuss its potential significance.

The document was released at an event in November 2012 at which government representatives from a number of local municipalities in the Chicago area attended. Those in attendance indicated that the document provided helpful and practical guidence regarding bringing healthier snack vending to government building locations. In addition, one of the report’s authors, Dr. Christine Bozlak, has disseminated it to academic, public health practice, and government colleagues in New York.

10. Please describe why you chose the presentation format you did.

We choose the format to be accessible to those unfamiliar with traditional research documents. The target audiences are advocates and government entities who are typically interested in the practical aspects of policy implemenation. The document is formated as a narrarative case study in order to convey the practical concerns and chronology of events related to the implementation of this effort. The outcomes selected for investigation were also influenced by the concerns of these audiences and the report was designed to provide practical and readable outcomes for this usage.

11. Please reflect on the strengths and limitations of your product. In what ways did community and academic/institutional collaborators provide feedback and how was such feedback used? Include relevant evaluation data about strengths and limitations if available.

The strengths of the document are its narrative format and detailed presentation of the process of enacting healthier snack vending. This level of information is typically not provided and will be helpful to those trying to replicate these efforts in their own locations. The document is limited in that we are unable to report pre and post healthy vending changes in sales revenue, an outcome of interest to many. The document has strengths in that it analyzes multiple dimensions of healthier vending outcomes including patron and staff responses, sales revenue, popular items sold and possible issues interfering with vending sales including machine malfunctions and restocking issues. Consideration of the multiple factors impacting sales is helpful to those who may wish to write contracts controlling for some of the factors identified. The study is limited in that it draws on a small, but representative sample of the Chicago Park District's 474 parks.

12. Please describe ways that the project resulting in the product involved collaboration that embodied principles of mutual respect, shared work and shared credit. If different, describe ways that the product itself involved collaboration that embodied principles of mutual respect, shared work and shared credit. Have all collaborators on the product been notified of and approved submission of the product to CES4Health.info? If not, why not? Please indicate whether the project resulting in the product was approved by an Institutional Review Board (IRB) and/or community-based review mechanism, if applicable, and provide the name(s) of the IRB/mechanism.

The project was approved by the Lurie Children's Hospital of Chicago Institutional Review Board (IRB #: 210-14368). All of the project colllaborators (who also serve as co-authors) have been informed and approved of the submission to CES4Health.info. The project reflects the principles of community-engaged participatory research in that:
its lead Co-Investigators: Maryann Mason, PhD (academic partner) and Lucy Gomez-Feliciano (community partner) worked collaboratively to select the
the project's focus and evaluation questions were developed collaboratively by Mason and Gomez-Feliciano and further shaped by feedback from the project's advisory group. Ms. Gomez-Feliciano's leadership was particularly important in shaping the evaluation questions as she always framed discussions in terms of how the data could be useful to efforts to sustain and expand the healthier vending initiative.
When problems were encountered in the initial project focus, alternative solutions were developed by Mason, Gomez-Felciano and the advisory group. For example, when it became apparent that park staff felt they had little influence on patron's snack choices, we discussed how this information was helpful and what additional questions it raised . This led to the addition of data collection on snack vending purchases so we could develop a better sense of the characteristics of snack vending purchasers and use this information to guide the development of further inteventions if needed.

All involved members were offered and took the opportunity to review, comment on and revise drafts of the document.

The product from the project was presented at a dissemination event in which Co-PIs and the Chicago Park District participated in presenting the results and contextualizing the project.
Follow-up from dissemination efforts was handled by all members of the team.