Evaluation of worksite policies and practices promoting nutrition and physical activity among hospital workers

Physical activity in the workplace: a cost or a benefit for organizations? A systematic review

Purpose

Most adults do not follow the minimum requirements for physical activity despite the benefits such activity can provide toward improving quality of life. On average, an adult spends 60% of daily hours in the workplace, making it essential to create working environments that are favorable to avoiding harmful effects on the health of workers. Toward this end, the application of physical activity programs in a work context is one of the possible interventions. This study aims to carry out a systematic review of the literature to identify the impact of physical activity programs applied in the workplace, on employee wellness and organizational productivity.

Design/methodology/approach

The search for reports was carried out in two databases, namely, Thomson Reuters Web of Science and Scopus, according to several inclusion and exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was applied to ensure the quality of the study. Microsoft Excel 2016 was used to organize the database to support the data analysis.

Findings

The sample comprised 64 reports published in international journals between 1986 and 2019. From these studies, six thematic clusters were formed: Workplace Physical Activity Interventions, Workplace Wellness, Physical Activity and Organizational Performance, Barriers to Developing Physical Activity Programs in the Workplace, Physical Activity and Sedentary Occupations and Workplace Physical Activity Incentives. The analysis of these clusters confirmed that the implementation of physical activity programs in this context could represent beneficial effects for workers and the organizational system by contributing to a reduction in the rates of absenteeism and presenteeism. However, there are still many organizations that do not implement such programs.

Originality/value

The results of this study are essential for managers of organizations to be able to implement physical activity programs in a work context, similarly to the application of a strategy of corporate social responsibility in an intra-organizational environment. This research may also be useful for professionals in the areas of sports and physical exercise, who want to build their business around physical exercise programs applied to a work context.

Availability of Healthy Food and Beverages in Hospital Outlets and Interventions in the UK and USA to Improve the Hospital Food Environment: A Systematic Narrative Literature Review

The aims of this systematic review are to determine the availability of healthy food and beverages in hospitals and identify interventions that positively influence the hospital food environment, thereby improving the dietary intake of employees and visitors. Embase, Medline, APA PsycInfo, Scopus, Google Scholar and Google were used to identify publications. Publications relating to the wider hospital food environment in the UK and USA were considered eligible, while those regarding food available to in-patients were excluded. Eligible publications (n = 40) were explored using a narrative synthesis. Risk of bias and research quality were assessed using the Quality Criteria Checklist for Primary Research. Although limited by the heterogeneity of study designs, this review concludes that the overall quality of hospital food environments varies. Educational, labelling, financial and choice architecture interventions were shown to improve the hospital food environment and/or dietary intake of consumers. Implementing pre-existing initiatives improved food environments, but multi-component interventions had some undesirable effects, such as reduced fruit and vegetable intake.

Describing workplace interventions aimed to improve health of staff in hospital settings - a systematic review

Background

A large proportion of staff working in hospital settings are overweight or obese, have poor dietary habits and low physical activity levels. The workplace is a priority setting for health promotion. This systematic review will describe dietary and physical activity workplace interventions that have aimed to improve the health of staff in hospital settings; and the barriers and enablers of implementing these interventions.

Methods

A systematic search retrieved 551 studies from 2004 to 2020 using the following databases CINAHL Complete, MEDLINE Complete, Academic Search Complete, Global Health, Health Source Nursing/Academic Edition and PsycINFO. Studies were included if they: (1) took place in a hospital setting; (2) employed a physical activity or dietary intervention to improve the well-being of staff; (3) the intervention duration was 12 weeks or over; (4) used a control group. The Integrated quality Criteria for the Review of Multiple Study designs (ICROMS) and National Institute of Health’s National Heart Lung and Blood Institute Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies tools were used to assess quality of included studies. A narrative review was conducted.

Results

Quality analysis identified six studies of high quality, nine moderate quality, and three low quality. Of these 18 studies, 15 reported at least one positive health outcome. The evidence revealed that multi-component strategies, financial incentives and motivational strategies were the most effective approaches to improve health behaviours of hospital staff.

