International Journal of Health Promotion and Education

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Using the social ecological model to evaluate

university faculty and staff perceptions of the
campus food environment

Georgianna Mann , Selby Greer , Laurel Lambert & Rebecca G. Miller

To cite this article: Georgianna Mann , Selby Greer , Laurel Lambert & Rebecca G. Miller
(2021): Using the social ecological model to evaluate university faculty and staff perceptions of
the campus food environment, International Journal of Health Promotion and Education, DOI:
10.1080/14635240.2021.1875019

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Published online: 11 Jan 2021.

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INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION
[Link]

Using the social ecological model to evaluate university

faculty and staff perceptions of the campus food environment
Georgianna Manna, Selby Greerb, Laurel Lamberta and Rebecca G. Millerc
a
Department of Nutrition and Hospitality Management, University of Mississippi, University, Mississippi,
USA; bBaptist North Mississippi Hospital, Oxford, MS, USA; cSchool of Dentistry, University of Louisville,
Louisville, Kentucky, USA

ABSTRACT ARTICLE HISTORY

The study purpose was to examine faculty and staff perspectives of Received 15 April 2020
healthy eating opportunities on a rural, southern university campus Accepted 8 January 2021
using qualitative research methods informed by the Social Ecological KEYWORDS
Model. Eight focus group discussions with faculty and staff were Food environment; socio-
conducted and analyzed using an inductive and deductive thematic ecological model; qualitative;
analysis approach. Enablers to healthy eating on campus included an workplace; faculty/staff
intrinsic desire to make healthy choices, food presentation, and cam­
pus wellness programming. Barriers included inconvenience, poor
food availability, lackluster presentation, inaccurate menu/portion
sizes, cost, and unawareness of options. Participants suggested provid­
ing more healthy and fresh foods, offering ‘grab-and-go’ options, and
expanding campus nutrition education. Future efforts should incorpo­
rate specific solutions provided by participants in this study.
Investment in marketing to faculty/staff about nutrition resources
available and how to effectively encourage the selection of healthy
foods from campus dining venues would also be warranted.

Introduction
In 2018, an estimated 42.4% of all U.S. adults were obese (Centers for Disease Control and
Prevention 2020). Obesity is associated with a higher risk of coronary heart disease (Must
1999), diabetes (Golay and Ybarra 2005), kidney disease (Wang et al. 2008), and certain
types of cancer (Guh et al. 2009; Steele et al. 2017). While factors leading to obesity are
complicated, a calorie-dense diet and sedentary lifestyle are two primary causes (Chaput
et al. 2011). The food environment, defined as all the opportunities to procure food within
a given area, including availability, accessibility, and encouragement of healthy food choices,
can heavily influence the dietary choices of an individual (Lake 2018; Lake et al. 2012).
The food environment can have an impact on eating behavior and health. With full-
time working adults spending much of their day at work (Centers for Disease Control and
Prevention 2019), the worksite food environment may be of concern as an average of 40%
of daily food intake are meals consumed in the workplace (Lima, Costa, and Rocha 2018).
Though many employees bring their lunch, others rely on what is provided on their
worksite or nearby which is often fast-food which tends to be associated with poorer diet

CONTACT Georgianna Mann grmann@[Link] Department of Nutrition and Hospitality Management,

University of Mississippi, P.O. Box 1848, 220 Lenoir Hall, Sorority Row, University, Mississippi 38677, USA
© 2021 Institute of Health Promotion and Education
2 G. MANN ET AL.

