Barriers to and facilitators of implementing complex workplace dietary interventions: Process evaluation results of a cluster controlled trial

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dc.contributor.author Fitzgerald, Sarah
dc.contributor.author Geaney, Fiona
dc.contributor.author Kelly, Clare
dc.contributor.author McHugh, Sheena M.
dc.contributor.author Perry, Ivan J.
dc.date.accessioned 2017-06-21T11:01:25Z
dc.date.available 2017-06-21T11:01:25Z
dc.date.issued 2016-04-21
dc.identifier.citation Fitzgerald, S., Geaney, F., Kelly, C., McHugh, S. and Perry, I. J. (2016) ‘Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial’, BMC Health Services Research, 16, 139 (13pp). doi: 10.1186/s12913-016-1413-7 en
dc.identifier.volume 16
dc.identifier.startpage 1
dc.identifier.endpage 13
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10468/4128
dc.identifier.doi 10.1186/s12913-016-1413-7
dc.description.abstract Background: Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees’ dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. Methods: A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7–9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7–9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Results: Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders’ perceptions of the benefits of participating, which facilitated implementation, included managers’ desire to improve company image and employees seeking health improvements. Other facilitators included stakeholder buy-in, organisational support and stakeholder cohesiveness with regards to the level of support provided to the intervention. Anticipation of employee resistance towards menu changes, workplace restructuring and target-driven workplace cultures impeded intervention implementation. Conclusions: Contextual factors such as workplace structures and cultures need to be considered in the implementation of future workplace dietary interventions. Negotiation and flexibility of key workplace stakeholders plays an integral role in overcoming the barriers of workplace cultures, structures and resistance to change. en
dc.description.sponsorship Health Research Board (Centre for Health & Diet Research grant HRC2007/13; Health Services Research Grant No. PHD/2007/16; Research Leader Award in Diabetes RL/2013/7) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central en
dc.relation.uri https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1413-7
dc.rights © 2016, Fitzgerald et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Process evaluation en
dc.subject Implementation en
dc.subject Facilitators en
dc.subject Barriers en
dc.subject Workplace dietary intervention en
dc.title Barriers to and facilitators of implementing complex workplace dietary interventions: Process evaluation results of a cluster controlled trial en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Sarah Fitzgerald, Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: sarahfitzgerald@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Research Board
dc.contributor.funder Department of Agriculture, Food and the Marine
dc.contributor.funder Irish Heart Foundation
dc.contributor.funder Nederlandse Stichting Zuivel voor Voeding en Gezondheid
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Health Services Research en
dc.internal.IRISemailaddress sarahfitzgerald@ucc.ie en
dc.identifier.articleid 139


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© 2016, Fitzgerald et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © 2016, Fitzgerald et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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