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01-17-13 SUNY SPH 1
>> Hello and welcome to public health live, the third Thursday
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Today's broadcast is surgery beverages, why the fuss, and
what can do you about it? . We have speakers today from county
health and thank you for being here.
>> Thanks. >> We are excited for you being
here and before we get started we will hear from a doctor from
the food center on obesity and we heard from him about the
scope of this public health problem facing our nation.
>> There are concerns about beverages and sugar and the risk
for obesity and diabetes. There is study after study that shows
this relationship to be true, but there are concerns with
these beverages. They carry no nutrition at all. There is the
addictive potential for upon consuming sugar and the addition
of the substance -- high amounts in some cases, namely caffeine,
and you can see that the beverages are bad actors and
it's no surprise public authorities are worried about 2
them. Americans are consuming a lot more calories in beverages.
It used to be milk and water and beverages and now there are
categories like vitamin fortified waters and shorts
drinks and the link and there has been research about the
addictive properties with food and what is going on in the
brain when people are consuming these foods. There is a lot of
research on sugar and it can act on the brain like traditional
things of abuse like caffeine, morphine, *** and the
question is is it addictive enough to create a health
menace? When it I was a boy the drinks were small in portion ask
number and there were just a couple of them and they had
8-ounce bottles and people consume whatever is in a
package. It's unit bias and when I was a kid you had a coke
or peppy and the event was over and now the event isn't over
until they consume the 20-ounce bottle or bigger in some cases
and they're available everywhere, vending machines all
over the place. Gas stations are now eating opportunities.
Drug stores are eating opportunities and you see this
all over the place and given the portion sizes are larger makes
it not surprising that public health officials have turned
their eyes to these surgery beverages as enemy one.
>> He is a great resource on this subject but I know you're a
great resource too and I am excited from hearing from you
Ian. This topic there is too much to cover in the hour but
what do you hope that we cover in the time that we have this 3
morning. >> Sure Rachel. I would like to
talk about some of the resources that we use to conduct public
surveillance on sugary drink consumption and how the data can
be used to focus the public health plan, and also in the
context of doing this I want to demonstrate -- hope to convince
you ongoing data collection is important part of the public
response on these drinks. >> Now sounds like we have
interesting conversation ahead of us. Has there been research
done to demonstrate the problem we're talking about today?
>> Absolutely. There have been numerous studies in the past
decade demonstrating the association between surgery
drink consumption and negative health outcomes. These are
prospective longitudinal studies, analysis that combine
multiple studies together and they demonstrate clearly that
surgery consumption often described as one 12-ounce per
day and outcomes and obesity in children and adults and
cardiovascular disease and type two diabetes in adults. The
consistency of the findings, the quality of the studies, the
plausibility of the mechanisms linking health to these outcomes
have lead to why the experts have identified surgery drinks
are worthy of our attention. >> Sounds to me it's worthy of
our attention but is this ongoing or we are seeing people
consume more than they did. Why are we talking about it now?
>> It's clear that the number of calories has increased
dramatically and from 1977 to 2006 among adults per capita 4
there has been an increase of 120% in terms of the number of
kilo calories we consume and among children it's around
75 percent and this coupled with the research and literature has
shown this is a concern to address.
>> Those are astonishing numbers, 120% and when you put
it that way. >> The facts don't lie.
>> Absolutely. You wanted to talk about surveillance efforts
and can you talk about what goes into that process?
>> Public health surveillance is core primary function. It
refers to the ongoing analysis and determination and
dissemination of data to craft our public health response, and
in this case coupled with the data that we saw we saw there
was an acute need for us to develop our infrastructure
around this surgery drink and we could plan and track the success
of the health initiatives. >> Okay. What specific needs
are being addressed right now in the efforts?
>> Sure we start with the basics. One of the needs is
understand how this risk behavior varies across the
segments of the population, across the state and then over
time and in epidemiology this is referred to as understanding
something over place, person and time. Second of all there was a
need to understand some of the social demographics, the
behavior, environmental characteristics that continue to
and sustain the behavior, and then as we moved forward data is
vital for us to plan our public health activities and in the 5
long-term it's necessary for us to understand whether our
investments and initiatives are contributing to a solution, so
the changes should this behavior over time data is essential.
