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To identify factors influencing the availability and sales of healthy food and drinks in a café located in a hospital setting in a rural area. Three online and 1 in-person group model building workshops were conducted with hospital staff members to develop a causal loop diagram. Four areas in the causal loop diagram were identified, 5 teams were created to implement 15 identified action ideas, and an action registry was created to track their progress. By May 2023, 4 actions were active, 6 inactive, 4 completed, and 1 abandoned. The group model building process identified factors and actions to improve the healthiness of the hospital's café and motivated staff members to act for change. However, progress was limited by staff turnover, recruitment, and inadequate participation from decision-makers. Better leadership and support by senior management can ensure that long-term objectives are achieved and healthier hospital food environments are sustained. [ABSTRACT FROM AUTHOR]

Introduction. Few studies have quantified children's adherence to sustainable healthy diets, and none have explored whether adherence varies with child or maternal characteristics. Objectives. To describe adherence to sustainable healthy among a sample of 958 Chilean preschoolers (3-6 years) from the Food Environment Chilean Cohort (FECHiC) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. Methods. A single 24-hour multi-pass dietary recall, collected by trained dietitians in 2016, was used to describe FECHiC participants' adherence to the Planetary Health Diet Index for Children and Adolescents (PHDI-C). Adjusted linear models were fitted to explore associations in total and individual component scores with child and maternal characteristics. Results. This sample of Chilean children obtained low PHDI-C total scores (median 50.0 [IQR 39.5-59.8] out of 150 points). This was due to low reported consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate (either low or excess) consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.63 [95%CI 49.60, 51.66] vs 47.26 [95%CI 44.97, 49.54]) among children whose mothers were =25 years compared to those with younger mothers. We observed positive associations between scores for fruits and maternal education, vegetables, and maternal age, and added sugars and child weight status, and negative associations between scores for fruits and child age, and vegetable oils and maternal education. Scores for dairy products were lower among girls. Conclusions. Our findings support the need for strategies targeting the low consumption of nuts & peanuts, legumes, vegetables (particularly dark green vegetables), and whole cereals, and high consumption of dairy products, palm oil, red meats, and added sugars, particularly among children with younger mothers and mother with low levels of education. Tripleduty actions aimed at increasing access to and affordability of minimally processed foods and decreasing the availability of animal-source foods and ultra-processed products might contribute to achieving sustainable healthy diets among children. [ABSTRACT FROM AUTHOR]