Barriers and facilitators to implementing a healthier food outlet initiative: perspectives from local governments

Abstract

Objective: Local governments have integral roles in contributing to public health. One recent focus has been on how local governments can impact community nutrition by engaging food service outlets to improve their food offer. The Healthier Catering Commitment (HCC) is an initiative where London local governments support takeaways and restaurants to meet centrally defined nutrition criteria on their food options. Using the case of HCC, the current study aims to provide (1) practical learnings of how local governments could facilitate and overcome barriers associated with implementing healthy food service initiatives in general, and (2) specific recommendations for enhancements for HCC. Design: Key informant, semi-structured interviews were conducted with local government staff involved in HCC, exploring barriers and facilitators to HCC implementation in food businesses. A thematic analysis approach was used, with results presented according to a logic pathway of ideal implementation in order to provide practical, focused insights. Setting: Local governments implementing HCC. Participants: Twenty-two individuals supporting HCC implementation. Results: Facilitators to implementation included flexible approaches, shared resourcing and strategically engaging businesses with practical demonstrations. Barriers were limited resources, businesses fearing negative customer responses and low uptake in disadvantaged areas. Key suggestions to enhance implementation and impact included offering additional incentives, increasing HCC awareness and encouraging recruited businesses to make healthy changes beyond initiative requirements. Conclusions: In order to facilitate the implementation of healthy food initiatives in food outlets, local governments would benefit from involving their environmental health team, employing community-tailored approaches and focusing on supporting businesses in disadvantaged areas.

UK government’s new placement legislation is a ‘good first step’: a rapid qualitative analysis of consumer, business, enforcement and health stakeholder perspectives

“…Two further recommendations highlighted for immediate government action include the provision of extra ring-fenced resources for local authorities and targeted support for affected smaller businesses. Both of these recommendations are supported by previous evaluations of healthy eating initiatives in small food stores and independent takeaways [ 45 – 47 ]. Local authority staff responsible for enforcement of these food initiatives reported that they were most successful when appropriate financial and workforce resources were available.…”

“…Local authority staff responsible for enforcement of these food initiatives reported that they were most successful when appropriate financial and workforce resources were available. These resources ensured officers had dedicated time to establish strong, respectful relationships with businesses [ 45 , 46 ]. Clear definitions and step-by-step guidance (as published by The Association of Convenience Stores [ 48 ]), accompanied by an intelligible rationale for local benefit (such as local childhood obesity and other health data), could be used in enforcement officers’ discussions with local businesses.…”

“…Interactive stakeholder fora which bring businesses and other local stakeholders together to discuss practical issues around legislation could be more time efficient for local authorities whilst fostering a sense of community ownership [ 46 , 47 ]. However, translation of resources into culturally appropriate languages is also likely to be necessary by local authorities to achieve consistent implementation, particularly amongst the convenience sector [ 45 , 46 ].…”

Dietitians Australia position statement on healthy and sustainable diets

“… Restricting the merchandising of discretionary food and beverages in retail settings (Australia) 121 Barriers and facilitators for creating healthy food retail outlets – perspectives from Australian local government authorities (Australia) 122 Applying the ecological determinants of health perspective to reconsider the current retail foodscape (United States of America and Canada) 123 A systematic review of factors influencing sustainable food consumption behaviours amongst university students, examining the effects of choice architecture interventions (International) 124 …”

UK food and nutrition security during and after the COVID‐19 pandemic

“…Inequalities, lack of access to affordable food, and rising obesity and malnutrition have been concerns for some time in the food system arena in the UK as in many other countries and international organisations. Hence, prior to the pandemic, there were concerns about the UK food system and calls for transformation of consumption patterns to improve diets and health and to achieve greater resilience and sustainability in production and supply chains (Williams et al 2018;Lang 2020;Boelsen-Robinson et al 2020;Springmann et al 2020). There have been calls for radically transforming the global food system to achieve a resilient food system (Willett & Rockstr€ om 2019; Poore & Nemecek 2018;Hawkes 2020), and even more so now during the pandemic (Stordalen & Rockstr€ om 2020).…”