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Rosin M, Ni Mhurchu C, Mackay S. Implementing healthy food policies in health sector settings: New Zealand stakeholder perspectives. BMC Nutr 2024; 10:119. [PMID: 39244614 PMCID: PMC11380432 DOI: 10.1186/s40795-024-00924-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND In 2016, a voluntary National Healthy Food and Drink Policy was released to improve the healthiness of food and drinks for sale in New Zealand health sector organisations. The Policy aims to role model healthy eating and demonstrate commitment to health and well-being of hospital staff and visitors and the general public. This study aimed to understand the experiences of hospital food providers and public health dietitians/staff in implementing the Policy, and identify tools and resources needed to assist with the implementation. METHODS A maximum variation purposive sampling strategy (based on a health district's population size and food outlet type) was used to recruit participants by email. Video conference or email semi-structured interviews included 15 open-ended questions that focused on awareness, understanding of, and attitudes towards the Policy; level of support received; perceived customer response; tools and resources needed to support implementation; and unintended or unforeseen consequences. Data was analysed using a reflexive thematic analysis approach. RESULTS Twelve participants (eight food providers and four public health dietitians/staff) were interviewed; three from small (< 100,000 people), four from medium (100,000-300,000 people) and five from large (> 300,000 people) health districts. There was agreement that hospitals should role model healthy eating for the wider community. Three themes were identified relating to the implementation of the Policy: (1) Complexities of operating food outlets under a healthy food and drink policy in public health sector settings; (2) Adoption, implementation, and monitoring of the Policy as a series of incoherent ad-hoc actions; and (3) Policy is (currently) not achieving the desired impact. Concerns about increased food waste, loss of profits and an uneven playing field between food providers were related to the voluntary nature of the unsupported Policy. Three tools could enable implementation: a digital monitoring tool, a web-based database of compliant products, and customer communication materials. CONCLUSIONS Adopting a single, mandatory Policy, provision of funding for implementation actions and supportive tools, and good communication with customers could facilitate implementation. Despite the relatively small sample size and views from only two stakeholder groups, strategies identified are relevant to policy makers, healthcare providers and public health professionals.
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Affiliation(s)
- Magda Rosin
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.
- Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Cliona Ni Mhurchu
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
- Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
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Gerritsen S, Rosin M, Te Morenga L, Jiang Y, Kidd B, Shen S, Umali E, Mackay S, Ni Mhurchu C. Awareness, support, and opinions of healthy food and drink policies: a survey of staff and visitors in New Zealand healthcare organisations. BMC Public Health 2024; 24:2179. [PMID: 39135033 PMCID: PMC11318292 DOI: 10.1186/s12889-024-19693-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/05/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, "the Policy") was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors' awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. METHODS Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. RESULTS Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that "Hospitals should be good role models." Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. CONCLUSIONS The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.
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Affiliation(s)
- Sarah Gerritsen
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand.
