Page 108 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 6. Process evaluation
support schools that voluntarily want to take action.
To further improve the implementation plan and continue national implementation of the ‘Guidelines for Healthier Canteens’ in Dutch secondary schools, our results and learnings were shared with the Netherlands Nutrition Centre. Based on these results, implementation tools were improved. For example, the Canteen Scan was improved by adding more explanations and an explanation video ‘how to use the scan’ was created. Moreover, regarding the fact sheet of students’ needs and wishes, we recommended schools to use input of students of different educational levels and grades.
The guidelines for healthier canteens are applicable to sports canteens as well. For this reason, the insights were also shared with stakeholders involved in creating healthier sports canteens. Further research is needed to show whether the findings in the present study are applicable to other settings (such as sports canteens and worksite cafeteria’s), other countries, and other health related school based interventions. Moreover, further research is needed to gain more insight into processes of implementation and to be able to compare the quality of implementation across studies. In our opinion, comparability could be improved by clear definitions of concepts like fidelity, dose received, and dose delivered, as well as clear operationalizations to measure these concepts [201, 203]. However, this is challenging because it is also recommended that these measures be adaptable to implementation tools in a specific context.
Conclusions
In conclusion, the tools to implement the Guidelines for Healthier Canteens seem to result in positive changes with regard to individual and environmental factors affecting implementation. The combination of implementation tools supports stakeholders in creating a healthier canteen. In particular, the tools that included students’ wishes, tailored information and feedback, reminders, and examples of healthier products/accessibility were evaluated positively.
Acknowledgements
The authors thank all involved schools and stakeholders for their contribution to the project.
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