Acceptability-minded frameworks for scaling institutional dining interventions: A scoping review and stakeholder analysis

Introduction: Research on institutional dining interventions often emphasizes the potential of behavior-change strategies to prime individuals toward healthier, more sustainable diets. While these solutions can be effective in shifting diner behavior, their ability to contribute to larger food systems transformation ultimately depends on how likely prospective implementers are to adopt and maintain them. With a focus on university foodservice, we explore the role of intervention acceptability in institutional dining research by identifying the indicators used to evaluate this dimension of intervention performance and examining how their incorporation aligns with the values of decision-making stakeholders.Methods: We conducted a scoping review to identify the metrics used to measure the acceptability of institutional dining interventions. After thematically arranging these metrics into indicator groups, we calculated the frequency with which individual acceptability indicators were reported and then asked foodservice stakeholders to rank those indicators based on relative importance. Results: From the 116 included studies, we identified eight acceptability indicators evaluating the impacts of institutional dining interventions on (1) diner experience, (2) dietary health, (3) dietary sustainability, (4) food prices, (5) operating costs, (6) staff satisfaction, (7) institutional sustainability, and (8) organizational culture. While most studies included some metric of intervention acceptability, the frequency with which individual acceptability indicators were reported varied by theme, with more studies evaluating changes in organizational culture than all other indicators combined. However, the frequency with which acceptability indicators were reported was not predictive of how indicators were perceived by decision-making stakeholders. Rather, seldom-reported themes, like diner experience, were rated as more important while frequently reported themes, like organizational culture, were rated as less important.Discussion: Efforts to align institutional dining research with the goals of foodservice stakeholders are needed to scale these solutions across institutions. Our findings demonstrate how current evaluation approaches fail to consistently represent the priorities of the decision makers responsible for managing foodservice change. To accelerate the adoption of institutional dining interventions, institutional dining research must move beyond assessing changes in food choice alone and recruit evaluation frameworks that consider the indicators of intervention acceptability prospective implementers care about.