Identifying barriers and facilitators in the development and implementation of government-led food environment policies: a systematic review.

Abstract

ContextPolicy-specific actions to improve food environments will support healthy population diets.ObjectiveTo identify cited barriers and facilitators to food environment policy (FEP) processes reported in the literature, exploring these according to the nature of the policy (voluntary or mandatory) and country development status.Data sourcesA systematic search was conducted of 10 academic and 7 grey-literature databases, national websites, and manual searches of publication references.Data extractionData on government-led FEPs, barriers, and facilitators from key informants were collected.Data synthesisThe constant-comparison approach generated core themes for barriers and facilitators. The appraisal tool developed by Hawker et al. was adopted to determine the quality of qualitative and quantitative studies.ResultsA total of 142 eligible studies were identified. Industry resistance or disincentive was the most cited barrier in policy development. Technical challenges were most frequently a barrier for policy implementation. Frequently cited facilitators included resource availability or maximization, strategies in policy process, and stakeholder partnership or support.ConclusionsThe findings from this study will strategically inform health-reform stakeholders about key elements of public health policy processes. More evidence is required from countries with human development indices ranging from low to high and on voluntary policies.Systematic Review RegistrationPROSPERO registration no. CRD42018115034.