Abstract
BackgroundWorksite-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.MethodsWe 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.ResultsEmployees 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.ConclusionA 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.
Highlights
Cardiometabolic diseases, such as cardiovascular disease (CVD) and diabetes, constitute the leading cause of global mortality and are a major contributor to reduced quality of life [1,2,3]
The Social Ecological Model, on the other hand, incorporates multiple determinants into different levels of influence on behavior and considers the interaction of behaviors across these different levels of influence, which leads to multi-level suggestions for interventions to effectively change behavior [18]. We selected this store because a) the cafeteria is managed by the store and the ability to improve it is enhanced, compared to out-sourced worksite cafeteria settings; b) the store employs diverse job types; and c) it is classified as a large enterprise based on the number of employees and stores owned by the same management across Mexico, allowing for possible scale up to other stores
A broad range of factors affect healthy eating at the cafeteria, some of which are related to nutrition, and others to the job design itself, such as the amount of, and timing of, breaks
Summary
Cardiometabolic diseases, such as cardiovascular disease (CVD) and diabetes, constitute the leading cause of global mortality and are a major contributor to reduced quality of life [1,2,3]. Cardiometabolic diseases, are the leading causes of death and disability, where about 46% of the CVD cases and 27% of diabetes cases are attributed to unhealthy dietary habits [7]. A healthy diet is a major means of prevention of cardiometabolic diseases and mortality [8, 9]. Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. Facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City
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