Conclusion

Hospital-based dietary and physical activity workplace interventions show promise as an effective strategy for improving health behaviours of hospital staff. Methodological limitations highlight the need for more research from high-quality, randomised control trials, to gain further insight into the benefits of workplace interventions in hospital settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07418-9.

Corporate Well-Being Programme in COVID-19 Times. The Mahou San Miguel Case Study

Employees’ health is being affected not only by the possibility of contracting COVID-19, but by all the negative consequences that this pandemic has brought, such as confinement, social distancing, and self-isolation. In recent decades, more companies have opted for corporate well-being programmes in their workplaces, improving the health and quality of life of their employees. The effects generated by the current COVID-19 pandemic require these programmes to adapt to this new situation. The objective of this case study is to analyse the corporate well-being programme, in times of COVID-19, of Mahou San Miguel, a benchmark company in corporate well-being in Spain. A mixed method approach to data collection was used. The findings show the benefits achieved in its adaptation to this new physical-virtual environment. This paper could help other companies around the world to adapt their corporate well-being programmes to the new reality brought about by COVID-19.

Attitudes and Consumer Behavior toward Foods Offered in Staff Canteens

The aim of our study was to analyze the attitudes of employees toward food offered in staff canteens, to analyze their eating behavior and the factors determining the choice of meals in staff canteens. The survey was conducted on a sample of 600 adult respondents, who patronize staff canteens in Warsaw, Poland. The research enabled a detailed and comprehensive assessment of consumer behavior toward the use of staff canteens, as well as their opinions on the functioning of the canteens and meals offered. Factors determining the frequency of use of canteens, type of meals, and factors influencing the use of such establishments were identified. Respondents assessed the quality and variety of meals, with the size of portion being the most valued. They were satisfied with the functioning of the canteens and had very few comments. However, they pointed out the need for an increase in the variety of meals, including the availability of vegetarian and vegan dishes. Our research enabled us to establish consumer profiles based on the reasons for not using staff canteens and comments about staff canteens. Patrons of staff canteens were referred to as “canteen enthusiasts” or “canteen medium-enthusiasts”, who are “snack lovers”, as well as “food choice-oriented” or “quality-oriented”. The results provide the basis for practical implications for owners or managers of staff canteens, part of whose work it is to analyze the needs and expectations of their potential customers.

The impact of a complex workplace dietary intervention on Irish employees' off-duty dietary intakes

A paucity of evidence exists regarding the impact of workplace dietary interventions on employees' off-duty dietary intakes. This study assessed the impact of workplace dietary interventions that included nutrition education and environmental dietary modification both alone and in combination on employees' dietary intakes inside (on-duty) and outside (off-duty) of work. A pre-post study on employees' on and off-duty dietary intakes was undertaken. Data were obtained from a complex workplace dietary intervention study (Food Choice at Work Trial). Four manufacturing workplaces were allocated to: Control (n = 111), nutrition education (n = 226), environmental dietary modification (n = 113) and nutrition education and environmental dietary modification combined (n = 400) (2013-14). Seven- to nine-month follow-up data were obtained for 517 employees (61% response) [Control (n = 67), Education (n = 107), Environment (n = 71) and Combined (n = 272)]. Dietary intakes were measured using 24-h dietary recalls. Differences between on and off-duty mean dietary intakes were compared and regression analyses adjusted for potential confounders. Significant reductions in on-duty intakes of total fat (-14.2 g/day, p = 0.000), saturated fat (-7 g/day, p = 0.000), salt (-1.4 g/day, p = 0.000) and total sugars (-8.9 g/day, p = 0.003) were observed in the Combined and in the Environment [total fat (-11.4 g/d, p = 0.017) and saturated fat (-8.8 g/day, p = 0.000)]. In the Combined, significant changes were also observed in off-duty intakes of total fat (-10.0 g/day, p = 0.001), saturated fat (-4.2 g/day, p = 0.001), salt (-0.7 g/day, p = 0.020) and total sugars (-8.1 g/day, p = 0.020). Food service can have a positive impact in our everyday environments, including inside and outside of work. Dietary interventions combining nutrition education and environmental dietary modification can improve employees' on and off-duty dietary intakes.

