Policy change + healthier food options = Fun Bites

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While community recreational facilities offer plenty of options for physical activity and getting healthy, the snacks offered at concession stands and vending machines are anything but that, often loaded with fats, salt and sugar. 

That’s where public health and social marketing step in.

The USF College of Public Health has used social marketing to improve health and prevent disease for more than 20 years through its Florida Prevention Research Center (FPRC).

Dr. Mahmooda Khaliq Pasha, an assistant professor and associate director for the World Health Organization Collaborating Center on Social Marketing and Social Change, says success for USF has resided in the empowerment and engagement of communities to achieve sustainable change.

Dr. Mahmooda Khaliq Pasha. (Photo courtesy of USF COPH)

She says this can be achieved through use of the community-based prevention marketing (CBPM) framework, which combines social marketing, community wisdom and control along with public health advocacy.

Social marketing is the use of commercial marketing principles to achieve change in behavior that is of benefit to society.

The bottom line for social marketing—change in behavior (wearing a seat belt, getting a mammogram, passing legislation on vaccination, etc.) verses financial gain. 

A successful example of social marketing in action was with USF’s Dr. Carol Bryant, professor emeritus, who worked with the Lexington, Kentucky, Tween Fitness and Nutrition Coalition to create the policy initiative “Better Bites: Snack Strong.” The policy initiative resulted in healthy food offerings on menus at public pools, government cafeterias, school concessions, movie theaters, restaurants, summer camps and the Kentucky State Park system.

Example of signage used in the Better Bites initiative. (Photo courtesy of Dr. Carol Bryant)

Hearing of this program’s success in Kentucky and wanting to replicate the effort in Florida, the Healthy Pinellas Consortium (HPC), a Florida Department of Health community coalition, worked with Dr. Khaliq Pasha, who provided training and technical assistance, to bring Better Bites to Florida.

“In Pinellas, an estimated 29 to 33.5 percent of preschool students are overweight or obese, as are one in three high school students,” Dr. Khaliq Pasha said. “Recreational facilities and sporting events encourage physical activity and healthy living, yet, send a contradictory message by offering unhealthy snacks and limiting a person’s ability to make healthy choices.”

Using the CBPM framework with a focus on policy development, the team consisting of researchers and students from USF and community members from Pinellas worked together to select, tailor, implement and evaluate a strategy that would  promote behavior change; the group concluded that part of the solution was to make nutritious choices easier for families managing after-school activities for their children. 

Through research with parents and children, owners of concession stands, and policy makers, the HPC decided to adapt and tailor Better Bites for Florida and improve the availability of healthy snack options at recreational facilities in Pinellas.

As a result, Fun Bites was born.

Fun Bites aims to provide healthier food options for tweens, aged 8 to 12-years-old, at municipal recreational facilities, including concession stands and snack bars.  “In some instances, facilities were contributing to a net increase in caloric intake as the tween would eat more calories than burn through exercise,” Dr. Khaliq Pasha said.

Posters created and used to indicate availability of healthier food. (Photo courtesy of Kim Lehto)
Example of new concession offerings with Fun Bites options. (Photo courtesy of Dr. Khaliq Pasha)

The City of Largo was the first to use Fun Bites in its city concessions, followed closely by the City of St. Petersburg.

“Fun Bites has led to healthier options becoming more affordable, attainable, and placed in close proximity to the tweens so that the right choice was the easier choice,” Dr. Khaliq Pasha said. “Generally, healthy items added to menus increased sales and were popular with customers. An evaluation by FDOH revealed that one out of every two who purchased an item, typically selected a ‘Fun Bite’ item.”

In fact, implementation of this initiative has led to institutional policy changes, making way for 13 locations to serve Fun Bites in Pinellas County, and an enactment of city-level policies in two municipalities related to community events and festivals. 

Municipalities also mandated that any food vendor at an event offer at least one Fun Bite option using the program guidelines, and the City of St. Petersburg enacted a policy related to concessions sold at internal events and programs.

Kim Lehto, the Healthy St. Pete Coordinator currently managing Fun Bites efforts in St. Petersburg, Fla. said policy change was instrumental in ensuring sustainability of the program.

She said they updated current parks and recreation policy language on what types of food could be offered at their facilities and also provided healthier options at 40 different vending machines.

“We followed up with a policy that was more precise and indicated that we would only serve items listed on the healthier concessions options list,” Lehto said.

Areas implementing the Fun Bites initiative. (Photo courtesy of Khaliq Pasha)

Rosy Bailey, food system consultant and facilitator for the Healthy Pinellas Consortium, said they were looking to make changes that impacted a community as a whole.

“That’s the true benefit of changes at the policy level as opposed to a program that is brought in. When you make an impact and change a policy and change the food environment, those changes are sustainable and long-term,” she said. “It was really important that the healthy choice become the easy choice, if there are no healthy foods to choose from, it’s not an easy choice.”

According to Dr. Khaliq Pasha, there is now an interest to expand Fun Bites beyond Pinellas County, with a pilot test being run at a cafeteria in Tallahassee. The current focus is on establishing an online certification system for vendors, so that they can receive materials to make their establishment a Fun Bite location and to ensure fidelity to nutritional guidelines.

Healthy Pinellas Consortium members discussing findings from a literature review on evidence-based policies for obesity prevention and selecting a policy area to guide future research. Conclusion from this meeting was to adapt Better Bites for Florida. (Photo courtesy of Dr. Khaliq Pasha)

“This component is key to the ongoing sustainability, implementation fidelity and success of this initiative, which is now receiving nationwide attention,” she said.

Bailey said the collaborative effort of Fun Bites and the use of social marketing helped to make lasting changes.

“It’s important to have many people at the table in addressing systemic changes, especially in regard to healthy food access,” Bailey said. “It’s amazing how the assistance we had with USF really helped us to unite individuals to make changes in a way that was effective.”

Story by Anna Mayor, USF College of Public Health