Hospital-Based Food Environment Interventions to Improve Workforce Dietary Behaviour: A Systematic Literature Review

The aim of this study was to determine the effectiveness of hospital-based interventions in improving eating patterns and food purchasing behaviours of hospital staff. Four electronic databases were searched from inception to November 2021 for intervention studies conducted within hospital retail food environments. Studies assessing outcomes pertaining to changes in eating patterns and/or food purchasing behaviour were included. Intervention effectiveness was defined as a statistically significant change in primary outcomes. Study quality was assessed independently by two researchers using the Mixed-Methods Appraisal Tool. In total, 20 studies were included in the review. 10 studies were moderate to low quality and almost half of the included studies (n = 9) utilised a quantitative descriptive design. Intervention modes included signage and health labels (n = 17), price modifications (n = 9), recipe modifications (n = 7), choice architecture (n = 5), altering healthy food availability (n = 5) and cooking processes (n = 1). Most studies (n = 15) contained more than one intervention type within their intervention design. Significant improvements in all primary outcomes were identified within eight studies, in which all had included a point-of-purchase prompt. Multicomponent interventions that incorporate point-of-purchase prompts may be useful in improving eating patterns and/or food purchasing behaviour of hospital staff. Further rigorous research identifying the long-term effectiveness of these interventions on improving health outcomes is warranted.