Food service in cancer hospitals: A co-creation approach to increase liking and to reduce food waste

The prevalence of food waste and meal dissatisfaction, poses challenges for cancer hospitals, prompting a need for effective solutions. Actively involving patients and chefs through a co-creation process in the development of new recipes may enhance the acceptability of hospital meals in cancer care, reducing food waste. This study aimed to replace current not well-liked recipes (based on target ingredients of the Mediterranean Diet) in an oncological hospital food service with co-created dishes tailored specifically to cancer patients. First, the co-creation process involved sixteen cancer patients and three chefs engaged separately in focus groups, using three complementary techniques (Jobs-To-Be-Done, free-association tasks and the SCAMPER). This phase led to forty-eight innovative concepts. Second, sixty-nine patients expressed their expected liking for the concepts' descriptions, leading to detailed briefs, based on the most appreciated concepts. Third, cooking sessions led to the development of ten final recipes of which seven were deemed technically feasible to replace current versions on the hospital lunch menu. Finally, liking scores and food waste data on the conventional and co-created dishes were collected in total on 242 hospitalized cancer patients in a field study using a quasi-experimental design (between subjects). Co-created dishes were liked more (p = 0.004) and tended to be less wasted (p = 0.083) than the conventional dishes in the field study. Mean liking scores increased by up to 35.88 % compared to conventional recipes, while food waste was reduced by as much as 67.44 % for some recipes. Overall, these findings suggest co-creation as a promising strategy to innovate hospital food service. They also underscore the importance of incorporating affective tests in field studies, as part of an iterative feedback loop informing and shaping process development.