The workplace meal: a migrant workers' perspective

Purpose

Employees eat at least one meal per day in the workplace on a regular basis, carrying implications for their physical and emotional well-being. For migrants, this can be challenging, owing to food culture differences. This study explores migrant workers’ perceptions of the food eaten in the hospitality workplace.

Design/methodology/approach

Eleven in-depth, face-to-face, semi-structured interviews were carried out with migrant workers in three- and four-star hotels in the southwest of England.

Findings

The findings show that the food eaten in the workplace is perceived as unhealthy and fattening and therefore unappealing. This partly informs a decision to eat home country food away from work.

Research limitations/implications

Further research is needed across many more organisations to investigate whether this would actually have the positive impact on employee well-being (migrant or home national) and employer reputation.

Practical implications

Providing additional “off-menu” meals for migrant employees is recognised. However, staff turnover within the hotel environment may mean that dishes acceptable to one nationality may not be acceptable to another. Alternatively, it may be that attention to such details and the provision of a food offering that is seen as fit for purpose by staff may reduce turnover and demonstrate “care” on the part of the employer. An annual staff survey could be conducted to gauge employee opinion.

Social implications

This study helps to show the significance of food for migrant well-being. It highlights that in increasingly globalised workplaces, food provision is important for both emotional and physical health. The study's findings have relevance to other multicultural workplaces where the food provided to staff may have consequences for employee well-being.

Originality/value

Little research has focused on the link between the food consumed in the hospitality workplace and migrant worker well-being. This study therefore makes an important contribution to knowledge by exploring feelings about the food eaten at work from the perspective of migrant workers themselves.

Health promotion program for office workers with SEM based on the WHO’s healthy workplace framework

This study attempts to develop and verify the effectiveness of a health promotion program for office workers based on the social ecological model and the World Health Organization’s Healthy Workplace Framework. This study involved 272 office workers of a small and medium-sized enterprise in Korea. Data were analyzed through descriptive statistics, repeated measures analysis of variance (ANOVA) and Bonferroni correction using SPSS/WIN 23.0. Workplace environmental support was provided to all workers, while a 6-month intensive core program based on social support was implemented for the intensive management group. Based on the participation rate, individuals were divided into the core and dropout groups. In all office workers, there were negative changes in high-density lipoprotein cholesterol and job stress during the period. Meanwhile, the intensive group showed significant changes in body mass index and diastolic blood pressure. The study suggests that the organization’s support for a healthy environment and an individual’s continued participation based on social support are essential for the effectiveness of a health promotion program for office workers.

The factors influencing the eating behaviour of shiftworkers: what, when, where and why

Shiftwork leads to altered eating patterns, with workers often eating foods at all times across the 24 h period. Strategies to reduce the burden of shiftwork on the workers should be prioritised and altering these eating patterns is an important area for change. This narrative review examines the current evidence on the individual and environmental factors influencing the eating behaviours of shiftworkers. A systematic search was conducted and yielded 62 articles. These were split into four themes that influence eating patterns; When shiftworkers eat, What type of foods shiftworkers eat, Where the food is sourced from, and Why shiftworkers choose to eat on shift. Irregular working hours was the biggest influence on when workers ate on shift, shift-type was the biggest influence on what workers ate, the majority of food was sourced from canteens and cafeterias, and socialising with colleagues was the biggest reason why workers chose to eat. While more research is needed to explore multiple industries and shift-types, and to investigate the ideal size, type and timing of food on shift, this review has highlighted that future research into shiftworker eating needs to adopt an integrative approach and consider the different individual and social contexts that influence eating patterns.

