{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T16:17:40Z","timestamp":1772122660112,"version":"3.50.1"},"reference-count":39,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T00:00:00Z","timestamp":1582588800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NIH Director\u2019s Pioneer Award","award":["5DP1ES02545903"],"award-info":[{"award-number":["5DP1ES02545903"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,2,5]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the perceptions, enablers and barriers to employees\u2019 healthy eating in a hospital site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30\u2009km east of Nepal's capital Kathmandu.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8\u201312\u2009hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The major factors for promoting healthy eating were identified as the availability of affordable healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for healthy eating were the unavailability of healthy options, including the lack of food supply from local market, the higher cost of healthy foods, individual food preferences and limited human resources in the cafeteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The availability of affordable healthy foods, supply of healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote healthy eating among employees in a Nepali hospital setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031404","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T06:15:12Z","timestamp":1582697712000},"page":"e031404","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Drivers of healthy eating in a workplace in Nepal: a qualitative study"],"prefix":"10.1136","volume":"10","author":[{"given":"Dipesh","family":"Tamrakar","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Kathmandu University School of Medical Sciences, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4741-090X","authenticated-orcid":false,"given":"Archana","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal"},{"name":"Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjana","family":"Rai","sequence":"additional","affiliation":[{"name":"Family Health International 360, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biraj Man","family":"Karmacharya","sequence":"additional","affiliation":[{"name":"Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasanti","family":"Malik","sequence":"additional","affiliation":[{"name":"Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josiemer","family":"Mattei","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Spiegelman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA"},{"name":"Department of Biostatistics, Center on Methods for Implementation and Prevention Science, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,25]]},"reference":[{"key":"2025102702560740000_10.2.e031404.1","unstructured":"National Research Council (US) Committee on Diet and Health . Diet and health: implications for reducing chronic disease risk. Washington, DC: National Academies Press (US), 1989."},{"key":"2025102702560740000_10.2.e031404.2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00852.2004"},{"key":"2025102702560740000_10.2.e031404.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.003"},{"key":"2025102702560740000_10.2.e031404.4","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu173"},{"key":"2025102702560740000_10.2.e031404.5","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.3504","article-title":"Exploring women's beliefs and perceptions about healthy eating blogs: a qualitative study","volume":"17","author":"Bissonnette-Maheux","year":"2015","journal-title":"J Med Internet Res"},{"key":"2025102702560740000_10.2.e031404.6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/jan.13185","article-title":"Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review","volume":"73","author":"Nicholls","year":"2017","journal-title":"J Adv Nurs"},{"key":"2025102702560740000_10.2.e031404.7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jneb.2015.11.001","article-title":"Promoting healthy choices in workplace Cafeterias: a qualitative study","volume":"48","author":"Thomas","year":"2016","journal-title":"J Nutr Educ Behav"},{"key":"2025102702560740000_10.2.e031404.8","unstructured":"Nepal Health Research Council . Assessment of burden of disease in Nepal, 2009. Kathmandu, Nepal: Nepal Health Research Council, 2018."},{"key":"2025102702560740000_10.2.e031404.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0134834","article-title":"The burden and determinants of non communicable diseases risk factors in Nepal: findings from a nationwide steps survey","volume":"10","author":"Aryal","year":"2015","journal-title":"PLoS One"},{"key":"2025102702560740000_10.2.e031404.10","doi-asserted-by":"publisher","DOI":"10.1136\/heartasia-2015-010666"},{"key":"2025102702560740000_10.2.e031404.11","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0019-4832(12)60045-5","article-title":"Prevalence of hypertension in Nepalese community triples in 25 years: a repeat cross-sectional study in rural Kathmandu","volume":"64","author":"Vaidya","year":"2012","journal-title":"Indian Heart J"},{"key":"2025102702560740000_10.2.e031404.12","first-page":"20","article-title":"Dietary patterns, hypertension and diabetes in nepal\u2013a community-based study","volume":"7","author":"Shrestha","year":"2016","journal-title":"Int J Health Nutrition"},{"key":"2025102702560740000_10.2.e031404.13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1108\/17538351011078929","article-title":"Healthy eating strategies in the workplace","volume":"3","author":"Quintiliani","year":"2010","journal-title":"Int J Workplace Health Manag"},{"key":"2025102702560740000_10.2.e031404.