{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:57:52Z","timestamp":1792378672237,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,8,4]],"date-time":"2024-08-04T00:00:00Z","timestamp":1722729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To improve the healthfulness of foods offered while accelerating the use of environmental sustainability practices, it is important to engage hospital food service operators in the adoption of such practices. The purpose of this study was to explore barriers, facilitators and best practices for implementing environmental sustainability standards in food service among veterans affairs (VA) hospitals in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an online survey with 14 VA hospital food service directors and then 11 qualitative interviews. The survey assessed motivations for initiating sustainability standards and included a self\u2010rating of implementation for each of five standards: increasing plant\u2010forward dishes, procuring and serving sustainable foods that meet organic\/fair trade and other certifications, procuring and serving locally produced foods, reducing food waste and reducing energy consumption. Interviews were transcribed verbatim. Qualitative analysis, including coding of themes and subthemes, was conducted by two coders to determine barriers, facilitators and best practices for each of these five standards. Quantitative methods (counts and frequencies) were used to analyse the survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had an average of 5 years of experience implementing sustainability standards. The top three motivators cited were reducing food waste, serving healthier foods and increasing efficiency or cost savings. Barriers revolved around patient preferences, contractual difficulties and costs related to reducing waste. Facilitators included taste testing new recipes that include more sustainable food options and easy access to sustainable products from the prime vendor. Best practices included making familiar dishes plant\u2010forward and plate waste studies to prevent overproduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although there were many barriers to implementation, food service directors had solutions for overcoming challenges and implementing food service sustainability standards, which can be tested in future sustainability initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.13357","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T01:54:20Z","timestamp":1722822860000},"page":"1420-1431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A qualitative exploration of barriers, facilitators and best practices for implementing environmental sustainability standards and reducing food waste in veterans affairs hospitals"],"prefix":"10.1111","volume":"37","author":[{"given":"Bethany D.","family":"Williams","sequence":"first","affiliation":[{"name":"Department of Nutrition and Exercise Physiology Washington State University Health Sciences Spokane Spokane Washington USA"},{"name":"Center for Science in the Public Interest Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-638X","authenticated-orcid":false,"given":"Stephanie Jilcott","family":"Pitts","sequence":"additional","affiliation":[{"name":"Department of Public Health East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Onufrak","sequence":"additional","affiliation":[{"name":"Division of Nutrition Physical Activity, and Obesity, Centers for Disease Control and Prevention Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Sirois","sequence":"additional","affiliation":[{"name":"Healthy Food in Health Care Program, Health Care Without Harm and Practice Greenhealth Reston Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Utech","sequence":"additional","affiliation":[{"name":"Nutrition and Food Services, US Department of Veteran Affairs Washington District of Columbia USA"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Wood","sequence":"additional","affiliation":[{"name":"Division of Chronic Disease and Injury Prevention Los Angeles County Department of Public Health Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessi","family":"Silverman","sequence":"additional","affiliation":[{"name":"Center for Science in the Public Interest Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funke","family":"Ajenikoko","sequence":"additional","affiliation":[{"name":"American Heart Association Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Murphy","sequence":"additional","affiliation":[{"name":"Chronic Disease and Health Equity Unit, County of San Diego Health and Human Services Agency San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Lowry Warnock","sequence":"additional","affiliation":[{"name":"Division of Nutrition Physical Activity, and Obesity, Centers for Disease Control and Prevention Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"Crimmins AlisonB GambleJ BeardJL BellCB DodgenJE et al. 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