Athena Institute, Faculty of Science, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam University Medical Centres, VU University Medical Center, Amsterdam, the Netherlands.
Int J Behav Nutr Phys Act. 2019 Nov 21;16(1):108. doi: 10.1186/s12966-019-0867-5.
Due to their central position in the modern food system, food stores present a unique opportunity to promote healthy dietary behaviour. However, there is a lack of insight into the factors that impede or enhance the implementation of nutritional interventions in food stores. We applied a systems innovation and implementation science framework to the identification of such barriers and facilitators.
We conducted a systematic literature review. A search string was developed to identify qualitative and quantitative articles on environmental nutritional interventions in the food store. Four databases were systematically searched for studies published between 2000 and 2018. Eligible publications described study designs or original studies, focused on stimulating healthier dietary behaviour through environmental changes in retail settings and contained information on the perceptions or experiences of retailers or interventionists regarding the implementation process of the intervention. Context-descriptive data was extracted and a quality assessment was performed.
We included 41 articles, of which the majority was conducted in the USA and involved single stores or a mix of single and multi-store organisations. We categorized barriers and facilitators into 18 themes, under five domains. In the 'outer setting' domain, most factors related to consumers' preferences and demands, and the challenge of establishing a supply of healthy products. In the 'inner setting' domain, these related to conflicting values regarding health promotion and commercial viability, store lay-out, (insufficient) knowledge and work capacity, and routines regarding waste avoidance and product stocking. In the 'actors' domain, no major themes were found. For the 'intervention 'domain', most related to intervention-context fit, money and resource provision, material quality, and the trade-offs between commercial costs and risks versus commercial and health benefits. For the 'process' domain, most factors related to continuous engagement and strong relationships.
This review provides a comprehensive overview of barriers and facilitators to be taken into account when implementing nutritional interventions in food stores. Furthermore, we propose a novel perspective on implementation as the alignment of intervention and retail interests, and a corresponding approach to intervention design which may help avoid barriers, and leverage facilitators.
PROSPERO; CRD42018095317.
由于食品店在现代食品系统中的核心地位，它们为促进健康饮食行为提供了独特的机会。然而，对于阻碍或促进食品店实施营养干预的因素，我们的了解还很有限。我们应用系统创新和实施科学框架来确定这些障碍和促进因素。
我们进行了系统的文献回顾。制定了一个搜索字符串，以确定 2000 年至 2018 年间关于食品店环境营养干预的定性和定量文章。系统地搜索了四个数据库，以寻找研究设计或原始研究的出版物，这些研究侧重于通过零售环境中的环境变化刺激更健康的饮食行为，并包含零售商或干预者对干预实施过程的看法或经验。提取了背景描述性数据并进行了质量评估。
我们纳入了 41 篇文章，其中大多数研究在美国进行，涉及单个商店或单个和多个商店组织的混合。我们将障碍和促进因素分为 18 个主题，分为五个领域。在外设领域，大多数因素与消费者的偏好和需求有关，以及建立健康产品供应的挑战。在内设领域，这些因素与健康促进和商业可行性、商店布局、（不足）知识和工作能力以及关于避免浪费和产品库存的惯例之间存在冲突。在行为者领域，没有发现主要的主题。对于干预领域，大多数与干预背景契合、资金和资源提供、材料质量以及商业成本和风险与商业和健康效益之间的权衡有关。对于过程领域，大多数因素与持续参与和强有力的关系有关。
本综述提供了在食品店实施营养干预时需要考虑的障碍和促进因素的全面概述。此外，我们提出了一种新的实施视角，即将干预和零售利益相协调，以及一种相应的干预设计方法，这可能有助于避免障碍，并利用促进因素。
PROSPERO；CRD42018095317。