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2005.03.001"},{"key":"2025102702560740000_10.2.e031404.15","doi-asserted-by":"crossref","first-page":"e287","DOI":"10.1097\/JOM.0000000000000813","article-title":"The impact of worksite supports for healthy eating on dietary behaviors","volume":"58","author":"Dodson","year":"2016","journal-title":"J Occup Environ Med"},{"key":"2025102702560740000_10.2.e031404.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.07.003"},{"key":"2025102702560740000_10.2.e031404.17","doi-asserted-by":"publisher","DOI":"10.1177\/1524839915596310"},{"key":"2025102702560740000_10.2.e031404.18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1365-277X.2012.01281.x","article-title":"A qualitative study to investigate the drivers and barriers to healthy eating in two public sector workplaces","volume":"26","author":"Pridgeon","year":"2013","journal-title":"J Hum Nutr Diet"},{"key":"2025102702560740000_10.2.e031404.19","first-page":"57S","article-title":"\"Pizza is cheaper than salad\": assessing workers' views for an environmental food intervention","volume":"15 Suppl 1","author":"Devine","year":"2007","journal-title":"Obesity"},{"key":"2025102702560740000_10.2.e031404.20","first-page":"33","article-title":"Barriers to healthy eating in the nursing profession: Part 1","volume":"15","author":"Faugier","year":"2001","journal-title":"Nurs Stand"},{"key":"2025102702560740000_10.2.e031404.21","doi-asserted-by":"crossref","DOI":"10.1136\/heartasia-2017-010956","article-title":"Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal","volume":"9","author":"Shrestha","year":"2017","journal-title":"Heart Asia"},{"key":"2025102702560740000_10.2.e031404.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2010.01116.x"},{"key":"2025102702560740000_10.2.e031404.23","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980011002655"},{"key":"2025102702560740000_10.2.e031404.24","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025102702560740000_10.2.e031404.25","unstructured":"DOHS . Annual Report 2072\/73. In: Department of health services, Ministry of health and population, eds. Kathmandu Nepal, 2017."},{"key":"2025102702560740000_10.2.e031404.26","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-016-1413-7","article-title":"Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial","volume":"16","author":"Fitzgerald","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"2025102702560740000_10.2.e031404.27","unstructured":"Burke K , Morris K , McGarrigle L , et al . An introductory guide to implementation: terms, concepts and frameworks, 2012."},{"key":"2025102702560740000_10.2.e031404.28","doi-asserted-by":"publisher","DOI":"10.1079\/NRR200244"},{"key":"2025102702560740000_10.2.e031404.29","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-010-9224-y"},{"key":"2025102702560740000_10.2.e031404.30","doi-asserted-by":"publisher","DOI":"10.1177\/1090198111434153"},{"key":"2025102702560740000_10.2.e031404.31","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0076723","article-title":"Does an 'activity-permissive' workplace change office workers' sitting and activity time?","volume":"8","author":"Gorman","year":"2013","journal-title":"PLoS One"},{"key":"2025102702560740000_10.2.e031404.32","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-7-86"},{"key":"2025102702560740000_10.2.e031404.33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5402\/2012\/790602","article-title":"Perceptions, facilitators, and barriers to consumption of whole grain staple foods among overweight and obese Tanzanian adults: a focus group study","volume":"2012","author":"Muhihi","year":"2012","journal-title":"ISRN Public Health"},{"key":"2025102702560740000_10.2.e031404.34","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114598001020"},{"key":"2025102702560740000_10.2.e031404.35","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980012004715"},{"key":"2025102702560740000_10.2.e031404.36","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/JOM.0b013e3182479f5c","article-title":"Free choice access to multipoint wellness education and related services positively impacts employee wellness: a randomized and controlled trial","volume":"54","author":"Sforzo","year":"2012","journal-title":"J Occup Environ Med"},{"key":"2025102702560740000_10.2.e031404.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(98)00260-0"},{"key":"2025102702560740000_10.2.e031404.38","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nutr.17.1.237"},{"key":"2025102702560740000_10.2.e031404.39","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-277X.1998.00124.x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-031404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T09:56:17Z","timestamp":1761558977000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-031404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,25]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bmjopen-2019-031404"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-031404","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}