The adoption of sustainable menu practices in healthcare institutions in Quebec : a study of feasibility
Background: In many societies, as in Quebec, there is an increased interest towards sustainable food systems. Food sustainability aims to maintain human and planetary health through nutritious food, all the while promoting economic and social development. In this perspective, foodservice managers in healthcare institutions can prioritize sustainable menu practices (SMPs). As there is little research on SMPs in this context, it is of uttermost importance to understand their feasibility in healthcare institutions. Objective: This study aimed to analyze the feasibility of adopting SMPs in Quebec healthcare institutions. Methods: Following an integrated knowledge translation and exchange approach and in partnership with Nourish (McConnell Foundation), a qualitative study was carried out using semi-structured interviews with seventeen foodservice managers, recruited through purposeful sampling in ten of thirty healthcare institutions in Quebec. The revised Diffusion of innovations theory, describing the nine principal determinants of the processes of the diffusion of an innovation (SMPs) in a complex social system (healthcare organization), structured the interview guide for data collection and the codebook for data analysis.  Results: Managers report being motivated by food sustainability, however this does not always translate to concrete actions due to its lack of prioritization in foodservices. Challenges to adopt and implement SMPs are considerably more recurrent than facilitators. Key barriers include perceived SMP complexity, the context of the healthcare system, a substantial lack of resources and shortfalls in clear political directives from Ministry of Health. Amongst enhanced support and ministry guidance, foodservice managers need increased collaboration between all food system actors for better SMP adoption.  Discussion: This research contributes to in-depth understanding of the managerial experience in SMP adoption in various regional and institutional settings. Findings suggest the need for food system partnerships, as well as support and strategies that would remove important barriers in SMP adoption.
Alimentation durable Nutrition Food sustainability Foodservice Diffusion of Innovations