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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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Cradock AL, Barrett JL, Daly JG, Mozaffarian RS, Stoddard J, Her M, Etingoff K, Lee RM. Evaluation of efforts to reduce sodium and ensure access to healthier beverages in four healthcare settings in Massachusetts, US 2016–2018. Prev Med Rep 2022; 27:101788. [PMID: 35656218 PMCID: PMC9152882 DOI: 10.1016/j.pmedr.2022.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 10/29/2022] Open
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Barriers, Enablers, and Perceptions on Dietary Salt Reduction in the Out-of-Home Sectors: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158099. [PMID: 34360392 PMCID: PMC8345971 DOI: 10.3390/ijerph18158099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
In this review, we have investigated the perceptions, barriers, and enabling factors that were responsible for a dietary salt reduction in the out-of-home sectors. For this purpose, we examined different knowledge databases such as Google Scholar, Ebscohost, MEDLINE (PubMed), Ovid, and Cochrane Library for research articles from September to December 2020. The inclusion criteria for the research articles were that they had to be published in English and had to be a qualitative or quantitative study that was conducted after 2010. These studies also had to report the various enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors. After implementing the inclusion criteria, we successfully screened a total of 440 studies, out of which 65 articles fulfilled all the criteria. The perceived barriers that hindered salt reduction among the out-of-home sectors included lack of menu and food variabilities, loss of sales due to salt reduction, lack of technical skills for implementing the salt reduction processes for cooking or reformulation, and an absence of environmental and systemic support for reducing the salt concentration. Furthermore, the enablers for salt reduction included the intervention programs, easy accessibility to salt substitutes, salt intake measurement, educational availability, and a gradual reduction in the salt levels. With regards to the behavior or perceptions, the effect of organizational and individual characteristics on their salt intake were reported. The majority of the people were not aware of their salt intake or the effect of salt on their health. These people also believed that low salt food was recognized as tasteless. In conclusion, the enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors were multifaceted. Therefore, for the implementation of the strategies, policies, and initiatives for addressing the barriers, the policymakers need to encourage a multisectoral collaboration for reducing the salt intake in the population.
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Sumarto, Saragih M. Does the Taste and Appearance of Food Affect Food Waste in Low-Salt Diet Patients? J Nutr Sci Vitaminol (Tokyo) 2021; 66:S56-S62. [PMID: 33612649 DOI: 10.3177/jnsv.66.s56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Large of food waste can be one indicator of nutritional deficiencies in patients. This lack of nutrition is a factor that can increase morbidity, length of stay and cost of care. The acceptance of the taste of food in patients with low-salt diets is often a problem. This study aimed to assess the effect of taste and appearance of foods on food waste in patients with low-salt diets. The study was a cross-sectional design with observational methods. Data was collection from interview using questionnaire. The study was conducted at the Jasa Kartini (JK) Hospital, Tasikmalaya in August-October 2017. Subjects (n=30) were patients in low-salt diet. The acceptance of the taste and appearance of food from JK Hospital according to the respondents, the value was quite varied, generally above the median value on a scale of 1-3. The average of food waste from patients with low-salt diets at JK Hospital was still above the PGRS (Nutritional Guideline for Hospital) standard 2013, which was 26%. Based on the analysis between variables, there was a significant relationship between food waste and food taste (p=0.002) and food waste and food appearance (p=0.000) in low-salt diets patients. The taste and appearance of food significantly affect the food waste in low-salt diet patients.
