Page 62 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 4. Development of the Canteen Scan
In the Netherlands, most students bring their own food and drinks from home and buy food or drinks at school only as complementary foods (snacks and drinks). School canteens can consist of a point-of-sale display (where people ask for, or take, a product from a display/cooler/shelf and pay at the cash register), and/or vending machines for food/ drinks. The school canteen can be run by an external catering company, the school itself, or by a combination of these two.
Study procedure
1. Development of a paper draft of the Canteen Scan
1a. Creating the draft tool
To operationalise the four constructs of the guidelines (basic conditions, availability on display and in vending machines, and accessibility), the project team generated a proposition for the methods and measurable items, based on earlier experience, scientific literature, and consultation with experts in nudging and social marketing. The project team consisted of seven multidisciplinary researchers in the fields of childhood obesity, nutrition, prevention and public health, nutritional professionals, and a school canteen advisor of the Netherlands Nutrition Centre. Discussed were: possibilities to make use of an existing database to classify products into healthier/less healthy products according to the current Dutch nutritional guidelines, different methods to assess the quantity of products [165, 166], and items to assess the accessibility of products using several nudging strategies.
1b. Expert meeting
A first concept of the Canteen Scan was discussed with experts to reach consensus about the proposed methods, items and response options. Whilst ensuring the scientific evidence, the practical feasibility was taken into account. The expert meeting was attended by 19 of 22 invited experts from research and policy on nudging, nutrition and health behaviour, and professionals representing school, sport and worksite organisations/caterers. Prior to the meeting, attendees received the draft tool by email and were invited to add additional ideas to be discussed. The draft tool consisted of two parts: one part with a proposal to quantify food products and another with proposed items to assess accessibility. An external chairperson directed and structured the meeting that was audio-recorded and minuted. NW reviewed and summarised the results and this was checked by EV and CR. All attendees received the consensus document of the meeting and were asked to check the content.
1c. Interviews and expert meetings with canteen managers/caterers and canteen advisors
To acquire feedback from end-users about the relevance, comprehensiveness and feasibility of the developed methods, items and response options, six semi-structured interviews and two expert meetings were held. The interviews were semi-structured in that specific questions of interest were posed but allowed the trained interviewer to probe questions if answers needed more explanation.
The interviews were conducted with two canteen managers and four representatives of caterers, representing different school canteens with diverse education levels throughout the Netherlands. During these semi-structured interviews (each lasting ± 120 min) the Canteen Scan was filled out for the respective canteen. After completion, the relevance,
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