U.S. Army Dining Facility Staff Considerations in Dietary Interventions: A Qualitative Analysis

Background (Background, Rationale, Prior Research, and/or Theory): A high quality diet is imperative for soldiers' operational readiness, health and resiliency. However, warfighter diet quality remains poor and interventions at military dining facilities have produced only modest improvements in diet quality. Objective: This study takes an in-depth look at operational barriers within Dining Facility (DFAC) in order to guide future interventions. Study Design, Setting, Participants, Intervention: Three iterations of anonymous DFAC staff focus groups were conducted four months apart at two separate facilities (n = 66, 79 and 71, respectively per iteration; 18% supervisors). Each session was led by a registered dietitian and audio-recorded then transcribed and reviewed twice for validity. Common themes were coded and analyzed using NVIVO 11 software. Results: Although each DFAC possessed unique barriers to program success, the most common barrier was low DFAC staff morale (201 references over 97% of sessions) related to high workloads, poor communication and long work hours. Program non-compliance barriers were also connected to three themes: management standards (158 references over 94% of sessions) related to internal and external DFAC operating procedures that interfere with resource optimization and recipe compliance; insufficient culinary skills training (124 references over 89% of sessions) reflective of menu and recipe adaptation of new foods; and nutrition knowledge (78 references over 74% of sessions) relevant to a lack of understanding behind reasons for the intervention and how to maintain compliance of the nutritional standards. Conclusions and Implications: The findings of this study support that attention to the needs of the culinary staff with adequate communication of rationale behind DFAC changes will improve diet quality and patron dining satisfaction. Specific recommendations are to provide culinary staff: classes in basic nutrition knowledge and culinary skills; continuous on-the-job training; resource management training and new production SOPs specifically adapted for the intervention. Funding: Department of Defense.