Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review

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.

Tools and resources used to support implementation of workplace healthy food and drink policies: A scoping review of grey literature

“…Previous research assessed workplace policy design, 12,13 and their compliance, effectiveness and impact (e.g., changes in consumer purchases 14 and nutritional content of available products 10 ). Generally, internal and external support is needed and valued by food providers who face barriers to implementation and compliance with healthy food policies 15 . Support encompasses organisational leadership endorsement of a policy, allocation of financial resources and assistance from nutritionists and dietitians 15 .…”

“…Generally, internal and external support is needed and valued by food providers who face barriers to implementation and compliance with healthy food policies 15 . Support encompasses organisational leadership endorsement of a policy, allocation of financial resources and assistance from nutritionists and dietitians 15 . However, this study focuses on the supportive paper‐based and digital tools and resources that tend to be developed by relevant government departments and nutrition organisations 15 .…”

“…Support encompasses organisational leadership endorsement of a policy, allocation of financial resources and assistance from nutritionists and dietitians 15 . However, this study focuses on the supportive paper‐based and digital tools and resources that tend to be developed by relevant government departments and nutrition organisations 15 . Examples of tools include implementation guides, training manuals, communication materials and compliant food provider and product databases 11,15 .…”

“…However, this study focuses on the supportive paper‐based and digital tools and resources that tend to be developed by relevant government departments and nutrition organisations 15 . Examples of tools include implementation guides, training manuals, communication materials and compliant food provider and product databases 11,15 . Such supportive tools often aim to interpret complex healthy food policy guidelines for end‐users (e.g., food providers) who may not have nutrition expertise 16 .…”

“…Such supportive tools often aim to interpret complex healthy food policy guidelines for end‐users (e.g., food providers) who may not have nutrition expertise 16 . Therefore, tools should be tailored, relevant and user‐friendly to facilitate use 15 …”