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Affiliation(s)
- Sumarto
- Department of Nutrition, Poltekkes Kemenkes Tasikmalaya.,Health and Disaster Emergency (HADE) Center, Center of Excellent Poltekkes Kemenkes Tasikmalaya
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Lane C, Naylor PJ, Tomlin D, Kirk S, Hanning R, Masse L, Olstad DL, Prowse R, Caswell S, Jarvis S, Milford T, Raine K. Healthy vending contracts: Do localized policy approaches improve the nutrition environment in publicly funded recreation and sport facilities? Prev Med Rep 2019; 16:100967. [PMID: 31497499 PMCID: PMC6718942 DOI: 10.1016/j.pmedr.2019.100967] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/09/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023] Open
Abstract
This study explored the influence of healthy vending contracts (HVC) on the nutritional quality of vending machine products in 46 Canadian publicly funded recreation and sport facilities. A quasi-experimental comparison design was used to examine the difference in nutritional quality of snack and beverage vending machine products at baseline (December 2015–May 2016) and 18-month follow-up. Staff Surveys assessed facility contract type (HVC or conventional) and vending machine audits identified product nutritional quality. Products were categorized by provincial guidelines as Do Not Sell (DNS), Sell Sometimes (SS) or Sell Most (SM). ANOVA compared categories cross-sectionally (HVC vs conventional) and repeated measures ANOVA compared them longitudinally (HVC-HVC, vs conventional-conventional and conventional-HVC). Approximately one quarter of contracts (24% beverage and 28% snack) had health stipulations at baseline or follow-up. Cross-sectionally, facilities with HVC at any time period had significantly lower percentage DNS (beverage: 56% vs 73%, p = 0.001; snack: 55% vs 85%, p < 0.001), higher SS (beverage: 24% vs 14%, p = 0.003; snack: 35% vs 12%, p < 0.001) and higher SM Products (beverage: 21% vs 13%, p = 0.030; snack: 10% vs 3%, p < 0.003). Longitudinally, facilities with consistent HVC or that changed to HVC showed greater decreases in DNS products over time (p < 0.050). Although less healthy products were still highly prevalent, facilities with HVC or that changed to HVC had fewer unhealthy products available in their vending machines over time compared to those without HVCs. Healthy vending contracts appear to be an effective change strategy. Healthy vending contracts are associated with healthier vending product profiles. Healthy vending contracts improved the ‘healthiness’ of the products sold in vending machines. Healthy vending contracts appear to improve the food environment of recreational and sport facilities. Unhealthy foods remain prevalent in recreational and sport facilities even when healthy vending contracts are in place.
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Affiliation(s)
- Cassandra Lane
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308, Australia.,Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Patti-Jean Naylor
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Dona Tomlin
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Sara Kirk
- Healthy Populations Institute, Dalhousie University, PO Box 15000, Halifax B3H 4R2, NS, Canada
| | - Rhona Hanning
- School of Public Health & Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Ave. W., LNH 3117, Waterloo N2L 3G1, ON, Canada
| | - Louise Masse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver V6T 1Z3, BC, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary T2N 4Z6, AB, Canada
| | - Rachel Prowse
- Centre for Health and Nutrition, School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 - 87 Ave., Edmonton T6G 1C9, AB, Canada
| | - Susan Caswell
- School of Public Health & Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Ave. W., LNH 3117, Waterloo N2L 3G1, ON, Canada
| | - Sherry Jarvis
- Healthy Populations Institute, Dalhousie University, PO Box 15000, Halifax B3H 4R2, NS, Canada
| | - Todd Milford
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Kim Raine
- Centre for Health and Nutrition, School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 - 87 Ave., Edmonton T6G 1C9, AB, Canada
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Santos JA, Sparks E, Thout SR, McKenzie B, Trieu K, Hoek A, Johnson C, McLean R, Arcand J, Campbell NRC, Webster J. The Science of Salt: A global review on changes in sodium levels in foods. J Clin Hypertens (Greenwich) 2019; 21:1043-1056. [PMID: 31301120 DOI: 10.1111/jch.13628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022]
Abstract
This review aims to summarize and synthesize studies reporting on changes in sodium levels in packaged food products, restaurant foods, and hospital or school meals, as a result of salt reduction interventions. Studies were extracted from those published in the Science of Salt Weekly between June 2013 and February 2018. Twenty-four studies were identified: 17 assessed the changes in packaged foods, four in restaurant foods, two in hospital or school meals, and one in both packaged and restaurant foods. Three types of interventions were evaluated as part of the studies: voluntary reductions (including targets), labeling, and interventions in institutional settings. Decreases in sodium were observed in all studies (n = 8) that included the same packaged foods matched at two time points, and in the studies carried out in hospitals and schools. However, there was little to no change in mean sodium levels in restaurant foods. The pooled analysis of change in sodium levels in packaged foods showed a decrease in sodium in unmatched food products (-36 mg/100 g, 95% CI -51 to -20 mg/100 g) and in five food categories-breakfast cereals, breads, processed meats, crisps and snacks, and soups. Twenty-two of the 24 studies were from high-income countries, limiting the applicability of the findings to lower resource settings.
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Affiliation(s)
- Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Emalie Sparks
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Briar McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Annet Hoek
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Claire Johnson
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rachael McLean
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Norman R C Campbell
- Department of Medicine, Physiology and Pharmacology and Community Health Sciences, O'Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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