Investigating the integration of sustainable food initiatives in healthcare institutions in Ontario, Canada: A grey literature scoping review protocol

IntroductionThe climate emergency and other sustainability challenges interact to threaten human and planetary health. Efforts to improve the sustainability of food initiatives within healthcare institutions could mitigate these threats by addressing the four pillars of sustainability: health, social, economic, and environmental. Understanding current initiatives to incorporate sustainability into food programs and the sustainability pillars that guide those initiatives is important to inform priorities for action. This scoping review was undertaken to investigate the extent to which major healthcare institutions in Ontario, Canada have publicly committed to, discussed, planned, and/or implemented sustainable food initiatives. Methods and AnalysisSteps are based on guidance from the Joanna Briggs Institute and Arksey & OMalley. First, the current strategic plans of 57 healthcare institutions in Ontario, Canada, will be retrieved from their websites and used to examine whether they include any commitments to or discussion, planning, and/or implementation of relevant initiatives. The healthcare institution websites, along with those of selected sustainability organizations, will be searched for grey literature from 2015 to 2024 describing sustainable food initiatives within these institutions. Documents will be screened for eligibility by two researchers. Data related to the incorporation of sustainable food into institutional food programs, and the sustainability pillars addressed, will be extracted by one researcher, with 10% of entries verified by a second researcher. The data will be synthesized to summarize publicly reported progress toward integrating sustainable food into healthcare institutions. Ethics and DisseminationThis review will use publicly available grey literature with no expectation of privacy and no research participants; therefore, no ethics clearance is required. Results will be shared with stakeholders in sustainability organizations, as well as at relevant conferences and in peer-reviewed journals, such as the Healthy Cities Conference and the Journal of Canadian Food Studies. This protocol is registered on the Open Science Framework and can be accessed at the following URL: https://doi.org/10.17605/OSF.IO/CU9P6