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Original research
Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal
  1. Archana Shrestha1,
  2. Prajjwal Pyakurel2,
  3. Abha Shrestha3,
  4. Rabin Gautam2,
  5. Nisha Manandhar2,
  6. Elizabeth Rhodes4,
  7. Dipesh Tamrakar3,5,
  8. Biraj Man Karmacharya3,6,7,
  9. Vasanti Malik8,
  10. Josiemer Mattei8,
  11. Donna Spiegelman1,8,9
  1. 1 Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
  2. 2 Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
  3. 3 Department of Community Programs, Dhulikhel Hospital – Kathmandu University Hospital, Dhulikhel, Nepal
  4. 4 Laney Graduate School, Emory University, Atlanta, Georgia, USA
  5. 5 Department of Community Medicine, Kathmandu University, Dhulikhel, Nepal
  6. 6 Department of Cardiology, University of Washington, Seattle, Washington, USA
  7. 7 Department of Community Medicine, Kathmandu Hospital, Dhulikhel, Nepal
  8. 8 Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
  9. 9 Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Archana Shrestha, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA; deararchana{at}gmail.com

Abstract

Objective Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate healthy food choices. The study explored perceptions about healthy eating as well as potential facilitators and barriers to healthy eating among employees in a wire manufacturing factory in Nepal.

Methods and materials We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method.

Results Most employees defined healthy eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to healthy eating included unavailability of healthy foods, difficulty in changing eating habits, the preference for fried foods in Nepali culture and the high costs of some healthy foods. The most commonly reported facilitator of healthy eating was the availability of affordable healthy food options in worksite cafeterias.

Conclusion Availability of healthy food options at an affordable price could lead to healthier food choices in the worksite.

  • education
  • public health
  • primary care

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/heartasia-2017-010956

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    Footnotes

    • Contributors ArS conceived the study. ArS, DS, VM, JM, DT and BMK contributed to the design of the study and development and pretesting of tools. RG, NM, PP, ArS, AbS and PP contributed to data collection, transcription and data management. ArS and PP analyzed the data. ArS wrote the manuscript. PP and ER contributed significantly to manuscript writing. All authors contributed to refinement and approved the final manuscript.

    • Funding This study was funded by NIH Director’s Pioneer Award (award no: 5DP1ES02545903).

    • Competing interests None declared.

    • Ethics approval We received ethical approval from the institutional review boards at the Harvard TH Chan School of Public Health, USA, and Kathmandu University School of Medical Science, Nepal. All procedures to recruit and enrol study participants were approved by the Ethical Review Board of Kathmandu University School of Medical Science and the institutional review board at Harvard TH Chan School of Public Health.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data are not available to share.