Improvement in primary school adherence to the NSW Healthy School Canteen Strategy in 2007 and 2010

Hills, Anne; Nathan, Nicole; Robinson, Keira; Fox, D M; Wolfenden, Luke

doi:10.1071/he14098

Cited by 38 publications

(39 citation statements)

References 16 publications

(9 reference statements)

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“…Similar to this study, literature spanning 10 years has shown that ‘unhealthy’ foods are more commonly purchased from public school canteens; there is inconsistent buy‐in from public school parents; and the role of public school canteens is to provide healthy food, promote healthy eating and support the school healthy eating curriculum . In addition, public school canteen compliance with guidelines, regardless of State/Territory mandates, was found to be moderate to low . While the schools included in this study have voluntarily incorporated healthy options within their school canteen, a comparison of these findings to the Australian public school canteen literature suggest that school canteen guidelines may not be achieving the desired effects.…”

Section: Discussionsupporting

confidence: 66%

“…1,3,22 In addition, public school canteen compliance with guidelines, regardless of State/Territory mandates, was found to be moderate to low. 6,7,23,24 While the schools included in this study have voluntarily incorporated healthy options within their school canteen, a comparison of these findings to the Australian public school canteen literature suggest that school canteen guidelines may not be achieving the desired effects.…”

Section: Discussionmentioning

confidence: 93%

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Scoping study investigating stakeholder perceptions and use of school canteens in an Australian city

Lawlis

Eckley

Jamieson

et al. 2017

Nutrition & Dietetics

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Despite the intense focus on school canteens to sell healthy food, little has changed in terms of student's food choices and the barriers to providing healthy options. The external environment and divided parental buy-in impact the canteen's ability to comply with guidelines. A holistic approach involving all stakeholder levels is required to successfully achieve a healthy school canteen environment and positively influence student's food habits and choices.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 93%

Scoping study investigating stakeholder perceptions and use of school canteens in an Australian city

Lawlis

Eckley

Jamieson

et al. 2017

Nutrition & Dietetics

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“…This reduced the relative size of the intervention effect at 24‐month compared to that reported at 12‐month follow‐up. Such changes were surprising given evidence suggesting the policy implementation had been largely stable prior to study commencement . Implementation improvements within control schools may indicate potential contamination after the initial intervention ceased through sharing of resources, or learnings by intervention with control group schools.…”

Section: Discussionmentioning

confidence: 90%

Two‐year follow‐up of a randomised controlled trial to assess the sustainability of a school intervention to improve the implementation of a school‐based nutrition policy

Wolfenden

Nathan

Reilly

et al. 2019

Health Prom J of Aust

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Issue addressed School‐based nutrition policies can have a positive effect on the school food environment. The primary aim of this study was to assess the primary school adherence to a mandatory state‐wide healthy canteen policy 12 months after an effective multi‐strategic implementation intervention concluded. Methods Primary schools were randomised to (a) a 12‐14 months multi‐strategic intervention or (b) no‐intervention (control). The intervention aimed to improve implementation of a state‐wide canteen policy by encouraging schools to remove unhealthy food and beverages (classified as ‘‘red’’ or ‘‘banned’’) from canteen menus and replace with healthy items (classified as ‘‘green’’). No implementation support was provided to either group by the research team between the 12 and 24 months data collection period. Results Seventy schools participated, of which 56 schools were assessed at 24‐month follow‐up. Intervention schools were less likely to have a menu which contained ‘‘red/banned’’ items at 24‐month follow‐up (RR = 2.28; 95% CI: 1.18‐4.40; P = 0.01). Intervention schools, however, were not more likely than controls to have a menu which contained >50% ‘‘green’’ items at 24‐month follow‐up (RR = 1.29; 95% CI: 0.98‐1.70; P = 0.10). Intervention schools were more likely to adhere to both policy components (no red/banned items and >50% green items on the menu) than control schools (RR = 2.61; 95% CI: 1.29‐5.29; P = 0.006). Among intervention schools that were fully adherent to the policy following implementation support (12‐month post baseline), all were also adherent at the 24‐month follow‐up. Conclusion The intervention was effective in achieving long‐term school adherence to a state‐wide canteen policy at 24‐month follow‐up. So what? The findings suggest that sustained improvements in implementation of school nutrition policies is possible following a period (12 months) of comprehensive implementation support.

