Publicaties

The role of staff in food behaviourinterventions in out-of-home and health care settings -an overview of existing literature

Taufik, Danny; Jaspers, Patricia; Bouwman, Emily; Reinders, Machiel

Samenvatting

In this deliverable of the PPP projectImplementatie van voedingsinterventies in intramurale zorginstellingen en horeca an overview is made of the role of staff in conducting interventions promoting healthy and sustainable food choices in out-of-home and health care settings. This deliverable provides insight into the role of the staff in behavioural interventions and what the barriers and supporting factors are for the staff to implement the intervention in these settings. The overview is based on 17 studies in total, that were found by doinga literature search in the database Web of Science. Results show that in the health care setting most studies are conducted in either a hospital or a nursing home. The role of the staff in the intervention was mainly that they had to undergo training, coaching and/or education. Main barriers of the staff to implementthe intervention are a lack of time, a lack of staff capacity and inflexibility of the food service system. Main supporting factors are satisfaction of the staff with the intervention and the involvement with patients as a result of the intervention. In the out-of-home setting most studies are conducted in a school setting. The role of the staff was mainly training in how to promote and prepare healthy food and educating about the consequences of unhealthy cooking. Main barriers for staff to implement the intervention are a lack of time, having to participate in a training, lack of communication from the managers to the staff and amongst staff members about execution of the intervention and negative perceptions of the staff towards the intervention. Supporting factors are positiveperceptions towards the intervention and knowledge of the intervention and the benefits for the target group. Taken together, some of the types of barriers and facilitators recur in both settings. A main barrier that is mentioned for bothsettings is lack of time. Other overlapping barriers were lack of staff, other competing priorities, negative perceptions of staff toward the intervention, a lack of support and a lack of communication to and amongst staff about the intervention. Facilitators that were similar across settings were satisfaction of the staff with the training, positiveperceptions towards the intervention, knowledge of the intervention and the benefits for the target group, being confident to make changes and, finally, the presence of incentives. The observed similarities in the twodifferent settings, might be an indication that these barriers and facilitators are important aspects to consider in implementing an intervention in other closed settings as well. Stated differently, withinthis study the settings health care and out of home were the focus, but it could be possible that the found barriers and facilitators also apply in other closed settings. This overview cannot only be helpful for researchers who are involved in the project Implementatie van voedingsinterventies in intramurale zorginstellingen en horeca, but alsoforthosewho are interested in developing or implementing real-life food interventions in a health care or out-of-home setting or other settings. Furthermore, this overview might be relevant for the management of these settings, as it provides information on critical success factors of implementing interventions, i.e. barriers amongst staff that need to be overcome as well as supporting factors that can be helpful in successfully implementing the interventions. Note that the studies described in this report depend on the search criteria that were set for the literature search. Therefore it is possible that some relevant studies might be missing. Nevertheless, we believe that this literature review gives an overview of how staff can be motivated to implement an intervention.