quality (Barnes et al. 2016). When not eating home-made food, most of the employees rely
on inside food environments consisting of vending machines and food cafeterias. Presence
of fast-food chains along the commute routes often lead to unhealthy food choices such as
snacking for lunch, binge eating, and soft drink consumption (Dornelles 2019).
The college campus food environment is unique because of the diverse populations and
the strong potential to either inhibit or promote healthy eating. Like other workplaces, most
university employees are on campus for lunch (Freedman and Rubinstein 2010). Unlike most
work environments though, college campuses largely have cafeterias and restaurants on
campus grounds. General perceptions of food on campus tend to be unhealthy, resulting in
a negative impact on the food choices made (Symonds, Martins, and Hartwell 2013). High
prices and time restriction can be barriers to consuming healthier foods on campus but when
the on-campus dining environments of fifteen college campuses were objectively analyzed,
results showed that 80% of dining halls offered low-fat, whole-wheat, and vegetarian options
(Horacek et al. 2013). Each campus environment is unique, creating the need for an
individual examination to completely understand how to improve the food environment.
There is extensive research on the eating behaviors and patterns of students in the
university setting, but information concerning faculty and staff health behaviors is lacking
(Tom Deliens et al. 2016). Few studies could be found addressing university work environ­
ments where many food choices onsite are limited to cafeterias and quick meals (Tseng et al.
2016), and patronized by diverse populations including faculty, staff, and students of varying
racial, age and socioeconomic backgrounds (Freedman and Rubinstein 2010). Research at
a large urban university in the northern U. S. found that food choices by faculty and staff were
largely impacted by the food choices offered on-campus, and 42% of respondents were not
satisfied with the food choices offered on campus (Freedman and Rubinstein 2010). There is
a need for insight into the factors that influence food choices and recommended strategies to
effectively encourage university employees to select healthier choices.
The Social Ecological Model (SEM) provides structure to categorize the many levels of
influence that affect an individual’s health-related behaviors (Figure 1). These levels
include societal/policy, community/institutional, interpersonal, and individual
(Bronfenbrenner 1979). SEM has been used efficaciously in exploring influences on
a variety of health-related behaviors including food consumption (T. Robinson 2008),
physical activity (Langille and Rodgers 2010), and vaccination (Gargano et al. 2014). SEM
has been applied to worksite wellness (Pratt et al. 2007), and school wellness programs
(Lohrmann 2008; Townsend and Foster 2013). However, only a paucity of research
applies to the university work site (Freedman and Rubinstein 2010; Terrell 2015).
The purpose of this study was to examine faculty and staff perspectives of healthy
eating opportunities in the university eating environment on a rural, southern university
campus in the United States using qualitative research methods informed by the SEM.

Methods
Subject recruitment
Participants for this study were recruited from a representative sample of faculty and
staff, via direct email, in which participants were invited to volunteer for focus group
discussions about the campus food environment. A survey panel group through the
 INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 3

Figure 1. Social Ecological Model (SEM) Levels.(Boyle 2016; Stokols 1996).

Office of Institutional Research, Effectiveness, and Planning, was used to recruit partici­
pants through a survey link in Qualtrics via email addresses (Qualtrics, Provo, UT).
A maximum number allowed for distribution was 33.3% for the representative sample of
university faculty/staff where demographics of gender and ethnicity were encoded in the
distribution list. Recruitment occurred once a week for three weeks to those who did not
respond previously.
Interested faculty and staff were contacted by researchers and scheduled for focus group
discussions. Ethics approval was received for research with human subjects from the
University of Mississippi institutional review board prior to study activities (Protocol
18x-189).

Design and procedures

Focus groups were chosen as they provide a unique opportunity to provide in-depth and
insightful responses within a particular research environment, often revealing unexpected
information relative to a topic (Ansay, Perkins, and Nelson 2004; Krueger 1998). Structured
discussion guide questions were developed based on the SEM framework and included an
opening question, five targeted study questions, two transition questions, and a concluding
question (Table 1) (Krueger 1998). During the discussions, participants were asked to rank
the healthy food offerings on campus to provide a quantitative evaluation using a scale of 1 to
10, where 10 is the most satisfactory. Prior to conducting the focus groups, researchers
collaborated with nutrition faculty and staff who reviewed the discussion guide for clarity.
Based on their review, slight changes were made to three key discussion questions with minor
wording and grammar modifications. Changes made were to ensure the participants inter­
preted the questions as intended by the researchers. Two experienced moderators assisted in
training two junior researchers on moderating focus group discussions and tested the
discussion guide during two pilot focus groups. The pilot groups were primarily to ensure
4 G. MANN ET AL.

Table 1. Focus group questions for faculty and staff.

(1) How would you describe a healthy meal?
(2) Do you try to make healthy food and beverage choices when eating on campus? If so, why or why not?
(3) What prevents you from making healthy choices on campus?
(4) How are healthy items being presented and served?
Are they served in an appeasing manner?
(5) Did you know that Aramark has nutrition information posted online?
(6) Are there places you can go on campus to eat healthy?
Y: Where are they and what kind of items do you normally select?
(7) N: What are you looking for?
(8) N: ‘Vending’ – We’ve tried some healthy vending initiatives in the residence halls.
Do you think we need more options here?
(9) On a scale of 1–10, how would you rank healthy food offerings on campus?
If not a 10, what needs to be changed to bring that ranking to a 10?
(10) What would a healthy campus-eating environment look like to you?
(11) What are some other things that we need to know about the healthy eating
environment on campus?
(12) How do you think we should encourage healthy eating on campus?l

