Research into ‘sweet treat’ incentives for healthcare inpatients

Research by a Fuse team at Teesside University has shown that offering 'treat' foods as a reward to inpatients in healthcare settings could be contributing to obesity issues.

The team worked with Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, to examine how the use of food as a reward to incentivise activities, encourage behaviours, or help relationships among patients in secure care, could detrimentally impact on a patient's weight.

Their findings, which have been published in the Journal of Human Nutrition and Dietetics, explore the culture of food being used as a 'treat'.  They found that people in secure care may be more at risk of weight gain due to their history, the secure care environment and the 'treat' culture adopted in these environments.

The researchers investigated staff views on patient weight gain, how it affects patients and how to better manage patient weight in this setting. It is one of the first studies to explore 'treat culture' and the perceptions of staff on patient weight gain, and the use of food treats given to patients in secure care.

The findings highlight concern among staff about the impact of weight gain on patients' physical and mental health, yet those staff members often also felt somewhat helpless about the patient weight gain.

The study found treats in the forensic secure care environment were perceived to have become habitual, contributing to patient's diets becoming higher in fat, sugar and calories. The findings show a need for clear guidance on what food restrictions are reasonable and proportionate in supporting patients with their weight.

"While taken at face value, such treats may appear harmless. However repeated use has been shown to impact on a person’s ability to regulate their food intake."

Dr Emma Giles, co-lead of the Fuse Behaviour Change Cluster

Dr Emma Giles, of Teesside University’s School of Health & Life Sciences and Fuse's Behaviour Change Cluster, who led the research, said: "Foods that are high in fat, sugar, and salt are often chosen as rewards. While taken at face value, such treats may appear harmless. However repeated use has been shown to impact on a person's ability to regulate their food intake."

The research findings showed treats were used for various reasons, from encouraging patients to participate in activities, to being a way to express kindness and care for someone.

Teesside University postgraduate student Anita Attala was involved in leading the research. She is now working as the lead adult weight management dietitian at Northumbria Healthcare NHS Foundation Trust.

Anita said: "While it would appear easy to say those working in care services need to be mindful of how food is being used, these research findings suggest that it may take a much bigger system and cultural change to lessen and avoid the use of foods that are high in fat, sugar and salt as treats."

Dr Giles and Anita co-authored the research with Professor Amelia Lake, Fuse Associate Director and Professor of Public Health Nutrition, all from the University's School of Health & Life Sciences, along with Jo Smith, of Tees, Esk and Wear Valleys NHS Foundation Trust.

Dr Giles said: "Anita's study shows that further research in this area is needed, to explore how and why treats are used in routine practice.

"Secure care services need to provide holistic care, recognising that the patient's complex history may contribute to their relationship with food and healthful behaviours. It is important that there are discussions with patients regarding changes to their food intake and activity."

Anita added: "There is a need for a whole system approach to weight management and health promotion, which focuses on the patient pathway and staff values, in which staff's own health beliefs need to be recognised.

"Staff as role models, participating in health promotion and healthful activities, is an important consideration for patient participation in these initiatives."

Funding for the research came from Health Education England (North East and Yorkshire) in conjunction with the National Institute for Health and Care Research (NIHR) and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, which provides mental health and disability services and support across the North-East of England and Cumbria.

Last modified: Thu, 09 Feb 2023 14:15:04 GMT