>> Sure. It certainly makes sense to me. Now let's talk
more specifically about surveillance efforts in New York
State focused around this subject.
>> Glad to do it. So to establish surveillance around
this issue we developed a system and the BBRS is an general
survey that represents collaboration between states our
partner, CDC, so the report is a random digital telephone survey
of households and cell phone only residents. It's sampled
that such the data allow us to project on to what the
population of adult has and in this case we will be talking
about data with children as well. It's a data system we
have used in the United States for 30 years and and this would
expand this existing resource. >> Great. So it sounds like a
comprehensive study. It's been going on for some time. What
can you tell us about some of the questions asked in the
survey? >> Great. I would like for
context talk about two questions that we have measured, so the
first question that should be on the screen, measures, are
regular seeda consumption and the doctor referred to it's not
just soda. It's the other surgery drinks and we catered
our questions to make that distinction. Now they were
asked of every adult that participated in a study and also 6
adults that had a child over 18 in the household they were asked
to answer the questions about a randomly selected child, and
again because of the design of the survey and our ability to
weigh the data we could do that with the adults and children
about their sugary drink consumption habits.
>> Interesting. What are some of the results you were able to
get from those? >> The data indicates 30
indicators and one is one or more of daily soda and the
consumption of one or more of other surgery drink and the
latte bar and adult and children and one or more surgery drinks
or regular sodas per day, and starting with the left side of
the graph starting with the left and one or more is more
prevalent among adults than children, but when you look at
the consumption of the other surgery drinks per day you can
see that the prevalence is more common among children under 18
than adults. >> Which is some interesting
findings and I think you have another chart that tells us more
of the relationship to age to consumption of surgery beverages
as well. >> Absolutely. So if we break
down age a little more let's focus on the data with children.
Even with children two to five years old daily consumption
about 25% consume one or more surgery drinks per day and
increases to 40% of the kids two to 17 years of age. Shifting to
adults consumption is most frequent among the younger age
segments and decreases in a linear fashion over time so 7
least prevalent among adults 60 years and older, so again what
this provides us is information about who in the population are
consuming these beverages. >> Right. So in addition to
looking at variances by age did you find there were differences
in terms of gender and consumption of surgery beverages
as well? >> We looked at this and it
defers with adult and children and there is no difference among
boys and girls but among adults we do find that adult males are
more frequent consumers than female.
>> What about -- did you find differences in race or ethnicity
or income level? Did that affect the consumption of
surgery beverages? >> We did and like so many
health risk behaviors we found differences and disparities and
race and ethnicity and household income and look at race and
ethnicity consumption is higher when compared to Non-Hispanic
whites and we see a similar gradient of consumption and it
was prevalent with a house household increase on the lower
end and these are the populations in need.
>> Right. That makes sense and we --
>> In their population. We don't have the resources to
address the entire population always with our interventions
and surveillance data identifies where the need is greatest.
>> Excellent. You provided us with specifics and information
so far. Can you summarize some take away points from the data
you provided? What are key things the audience should focus 8
on? >> I am glad to. Starting out
we find it striking when looking at surgery drink consumption by
children it's three more prevalent than the consumption
of regular soda so in terms what are the surgery drinks they're
drinking? It's these other ones, not soda. We think it's
also looking across the entire age spectrum. Consumption is
highest among children from 12 to 17 and tails off with adults.
Again among adults consumption is more frequent with males than
female and looking across our entire population as I have
stated before consumption is greatest among youngest adults,
adults of Hispanic ethnicity and also that have lower household
income, so I've been able to talk a little bit about the data
we collect on consumption and why we think it's vital and
planning our programs and long-term tracking the success
of our initiatives. I would like if I could talk about some
of the other data collection efforts that we under take and
project again how it influences our public health action.
>> Sure. >> So when we look at surgery
drink data it is clear that as a population we're over consuming
these beverages and excess calories they have with them.
What isn't clear, and again it's been stated in a number of
important scientific articles is that what we refer to as the
beverage environment plays a critical role in influencing
this behavior, and also explaining some of the
disparities that we see, so looking at it as Kelly Brunel -- 9
Dr. Brunel had stated, these sugary drinks are ubiquitous.
