Nudging night-shift workers towards healthier choices – beliefs, confidence and support for making healthy dietary choices at work.

Abstract

Aim: Hospitals operate 24 hours a day, seven days a week. People working night shift have a high risk of obesity and diet-related chronic health conditions. Factors, such as unpredictable breaks and limited access to healthy options influence a person's dietary choices. This study aims to co-design strategies with staff to improve the dietary environment for hospital staff working night shift. Methods: This is an exploratory mixed-methods design. Phase 1 of this project involved a baseline survey. Data collected included: demographic information; attitude and beliefs regarding the work dietary environment (visual analogue scale); food choice motives (not reported); and overall intake of fruit, vegetable and water (VicHealth Indicators Survey questions). Descriptive statistics, non-parametric tests and correlation coefficients were used to investigate relationship between food versus drink scales and differences by work setting (acute, subacute, emergency). Fruit, vegetable and water intake was compared to publicly available data (university-educated Victorians). Results: Respondents (n=127) were mostly female (86%), nurses (95%), worked mixed/rotating night shift (70%) and many worked in the acute setting (55%). The attitude and belief scale had good internal reliability (a = .81). Average correlation between food/drink pairs was acceptable (a = .74). Median scores indicate staff value healthy dietary choices (scores over 35; possible range -50 'extremely untrue' to +50 'extremely true'). Belief and confidence making healthy choices was higher for drink than food. Emergency department respondents recorded lower median scores than the other locations for food items. Fruit, vegetable and water intake was similar to state data. Conclusion: Healthy food and drink choices are important to night shift staff. Staff who work in the emergency area reported lower levels of belief and confidence to make health food choices compared to people who work in other health service locations.