Page 70 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 4. Development of the Canteen Scan DISCUSSION
The present study translated the Dutch Guidelines for Healthier Canteens into an online tool called the ‘Canteen Scan’ in a 3-step iterative process. The Canteen Scan provides insight into the level of compliance with the guidelines, and offers feedback with directions for improvement. The tool was developed for and with various users, e.g. (school) canteen advisors/managers/employees and caterers, as well as involving stakeholders representing science and policy. Pilot tests revealed that stakeholders evaluated the tool positive on its usability, with positive evaluations on the concepts comprehensibility, user-friendliness, feasibility and satisfaction.
Besides the Netherlands, other countries have developed guidelines or policies and accompanying tools to stimulate healthy eating behaviour in public settings [28, 152, 155, 157]. Unfortunately, none of the available tools were suitable to monitor Dutch school canteens due to the differences in goals, criteria and the definitions used. The Canteen Scan was specifically developed to evaluate compliance with the Dutch guidelines for canteens, according to Dutch nutritional guidelines, suitable for the products sold in Dutch school canteens and with the recommended definition (by stakeholders) of accessibility. However, the process of development and the content of the tool can be valuable to others developing a similar tool for their canteens.
To our knowledge, the Canteen Scan is the first online tool to translate policy for public food settings into a tool that combines assessments of the healthiness of products, the proportion of healthier products available in a canteen, and criteria for accessibility. In the present study, end-users evaluated the different elements of the Canteen Scan as positive on comprehensibility user-friendliness and feasibility. The combination of concepts (availability and accessibility) concurs with the recommendations of earlier tools developed to measure the consumer food environment [28, 157]. The tool can be used by a diversity of stakeholders: school managers, canteen employees, caterers, school canteen advisors and policy makers. In accordance with recommendations, the Canteen Scan combines the functions providing insight into the current level of compliance with guidelines, monitoring changes over time, and providing tailored feedback to improve the healthiness of the canteen [39, 144, 155, 157]. Moreover, since the adjustments with regard to accessibility/ availability are immediately apparent in the result section of the tool, this may stimulate caterers and canteen managers to make changes. As the Canteen Scan is administered online, stakeholders could easily use the scan to monitor changes in healthiness over time.
Another strength of the Canteen Scan is that it is linked with the Dutch database that automatically classifies commonly sold food/drink products according to the current Dutch nutritional guidelines, based on the nutritional composition of products. The fact that users themselves do not have to classify products increases the usability of the tool [155, 180]. Moreover, this link allows to automatically include updates of the nutritional guidelines in the Canteen Scan. On national level, the (anonymized) online data might be used to monitor how many organizations implement and comply with the Guidelines for Healthier Canteens, although first more insight should be gained in the reliability and validity of the tool. The monitoring of implementation and compliance to guidelines is recommended to be able to evaluate the (un)intended effects of stated policy and to improve policy in
68