They're highly available and promoted. They come in the
large container sizes. When we're thinking how to deal with
an individual behavior like surgery drinks from a public
health perspective it's important to recognize and
remember that this is rooted in the environment, and to address
this individual behavior makes sense to look at beverage
environment as a potential for intervention.
>> Sure. So if there are these different factors, both the
individual risk factors and considering the environment that
the beverages are promoted in or available in, what's the best
method -- I mean as a public health official what is the best
way to really address this problem?
>> Well, one way to think about the spectrum of activities that
public health take on is in terms of a pyramid and we can
think of the public health event to about thing like surgery
drinks on the top reflects the more intensive person to person
activities. As we move down the pyramid the expectation that
activities can have more impact of their ability to reach larger
segments of the population. It has always been historically the
goal of public health to work at this environmental level and
take action to make the default behavior a healthy one, so in
the case of surgery drinks this means taking on activities that
reduce the availability and the promotion and promote healthy
choices as water as alternatives. 10
>> Today we're talking from a public health perspective and we
see the value in this. Is there research about the general
public and do they have opinions on the issue?
>> We collect that as well but unfortunately I don't have time
to talk about all of the activities we do to assess the
surgery drink environment but I would like to focus on some of
the activities and data collection that we have done to
support actions to reduce the prominence of surgery drinks and
promote health alternatives and data around the harm of the
surgery drinks and how it relates to the data, so the next
thing I would like to talk about is a public opinion poll that
was conducted in conjunction with a research institute. It
was completed on about 1200 residents and sampled to produce
population estimates with a relatively high degree of
precision, two -- >> Can you share the information
on the screen? >> I will. And we show the
appropriateness of children consuming different types of
beverages, not just sugary drinks but a number of them.
And they were asked about the health and harm for children
from two to 12 and the question was worded to ask about whether
they thought there was a harm or benefit for a child drinking one
or more of these beverages per day.
>> Okay. When asking the question what did the results
show? What was the general public's opinion on this?
>> On the display you see beliefs on this and we see this 11
data but when looking at sports drinks a much larger segment of
the population, 41%, indicated they would see -- only 41
indicated it would be harmful for a child two to 12 to consume
one or more of the beverages per day. Again on the other side of
the spectrum only 1% indicate that there would be a health
benefit for consuming more than one per day and when talking
about sport drinks 20% thought there could be a health benefit
and this is a striking difference and the caloric load
is similar so in terms of moving this forward we saw this
discrepancy an important opportunity for messaging.
>> Yeah. It seems like an important message to me and the
marketing promotes it differently and you think a soda
more harmful than a sports drink.
>> Absolutely. >> And it shows interesting
relationship to age to what types of drinks children are
consuming and goes back what what you were talking about
earlier. Can you expand on that?
>> Sure. Looking at the data that we collected if you recall
I pointed out what children are drinking regularly and there is
this disparity children are drinking these other surgery
drinks more than soda on a routine basis and we think there
is a clear connection between these findings and the polling
data, so it's very evident that adults and parents view these
sports drinks as being different, and again as we
refine and think about addressing surgery drink 12
consumption it's very clear if we want to address it among
children we need to tackle this understanding that sports drinks
somewhat represent a healthier alternative to soda.
>> And then did you also ask questions about people felt
restricting access to the surgery beverages?
>> We did. Again one way we could shape or change the
environment is restricting access to these beverages and
clearly the data says if we're going to focus on a population
it would be children, so we asked children that ascertained
the public's opinion about banning the sales or restricting
serving these drinks in key settings, child care settings
and elementary and middle and high school and we asked
questions about this assessing the public's support for taking
action to restrict these beverages in these settings.
>> And what kind of things did you find in conducting that
survey? >> Well, we found that overall
with the exception of high school there was strong support
for the public taking action and school districts to ban the
sales of these beverages from elementary and middle school,
and then also restricting them from child care setting so there
was strong public support for taking action to change the
sugar drink environment in these settings.
>> Interesting. So on the flip side of that we see there is
support for restricting access, but you also looked at the other
side and not just restricting access to the unhealthy choices 13
but promoting access to healthy choices. Can you talk about
that? >> Absolutely. Like I said the
environmental approach is make the default action the reaction
that we do everyday, the healthy choice, and one way this could
be done is through kids' meals and we asked the question
whether the public is supportive of making the default with the
meal be a healthier alternative and not include soda or sugary
drinks or these sports drinks. >> What did you find?
