Page 165 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

SUMMARY
Introduction
Many adolescents have an unhealthy dietary pattern, which is associated with an increased risk for many chronic non-communicable diseases, amongst others, overweight and obesity. This can cause physical and psychosocial health problems and reduced quality of life in the short-term, and also during adulthood. Creating a healthier food environment is likely to make it easier for adolescents to make healthier food choices. Due to their reach and pedagogical tasks, schools in particular can contribute to stimulating healthy choices in adolescents. Increased availability and accessibility of healthier products in school canteens, including cafeterias and vending machines, makes it easier for students to choose the healthier option. In addition, by implementing a healthy school canteen, the school is likely to set a norm with regard to healthy food and drinks. Thereby they contribute to the personal development of students, which includes learning to make responsible and healthy lifestyle choices.
In the Netherlands, schools have autonomy in terms of how they arrange their food and drinks. Since 2003, the Netherlands Nutrition Centre supports schools to create a healthier school canteen in secondary (vocational) schools with the “Healthy School Canteen Programme”. This programme is commissioned and financed by the Dutch Ministry of Health, Welfare, and Sports and is available to all Dutch secondary (vocational) schools. It has been implemented and elaborated over the years, including the development of the Guidelines for Healthier Canteens in 2014. The guidelines combine the offer of healthier products, including tap water, (availability) with the promotion and placement of these healthier products (accessibility), and anchoring policy. It aims to support stakeholders creating healthier canteens through three incremental levels: bronze, silver and gold, although only the levels silver and gold are sufficient to be designated a healthier school canteen. After the development of the guidelines, the next step was their implementation. Hence, more insight was needed into how this implementation could be supported appropriately according to different involved stakeholders with different needs and wishes; in what extent are the existing supportive tools of the Healthy School Canteen Programme suitable, and how could the programme be improved?
These considerations were the basis of this thesis. The overall research question studied
in this thesis was formulated as: Is support for the implementation of the Guidelines for
Healthier Canteens helpful in creating healthier school canteens in the Netherlands? This S question is addressed in two parts: the development of the support, and the evaluation
of that support.
Part I: Development of the support to implement healthier school canteen guidelines
First, drawing on three studies, this thesis explains how the support to facilitate the implementation of the Guidelines for Healthier Canteens was developed.
Chapter 2 describes the design of the study to develop and evaluate an implementation plan for the Guidelines for Healthier Canteens in secondary schools. This plan, consisting of a number of different tools, was developed in three steps based on the “Grol and Wensing
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