training was adequate and question flow worked well. No further discussion guide changes
were made.
Focus group discussions were conducted separately with faculty and staff in the 2018
school year during the lunch hour in a central place on campus. Faculty and staff
discussions were conducted separately in order to increase compatibility during discus­
sions (Morgan and Krueger 1998). Faculty included on-campus instructors and research­
ers, both non-tenure and tenure-track, who generally have more flexible schedules. Staff
included non-teaching personnel who, compared to faculty, tend to have more rigid
schedules or are on hourly pay.
Discussions were kept to 60 minutes or less. Before discussions, written consent was
obtained from all participants. Discussions were recorded and conducted by one mod­
erator and one note-taker in a roundtable setting to facilitate conversation. Participants
were provided with a 60 USD meal box gift card or an equivalent ‘goodie’ bag funded by
the university wellness program as an incentive. At the end of each discussion, the
moderator and note-taker convened to identify any themes or commonalities among
the groups per standard practice.

Data analysis
Recordings were transcribed by the researchers who moderated the focus group sessions
using Express Scribe (version 7.01). Transcripts were read several times by both research­
ers. A codebook was developed by the two researchers and reviewed by two senior
researchers. Codes were developed based on an inductive and deductive thematic
analysis approach using the SEM levels and themes that emerged from the focus group
transcripts (Creswell and Poth 2007; Patton 2001). Data were analyzed using qualitative
software for a thematic analysis approach (NVivo 12 Plus, QSR International, Version
[Link]). The two researchers independently coded transcripts and Kappa coefficients
were above 0.080 (Krippendorff 2018).
 INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 5

Table 2. Focus Group Themes and Level of the Social

Ecological Model.
Overarching Theme 1: Enablers for Healthy Eating
Level of SEM Subtheme
Individual Desire to make healthy choices
Institutional Presentation of foods
Institutional Campus Wellness Programs
Overarching Theme 2: Barriers to Healthy Eating
Level of SEM Subtheme
Institutional Poor Presentation of foods
Institutional Poor Availability of foods Inconvenience
Institutional Inaccurate menu and portion sizes
Institutional High Price
Institutional Lack of Healthy Vending
Institutional Unaware of options
Overarching Theme 3: Proposed Solutions
Level of SEM Subtheme
Institutional More healthy options
Institutional Grab and go options

Results
Focus group discussions were conducted until a point of saturation was reached. In the
eight discussions (3–8 per group), 25 faculty participated (17 female) and 12 staff (9
female) from various departments at a large southern United States university of 24,000
students.
Primary themes identified from the discussions were grouped into three categories:
enablers, barriers, and solutions to healthy eating (Table 2). Results from participants’
ranking of the healthy food offerings on campus along with illustrative comments are
reported in Table 3.

Enablers to healthy eating

Desire to make healthy choices
Most participants expressed a desire to make healthy choices while on campus. Some
stated the reason for making healthier choices was due to health beliefs or weight
management/loss. Some commented on their ability to perform their job duties: ‘Long
term health would obviously benefit from better health nutrition, but just in terms of being
a faculty member, performance would be better if people could eat better on campus’ with
another participant stating, ‘the reason I eat healthy is that I am trying to lose weight and
that is one of my goals is to eat healthier but not be hungry, and to lose weight.’

Appealing presentation of food

Participants noted when food was presented in an appealing manner (i.e. fresh, colorful,
appropriate temperature), it helped them to choose healthier options. Positive remarks
generally focused on the freshness of items offered at campus venues: ‘Like both of the
salad bars at [campus venues]. Usually it’s very colorful and everything looks very fresh so
that’s appealing’ and ‘The fruit at [campus venues] is delicious. It’s fresh and it’s really
good.’ Some participants mentioned the on-campus restaurant managed by the nutrition
and hospitality students: ‘If you go to [student restaurant], everything is presented in
 6
G. MANN ET AL.