>> You sought overwhelming majority, 62% of the public,
supported taking this action and we found that support was
particularly high among ethic and racial minorities and low
income New Yorkers and we think this is important because the
data suggests this is a group that tends to be a consumers of
fast food and looking at the data they're consumers of these
drinks. >> And Ian there is no much data
that is helpful. Is there a way to sump rise the information of
the main message. >> Sure. To focus on three main
messages. One it is evident that sports drinks and other
drinks are viewed differently from soda and again to reiterate
this is an important challenge for the public health messaging
and education work. Second, it's very evident that the
public supports school districts taking action to remove and
banning the sales of these drinks in elementary and middle
schools, and also restricting them from being served in child
care settings, and finally we do find strong public support for 14
taking action to make sure that the beverage that accompanies a
kid's meal is a healthy alternative and in particular
support was strong in the population of fast food
consumers and these drink consumers.
>> Thank you. I am sure the viewers find this interesting
and if people want more information on the topic are
there resources that you recommend people visit to find
out more? >> With respect to the data I
presented today the web links shown here show some of the
broader topics for children and adults. They're available on
the website. I included a link from other reports. We track
other health behaviors, receiving the flu shot,
colorectal screening and that is there and those that want to
access the raw data on drink consumption I included a drink
to the metric website off of the public health website and those
that are research oriented could download the files and the
documentation that we use and repeat or conduct additional
analysis on the data we discussed today and as usual my
Email and contact information is available as well. They keep me
busy but I am always responded to inquiries.
>> Thank you very much. You painted a vivid picture of what
it shows. And we will talk to Dr. Kelly Brunel as we look at
efforts around the nation with these beverages.
>> There's a lot of activity going on around the United
States and the countries outside the U.S. to dissuade consumption 15
of these beverages. There are educational campaigns. There is
the famous one New York City did but lots of other places are
doing them too to discourage consumption of the beverages.
There are programs around the country getting rid of them.
The schools were the first front ear and national legislation
will kick in soon and what can be sold to get rid of the
beverages. The Mayor of Boston declared it's not a good idea to
sell things that make people sick on government property so
the beverages are out. Hospitals around the country
are getting rid of these beverages and this is a tide
that I think is sweeping the nation so I expect the companies
will have a problem dealing with this and they will try to
respond by marketing aggressively and push people
away from the beverages but again they might be akin to the
way we look at tobacco and it's not good and the next
generations will be drinking far fewer of these things than you
see today. My colleagues have under taken extensive research
on the food products marketed to children and produced a report
on this and the beverages for children and the picture is
appalling. There is no much unhealthy marketing to kids it's
no surprise they're drinking these in large amounts and
they're not just the things that we consider and soda, but it's
all the sugary drinks marketed to kids and Capri Sun and
Kool-Aid and they're big players in this. There was a report
several years ago by leading nutrition experts how much 16
physical activity you needed to do to replace the electrolyte
replacement and what the sports drinks are about and said it
would take 100-mile bike ride so the fact they're aggressively
marketd and the kids are thinking they're healthy for
them and the vast majority aren't doing enough activity to
merit these drinks is a real concern, and kids may feel like
when they drink these things they're given a free pass that
they have magical properties that you're just consuming sugar
water with things that aren't necessary for them. That's a
real concern. >> So Melanie we heard from
these experts and I would like to hear from you now. You're
representing Rocklyn County and good to get information
specifically what you're doing locally and how did you get
involved working on this issue? >> Within our division of health
promotion education in our department we focus heavily on
chronic disease prevention and obesity and this has been an
effort over the last few years and we were lucky to receive a
grant from the New York State association of county health
officials and that grant focused specifically on reducing sugary
beverages in our community so it's at that point we began
addressing this issue more comprehensively. Since then we
incorporated it into the work site wellness program and create
policies and environments that create a healthy work place so
in this case promoting healthy beverages. This work has been
something we're submitted to and we plan to sustain in our 17
organization. >> Excellent. It's great to
hear about organizations taking steps try to promote health.
