Leadership, Liaisons, and Logistics: Military Perspectives on Facilitators and Barriers to Optimizing the Food Environment

<h2>ABSTRACT</h2><h3>Objectives</h3> This study explored factors that influence the development and implementation of food environment improvement interventions at military installations. <h3>Methods</h3> As part of a mixed-methods study with 12 military installations representing all service branches, researchers conducted feedback sessions to explore facilitators and barriers of the food environment improvement process. Local team members (n=36) across two cohorts and 12 sites, including health and nutrition professionals, food-venue operators, foodservice professionals, and unit leadership. Local teams evaluated their local food environment using the military nutrition environment assessment tool (mNEAT) then created and executed, as able, an intervention to improve healthy food policy, availability, or behavioral design at a selected food venue. During feedback sessions, local teams were asked about facilitators and barriers to success overall and during each study phase (food environment assessment, intervention venue selection, intervention planning, and implementation). <h3>Results</h3> Researchers used a qualitative description approach to code feedback sessions and identify themes. Key facilitators included leadership support and buy-in (leadership), stakeholder relationships (liaisons), and provision of resources (materials, knowledge, assistance) locally and by researchers (logistics). Key barriers included limited resources (time, funds, personnel), perceived challenges with menu changes, existing vendor contracts and profitability priorities, lack of leadership support, and insufficient knowledge of the evaluation tool and its potential benefits. Participants also stated the current American food culture is a barrier to improving local food environments. <h3>Conclusions</h3> Some barriers can be addressed locally while others must be addressed at higher levels of leadership. Multi-level strategies are essential to transform the built environment into one where nutrition is prioritized.