{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:08:37Z","timestamp":1788865717372,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Planning &amp;amp; Management"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Health promotion policy is an effective way to improve population health and reduce the burden of chronic disease, yet how implementation of health promotion at policy levels occurs within healthcare remains unclear. Healthcare organizations, on the one hand, aim to improve population health and \u2018upstream\u2019 health determinants through the Quintuple Aim, but, on the other, are complex and dynamic organizations, with a particular emphasis on downstream clinical care services. Many types of practitioners interpret health promotion policies within the healthcare setting and must implement them in their everyday work: policy implementation as an everyday occurrence. Healthy eating policies focused on creating supportive food environments (e.g.,\u00a0cafeterias, cafes) are being adopted by healthcare organizations as a way to improve diets and reduce the burden of chronic disease. An examination of healthy eating policy implementation is essential to better understand how health promotion is integrated into healthcare organizations. This qualitative phenomenological study uses organizational social theory on street\u2010level bureaucrats to interpret the implementation of a healthy eating policy within healthcare food retail services and the relationships between street\u2010level bureaucrats. We conducted 12 in\u2010depth policy key informant interviews and analysed findings using directed content analysis. The findings showed a shift in priorities from leadership to allocate resources for health promotion tasks to make food more accessible and available to staff. Participants considered context as they implemented the policy using local knowledge arising from informal and formal networks and identified other opportunities to influence healthy eating. Studying the actions of healthcare practitioners in everyday policymaking provides essential context and insight into how policy implementation unfolds. Although standards for health promotion are lacking, practitioners can engage in quality improvement initiatives to challenge the status quo and improve food environments.<\/jats:p>","DOI":"10.1002\/hpm.70102","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T20:39:31Z","timestamp":1784407171000},"page":"903-913","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Practices of Healthcare Practitioners During the Implementation of a Healthy Eating Policy"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-4307","authenticated-orcid":false,"given":"Laura J.","family":"Kennedy","sequence":"first","affiliation":[{"name":"School of Health Administration Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanna Parsons","family":"Leigh","sequence":"additional","affiliation":[{"name":"School of Health Administration Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara F. L.","family":"Kirk","sequence":"additional","affiliation":[{"name":"School of Health and Human Performance Healthy Populations Institute Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meaghan","family":"Sim","sequence":"additional","affiliation":[{"name":"Research and Innovation IWK Health  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Mah","sequence":"additional","affiliation":[{"name":"School of Health Administration Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"WHO.Ottawa Charter for Health Promotion.1986."},{"key":"e_1_2_11_3_1","first-page":"24","article-title":"Health\u2010Promoting Hospitals","volume":"3","author":"Pelikan J.","year":"1997","journal-title":"World Health"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010021\u201007418\u20109"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpja.557"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2013.10.002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.21101\/cejph.a6172"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13668\u2010019\u201000295\u2010z"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30752\u20102"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010020\u201009160\u2010z"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12080"},{"key":"e_1_2_11_12_1","volume-title":"Street\u2010Level Bureaucracy: Dilemmas of the Individual in Public Service","author":"Lipsky M.","year":"1980"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2753\/atp1084\u20101806330110"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jopart\/muy024"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20106210.2010.02131.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/14719037.2021.1963824"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467\u20108551.2004.t01\u20101\u201000403.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/spol.12550"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.1016\/S2155-8256(15)30200-3","volume-title":"Mclaughlin and Kaluzny\u2019s Continuous Quality Improvement in Health Care, 4th Edition","author":"Sollecito W. 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