Now one of the things you did in your campaign what you mean by a
sugar sweetened beverage and it's not just the soda so talk
about what beverages you were talking about?
>> Yeah, this an important piece of the educational effort so the
public hears things in the media like the soda tax and ban so
they are aware soda falls into this category of sugary drinks
but we found misconceptions about the other beverages and
that seems similar to what Ian presented on the public
perception so we made sure to discuss the different drinks and
they include the drinks and sports drinks and energy drinks
and many of the fruit drinks have no fruit in them whatsoever
but the public tends to get confused by that and sweetened
coffee beverages and any beverage that contains added
sugar. >> Yeah, the first point of
clarifying what do you mean and I know for myself it's a
misconception about what things we're looking at, what falls
into that category. Now, you defined what you meant by that,
and where did you go from there? What were the goals of the
campaign? >> The over arching goal was to
reduce the availability of these beverages in the community and
included three activities. First we wanted to implement
awareness around these beverages. We wanted to educate
our employees and the public why this was an important topic to 18
address. Secondly, we wanted to improve and modify the vending
machines within the county owned buildings. We wanted to make a
positive impact on employees and visitors and serve as a role
model for the changes we would like to see in the community.
Lastly we wanted to partner with other sites, particularly
employers in the county and support environments that
promote healthy options. >> Great. Let's talk about the
first objective you mentioned about the media campaign. Can
you talk about what was involved?
>> Sure. So we started the development by partnering with
New York City to use and modify their very successful applying
the pounds campaign and I am sure the view ares have seen.
It's an excellent campaign so we signed an agreement with New
York City and provides access to all of their materials so used
our grant funds to hire a consultant and modify the
materials and customize them to our needs in Rocklyn County. We
created additional materials that utilized similar concepts
from the campaign as well. >> Can you describe some of the
different components of the campaign you implemented?
>> Sure. I also wanted to mention if a company or
organization wants to use New York City's materials they can
contact New York City. It's the health media and marketing
division and they can complete the same type of form we
completed and will have access to the materials so it's a great
resource for organizations to get some free materials on this 19
topic. >> Yeah. That sounds like a
great resource and I am glad you mentioned that and certainly
everyone wants the most *** for the buck to get the word out and
that is a great opportunity for other organizations.
>> Absolutely. In terms of the components for the campaign we
tried to utilize different components to reach different
segments of the population as we can. We printed in English and
Spanish and fact sheets and posters. We created small cards
that show case the calories in common beverages and since we
developed those materials about a year ago we displayed or
distributed over 5,000 pieces of them so there has been quite a
demand from our community to share those materials which
we're very happy about. Another component of the campaign
included visual and audio advertisements within our county
buses so that element did have a cost associated with it, but we
were able to place brochures in a unit behind the driver and we
got to do that for free and for other municipalities it's worth
looking into. We got a lot of great testimonials from that
campaign and particularly health providers and patients were
mentioning the ads and they were telling us so we were pleased to
get that feedback about that portion of the campaign. We
also did advertisements on the entrance and exit doors as well
as on the directors of the palisade center. That is I
large mall in Rocklyn County and we did that during the holiday
season last year so as a result we got a lot of traffic and 20
views because of the timing of the year, and the last element
we worked with New York City commercials and included the
local information at the end and played those on a variety of
television channels in our area and again that piece did cost
money but the clips are readily available on the internet so I
encourage other places to post them on their website or posting
on their Facebook and getting that message out.
>> Great. And looking at the visuals and what is available on
the hand outs seems like great resources for organizations to
use and I have seen the commercials myself and we're
going to take a moment and I would like the audience to view
one of the commercials to see how effective these media
materials are. >> I really do love those
commercials. I think it's such a great way to visualize to show
how much sugar is actually in one of those beverages and it's
an abstract concept but when you put it out there like that it's
appalling to see someone downing 16 packets of sugar.
>> Sure. >> In addition to the
commercials and the best promotions and you did point of
purchasing messaging. Is that correct?
