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Cited by 127School Health and Nursing EducationHealth Policy Implementation ScienceObesity, Physical Activity, Diet

Effectiveness of a multicomponent intervention to enhance implementation of a healthy canteen policy in Australian primary schools: A randomised controlled trial

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Nathan, Nicole, Yoong, Sze Lin, Sutherland, Rachel, Reilly, Kathryn, Delaney, Tessa, Janssen, Lisa, Robertson, Katie, Reynolds, Renee +4 more·2016·International Journal of Behavioral Nutrition and Physical Activity
DOI 10.1186/s12966-016-0431-5PMC PMC5054617
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Abstract

BACKGROUND: The implementation of school nutrition policies, which govern the provision of food in schools, is recommended as a public health strategy to support the development of healthy dietary behaviours in school-aged children. Despite this, research internationally and in Australia indicates that few schools implement such policies. This study aims to examine whether a theoretically designed, multi-strategy intervention was effective in increasing the implementation of a healthy canteen policy in Australian primary schools. METHODS: A parallel group randomised controlled trial was conducted with all government and Catholic primary schools within one region in New South Wales, Australia who had an operational canteen that provided food to primary school aged children (5-12 years) and were not currently receiving an intervention to change their canteen practices. Schools randomised to the intervention arm received a 9-month multicomponent intervention including ongoing support, provision of resources, performance monitoring and feedback, executive support and recognition. The primary outcomes were the proportion of the schools with a canteen menu that: i) did not include 'red' or 'banned' items according to the healthy canteen policy; and ii) had more than 50 % 'green' items. The primary outcome was assessed via menu audit at baseline and follow up by dietitians blinded to group allocation. RESULTS: Fifty-three eligible schools were randomised to either the intervention or control group (28 intervention; 25 control). Analyses with 51 schools who returned school menus found that intervention schools were significantly more likely relative to control schools to have a menu without 'red' or 'banned' items (RR = 5.78 (1.45-23.05); p = 0.002) and have at least 50 % of menu items classified as green (RR = 2.03 (1.01-4.08); p = 0.03). CONCLUSIONS: This study found that a multi-component intervention was effective in improving primary schools' compliance with a healthy canteen policy. Given the lack of evidence regarding how best to support schools with implementing evidence-based policies to improve child diet, this trial for the first time provides high quality evidence to practitioners and policy makers seeking to improve nutrition policy implementation in schools. TRIAL REGISTRATION: This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12614001148662 ) 30th October 2014.

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  1. [4]Frazao E America's Eating Habits: Changes and Consequences: High costs of poor eating patterns in the United States. Agriculture Information Bulletin No. (AIB-750) 494 pp 1999 Washington, DC Economic Research Service, USDA
  2. [19]World Health Organization School policy framework: implementation of the WHO global strategy on diet, physical activity and health 2008 Geneva WHO Press
  3. [26]Green Party of Aotearoa New Zealand. Annual tuckshop survey shows pies, chips still staples. 2007; https://home.greens.org.nz/press-releases/annual-tuckshop-survey-shows-pies-chips-still-staples. Accessed 26 Mar 2016.
  4. [36]NSW Ministry of Health NSW Office of Preventive Health: The First Year (2012–13) in Review 2013 Sydney NSW Health
  5. [48]Mâsse LC de Niet-Fitzgerald JE Watts AW Naylor PJ Saewyc EM Associations between the school food environment, student consumption and body mass index of Canadian adolescents Int. J. Behav. Nutr. Phys. Act. 2014 11 29 10.1186/1479-5868-11-29 24666770 PMC3987130 · DOI

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Authors
Nathan, N., Yoong, S. L., Sutherland, R., Reilly, K., Delaney, T., Janssen, L., Robertson, K., Reynolds, R., Chai, L. K., Lecathelinais, C., Wiggers, J., & Wolfenden, L.
Affiliations
Hunter Medical Research Institute (AU)
Corresponding author
Nathan, Nicole
ORCID
Venue
International Journal of Behavioral Nutrition and Physical Activity
Publisher
Springer Science and Business Media LLC
Published
2016-10-07
Volume
13
Issue
1
Pages
106-106
ISSN
1479-5868 (ISSN-L)
DOI
10.1186/s12966-016-0431-5
PMC
PMC5054617
OpenAlex
W2529378100
Cited by
127
References
31
Citations by year
2025: 3 · 2024: 7 · 2023: 6 · 2022: 10 · 2021: 23 · 2020: 58 · 2019: 10 · 2018: 5 · 2017: 5
FWCI
13.85
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
  • Swinburne figshare (Swinburne University of Technology) (submittedVersion)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
Funders
Hunter Medical Research Institute
Topics
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
policy implementation, multicomponent intervention, elementary school, school nutrition policy, executive support, school food environment
MeSH terms
Australia, Child, Child Behavior, Child, Preschool, Diet, Feeding Behavior, Female, Food, Food Services, Health Promotion, Humans, Male, New South Wales, Public Health, School Health Services, Schools, Health Behavior, Nutrition Policy

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