Table 3. Faculty and Staff Rankings of the Campus Eating Environment on a Scale of 1 to 10, where 10 is the most conducive to eating healthy.
Faculty Staff
Ranking % (n) Comments % (n) Comments
7–10 28% “I would give it an 8. The reason that its not a 10 is because of costs in the vending machines. 58% (7) ‘I think you can find a healthy option – it may not always be
(7) ‘water costs the same as a soda’ what you want to eat . . . ’
‘It’s my choice. There are things that I could choose from . . .
So I think it is a matter of what I want to do a lot of the
times.’
4–6 56% ‘I know there are some healthy offerings on campus, they exist somewhere (. . .) I know there 42% (5) ‘ . . . you need better convenience and better price’
(14) are some out there but I think may be just bringing awareness more to faculty, knowing
what options are available to bring that up to.’
1–3 16% ‘I know that they’re appealing to the target demographic on campus is students and its 0% (0)
(4) whatever the students want to eat (. . .) just make sure that every place that already exists on
campus had several healthy options that were available.’
 INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 7

a professional restaurant-style manner so it always looks appealing whether it’s healthy

or not’.

Campus wellness programming

The campus wellness program was also mentioned as an enabler for making healthy
choices. This program provides incentivized wellness-related fitness competitions and
encouragement to faculty and staff. This program also includes ‘Wellness Champions’
who are trained volunteers that help to relay program information to the campus
community. Participants commented that the incentives helped them reach wellness
goals: ‘We are doing it as a group, and [wellness program coordinator] is tracking our
exercise and there was a program where if you filled it out you got a fleece in the winter’.
The program also has a social media presence that encourages healthy choices: ‘[Wellness
program’s] social media presence is going to continue to push people to make more healthy,
conscious decisions . . . ’

Barriers to healthy eating

Inconvenience
One of the most recurring comments regarding barriers to healthy eating was the lack of
convenience of healthy foods on campus. Participants felt that healthy foods were not as
convenient as unhealthy food options, which was further compounded by short lunch
breaks or limited time between meetings. Some participants chose unhealthy options
because they felt options were limited, healthy choices were too inconvenient, or it was
too time-consuming to find healthier options: ‘I’m rushed frequently when I’m on campus.
I’m in a hurry and I eat whatever is available’ and ‘the places that are convenient are the
unhealthy ones. The places that offer the healthy options are not convenient’.

Poor availability of foods

Participants felt there were fewer healthy options to choose from, stating ‘there’s an
abundance of unhealthy choices’. Recent campus additions have included food venues
targeted towards student desires which include fast-food restaurants, and some participants
also noted that they have chosen to pack their lunches to avoid the temptation to consume
less-healthy options: ‘I found it difficult to find a healthy option on campus and so now I just
avoid that temptation. I find myself just packing lunch everyday’. Participants noted that
while vending offered convenience particularly in light of time restraints, offerings were
generally high in solid fats and added sugars: ‘it’s not healthy at all. I mean, I’ll be honest, its
chips or its cake or its chocolate . . . ’ Some noted that they would be more likely to use the
vending machines if healthy options were offered: ‘if there was a machine that had nothing
but healthy options, you would use them more’. Participants shared their struggles with
summer options, when hours are drastically reduced, and many venues are closed leaving
full-time staff with few options for healthy eating: ‘I would eat on campus in the summer
more often if there was availability of food and the menu was accurate.’ Where menu
accuracy here refers to menu items offered at the venue matching the posted menu online.
8 G. MANN ET AL.

Lackluster presentation of food

Contrary to some of the positive comments regarding food presentation, the overall
sentiment towards food presentation was poor. Most comments referred to the cooking
or holding process: ‘you get something that’s been sitting there for half an hour to an hour,
it starts turning to mush’. The salad bars were described as boring and colorless, and easy
to pass right by because it was the same thing every day: ‘I would say that, they’re kind of
presented in the same way everything else is . . . that makes them easy to pass.’ Healthy
items were often unappealing in contrast to less healthy choices: ‘unhealthy options tend
to be the most attractive’.

Inaccurate menu and portion sizes

Though the on-campus dining posts menus and nutrition information daily, menus and
portion sizes are often inconsistent with offerings. Some participants select their lunch
location based on the information online, only to arrive to a different menu. Nutrition
information is available online and noted on a screen or notecard in the dining facility; yet,
portion sizes are inconsistent which raised concerns about accuracy of nutrition information:
‘I don’t know that I am always getting the amount that is posted as the typical serving size . . .
I mean a lot of the time I think I am getting more than that’ and ‘there’s no real consistency
between one person being served than the next person being served may get two pork chops and
I may get one pork chop’. Furthermore, concerns were raised over dietary needs, for example:
‘The website they have like the nutrition information (. . .) but I found out that it’s actually
inaccurate because there was a vegan burger one time, but there was actually eggs in it’.

