Positive attitudes and beliefs drive the intention to adopt a more plant-derived diet in hospitals: Insights from patients and healthcare professionals

Background and aims: Public health and sustainability prompt hospitals to promote more plant-derived nutrition for patients. Yet, successful implementation remains limited. The extent to which patients intend to consume such nutrition and healthcare professionals intend to provide it to patients, is unexplored. To support more effective implementation strategies, this study examines factors that predict patients' intention to consume and healthcare professionals' intention to provide more plant-derived protein-rich nutrition during hospitalization. Methods: A single-center cross-sectional study using two parallel surveys - one for patients and one for healthcare professionals - was conducted between September 2024 and January 2025. Both surveys incorporated constructs from the Theory of Planned Behavior and the Stages of Change, assessing dietary habits, attitudes, behavioral beliefs, perceived behavioral control, stages of change, and intention towards plant-derived food consumption and provision. Regression analyses using PROCESS v5.0 were performed to identify predictors of behavioral intention for both groups. Results: In total, 603 participants were included comprising patients (n = 300) and healthcare professionals (n = 303). For both groups, intention was significantly predicted by a positive attitude towards consuming (β = 0.33, p < 0.001) or providing (β = 0.29, p < 0.001) more plant-derived nutrition and by a positive subjective norm towards consuming (β = 0.19, p < 0.05) or providing (β = 0.14, p < 0.05) more plant-derived nutrition. For both groups, the behavioral beliefs (resp. β = 0.75, p < 0.001; β = 0.61, p < 0.001) were the most influential determinant of attitude. Conclusion: To increase behavioral intention among patients and healthcare professionals, interventions must strengthen positive attitudes by addressing specific underlying behavioral beliefs that are related to these attitudes. The behavioral beliefs regarding ‘taste’ and ‘plant-derived nutrition supports recovery’ offer the most potential for improvement in both groups. Future research should assess whether addressing these beliefs effectively enhances attitudes and promotes the intention to consume or provide more plant-derived protein rich nutrition in hospitals.