The adoption, implementation and maintenance of a school food policy in the Canadian Arctic: a retrospective case study

Abstract

Summary With increasing childhood obesity rates and type 2 diabetes developing in younger age groups, many schools have initiated policies to support healthy eating and active living. Policy interventions can influence not only health behaviours in students but can also impact these behaviours beyond the school walls into the community. We articulate a policy story that emerged during the data collection phase of a study focused on building knowledge and capacity to support healthy eating and active living policy options in a small hamlet located in the Canadian Arctic. The policy processes of a local school food policy to address unhealthy eating are discussed. Through 14 interviews, decision makers, policy influencers and health practitioners described a policy process, retrospectively, including facilitators and barriers to adopting and implementing policy. A number of key activities facilitated the successful policy implementation process and the building of a critical mass to support healthy eating and active living in the community. A key contextual factor in school food policies in the Arctic is the influence of traditional (country) foods. This study is the first to provide an in-depth examination of the implementation of a food policy in a Canadian Arctic school. Recommendations are offered to inform intervention research and guide a food policy implementation process in a school environment facing similar issues.

Enablers and barriers to implementation of and compliance with school-based healthy food and beverage policies: a systematic literature review and meta-synthesis

“…Nearly half of the studies (n 11) were conducted in the United States (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) , eight in Canada (24,(55)(56)(57)(58)(59)(60)(61) , five in Australia (62)(63)(64)(65)(66) and one each in the United Kingdom (33) , Norway (67) , Philippines (68) and Malaysia (69) . Most studies (n 21) focused on both primary and secondary schools (24,(44)(45)(46)(47)(50)(51)(52)(53)(54)(57)(58)(59)(60)(61)(63)(64)(65)(66)(67)(68) , four on primary schools exclusively (33,<...>…”

“…Of the twenty-eight included studies, thirteen were qualitative investigations (24,33,51,52,54,55,(57)(58)(59)61,62,67,68) , five were quantitative (45,49,50,53,69) and ten used mixed-methods approaches (44,(46)(47)(48)56,60,(63)(64)(65)(66) . However, out of the ten mixed-methods studies, nine used qualitative approaches (44,46,48,56,60,(63)(64)(65)(66) and one (47) used a quantitative approach to explore enablers and barriers.…”

“…Only four studies provided psychometric properties of their measurements, of which three studies (49,50,69) used content validity and two (45,69) used face validity to review their surveys. Semi-structured/in-depth interviews and/or focus groups were the most common data collection methods used by the qualitative studies (n 21) (24,33,44,46,48,51,52,(54)(55)(56)(57)(58)(59)(61)(62)(63)(64)(65)(66)(67)(68) . One study used a survey with open-ended questions to collect qualitative data (60) .…”

“…These studies stated that food outlets around schools selling unhealthy foods to schoolchildren consequently affect policy implementation and the profits of food providers within schools. Interestingly, one study stated that the school authority worked with a neighbourhood store manager to reduce sale of unhealthy food during school hours, which positively impacted policy implementation (61) . The home environment, including unhealthy foods brought from home, lack of parents' support to policies and low levels of food literacy, was seen as barriers for policy implementation and compliance in five studies (33,52,57,60,63) .…”

“…Some stakeholders were overwhelmed with sudden changes required following the introduction of new policy and suggested that it needed to be a gradual process. Indeed, one study reported policy implementation by a 'harm reduction' approach where the policy on unhealthy foods was introduced gradually, which acted as an enabler (61) . Only three studies reported policy communication as an enabler, stating that school stakeholders were well informed about the policy and the reasons for change (61,64,65) .…”