Abstract
Supporting the implementation of school food and nutrition policies (SFNPs) is an international priority to encourage healthier eating among children and youth. Such policies can improve equitable access, resources, and supports for healthy eating. However, despite the potential impact of SFNPs, several implementation barriers have been reported. This study sought to examine the system-level intervention points within a school food system using a complex systems framework. We conducted semi-structured interviews with various stakeholders working to influence the school food system in Nova Scotia, Canada. We sought to understand their roles and experiences with the SFNP by applying the Intervention Level Framework (ILF), a novel, solutions-oriented approach to better understand how complex systems function. Participants (n = 33) included teachers, parents, cafeteria workers, public health staff and non-profit organizations. Interview transcripts were first coded, then themed and finally analyzed using the ILF, resulting in three intervention points within the school food system. These were defined as: (1) Actors and Elements, (2) System Regulation and Interconnections and (3) Purpose and Values. We concluded that understanding the interactions between these system levels and stakeholder roles can help to inform the development of relevant policy strategies that better support healthier school food environments in this jurisdiction.
Highlights
Strategies that encourage healthy eating are an international priority to address diet quality among children and youth [1,2]
When mapped to the Intervention Level Framework (ILF), the qualitative data generated in this research resulted in three themes that could be considered as system-level intervention points
Creating a healthy school food environment means targeting features of the school that may support healthier eating among students, such as access to healthy foods, programs or initiatives and creating a culture where healthy eating is modeled and supported throughout the school day
Summary
Over the past decade an increasing number of school jurisdictions internationally have advocated for, and introduced changes to, school food environments to support healthy eating [1,2]. These school food environments encompass policies and practices that influence the quality and types of foods served and/or sold in schools, as well as how food and nutrition is taught or modelled in these settings [1,2]. Healthy school food environments provide students with equitable access to healthy foods during the school day and support the attainment of nutrition knowledge and skills [1]. Public Health 2019, 16, 712; doi:10.3390/ijerph16050712 www.mdpi.com/journal/ijerph
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