| | - Magda Rosin
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Bruce Kidd
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Stephanie Shen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Te Whatu Ora - Te Toka Tumai Auckland, Auckland, New Zealand
| | - Elaine Umali
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- George Institute for Global Health, Sydney, Australia
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Rosin M, Mackay S, Gerritsen S, Te Morenga L, Terry G, Ni Mhurchu C. Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review. Nutr Rev 2024; 82:503-535. [PMID: 37335857 PMCID: PMC10925903 DOI: 10.1093/nutrit/nuad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
CONTEXT Many countries and institutions have adopted policies to promote healthier food and drink availability in various settings, including public sector workplaces. OBJECTIVE The objective of this review was to systematically synthesize evidence on barriers and facilitators to implementation of and compliance with healthy food and drink policies aimed at the general adult population in public sector workplaces. DATA SOURCES Nine scientific databases, 9 grey literature sources, and government websites in key English-speaking countries along with reference lists. DATA EXTRACTION All identified records (N = 8559) were assessed for eligibility. Studies reporting on barriers and facilitators were included irrespective of study design and methods used but were excluded if they were published before 2000 or in a non-English language. DATA ANALYSIS Forty-one studies were eligible for inclusion, mainly from Australia, the United States, and Canada. The most common workplace settings were healthcare facilities, sports and recreation centers, and government agencies. Interviews and surveys were the predominant methods of data collection. Methodological aspects were assessed with the Critical Appraisal Skills Program Qualitative Studies Checklist. Generally, there was poor reporting of data collection and analysis methods. Thematic synthesis identified 4 themes: (1) a ratified policy as the foundation of a successful implementation plan; (2) food providers' acceptance of implementation is rooted in positive stakeholder relationships, recognizing opportunities, and taking ownership; (3) creating customer demand for healthier options may relieve tension between policy objectives and business goals; and (4) food supply may limit the ability of food providers to implement the policy. CONCLUSIONS Findings suggest that although vendors encounter challenges, there are also factors that support healthy food and drink policy implementation in public sector workplaces. Understanding barriers and facilitators to successful policy implementation will significantly benefit stakeholders interested or engaging in healthy food and drink policy development and implementation. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021246340.
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Affiliation(s)
- Magda Rosin
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Sarah Gerritsen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Gareth Terry
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
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Sponselee HCS, ter Beek L, Renders CM, Robroek SJW, Steenhuis IHM, Kroeze W. Stakeholders' Perceptions Regarding Adaptation and Implementation of Existing Individual and Environmental Workplace Health Promotion Interventions in Blue-Collar Work Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13545. [PMID: 36294131 PMCID: PMC9603088 DOI: 10.3390/ijerph192013545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers often have disadvantageous health statuses and might therefore benefit from a combination of individual and environmental workplace health promotion interventions. Exploring stakeholders' perceived facilitators and barriers regarding the combined implementation of these interventions in blue-collar work settings is important for effective implementation. A qualitative study consisting of 20 stakeholder interviews within six types of organisations in The Netherlands was conducted. The potential implementation of the evidence-based individual intervention SMARTsize and the environmental intervention company cafeteria 2.0 was discussed. Data were analysed using thematic analysis with a deductive approach. Five main themes emerged: (1) the availability of resources, (2) professional obligation, (3) expected employee cooperation, (4) the compatibility of the proposed health interventions, and (5) the content of implementation tools and procedures. Generally, stakeholders expressed a sense of professional obligation toward workplace health promotion, mentioning that the current societal focus on health and lifestyle provided the perfect opportunity to implement interventions to promote healthy eating and physical activity. However, they often perceived the high doses of employees' occupational physical activity as a barrier. We recommend co-creating interventions, implementation tools, and processes by involving stakeholders with different professional backgrounds and by adapting communication strategies at diverse organisational levels.
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Affiliation(s)
- Hanne C. S. Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Lies ter Beek
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Suzan J. W. Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3015 GD Rotterdam, The Netherlands
| | - Ingrid H. M. Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
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Mesías FJ, Martín A, Hernández A. Consumers' growing appetite for natural foods: Perceptions towards the use of natural preservatives in fresh fruit. Food Res Int 2021; 150:110749. [PMID: 34865767 DOI: 10.1016/j.foodres.2021.110749] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/25/2021] [Accepted: 10/09/2021] [Indexed: 11/25/2022]
Abstract
Recent changes in food purchasing and consumption have led consumers to place greater importance on aspects such as convenience and the impact of food production and processing on health and the environment. This, in turn, poses a challenge for the food industry, especially with respect to highly perishable foods such as fruit. Great efforts have been made by the industry to reduce post-harvest losses by using natural preservatives that can replace traditional chemical fungicides, which are increasingly rejected by both citizens and governments. In this context, the purpose of this study was to obtain an overview of consumer perceptions towards the application of these novel products in fruit. In order to achieve this goal, five focus group sessions were held in multiple Spanish cities from December 2019 to February 2020. A total of 48 people with a mixed socio-demographic background took part in the study. The results showed both positive and negative consumer perceptions towards fruit, on the one hand being healthy and natural, and on the other lacking convenience. Packaging increases fruit convenience at the cost of its perception as a natural food product. In addition, consumers reported negative opinions associated with both the use of chemicals to improve fruit preservation and the environmental impact of the packaging. Participants showed interest in the use of natural preservatives in fruit, as these are considered more natural, healthier and more environmentally friendly. Although natural preservatives can influence consumers' fruit purchasing decisions, lack of information about such preservatives can cause doubts about their effectiveness and misjudgements about the price premium they add. Therefore, information about these types of preservatives, their characteristics and their benefits is key to overcoming mistrust and communicating to consumers the differentiation that their use adds to foods.
