The effect of supportive implementation of healthier canteen guidelines on changes in Dutch school canteens and student purchase behaviour
Open accessAbstract
We developed an implementation plan including several components to support implementation of the "Guidelines for Healthier Canteens" in Dutch secondary schools. This study evaluated the effect of this plan on changes in the school canteen and on food and drink purchases of students. In a 6 month quasi-experimental study, ten intervention schools (IS) received support implementing the guidelines, and ten control schools (CS) received only the guidelines. Changes in the health level of the cafeteria and vending machines were assessed and described. Effects on self-reported purchase behaviour of students were analysed using mixed logistic regression analyses. IS scored higher on healthier availability in the cafeteria (77.2%) and accessibility (59.0%) compared to CS (60.1%, resp. 50.0%) after the intervention. IS also showed more changes in healthier offers in the cafeteria (range -3 to 57%, mean change 31.4%) and accessibility (range 0 to 50%, mean change 15%) compared to CS (range -9 to 46%, mean change 9.7%; range -30 to 20% mean change 7% resp.). Multi-level logistic regression analyses on the intervention/control and health level of the canteen in relation to purchase behaviour showed no relevant relations. In conclusion, the offered support resulted in healthier canteens. However, there was no direct effect on students' purchase behaviour during the intervention.
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Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported.
“Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported [26, 44, 51, 53, 54, 60, 62–64, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [67]
Seven studies were assessed as unclear for potential risk of recruitment to cluster.
“Seven studies were assessed as unclear [26, 37, 38, 41, 42, 46, 67], whilst the remaining study [27] was assessed as high risk of bias due to randomization occurring prior to recruitment and a lack of blinding of recruiters.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [67]
It was unclear in the remaining five nonrandomized studies whether confounders had been sufficiently adjusted for.
“Of the seven nonrandomized studies, three were considered as high risk of confounding [26, 52, 59], while it was unclear in the remaining five studies whether confounders had been sufficiently adjusted for [39, 43, 57, 61, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [67]
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- Authors
- Evenhuis, I. J., Jacobs, S. M., Vyth, E. L., Veldhuis, L., de Boer, M. R., Seidell, J. C., & Renders, C. M.
- Affiliations
- Amsterdam Public Health (NL)
- Netherlands Nutrition Centre (NL)
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
- Corresponding author
- Evenhuis, Irma J.
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2020-08-12
- Volume
- 12
- Issue
- 8
- Pages
- 2419
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC7468849
- OpenAlex
- W3048716610
- Cited by
- 17
- References
- 56
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2022: 5 · 2021: 5
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw (50-53100-98-043)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- school canteens, implementation support, vending machines, secondary schools, school food environment
- MeSH terms
- Diet, Healthy, Adolescent, Consumer Behavior, Female, Food Services, Health Plan Implementation, Humans, Male, Netherlands, School Health Services, Students, Program Evaluation, Logistic Models, Nutrition Policy, Non-Randomized Controlled Trials as Topic
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