High prices
Participants shared that healthier foods seemed to be the most expensive: ‘The bad stuff is
cheap and a lot of the healthy options are expensive’. One campus food venue was noted as
offering only healthy choices yet lacked affordability. Unfortunately, this belief often
stops participants from making healthy choices: ‘The expense keeps me from going and
making that choice.’

Unaware of options
Awareness of healthy options was also discussed. Participants seemed to either be
unaware of healthy options on campus and thus assumed all options were unhealthy,
or believed that the healthy options were available on campus but were uncertain where
to go to get them. Participants noted that this was particularly difficult when seeking
options for specific diets: ‘I just don’t find that [vegan options are] readily apparent and so
there’s sort of expedition or digging aspect to it’.

Solutions for healthy eating

Providing more healthy options
The most common suggestion among participants was to provide more healthy options with
a variety of choices. This could be accomplished by incorporating healthier choices in existing
venues, rather than adding new venues to the campus: ‘just incorporating healthy food as if it’s
a regular option’. Some also commented that decreasing unhealthy options would be helpful
to incentivize the selection of healthy choices, especially in light of chronic illnesses such as
 INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 9

diabetes, where a shift in diet could be life-altering. This could also be applied to beverage
options: ‘Even if they remove the soda fountains. If they would just put seltzer water and
different kinds of flavorings or fruit juices.’
Fresh foods were commonly associated with healthy choices. One suggestion was to
have fresh choices, and ‘more options that our local farms could provide for us’. Some
noted that simple offerings such as fresh fruits as snacks would encourage healthy
choices.

Offering grab and go options

As time and lack of convenience were barriers to healthy food choices, participants
suggested the addition of grab and go options for both snacks and meals, where grab and
go options included meals that were made ahead of time such as sandwiches and
premade salads: ‘But if you say, ok here’s a piece of turkey, here’s a small salad with it.
Here’s some rice. I would say, “oh that looks really nice. I’m just going to grab that bowl and
immediately you’ve given me the proper portion size. You’ve given me the variety I want.
And it’s fast”’. One participant suggested that a delivery system accompanied by a small
fee would entice them to select healthy options.

Discussion
The purpose of the study was to explore faculty and staff perspectives of healthy eating
opportunities in the university eating environment using the SEM as a framework.
Individual- and institutional-level factors were most influential which is reflective of
how the university work environment shapes an individual’s food choices while on
campus.
Primary enablers for healthy food choices were the individuals’ desire to make
healthier food choices, and institutional-level factors such as appealing food presentation
and campus wellness programming. Barriers reported were institutional-level factors:
inconvenience, poor availability of foods, lackluster presentation of food, inaccurate
menu and portion sizes, high prices, and lack of awareness of healthy options. Very
few comments were made in reference to the intrapersonal level of the SEM. Two staff
commented on the influence of southern U.S. culture which generally consists of fried,
high-fat foods. However, there was a paucity of conversation concerning their coworkers’
eating behaviors, which is not surprising given the lack of literature available that
provides strong evidence connecting social pressures and food-related purchases (E.
Robinson 2015).
While the campus is small and rather compact (3,500 acres), many participants
verbalized that healthy options were difficult to find without substantial effort. Either
availability was low, little time was available, or participants were unsure of the healthy
options in food venues. The most common and well-supported solution by participants
was to provide more healthy choices on campus by increasing options at current
locations and providing additional venues for food purchases. Previous work demon­
strates that an increased availability of healthy choices results in improved dietary
behavior (Franco et al. 2009). This could be done by adding a daily healthy option for
each food venue on campus and advertising to increase awareness. A detailed campus
map with specific icons noting where healthy foods could be located could also improve
10 G. MANN ET AL.