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Affiliation(s)
- F J Mesías
- Department of Economics, Universidad de Extremadura - Ctra. Cáceres s/n, 06071 Badajoz, Spain; Research Institute of Agricultural Resources (INURA), Universidad de Extremadura, Avda. de Elvas s/n, Campus Universitario, 06006 Badajoz, Spain.
| | - A Martín
- Research Institute of Agricultural Resources (INURA), Universidad de Extremadura, Avda. de Elvas s/n, Campus Universitario, 06006 Badajoz, Spain; Department of Animal Production and Food Science, Universidad de Extremadura, Ctra. Cáceres s/n, 06071 Badajoz, Spain
| | - A Hernández
- Research Institute of Agricultural Resources (INURA), Universidad de Extremadura, Avda. de Elvas s/n, Campus Universitario, 06006 Badajoz, Spain; Department of Animal Production and Food Science, Universidad de Extremadura, Ctra. Cáceres s/n, 06071 Badajoz, Spain
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Pinto VRA, Campos RFDA, Rocha F, Emmendoerfer ML, Vidigal MCTR, da Rocha SJSS, Lucia SMD, Cabral LFM, de Carvalho AF, Perrone ÍT. Perceived healthiness of foods: A systematic review of qualitative studies. FUTURE FOODS 2021. [DOI: 10.1016/j.fufo.2021.100056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tay BSJ, Cox DN, Brinkworth GD, Davis A, Edney SM, Gwilt I, Ryan JC. Co-Design Practices in Diet and Nutrition Research: An Integrative Review. Nutrients 2021; 13:nu13103593. [PMID: 34684593 PMCID: PMC8540362 DOI: 10.3390/nu13103593] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/04/2022] Open
Abstract
Co-design, the method of involving users, stakeholders, and practitioners in the process of design, may assist to improve the translation of health evidence into tangible and acceptable intervention prototypes. The primary objective of this review was to identify and describe co-design techniques used in nutrition research. The secondary objective was to identify associations between co-design techniques and intervention effectiveness. An integrative review was performed using the databases Emcare, MEDLINE, PsycINFO and Google Scholar. Eligible studies included those that: (1) utilised participatory research or co-design techniques, (2) described development and/or evaluation of interventions aimed at improving dietary behaviours or nutrition, and (3) targeted community-dwelling adults aged ≥18 years. We identified 2587 studies in the initial search and included 22 eligible studies. There were 15 studies that utilised co-design techniques, with a strong focus on engagement of multiple stakeholder types and use of participatory research techniques. No study implemented a complete co-design process. Most studies (14/15) reporting outcomes reported positive health (maximum p < 0.001) or health behaviour outcomes attributed to the intervention; hence, associations between co-design techniques and effectiveness could not be determined. Currently published intervention studies have used participatory research approaches rather than co-design methods. Future research is required to explore the effectiveness of co-design nutrition interventions.
