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

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.

SUBMITTER: Law KK

PROVIDER: S-EPMC8232694 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundTo achieve zero hunger targets set within the United Nations' Agenda 2030, high-income countries such as Australia must reconsider current efforts to improve food security. This study aimed to; explore perspectives from public health nutrition experts on the usefulness of drawing on the international human right to food, and associated mechanisms, to address food insecurity; identify potential roles of key stakeholders in Australia to implement a rights-based approach; and examine barriers and enablers to achieving the right to food in Australia.MethodsQualitative in-depth interviews were conducted with key informants (> 10 years professional experience). Braun and Clarke's (2006) six-phase approach to thematic analysis was employed to analyse data, using Kingdon's multiple streams framework (1984) to examine interactive variables which affect policy-making processes.ResultsThirty interviews took place, with most participants representing academia (n = 16), majority had 10-14 years of experience (n = 12) and almost one quarter (n = 7) were in senior leadership roles. Participants believed that framing food insecurity as a human rights issue could be effective when communicating with some audiences, however alternative rhetoric is more popular and potentially more effective. Citizens, government, food industry, non-profit sector, research/tertiary and legal institutions were described as playing critical roles. Barriers to progress were identified as lack of awareness and acknowledgement of the problem, prioritisation of the private sector, lack of political will and domestic laws, and an inefficient/ineffective charitable food sector. Participants identified various enablers and opportunities for implementing a rights-based approach such as grass-roots advocacy efforts to raise awareness of the issue, integrating human rights into government frameworks and community projects and the political will to support action aligned with sustainable development.ConclusionsHuman rights language and mechanisms have the potential to trigger genuine commitment to addressing food insecurity however should be used with caution. Australia's public health workforce requires increased capacity to implement a human-rights approach and framing such efforts to align with sustainable development may achieve greater political action.Trial registrationEthics approval was received from the Deakin University Human Research Ethics committee (project ID HEAG 168_2018).

Project description:BackgroundEnacting evidence-based public health policy can be challenging. One factor contributing to this challenge is a lack of public support for specific policies, which may stem from limited interest or conviction by policy arguments. This can happen when messaging strategies regarding policy do not resonate with the target group and/or policy narratives compete in public discourse. To understand how policy messaging can better resonate with a target audience, we examined the frames and narratives used by the Australian public when discussing nutrition policies.MethodsWe conducted 76 street intercept interviews in urban and regional settings in Queensland, Australia. Quantitative data were analysed using mean agreement scores and t-tests, and the qualitative data were analysed using an adapted qualitative narrative policy framework (QNPF). The QNPF is used to illustrate how competing narratives vary in the way they define different elements. These elements often include setting, characters, plot, policy solution and belief systems.ResultsLevel of support for all nutrition policies was generally moderate to high, although nutrition policies perceived to be most intrusive to personal freedoms were the least popular among the public. The value of fairness was consistently invoked when participants discussed their support for or opposition to policy. Using the QNPF, two distinct settings were evident in the narratives: concern for the community or concern for self. Villains were identified as either "other individuals, in particular parents" or "Big Food". Victims were identified as "children" or "the food industry, in particular farmers". Frequently used plots focused on individuals making poor choices because they were uneducated, versus Big Food being powerful and controlling people and the government.ConclusionsThe study examined the frames and narratives used by the Australian public when discussing nutrition policies. By examining these frames and narratives, we gained insight into multiple strategies which may increase public support for certain nutrition policies in Australia.

Project description:Background: Only limited information is available on the nutrition knowledge of the general Austrian population and how this relates to the nutrition knowledge of health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. Methods: Adolescents and adults at the age of 14–75 years (n = 1000), medical doctors (n = 307), pharmacists (n = 295), nutritionists (n = 124), dieticians (n = 160) and school teachers (n = 873) completed an online survey using a German version of the General Nutrition Knowledge Questionnaire-Revised (GNKQ-R) including self-reported data on sex, age, BMI, and health status. Adolescent and adult participants were recruited by a research agency to be representative for the Austrian population for age, sex, and education. A convenience sample was used for health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. All participants completed a computer-assisted web-based interviewing (CAWI) survey. Results: Total scores for nutrition knowledge of the general population (61.4%) were significantly lower than scores from all other groups (medical doctors 81.3%, pharmacists 83.0%, dieticians 87.5%, nutritionists 85.6%, school teachers 74.5%). The main drivers for better nutritional knowledge were female sex, higher age, and higher level of education, while BMI classification and self-reported health status had no impact. In regard to single questions, the most striking result was the misclassification of sugar as the nutrient with the most calories by 41.4% of the general population while only 29.0% correctly identified fat to be the nutrient with the most calories. Conclusions: The nutritional knowledge of the general population should be significantly improved in order to lay a basis for better dietary behavior. In view of the relatively low scores of teachers, their nutrition education should be improved in order to enable transfer of sound education in schools.

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

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