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Eat Smart! Workplace Cafeteria Program: A Valuable Tool to Implement in The Ottawa Hospital

Eat Smart! Workplace Cafeteria Program: A Valuable Tool to Implement in The Ottawa Hospital. Alicia McKellar , Dietetic Intern, 2007-2008 Ted Paluch, General Manager, Retail Food Services Research Advisor. Acknowledgements.

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Eat Smart! Workplace Cafeteria Program: A Valuable Tool to Implement in The Ottawa Hospital

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  1. Eat Smart! Workplace Cafeteria Program: A Valuable Tool to Implement in The Ottawa Hospital Alicia McKellar , Dietetic Intern, 2007-2008 Ted Paluch, General Manager, Retail Food ServicesResearch Advisor

  2. Acknowledgements This article is based on Alicia McKellar’s dietetic internship report, which was completed under the supervision of Ted Paluch and Joe Murphy, RD. Appreciation goes to: Erinn Salewski, RD - development of the questionnaire Louise Gariepy, Ph.D. - statistical support Frances Furmankiewicz, Director - peer reviewer VanHoutte Coffee - donation of prizes TOH Research Ethics Board TOH Translation Services TOH Printing Services TOH Cafeteria Services (Café 501 & The Greenery) Research participants

  3. Outline • Research Problem • Research Objectives • Literature Review • Methodology • Results • Discussion • Limitations • The Next Step… • Conclusion • References

  4. Research Problem Is implementing Eat Smart! in The Ottawa Hospital cafeterias worthwhile provided that customers would utilize the program? “A company with healthy employees has a positive impact on its community and customer”(1).

  5. Research Objectives The study will determine whether: Customers of Café 501 and The Greenery cafeterias are… Aware of the Eat Smart! program 2) Want healthier food choices 3) Would be influenced to make healthier food choices if a healthy promotion program such as Eat Smart! is implemented in the cafeterias

  6. Eat Smart! Workplace Cafeteria Program • Overall Goal: contribute to the reduction of food-borne illness and chronic diseases in Ontario (3). • Increased awareness and knowledge of healthy eating, food • safety and the advantages of being tobacco free • Increased availability of healthier food choices in a smoke free • environment • Promotion of safe, healthier food choices in the cafeteria • Eat Smart! programs: • Ontario’s Healthy Restaurant Program • Healthy School Program • Healthy Recreation Centre Program

  7. How to Become Eat Smart! Certified • Public health units across Ontario give an award of • excellence to restaurants that meet specific standards in • nutrition, food safety, and non-smoking seating • Must meet the standards to qualify • Registered Dietitian visit: • Review Eat Smart! standards • Inspection of the cafeteria • Confirm food handler certification • Recognized with an Award of Excellence Certificate

  8. Benefits of a Health Promotion Program “The eating habits of Ontarians can be improved” (1). The Ontario Public Health Association claims the workplace as an ideal setting to implement a health promotion program, as it is a convenient way to reach the adult population through many existing communication channels (1). TOH cafeterias feed meals to thousands of employees, volunteers, patients and visitors daily. “Research shows that healthy, supportive environments are critical for productive and satisfied employees. Health and wellness programs like Eat Smart! help to reduce absenteeism, staff turnover, worker compensation claims, and health insurance claims”(3)

  9. Research on Eat Smart! • Studies have been executed on the Eat Smart! Ontario’s Healthy Restaurant Program: • Participating Restaurant Operators: • 98% participated to have their establishment known as clean and • healthy (4). • Eat Smart! is on track in achieving its program objectives (4). • Intend to continue participating in the program (4). • Non-participating Restaurants: • Misunderstandings about how to qualify • Lack of time • Non-smoking bylaws • Potential loss of revenue (5).

  10. Research on Eat Smart! Continues… • Evaluation of the Nutrition Component: • ESWCP -chronic care hospital in Hamilton, ON • Assessed: • Staff’s frequency of visits and purchases • Attitudes about the program • Short-term eating behavior change • Suggestions to improve the ESWCP (2) • Conclusion: • Many aware of the program • Positive comments • Positive changes in eating habits (2)

  11. Methodology • Participants: • Convenience sampling • Clientele entered the retail area of Café 501 (General campus) or • The Greenery (Civic campus) cafeterias (n=747) • Clientele consisted of: • Patients • Employees • Volunteers • Visitors • Inviting all clientele conveyed that everyone’s feedback and suggestions were equally important

  12. Questionnaire • Developed by a dietetic intern • Self-administered • Bilingual • Six closed ended questions: • First three: addressed the objectives • Last three: revealed demographics of the subject population • Introduction Paragraph: • Purpose of the study • Ensured participants confidentiality • Concluding Paragraph: • Instructions for submission of completed questionnaires • Name and contact information for a draw • Pilot test

  13. Sampling Procedure • Dietetic intern distributed the questionnaires • Data collection: 2 days (1 day/campus) for 2 hours during lunch • Questionnaires accessible to all cafeteria customers • Prize: Van Houtte gift basket The Ottawa Hospital research ethics and review committee provided ethical approval for the study

