"Just So You Know, It Has Been Hard": Food Retailers' Perspectives of Implementing a Food and Nutrition Policy in Public Healthcare Settings.

Kristy Karying Law,Christina Mary Pollard,Janelle Diann Healy,Claire Elizabeth Pulker

doi:10.3390/nu13062053

Kristy Karying Law, Christina Mary Pollard + Show 2 more

Open Access

https://doi.org/10.3390/nu13062053

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Journal: Nutrients	Publication Date: Jun 15, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: North Metropolitan Health Service, Curtin University

Abstract

Mandated policies to improve food environments in public settings are an important strategy for governments. Most Australian governments have mandated policies or voluntary standards for healthy food procurement in healthcare facilities, however, implementation and compliance are poor. A better understanding of the support required to successfully implement such policies is needed. This research explored food retailers’ experiences in implementing a mandated food and nutrition policy (the Policy) in healthcare settings to identify barriers, enablers, and impacts of compliance. Three 90-min workshops facilitated by two public health practitioners were undertaken with 12 food retailers responsible for operating 44 outlets across four hospitals in Perth, Western Australia. Workshop discussions were transcribed non-verbatim and inductive thematic content was analyzed. Three main themes were identified: (1) food retailers had come to accept their role in implementing the Policy; (2) the Policy made it difficult for food retailers to operate successfully, and; (3) food retailers needed help and support to implement the Policy. Findings indicate the cost of implementation is borne by food retailers. Communications campaigns, centralized databases of classified products, reporting frameworks, recognition of achievements, and dedicated technical expertise would support achieving policy compliance. Feasibility assessments prior to policy implementation are recommended for policy success.

Highlights

Poor diet is a leading risk factor for non-communicable diseases including obesity, type 2 diabetes, cardiovascular disease, and some cancers
Three main themes were identified: (1) food retailers had come to accept their role in implementing the Policy; (2) the Policy made it difficult for food retailers to operate successfully, and; (3) food retailers needed help and support to implement the Policy
The findings of this study indicate that the reason why the food retailers overcame the challenges to achieve compliance was the quality improvement (QI) approach taken by the East Metropolitan Health Service (EMHS) to support policy implementation since 2018

Summary

Introduction

Poor diet is a leading risk factor for non-communicable diseases including obesity, type 2 diabetes, cardiovascular disease, and some cancers. Food environments can influence what people eat, and hold the potential to reduce obesity and diet-related chronic diseases [5]. Food procurement policies that aim to improve the availability of healthy food and drinks in organizational food environments such as hospitals are a promising public health initiative [7]. Governments can lead the implementation of healthy public food procurement policies in their owned healthcare facilities and hospitals [8]. Public hospitals are well placed to model and lead efforts to promote public health and prevent diet-related non-communicable diseases [9]. The World Health Organization recommends that nutrition criteria should be mandatory, specific, and enforceable [8]

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