An Exploration of Implementation Enablers and Barriers for Norwegian School Meal Guidelines

Abstract

School meal guidelines can be important tools to promote children’s diets, but their implementation depends on several influencing factors. Understanding these is important for designing effective interventions to increase implementation. The aim of this study was to examine barriers to and enablers of implementation of the Norwegian national guideline on food and meals in schools by applying a school-based implementation framework to data collection and analysis. The Multi-level Quality Implementation Framework (MQIF) was used to develop semi-structured interview guides. At four schools, principals and after-school leaders were interviewed individually, whereas teachers (n = 27) and children (n = 26) participated in separate focus group interviews. The interviews were recorded, transcribed verbatim, and analyzed deductively according to predefined constructs in the MQIF. Most implementation barriers and enablers were identified at the school level and barriers dominated. Important barriers included a weak mandate to prioritize work on school meals; weak administrative leadership; the lack of a school culture around meal practices; a noisy classroom climate undermining social meals; limited facilities; and difficulties with the teacher–parent collaboration around packed lunches. Important enablers were engagement by the education authorities; coordinated action at a municipal level; whole-school discussions on meal practices; and teachers’ facilitation for social meals. The MQIF successfully guided us in identifying factors that influence school meal guideline implementation. Low priority of school meals and low implementation authority appeared as underlying reasons for some implementation barriers. The study indicates that, to overcome these barriers, schools need support for implementation.