Page 43 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

The Dutch Guidelines for Healthier Canteens
The implementation plan was developed to support implementation of the ‘Guidelines
for Healthier Canteens’ in Dutch secondary schools. According to these guidelines, school
canteens should offer a majority of healthier products and promote these products
through accessibility criteria [78]. Healthier products are defined as the foods and drinks
included in the Dutch nutritional guidelines the “Wheel of Five”, such as fruits, vegetables,
whole grain bread, low fat dairy and water [79], and products that, while not included
in the “Wheel of Five”, contain a limited amount of calories, saturated fat and sodium .
In addition, accessibility is defined by nine criteria to promote these healthier products,
such as placement of healthier products in the most eye-catching locations and attractive 3 presentation of fruit and vegetables [78].
Several stakeholders are involved in creating a healthier canteen. Which and how they are involved can differ. Dutch school canteens can be run by the school itself, by an external catering company, or by a combination of these two. As mentioned, schools can receive support from school canteen advisors from the Netherlands Nutrition Centre and, in some municipalities, local community health promotors also support schools. In most schools, a teacher or facility manager coordinates the involved activities in consultation with the school management. The school canteen itself is mostly run by the canteen manager or canteen employee, of the school itself or an external caterer. Sometimes, students and/ or parents are involved in volunteering in the canteen or contribute to the preparation of food.
As mentioned, the development of the implementation plan consisted of three steps. These were: 1) identification of factors that impede of facilitate implementation; 2) prioritization of these factors; and 3) development of implementation strategies and tools.
Step 1: Identification of factors that impede or facilitate implementation Participants
We conducted 14 semi-structured interviews with 18 different stakeholders to identify experienced and expected factors that may impede or facilitate creating a healthier school canteen using the guidelines. Invitations were sent to 15 stakeholders, one of whom was unable to attend due to organizational changes. Four other participants proposed being interviewed together with an involved colleague. In order to collect a range of experiences and opinions, participants were sampled as “users” (i.e. people who decide about the product offer and product display and will potentially use the “Guidelines for Healthier Canteens”), and “stakeholders on organization level” (i.e. school and caterer managers). Users included school canteen advisors of the Netherlands Nutrition Centre (n=2), school canteen employees (n=1), and school canteen managers (n=5). “Stakeholders on organization level” included caterers (n=7), school directors (n=2), and a food supplier (n=1). During recruitment, participants experiences with a healthier canteen were also taken into account in order to recruit participants, based on Rogers’ diffusion of innovation theory [94], innovators (n=6), majority (n=10), and laggards (n=2).
Instrumentation and procedure
After written informed consent was obtained, participants received the guidelines. The topic list, which drew upon the MIDI and the BCW [95, 96], was optimized on the
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