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

Introduction: Research on institutional dining interventions often emphasizes the promise of behavior-change strategies in shifting individuals toward healthier, more sustainable diets. While these solutions can be effective in shaping diner behavior, their potential to contribute to larger food systems transformation ultimately depends on how likely decision makers 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 measure it and examining how their incorporation within the literature aligns with the operational priorities of prospective implementers. Methods: We conducted a scoping review of 116 studies to identify the metrics used to measure the acceptability of institutional dining interventions. After arranging these metrics into themed indicator categories, we calculated the frequency with which individual indicators were reported and asked university-foodservice stakeholders to rank them based on their relative importance. Results: We identified eight indicators measuring changes in diner experience, dietary health, dietary sustainability, food prices, operating costs, staff satisfaction, institutional sustainability, and organizational culture. While most studies included some metric of intervention acceptability, reporting prevalence across indicators varied by theme, with more studies tracking changes in organizational culture than all other indicators combined. Reporting prevalence, however, was not predictive of how indicators were perceived by university-foodservice stakeholders, with seldom-reported themes, like diner experience, often being rated among the most important, and frequently reported themes, like organizational culture, often being rated among the least. Discussion: Efforts to align research with the goals of foodservice stakeholders are needed to scale sustainable dining interventions across institutions. Our findings demonstrate how the frameworks used to evaluate institutional dining interventions fail to represent the priorities of decision makers responsible for managing foodservice change. To accelerate the adoption of these solutions, institutional-dining research must move beyond assessments of dietary change alone and begin incorporating metrics that matter to prospective implementers.