S B Jilcott Pitts1, J Graham2, A Mojica3, L Stewart4, M Walter4, C Schille4, J McGinty4, M Pearsall4, O Whitt1, P Mihas5, A Bradley6, C Simon6. 1. Department of Public Health, East Carolina University, Greenville, NC, USA. 2. North Carolina Institute for Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 3. Public Health Executive Leadership Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 4. Department of Nutrition, North Carolina Institute for Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. Odum Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 6. Partnership for a Healthier America, Washington, DC, USA.
Abstract
BACKGROUND: Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. METHODS: Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. RESULTS: Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. CONCLUSIONS: Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings.
BACKGROUND: Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. METHODS: Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. RESULTS: Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. CONCLUSIONS: Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings.
Authors: Angie L Cradock; Jessica L Barrett; James G Daly; Rebecca S Mozaffarian; John Stoddard; Meg Her; Kim Etingoff; Rebekka M Lee Journal: Prev Med Rep Date: 2022-04-04
Authors: Hatidza Zaganjor; Katherine Bishop Kendrick; Stephen Onufrak; Julie Ralston Aoki; Laurie P Whitsel; Joel Kimmons Journal: Am J Health Promot Date: 2019-08-01