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Affiliation(s)
- Brenda S. J. Tay
- Nutrition & Dietetics, College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
- Correspondence:
| | - David N. Cox
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, 13 Kintore Avenue, Adelaide, SA 5000, Australia; (D.N.C.); (G.D.B.); (J.C.R.)
| | - Grant D. Brinkworth
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, 13 Kintore Avenue, Adelaide, SA 5000, Australia; (D.N.C.); (G.D.B.); (J.C.R.)
| | - Aaron Davis
- UniSA Creative, University of South Australia, Adelaide, SA 5001, Australia; (A.D.); (I.G.)
| | - Sarah M. Edney
- Physical Activity and Nutrition Determinants in Asia (PANDA) Programme, Saw Swee Hock School of Public Health, National University of Singapore, Singapore 119077, Singapore;
| | - Ian Gwilt
- UniSA Creative, University of South Australia, Adelaide, SA 5001, Australia; (A.D.); (I.G.)
| | - Jillian C. Ryan
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, 13 Kintore Avenue, Adelaide, SA 5000, Australia; (D.N.C.); (G.D.B.); (J.C.R.)
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Immink V, Kornelis M, Van Kleef E. Vegetable interventions at unconventional occasions: the effect of freely available snack vegetables at workplace meetings on consumption. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-06-2020-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeSnacks at work are often of poor dietary quality. The main objective of the current study is to examine the effect of making vegetable snacks available at workplace meetings on consumption.Design/methodology/approachIn three between-subjects field experiments conducted at a hospital and three ministries in the Netherlands, with meeting as the unit of condition assignment, attendees were exposed to an assortment of vegetables, varying in vegetable variety and presence of promotional leaflet in study 1 (N = 136 meetings), serving container in study 2 (N = 88 meetings) and additional presence of cookies in study 3 (N = 88 meetings). Consumption of vegetables and cookies was measured at meeting level to assess grams consumed per person.FindingsAcross the three studies, average consumption per meeting attendee was 74 g (SD = 43) for study 1; 78 g (SD = 43) for study 2 and 87 g (SD = 35) for study 3. In the first study, manipulation of perceived variety and information leaflets did not affect intake. In the second study, significantly more vegetables were eaten when they were offered in single sized portions (M = 97 g, SD = 45) versus in a shared multiple portions bowl (63 g, SD = 38) (p < 0.001). In the third study, no effect was found of the additional availability of cookies on vegetable consumption during the meeting.Practical implicationsThe present studies show how availability of vegetables at unconventional occasions makes meeting attendants consume considerable portions of vegetables on average. As such, offering healthy snacks at the workplace may be a valuable part of workplace health promotion programs and positively change the “office cake culture”.Originality/valueVegetable intake is less than recommended in many countries worldwide. Many snacking occasions are at work, which makes office meetings a potential consumption occasion to encourage vegetable intake. Hence, the aim of this study is to examine whether free availability of vegetable snacks during meetings contributes to their consumption among meeting attendees and under what conditions consumption is optimal.
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Stern D, Blanco I, Olmos LA, Valdivia JJ, Shrestha A, Mattei J, Spiegelman D. Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study. BMC Public Health 2021; 21:973. [PMID: 34022846 PMCID: PMC8141192 DOI: 10.1186/s12889-021-11004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 05/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City. METHODS We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. RESULTS Employees defined healthy eating as eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of healthy eating at the worksite were availability of affordable healthy food options and employees' high health awareness. Major barriers to healthy eating included unavailability of healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. CONCLUSION A broad range of factors affect healthy eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for healthy eating, may help improve dietary behaviors and health of employees.
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Affiliation(s)
- Dalia Stern
- CONACyT-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, 7ª Cerrada Fray Pedro de Gante # 50, Col. Sección XVI Tlalpan, 14080, Mexico City, Mexico.
- Lown Scholar, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Ilian Blanco
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lucy A Olmos
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joel J Valdivia
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Archana Shrestha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Institute of Implementation Science and Health, Kathmandu, Nepal
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
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