From Paper to Practice: Barriers to Adopting Nutrition Guidelines in Schools

Downs, Shauna; Farmer, Anna; Quintanilha, Maira; Berry, Tanya R.; Mager, Diana R.; Willows, Noreen D.; McCargar, Linda J.

doi:10.1016/j.jneb.2011.04.005

Cited by 71 publications

(104 citation statements)

References 19 publications

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“…Similar barriers to policy adoption were identified in a survey of Alberta schools. 19 While a number of studies across Canada have examined the success of school nutrition policy implementation, as measured by the availability of healthy foods in cafeterias and tuck shops (i.e., school stores), few have evaluated the extent to which school vending machines, specifically, are policy compliant. 20,21 Further, research on implementation in the secondary school environment (grades 9-12) has been limited, and virtually absent from evaluations of vending machine contents in Ontario.…”

Section: School Interventions To Promote Healthy Eatingmentioning

confidence: 99%

Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study

Vine

Harrington

Butler

et al. 2017

Can J Public Health

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OBJECTIVES: We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. METHODS:This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta.RESULTS: Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years.CONCLUSION: Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.KEY WORDS: School nutrition; policy implementation; school health; built environment La traduction du résumé se trouve à la fin de l'article.

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Section: School Interventions To Promote Healthy Eatingmentioning

confidence: 99%

Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study

Vine

Harrington

Butler

et al. 2017

Can J Public Health

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“…One study identified that lower complexity, higher compatibility, and greater perceived relative advantage assisted schools in implementing nutrition guidelines [104]. In another example, Andreyeva et al [105••] assessed food retailers' attitudes and perceptions regarding healthy food provision.…”

Section: Policy Issuesmentioning

confidence: 99%

Current Trends in Childhood Obesity Research

2012

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Childhood obesity is a global health issue. To identify research trends and gaps of childhood obesity research, we reviewed MEDLINE publications from January 2011 to May 2012 and qualitatively analyzed the major domains and themes of research focus. Major domains are: measurements, obesity correlates, prevention interventions, treatment interventions, and policy issues. Key advances and innovations are highlighted within each domain. Emerging areas include the advancement of measurement methodologies that simultaneously capture individual and contextual information across time, analysis of policy problems, and the development of multilevel, community interventions. However, few effective and sustainable interventions are exemplified; some strategies are promising. Recommendations for future research includes the adoption of a systems approach that integrates individual, environmental, and policy change, the scale up and diffusion of innovations, studies of intended and unintended policy impacts, and the design and testing of effective social marketing strategies.

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“…Factors influencing implementation of nutrition guidelines in intensive care units include guideline characteristics, the implementation process, institutional factors, provider characteristics and attitude, and the clinical condition of the patient [31]. Barriers to the implementation of nutrition guidelines in schools include lack of funding, lack of leadership, student preferences for “unhealthy” food, and perceived goal conflict [32-34]. These studies suggest that factors influencing the implementation of nutrition guidelines may be context dependent and the relevance of existing research to residential care homes is unclear.…”

Section: Introductionmentioning

confidence: 99%

Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

et al. 2012

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BackgroundOptimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT) to understand the barriers and facilitators to implementing the guidelines and inform future implementation.MethodsWe conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews) to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT.ResultsMany staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence), and as a result, relatively few staff invested in the guidelines (cognitive participation). Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action). Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring).ConclusionsThe successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to devise ways of evaluating the outcomes of modified menus. NPT proved useful in conceptualizing barriers to implementation; robust links with behavior-change theories would further increase the practical utility of NPT.

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From Paper to Practice: Barriers to Adopting Nutrition Guidelines in Schools

Cited by 71 publications

References 19 publications

Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study

Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study

Current Trends in Childhood Obesity Research

Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

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