Healthiness of Food and Beverages for Sale at Two Public Hospitals in New South Wales, Australia

(1) Background: Our aim was to conduct objective, baseline food environment audits of two major western Sydney public hospitals and compare them to recently revised state nutritional guidelines. (2) Methods: A cross-sectional assessment was conducted (June-July2017) across 14 fixed food outlets and 70 vending machines in two hospitals using an audit tool designed to assess the guideline's key food environment parameters of availability, placement, and promotion of 'Everyday' (healthy) and 'Occasional' (less healthy) products. (3) Results: Availability: Overall, Everyday products made up 51% and 44% of all products available at the two hospitals. Only 1/14(7%) fixed outlets and 16/70(23%) vending machines met the guideline's availability benchmarks of ≥75% Everyday food and beverages. Proportion of Everyday products differed among different types of food outlets (café, cafeteria, convenience stores). Placement: On average, food outlets did not meet recommendations of limiting Occasional products in prominent positions, with checkout areas and countertops displaying over 60% Occasional items. Promotion: Over two-thirds of meal deals at both hospitals included Occasional products. (4) Conclusion: Baseline audit results show that substantial improvements in availability, placement, and promotion can be made at these public hospitals to meet the nutrition guidelines. Audits of other NSW hospitals using the developed tool are needed to investigate similarities and differences in food environment between sites. These findings highlight the need for ongoing tracking to inform whether the revised guidelines are leading to improved food environments in health facilities.

The effectiveness of healthy meals at work on reaction time, mood and dietary intake: a randomised cross-over study in daytime and shift workers at an university hospital

Our dietary habits affect both cognitive performance and mood. The aim of the study was to examine the effect of increased availability of healthy meals and water at work on healthcare staff. The study used an 8-week randomised cross-over design. A total of sixty physicians, nurses and nursing assistants, including sixteen working on shifts, were recruited. The participants received a self-selected keyhole-labelled (Nordic nutrition label) lunch, snack and bottled water during each shift throughout the intervention period. Reaction time (Go/No-Go test), mood-related scores (POMS) and dietary intake were assessed at run-in, and at the end of the intervention and the control periods. The intake of fat (P=0·030) and PUFA (P=0·003) was lower, and the intake of carbohydrate (P=0·008), dietary fibre (P=0·031) and water (P<0·001) was greater in the intervention period than in the control period. The intervention had no effect on reaction time or any of the mood-related scores in the group as a whole. In shift-working participants, the intervention period resulted in a 31·1 % lower Fatigue-Inertia Score (P=0·003), a 15·3 % higher Vigour-Activity Score (P=0·041) and a 42·7 % lower Total Mood Disturbance Score (P=0·017), whereas the only dietary component that significantly improved was water intake (P=0·034), when compared with the control period. Providing healthy meals, snacks and water during working hours seems to be an effective way of improving employees' dietary intake. Moreover, increased intake of water may be associated with beneficial effects on fatigue, vigour and total mood in shift-working healthcare staff.

Enabling healthy food choices in the workplace: the canteen operators’ perspective

Purpose

Employees eat regularly in workplace foodservice settings, thus the food served can significantly impact their overall diet. Workplace foodservice providers are facing several challenges, including changing consumer demands, partial blame for high levels of obesity and the delivery of accessible information that can encourage healthier food choices. The purpose of this paper is to explore the industry perspective on consumer information needs and to assess the challenges faced by foodservice providers in terms of responding to these in a workplace setting.

Design/methodology/approach

A qualitative approach was adopted, involving ten in-depth semi-structured interviews with contract catering managers in the UK and Germany.

Findings

Canteen operators have a sound understanding of what is important to their customers. However, the amount of dish information currently provided is limited, and the reasons for this are discussed. The menu remains the traditional medium of communication of information on dishes, but there is openness to technical platforms, which not only reduce information overload but also increase customer engagement.

Practical implications

Technological solutions are discussed as a way to overcome barriers to information provision providing workplace caterers with a clear approach to effectively communicate enhanced dish information.

Social implications

The provision of enhanced dish information has been found to influence consumers’ to make more healthful selections. This is an important public health issue given the growing rates of obesity and diabetes type 2.

Originality/value

This study makes an original contribution by exploring the industry perspective on consumer needs for information and on how this information can be provided.