>> Yeah. We placed the messages in a location where an
individual is faced with the decision what to buy and we
placed these decals. We placed them on all of the county
vending machines and we display posters near the machines. We
put both of items on the fridge in the employee kitchen and in 21
the cafeteria and next to the fountain drink and put them in
places where people are deciding what to consume and we did this
and many did. >> That sounds like an excellent
idea. Now, in addition to putting the message out there,
hey make the healthier choice; you modified what is in the
vending machine as well. Why is that important?
>> From the data and from the slide you will look at in a
minute we know that super markets and these stores make up
the largest portion of these sales but vending machines
represent about 13% of the market share and that is a
significant amount and in our locations a vending machine is
the only place to buy this type of beverage and we knew by
making this positive change could impact 3,000 people daily
and that made sense to focus on the vending part of the
equation. >> Sure. What did the process
under take if you're trying to restructure everything
available? How do you do that? >> It was a long process but we
started by getting a copy of the existing vending contract and we
wanted to see if there was anything in there related to
health and at that point there wasn't. Next we created an
assessment of each of the county owned vending machines so we
looked at the different products in the machine. We looked at
the price and where they were placed and did this to establish
a baseline for improvement. We then met with the purchasing
department and vending company and solicited about next steps 22
and at that point we were able to provide us with a list of the
available beverages they had within their distribution and we
used to list to do a employee survey and find out which of the
options available which are the ones you would most likely
purchase and see in the vending machines? We got a great
response to that survey. I was shocked about how many people
replied and they were thrilled we were moving in this direction
and we had a taste test and make the employee part of the process
and we worked on the policy and get that into the contract to
make this a sustainable change and we're in the process of
implementing that new product mix and we're excited about the
process. >> That sounds exciting. Now,
if other organizations want to do this and effective for them
as well would it be the same process across the board? Is
that something they could do? >> The process would depend and
it's similar and elements I would recommend regardless like
the taste test and the employee survey. In our case we were
dealing with contracts, required to do a bidding process. We had
involvement from the purchasing department so the process was
lengthy but we worked with other companies in our county. Just
recently I worked with a county in the last couple of weeks and
they were able to make these changes in a couple weeks
because they have a simpler relationship with the vending
company and we would like these changes and they do that so it
depends on the formality of the relationship with your vending 23
company. >> That makes sense. Now, what
types of changes did you want to see with the vending machines?
What did the feedback say and what was important to you to
make changes? >> We looked on the internet and
found great guidelines and policies that other places had
implemented and used those for a best fit here in Rocklyn County.
We wanted to provide people with a more proportional mix and
healthy alternatives. We knew there were some machines that
didn't carry water at all or others where the water was
regularly out of stock. We wanted water to be a minimum of
two rows or equivalent number of buttons depending on it is
machine. We wanted water placed in the most prominent location
of the machine and typically eye level and the sugar drinks at
the bottom. We wanted to implement a pricing differential
with the water 25 cents less than the sugary drinks and no
more than two rows to be sugar sweetened beverages and that
contained more than 25 calories per 8-ounce serving.
>> I am trying to visualize if we have two rows water and no
more than two sugar sweetened what are the other options
available? >> That's the hard part and
figuring out what other beverages to have in there. You
see diet or 0-calorie versions of beverages. They're widely
available but we didn't want diet drinks be the healthier
option so we looked for other options. And by the survey the
top two were unsweetened ice tea and club soda in favors and 24
100 percent fruit juice which we exempted because it doesn't
contain added sugar and you might see milk, vegetable juice.
There is a variety of other things but it depends what the
vending company has available. Do you have a bottle or can
machine? What price point do you want sell the beverages so
it varies. >> Okay. Interesting. Now, in
addition to modifying vending machine content what are other
things a organization can do to implement and reduce
consumption? >> One thing is practice healthy
meetings so when you have a meeting and serving beverages
include a water or club soda option for example. You can
create healthy policies like we did. You can create pricing
differentials that support this process. You can provide free
water to employees with a water cooler or fountain for example.
You can provide taste tests of healthy beverages. A lot of
times the vending companies are willing to provide you with free
samples for the taste test so that is worth looking into and
point of messaging and you could include these in the
interventions with the community. Many of the
activities can be translated into your public health work
with employers, with schools, corner stores and restaurants
and all of the community. >> Excellent, and I think you
have -- that is certainly a comprehensive list of what
organizations can do and interesting that the vending
companies are willing to do taste tests or samples but I 25
believe you have more suggestions as well.
