Social shaping of food intervention initiatives at worksites: Canteen takeaway schemes at two Danish hospitals

AIMS: The aim of this article is to analyse the social shaping of worksite food interventions at two Danish worksites. The overall aims are to contribute first, to the theoretical frameworks for the planning and analysis of food and health interventions at worksites and second, to a foodscape approach to worksite food interventions.

METHODS: The article is based on a case study of the design of a canteen takeaway (CTA) scheme for employees at two Danish hospitals. This was carried out as part of a project to investigate the shaping and impact of schemes that offer employees meals to buy, to take home or to eat at the worksite during irregular working hours.

Data collection was carried out through semi-structured interviews with stakeholders within the two change processes. Two focus group interviews were also carried out at one hospital and results from a user survey carried out by other researchers at the other hospital were included. Theoretically, the study was based on the social constitution approach to change processes at worksites and a co-evolution approach to problem–solution complexes as part of change processes.

RESULTS: Both interventions were initiated because of the need to improve the food supply for the evening shift and the work–life balance. The shaping of the schemes at the two hospitals became rather different change processes due to the local organizational processes shaped by previously developed norms and values.

At one hospital the change process challenged norms and values about food culture and challenged ideas in the canteen kitchen about working hours. At the other hospital, the change was more of a learning process that aimed at finding the best way to offer a CTA scheme. CONCLUSIONS: Worksite health promotion practitioners should be aware that the intervention itself is an object of negotiation between different stakeholders at a worksite based on existing norms and values.

The social contextual model and the setting approach to worksite health interventions lack reflections about how such norms and values might influence the shaping of the intervention. It is recommended that future planning and analyses of worksite health promotion interventions apply a combination of the social constitution approach to worksites and an integrated food supply and demand perspective based on analyses of the co-evolution of problem–solution complexes.