Page 18 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 1. General Introduction
Aim of this thesis
The aim of this thesis was to investigate how schools can be supported to improve implementation of the Guidelines for Healthier Canteens in secondary schools, thereby creating healthier canteens. The main research question was: Is support for the implementation of the Guidelines for Healthier Canteens helpful in creating healthier school canteens in the Netherlands?
This thesis consists of two parts to answer this main question, where the following research questions are addressed:
Part I: Development of the support to implement healthier school canteen guidelines
1. How to develop and evaluate an implementation plan to support practice creating a healthier school canteen? (chapter 2)
2. What are stakeholders’ needs and aligned implementation tools, including the Canteen Scan, to support implementation of healthier school canteen guidelines in secondary schools? (chapter 3 and 4)
Part II: Evaluation of the support to implement healthier school canteen guidelines
3. What is the effect of the offered support aimed at implementation of healthier canteen guidelines on the availability and accessibility of healthier food and drinks in canteens and purchase behaviour of students? (chapter 5)
4. What is the effect of the offered support aimed at implementation of healthier canteen guidelines on changes in determinants related to implementation, as perceived by stakeholders? (chapter 6)
5. How did the involved stakeholders evaluate the quality of each implementation tool? (chapter 6)
Outline of this thesis
Chapter 2 describes briefly how we developed the plan to support implementation of the “Guidelines for Healthier Canteens” in Dutch secondary schools, paying attention to the collaboration with practice and alignment to science. It further illustrates how we planned to evaluate this plan in practice on effect and process level.
The implementation plan is described in more detail in Chapter 3. First, the identified factors that, according to stakeholders, hindered or facilitated the implementation of a healthier canteen are described. Next, how these factors were translated into implementation tools via behavioural change methods and implementation strategies are also described. Further, it describes each implementation tool, in detail, including action(s), aims and target group.
One of the implementation tools is the “Canteen Scan”: an online tool to provide insight into, and directions for, improvement of healthier food and drink products in canteens. Chapter 4 describes the development, content validity and usability of this scan.
Next, Chapter 5 presents the effect evaluation of the implementation plan aimed to support secondary schools in creating a healthier canteen. This effect was evaluated at canteen level by the health level of the canteen and at student level by self-reported purchase behaviour of students.
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