>> We found that the educational piece is essential for us in
establishing buy in and encouraging other organizations
in our community to make sustainable changes around sugar
sweetened beverages so there is a number of activities you can
do. You can distribute educational materials and again
there is a variety of materials available on the subject at this
point so I referenced New York City's earlier but there are
others to look into. You could include information about these
drinks in your newsletter or other communication you have or
website or Social Media outlets. You can display displays that
show the calories of these beverages and taking a container
and filling it with the sugar in that beverage. We find that
people don't know what X number of grams means when it's on a
food label but when you present it visually they're surprised
and it's interesting and we do that often. We recently started
lunch and learns with the employers and that is going
well. We offered community presentations to head start and
schools and local coalition and we find out by doing the
presentations the group follows up and wants to make a permanent
change or do something more than the educational piece.
>> It sounds like your organization is taking action
getting involved in a lot of ways to combat this problem.
Have you received any feedback from the public how your efforts
are being received? >> Yes. I have to say when we 26
began embarking on this campaign I'm not sure how the public or
our employees would respond to this, and particularly the media
element and it's visual and in your face, but overall the
feedback has been extremely positive. We have gotten a lot
of Emails and verbal self reports of reduce sugary drink
consumption and sometimes people say "I was going to drink this
and I thought of your ad, so I changed my order" And it's nice
to hear that and the community has been great and taken
elements and implemented within their own organization and to me
that's the best feedback. >> That is terrific to hear and
not only you're doing this work but people are perceptive to it
and changing their actions which is the ultimate goal. We have a
couple of questions from the audience but in addition to the
information you provided and the questions we're going to answer
what resources would you recommend if folks want to get
more information about what you're doing or get promotional
materials? >> These are just a couple of
resources. If you would like to see the materials that created I
encourage you to visit our website. You can contact me
directly. I am happy to share the resource. Another is listed
here. They have great information about the other
grant recipients and their projects and recommendations
about making vending policy changes and in New York I sent
out a packet of sample materials that we developed and other
grant recipients and I believe they have more and you may want 27
to reach out to them. Another research is New York drink
sugary drink page and that contains factor page and videos
like we saw before and the Center for Disease Control has a
campaign "rethink your drink" and I am sure the audience is
familiar with but they have other resources.
>> Thank you very much. We did get questions from the audience
and the first is for you Ian. What other sources of data could
you look at to better understand this public health problem?
>> Sure. I could speak to three. Two are really from a
population perspective and moving down to what tools could
be used at a community level, so at the state perspective we also
looked at data on purchasing of these beverages through scanner,
grocery scanner data again that's another way we could look
at this behavior, understand what is being purchased in
seasonality. Earlier I talked about the idea of schools taking
action to restrict beverages so in our state we're currently
looking at wellness policies that school districts are
required to have and submit to the Department of Education so
we're looking at the percentage of number of schools that have
taken action on their own to restrict the beverages that are
available, and another opportunity is there are a
number of great tools that can be used to do retail assessment
so assessing what is available in retail outlets in the
community. We have done a project in upstate New York we
developed a tool and conducted these assessments of what is 28
available. I know New York City who we worked on this project
also has an assessment tool and for someone interested in
gathering information what is available in their community,
whether it be broad or narrow I think those resources would
provide useful information. >> Excellent thank you. Melanie
the next question is for you. If your public health
organization has limited resources to address this issue
what would be a good first step. >> I think some of the
interventions I mentioned toward the end. I know the media
campaign had elements with a cost associated with them but
some of the point of purchase things can be implemented
without any money if you're able to print materials available and
I am happy to share what we have done and created so people can
use those. Definitely practicing the meetings,
presentations you could do with the community. There are a
number of things. You have to be creative and I know funding
is definitely an issue right now. We're felling it too and
we're being creative to keep this momentum going.
>> Okay. Ian, is there any consideration in including
alcohol base beverages in these surveys.
>> We collect that separately. The indicators around the public
health perspective is around binge drinking as a risk
behavior and interesting to look at general consumption and how
it correlates to sugary drink consumption and I know that is
also a source of excess calories in the diet. 29
>> Sure. And thank you very much for joining us today.
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