title: Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review.
abstract: OBJECTIVE
  The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses.
  
  
  BACKGROUND
  There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace.
  
  
  METHODS
  Integrative mixed method review.
  
  
  METHODS
  Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative.
  
  
  METHODS
  An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis.
  
  
  RESULTS
  Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, individual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake.
  
  
  CONCLUSIONS
  Reorientation of the workplace to promote healthy eating among nurses is required.
authors.affiliation: Faculty of Health, University of Technology Sydney, New South Wales, Australia.
authors.forename: Rachel
authors.identifier: http://orcid.org/0000-0001-7491-2166
authors.initials: R
authors.lastname: Nicholls
authors.affiliation: Faculty of Health, University of Technology Sydney, New South Wales, Australia.
authors.forename: Lin
authors.identifier: http://orcid.org/0000-0002-8507-1283
authors.initials: L
authors.lastname: Perry
authors.affiliation: Centre for Health Services Management, Faculty of Health, University of Technology Sydney, New South Wales, Australia.|Edith Cowan University, Perth, Western Australia.
authors.forename: Christine
authors.identifier: http://orcid.org/0000-0001-6534-8743
authors.initials: C
authors.lastname: Duffield
authors.affiliation: Charles Perkins Centre, Sydney Nursing School, University of Sydney, New South Wales, Australia.
authors.forename: Robyn
authors.identifier: http://orcid.org/0000-0001-5588-9351
authors.initials: R
authors.lastname: Gallagher
authors.affiliation: Faculty of Health, University of Technology Sydney, New South Wales, Australia.
authors.forename: Heather
authors.identifier: http://orcid.org/0000-0002-3760-935X
authors.initials: H
authors.lastname: Pierce
mesh_terms: D001828:Body Image; D000072001:Diet, Healthy; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D062407:Meals; D009042:Motivation; D009726:Nurses / Q000523:psychology*; D009765:Obesity / Q000517:prevention & control; D009784:Occupational Diseases / Q000523:psychology; D015279:Organizational Culture; D020377:Self Efficacy; D013315:Stress, Psychological / Q000523:psychology; D013997:Time Factors; D014940:Work Schedule Tolerance; D016526:Workload; D017132:Workplace
keywords: barriers; diet; facilitators; healthy eating; integrative review; literature review; mixed method; nurses; obesity; overweight; systematic review; workplace