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“…Differences in the implementation of nutrition policies are also apparent by a number of school factors. In Australia for example, rural school canteens had significantly poorer implementation of a mandatory school canteen policy [17]. While such findings suggest that additional efforts to support policy implementation in rural schools may be required [17], providing such support across a population of schools that are geographically dispersed represents a considerable challenge to health policy makers and practitioners.…”

Section: Introductionmentioning

confidence: 99%

CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: a randomised controlled trial

Yoong

Nathan

Wolfenden

et al. 2016

Int J Behav Nutr Phys Act

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BackgroundThe implementation of nutrition policies in schools has been recommended as a strategy to improve child dietary intake. Internationally, research suggests that the majority of schools do not implement these policies. In New South Wales (NSW), Australia, the NSW Healthy School Canteen Policy requires that school canteens prohibit the sale of ‘red’ foods (i.e. foods that are typically nutrient poor and high in energy, such as confectionary and deep-fried foods) and ‘banned’drinks (i.e. soft drinks); and that the majority of items on the menu are ‘green’ (i.e. foods that are good sources of nutrients, such fruits, vegetables and lean meats). This study examined the impact of a multicomponent audit and feedback intervention on schools’ implementation of the NSW Healthy School Canteen Policy. A secondary aim was to assess the impact of the intervention on menu composition.MethodsThis study was a parallel group randomised controlled trial with 72 rural and remote primary schools (36 interventions, 36 controls) located in one region within NSW, Australia. Intervention schools received an initial face to face contact and up to four cycles of audit and feedback (consisting of a menu audit, written feedback report and telephone feedback) over a 12-month period. The primary trial outcomes were the proportion of schools with a canteen menu that had: i) no ‘red’ foods or ‘banned’ drinks; and ii) >50% ‘green’ items, as assessed via standardised menu audits undertaken by trained dietitians. For each primary outcome, between-group differences were assessed using Fisher’s exact test under an intention to treat approach.ResultsThere was insufficient evidence to conclude the intervention had a positive impact on the proportion of intervention schools with no ‘red’ or ‘banned’ items on their menu (RR = 2.8; 95% CI: 0.9 to 8.9; p = 0.0895), or on the proportion of intervention schools with more than 50% ‘green’ items (RR = 1.5; 95% CI: 0.7 to 3.2; p = 0.2568). These findings remained non-significant in the multiple imputation analyses. Intervention schools were significantly more likely to have a lower percentage of ‘red’ items (p-value: 0.007) and a higher percentage of ‘green’ items on the menu (p-value: 0.014). This remained statistically significant in the multiple imputation analyses for ‘red items’ (p-value: 0.0081) but not for ‘green’ items (p-value: 0.0910).ConclusionsWhile there was insufficient statistical evidence to suggest that this multicomponent audit and feedback intervention was effective in improving primary schools’ compliance with a healthy canteen policy, the intervention demonstrated some positive impact in reducing the availability of ‘red’ items on the menu.Trial registrationThis trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000543785). Registered 15th May 2013.

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Improvement in primary school adherence to the NSW Healthy School Canteen Strategy in 2007 and 2010

Cited by 38 publications

References 16 publications

Scoping study investigating stakeholder perceptions and use of school canteens in an Australian city

Scoping study investigating stakeholder perceptions and use of school canteens in an Australian city

Two‐year follow‐up of a randomised controlled trial to assess the sustainability of a school intervention to improve the implementation of a school‐based nutrition policy

CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: a randomised controlled trial

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