A case study assessing implementation of the Victorian Government’s Healthy Choices Policy Directive in a rural hospital café

Introduction In 2021, the Victorian Government in Australia introduced the Healthy Choices policy directive to improve availability of healthier food and drink options in health services.Theory We applied the Consolidated Framework for Implementation Research to assess implementation of Healthy Choices in a rural hospital Café (June 2021 – October 2023) and identify enablers and limiters of compliance.Methods We conducted a case study and assessed changes in food choices and availability via an online customer survey and food and drink audits. Enablers and limiters were assessed by analysing minutes of implementer meetings and management reports.Results Most customers (56%) expressed a high level of support for Healthy Choices, but a similar proportion (57%) reported never using the associated traffic light tool for making food choices. Policy compliance was achieved for drinks (green drinks increased from 73–81%) by August 2022 and foods (green foods increased from 19% to 56%) by October 2023, the mandated timeframes. Enablers included supportive health service and Café staff and good relational connections and communication between them, support with monitoring compliance and positive feedback from customers on menu changes. Limiters included procurement constraints, insufficient Café infrastructure, staff shortages, and inconsistent support from health service management.Discussion Context-specific strategies are needed to improve availability of healthier food and drinks on health service premises.