School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland, New Zealand.
Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
BMC Public Health. 2024 Aug 12;24(1):2179. doi: 10.1186/s12889-024-19693-2.
In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, "the Policy") was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors' awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy.
Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants.
Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that "Hospitals should be good role models." Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options.
The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.
2016 年，新西兰发布了一项自愿的国家健康食品和饮料政策（以下简称“政策”），以鼓励公立医院提供符合国家饮食指南的食品和饮料选择。五年后，20 家机构中有 8 家采用了该政策，其中几家更愿意保留或更新自己机构层面的版本。本研究评估了员工和访客对该政策的知晓程度、支持或反对情况，并收集了自政策实施以来对感知食品环境变化的反馈。
2021 年 6 月至 2022 年 8 月期间进行了横断面电子和纸质问卷调查。采用描述性统计方法呈现定量发现。对自由文本回复采用一般归纳法进行分析。通过政策实施程度、参与者的种族和经济保障水平对定性和定量发现进行了比较。
共从 19 家医疗机构收集了 2526 名员工和 261 名访客的数据。80%的员工和 56%的访客知晓该政策。无论员工是否知晓该政策，他们普遍支持该政策，大多数人认为“医院应该是良好的榜样”。反对该政策的员工中，最常见的反对理由是自由选择。由于更频繁地在现场购买食品，该政策对毛利人和太平洋岛民员工产生了更大的积极和消极影响。大多数员工注意到自政策实施以来食品和饮料供应方面的差异。一些医院提供的选择种类繁多，得到了积极反馈，但总体而言，40%的自由文本评论提到选择有限。74%的员工报告称，食品和饮料价格更高。低收入员工/访客和轮班工人特别受到健康选择减少和价格上涨的影响。
该政策导致新西兰医院提供的食品和饮料的健康程度发生了显著变化，但这伴随着对价值和选择减少的看法。虽然普遍得到支持，但调查结果表明有机会改进食品和饮料政策的实施（例如，提供更多健康食品选择、更好地与员工互动、保持健康选择的低价格），并确认该政策可以扩展到其他公共工作场所。
