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March 1, 2026Current Developments in NutritionOpen Access

Policy on Paper vs. Policy in Practice: A Study of Healthy Default Beverage Implementation and Enforcement in the US

Samantha M. Sundermeir Megan R. Winkler Jennie N Davis Alexandra Mack Jennifer Falbe Melissa Fuster

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Key Points

This research aims to assess the implementation and enforcement of healthy default beverage policies across various jurisdictions in the US.
Mixed-methods approach combining policy document analysis and online surveys
Developed a codebook to assess implementation and enforcement provisions
Analyzed data from 19 policy documents and 64 unique jurisdiction survey responses
72% of jurisdictions were knowledgeable about their HDB policy
86% of state and all local jurisdictions used a communication strategy
State compliance assessed through in-person visits (78%) while local jurisdictions assessed (42%)
67% of state and 73% of local jurisdictions issued warnings and fines for enforcement
Implementation often exceeded policy requirements but showed gaps in enforcement knowledge

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Implication

Mixed-methods analysis examines policy compliance and equity in jurisdictions, suggesting improvements are needed.

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Cite This Study

Sundermeir et al. (2026) studied this question.

synapsesocial.com/papers/69b79da78166e15b153aae6f https://doi.org/10.1016/j.cdnut.2026.107674

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Keep reading

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1Implementation evaluation of a healthy beverage default policy in IllinoisOriginal Research · 2026
2Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy2024 · 3 citations
3The New Orleans Healthy Default Beverage Policy and Beverage Ordering Among ChildrenOriginal Research · 2026
4Compliance, Barriers, and Improvement Areas of Two Food Programs in Mexican Middle Schools: Stakeholders' Perceptions2025
5A case study assessing implementation of the Victorian Government’s Healthy Choices Policy Directive in a rural hospital caféOriginal Research · 2026

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