  14. Statistics SPSS for Windows, Rel. 11.0.1 2001. Chicago: SPSS Inc. • Descriptive Statistics • Percentages calculated for each cafeteria separately and together • Percentages calculated for differences between age and gender of • participants • Unanswered questions: results were based on the number of responses

  15. Results: Response Rate • 265 questionnaires completed and returned = 35.5% response rate • 146- General 119- Civic • Observational Estimation: • 75% of customers at the General took a questionnaire • 65% of customers at the Civic took a questionnaire

  16. Results: Demographics

  17. Results: Demographics continued…

  18. Results: Awareness of Eat Smart! • 35% have heard or read about Eat Smart! • General 32.6% Civic 37.8% • No significant difference between gender • 50 years old were more aware

  19. Results: Want Healthier Food Choices • 96.2% want healthier food choices in the cafeterias • General 95.1% Civic 97.5% • 2% do not want healthier choices • 2% undecided • No significant difference between males and females • No significant difference between age groups

  20. Results: Influence of a Health Promotion Program • 90.5% would be influenced to make healthier food choices with the implementation of a health promotion program. • General 86.1% Civic 94.9% • 3.1% would not be influenced • 6.9% undecided • 90% females • 86% males • No significant difference between age groups

  21. Summary of Results

  22. Discussion • Response Rate: fewer responded compared to other Eat Smart! studies • Demographics: • More females than males • More females use the cafeteria? • More inclined to complete a questionnaire? • Greater interest in nutrition? • Dutch worksite study • Employees are the largest customer • Age of participants did not show a significant difference in results

  23. Awareness of Eat Smart! • 1/3 aware of the program • 25% Toronto residents aware in 2003 • 86% aware of ESWCP once implemented in workplace • promotional materials: on tables, in foodservice area • TOH: heard or read about Eat Smart! through a variety of different channels • Eat Smart! certified: 788 restaurants • 235 schools • 147 workplaces

  24. Want Healthier Choices • Large majority want healthier choices available in the cafeterias • Many do not purchase the healthier choices • Comments from other Eat Smart! surveys: • “Salad is more expensive than french fries, so where is the incentive to eat healthier while remaining on a budget?” • “When offering fruit, lower the prices: a banana in the cafeteria cost 99 cents, I can buy a bunch at the grocery store for that price.”

  25. Influence of a Health Promotion Program TOH statistic: 90.5% Ontario Public Health Association statistic: “70% of employees support employer involvement in workplace health promotion programs”

  26. Limitations • Distribution only 2 hours • Large entrance/ exit at The Greenery • 2 entrances at The Greenery • Incentives unavailable • Writing materials • Statutory Holiday • Response rate • Personalize questionnaires • Follow up / send reminders

  27. The Next Step…. • Program promotion • Point of purchase table stands • Postcards • Promotional messages • Infonet • Increase variety of healthier food choices • Influence Behaviour • Incentives • Coupons

  28. Conclusion The Ottawa Hospital should implement the Eat Smart! Program Further Research: Once implemented, observational research must be conducted to evaluate the program’s actual influence on customer food choice.

  29. The Ottawa Hospital Mission “playing an active role in promoting and improving health within our community”

  30. References • Ontario Public Health Association. Nutrition Resource Centre. Toronto. June 2002. • (2) Dawson J, Dywer JJM, Evers S, et al. Eat Smart! Workplace Cafeteria Program: • Evaluation of the Nutrition Component. Can J Diet Prac Res 2006;67:86-89. • (3) Eat Smart! Workplace cafeteria program manual. Ottawa: Ottawa Public Health • Nutrition. • (4) Macaskill LA, Dywer JJM, Uetrecht CL, et al. Eat Smart! Ontario’s Healthy • Restaurant Program: A Survey of Participating Restaurant Operators. Can J Diet • Res 2003 ;64:202-7. • (5) Dwyer, JJM, Macaskill LA, UetrechtCL, et al. Eat Smart! Ontario’s healthy • Restaurant Program: Focus Groups with Non-participating Restaurant • Operators. Can J Diet Res 2004:65:6-9 • (6) The Ottawa Hospital Retail Food Services Masterplan. July 2006.

  31. References continued… • (7) Steenhuis I, Van Assema P, Van Breukelen G, et al. The impact of educational • and environmental interventions in Dutch worksite cafeterias. Health • Promotion Internatiional. 2004. 19. 3:335-343. • Health Information Team, Planning and Policy Services. Rapid Risk Factor Surveillance System- Toronto Residents: Eat Smart! Healthy Restaurant Program. Toronto Public Health. October 2003. • (9) Eat Smart! and the Nutrition Resource Centre. 2008.www.eatsmartontario.ca • (10) French, SA. Symposium: Sugar and Fat-From Genes to Culture. Pricing • Effects on Food Choices. The American Society for Nutritional Sciences. J. • Nutr. March 2003 133:841S-843S • (11) The Ottawa Hospital. Mission. 2003.

  32. Questions?

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