The Effect of Supportive Implementation of Healthier Canteen Guidelines on Changes in Dutch School Canteens and Student Purchase Behaviour

Abstract

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.

A Cross-Sectional Study of the Nutritional Quality of New South Wales High School Student Food and Drink Purchases Made via an Online Canteen Ordering System

“…Although these data represent food and beverage purchases for only one break period, the finding that 56% of items purchased were classified as less healthy ('Occasional' or 'Should not be sold') suggests that online canteen lunch orders for high school students would be an appropriate target for intervention to reduce dietary risk factors for chronic disease. Similar findings have been reported in a study of secondary school canteen purchasing behaviour from the Netherlands, which found that both boys and girls reported purchasing a higher proportion of 'less healthy' items compared to 'healthier' items from the canteen [17]. To increase the nutritional quality of food and drinks available in school settings, many government education departments around the world have developed policies to guide schools in the types of products, and relative proportions of products, that should be available [40,41].…”

“…To increase the nutritional quality of food and drinks available in school settings, many government education departments around the world have developed policies to guide schools in the types of products, and relative proportions of products, that should be available [40,41]. However, the implementation of healthy canteen policies and guidelines, within high schools is often suboptimal [17,42,43]. For example, one Australian study found that, out of 53 high school canteens, only 6% of canteen menus met the criteria of having more than 75% of menu items being 'Everyday' items [42].…”

“…The school food environment plays an important role in the overall diet of adolescents (11-19 years), with students spending approximately 30 h per week at school and consuming a large amount of their dietary intake while in this setting [11]. While many countries provide school meal programmes or cafeteria-style provision of student lunches [12], other countries such as Norway, the Netherlands, Malaysia, New Zealand and Australia [13][14][15][16][17] have a school canteen or tuck-shop, which students have the option of using to purchase food and drinks in addition to, or instead of, bringing food and drinks from home. The nutritional quality of foods and drinks purchased by high school students at school canteens is often perceived as being less healthy than lunch brought from home.…”

“…The nutritional quality of foods and drinks purchased by high school students at school canteens is often perceived as being less healthy than lunch brought from home. However, while the availability of items on canteen menus is often reported, only a few studies internationally have investigated the types of products actually purchased by secondary school students at canteens [13,[17][18][19], and no studies have reported data on the nutrient composition of those products.…”

How physical cues in micro food environments influence consumption: a social norm account

“…To go one step further, it may even be suggested that entire adjustments in the availability and accessibility of foods are not necessary when the signals conveyed by, or connected to, available foods are taken into consideration. Ideally, in future, relevant stakeholders should be provided with certain instructions (implementation tools) on how to make changes effectively in physical cues in food environments, resulting in their intended interpretation and subsequent behavior -this may be part of current implementation strategies (see for example Evenhuis et al (2020)).…”