awareness. Healthy options could be sold as a ‘grab-and-go’ option, suggested by

participants as a solution to the time barrier. Some grab-and-go options are available
for purchase, but healthy options are not currently labeled. A sticker indicating healthy
choices may be efficacious to help guide patrons (Seward, Block, and Chatterjee 2016).
Vending machines can provide convenience, but limited healthy options were avail­
able according to participants. However, in the fall of 2018, a ‘healthy vending’ initiative
focused primarily on students was launched which labeled the healthy choices in accor­
dance with the Smart Snacks in School foods regulations (Mann, Lambert, and Partacz
2019; United States Department of Agriculture 2016). It seems that this initiative might
be well received if implemented across campus venues.
Similar to barriers reported here, previous studies suggest that price decreases alone
can encourage more purchases of healthy foods (Darmon and Drewnowski 2015).
A price reduction strategy in both vending and dining halls may be helpful, where
healthy options are priced lower than less healthy choices such as sugar-sweetened
beverages and sweets (French 2003). By making healthier options the easier choice, it
might be possible to improve perceptions towards healthy food availability and eating
behaviors (Ashe, Graff, and Spector 2011). Other simple solutions for the barriers
identified here would be to ensure an appealing presentation of healthy options and
providing an accurate, up-to-date point of purchase information for foods sold in dining
venues by updating the online menu consistently (Harnack and French 2008). However,
foodservice on this campus is through a contractual agreement. Such information as
presented here may be welcomed by the foodservice organization in assisting them with
meeting their customers’ needs.
Participants also reported that often the less nutritious choices were presented well, or
some foods were held too long to be appealing. Individuals are more likely to select
healthy food when presented in an appealing manner, as they are perceived to be of
higher quality (Zellner et al. 2014). Participants suggested that the provision of fresher
foods would entice them to eat healthier, including sales of local foods.
The university has hosted a ‘pop-up’ local market, but the event was not well known
among participants. The market was tailored towards students, with little advertisement
to the general university community. Perhaps with improved marketing to university
employees and appropriate timing, a farmer’s market on campus could be a feasible
recurring event to improve the campus food environment while supporting local
business.
The campus wellness program was discussed as an enabler for healthy decision-
making, noting that the fitness/wellness challenges incentivized them to make healthy
choices, which has shown to improve health behaviors in previous work (Chan,
Kwortnik, and Wansink 2017; Hill-Mey et al. 2013). Wellness programs on college
campuses have been shown to promote improved health outcomes resulting in fewer
sick days (Hill-Mey et al. 2015). This wellness program, led by a registered dietitian,
included events such as fitness classes, cooking demonstrations, and weekly group
counseling sessions on campus and in the community.
Participants expressed a desire for more nutrition programming and to work one-on-
one with a registered dietitian nutritionist. These options are offered through the uni­
versity’s wellness program, suggesting a need for greater outreach and advertising of the
availability of nutrition services. Increased direct education has shown to be helpful in the
 INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 11

form of health risk appraisals, lunch hour informational seminars, and newsletters (Lloyd
et al. 2017).
In a study that surveyed students and staff at a large urban New Zealand university,
food choice was determined by money, nutritional value, and taste (Roy et al. 2019).
Suggestions to improve the campus food environment included improving food avail­
ability, accessibility, prices and promotions which is similar to the current study in a rural
setting. Young adults (18–24) are most strongly influenced by taste, convenience, cost,
nutritive value, and stimulatory properties such as caffeine (Hebden et al. 2015). Unlike
students, faculty and staff in this study did not seem to weight taste or stimulatory
properties as important as availability and nutritive value. It seems that students, faculty,
and staff would benefit from readily available healthy, tasty foods at a low cost (Hebden
et al. 2015; Michels et al. 2008; T. Deliens et al. 2014). Additional signage encouraging
and promoting items identified as healthy would also be beneficial for eatery patrons
(Michels et al. 2008; T. Deliens et al. 2014).

Limitations
Some key limitations need to be addressed. Participants were given culinary or wellness
incentives, which may have skewed the sample. It is likely that the participants who
attended the focus groups were already more health-conscious than the general faculty/
staff population, where there is a general health behavior bias introduced into the study.
It is also possible that participants may have been influenced by the responses of their
peers attending the focus groups. This study contained only subjective perceptions and
did not include audits or surveillance of the built food environment. This study took
place on one large, southern university which limits the generalizability of this research.

Conclusions
This research serves as an important needs assessment to gage what faculty and staff on
this campus believe to be the most prominent obstacles they face in their efforts to eat
healthy. Some specific, less complicated, possibilities on campuses to help promote
healthy decision-making are also presented here. Participants provided some feasible
campus-wide solutions to foster a healthier food environment. What is interesting to
note is that enablers were individual and institutional-level factors, yet barriers were only
institutional and fairly simple to overcome. Highlighting healthy options, increasing
advertising, and ensuring consistency are small changes that could have a large impact.

Disclosure statement
The authors report no conflicts of interest.

Funding
This work was supported by a university grant supporting a campus wellness program (funder did
not want details reported);
12 G. MANN ET AL.

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