Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach
Abstract Background Creating healthy and sustainable food environments within long-term healthcare facilities asks for a systemic approach. This study aimed to: (1) identify system dynamics underlying the food environment of long-term healthcare facilities, (2) formulate actions for changing the sys...
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2025-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-024-21124-1 |
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| author | Joline J. Wierda S. Coosje Dijkstra Tamika M. Wopereis Sanne K. Djojosoeparto Maartje P. Poelman |
| author_facet | Joline J. Wierda S. Coosje Dijkstra Tamika M. Wopereis Sanne K. Djojosoeparto Maartje P. Poelman |
| author_sort | Joline J. Wierda |
| collection | DOAJ |
| description | Abstract Background Creating healthy and sustainable food environments within long-term healthcare facilities asks for a systemic approach. This study aimed to: (1) identify system dynamics underlying the food environment of long-term healthcare facilities, (2) formulate actions for changing the system to promote a healthy and sustainable food environment and (3) evaluate stakeholder perspectives about the process and progress towards action implementation up to one-year follow-up. Methods A group model building (GMB) approach was used during two workshops with stakeholders of five different long-term healthcare facilities in the Netherlands. Stakeholders created a causal loop diagram (CLD) and formulated actions for change. Interviews were conducted at six- and twelve months to evaluate perspectives on the GMB process and progress towards action implementation. Results The developed CLD consisted of 30 factors influencing the food environment in long-term healthcare facilities and four interrelated subsystems (patient; healthcare organization; national governance and policy; purchasing, procurement and budget). Stakeholders formulated 40 corresponding actions. After one year follow-up, small steps towards action implementation were observed (e.g., agenda setting, raising internal awareness, formulating plans), with several barriers hindering implementation being noted (e.g., lack of time, budget, priority). Conclusions This study gained a comprehensive, collectively acknowledged understanding of the system dynamics underlying the food environment in Dutch long-term healthcare institutions. The results underscore the importance of crafting a coherent set of actions that addresses various factors and underlying mechanisms to initiate systemic change. However, achieving actual system changes in long-term healthcare facilities requires prolonged efforts and overcoming barriers towards implementation. |
| format | Article |
| id | doaj-art-77a3e398a47249359217b7cb6ba3c585 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-77a3e398a47249359217b7cb6ba3c5852025-02-02T12:46:09ZengBMCBMC Public Health1471-24582025-01-0125111710.1186/s12889-024-21124-1Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approachJoline J. Wierda0S. Coosje Dijkstra1Tamika M. Wopereis2Sanne K. Djojosoeparto3Maartje P. Poelman4Chair group Consumption and Healthy Lifestyles, Wageningen University & ResearchAmsterdam UMC, Location Vrije Universiteit Amsterdam, Public and Occupational HealthChair group Consumption and Healthy Lifestyles, Wageningen University & ResearchChair group Consumption and Healthy Lifestyles, Wageningen University & ResearchChair group Consumption and Healthy Lifestyles, Wageningen University & ResearchAbstract Background Creating healthy and sustainable food environments within long-term healthcare facilities asks for a systemic approach. This study aimed to: (1) identify system dynamics underlying the food environment of long-term healthcare facilities, (2) formulate actions for changing the system to promote a healthy and sustainable food environment and (3) evaluate stakeholder perspectives about the process and progress towards action implementation up to one-year follow-up. Methods A group model building (GMB) approach was used during two workshops with stakeholders of five different long-term healthcare facilities in the Netherlands. Stakeholders created a causal loop diagram (CLD) and formulated actions for change. Interviews were conducted at six- and twelve months to evaluate perspectives on the GMB process and progress towards action implementation. Results The developed CLD consisted of 30 factors influencing the food environment in long-term healthcare facilities and four interrelated subsystems (patient; healthcare organization; national governance and policy; purchasing, procurement and budget). Stakeholders formulated 40 corresponding actions. After one year follow-up, small steps towards action implementation were observed (e.g., agenda setting, raising internal awareness, formulating plans), with several barriers hindering implementation being noted (e.g., lack of time, budget, priority). Conclusions This study gained a comprehensive, collectively acknowledged understanding of the system dynamics underlying the food environment in Dutch long-term healthcare institutions. The results underscore the importance of crafting a coherent set of actions that addresses various factors and underlying mechanisms to initiate systemic change. However, achieving actual system changes in long-term healthcare facilities requires prolonged efforts and overcoming barriers towards implementation.https://doi.org/10.1186/s12889-024-21124-1Food environmentHealthcare institutionLong-term careSystem dynamicsGroup model buildingCausal loop diagram |
| spellingShingle | Joline J. Wierda S. Coosje Dijkstra Tamika M. Wopereis Sanne K. Djojosoeparto Maartje P. Poelman Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach BMC Public Health Food environment Healthcare institution Long-term care System dynamics Group model building Causal loop diagram |
| title | Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach |
| title_full | Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach |
| title_fullStr | Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach |
| title_full_unstemmed | Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach |
| title_short | Identifying mechanisms that shape the food environment in long-term healthcare facilities in the Netherlands: a participatory system dynamics approach |
| title_sort | identifying mechanisms that shape the food environment in long term healthcare facilities in the netherlands a participatory system dynamics approach |
| topic | Food environment Healthcare institution Long-term care System dynamics Group model building Causal loop diagram |
| url | https://doi.org/10.1186/s12889-024-21124-1 |
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