scholarly journals Understanding the need for a whole-of-society approach in school nutrition policy implementation: a qualitative analysis

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Natasha P. Sobers ◽  
Lisa Bishop ◽  
Shu Wen Ng ◽  
Suzanne Soares-Wynter ◽  
Natalie S. Greaves ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Policy Development ◽  
School Administrators ◽  
Nutrition Policy ◽  
School Nutrition ◽  
Civil Society Organizations ◽  
Nutrition Guidelines ◽  
Documentary Analysis ◽  
National School ◽  
Outer Setting

Abstract Background Only three of twenty Caribbean Community (CARCICOM) countries have mandatory school nutrition policies despite one third of the region’s children being overweight or obese. In Barbados, there are nutrition guidelines which lack the legal mandate of a formal policy. We aim to assess the comprehensiveness of current national nutrition guidelines and to understand the factors operating in the inner and outer school setting that may influence the implementation of a mandatory school nutrition policy from the perspectives of school administrators. Methods A documentary analysis of existing nutritional guidelines was conducted along with qualitative semi-structured interviews in primary (elementary) and secondary (high) schools in Barbados. We purposively sampled six primary and four secondary school administrators (principals, deputy principals or senior teachers) to explore their knowledge and views on the National School Nutrition Guidelines. The deterministic implementation paradigm, Consolidated Framework for Implementation (CFIR), was used to explore the complexities within the inner and outer settings of schools. Documentary analysis used a theory-based framework informed by the Wellness School Assessment Tool—school policy analysis questionnaire. Interview transcripts were team coded using thematic analysis with constant comparison facilitated by NVIVO software version12. Results School administrators were unaware of the existing National School Nutrition Guidelines which documentary analysis found to be restrictive and weak for implementation. Administrators envisioned a government-led (outer setting), whole of society approach as the most effective strategy for the development and implementation of a proposed mandatory school nutrition policy. School administrators identified lack of financial and human resources as barriers to nutrition policy implementation. Formal and informal food vendors are institutionalized in schools and are influential determinants of the school food environment. Schools have individually reached into the outer setting to work with civil society organizations and private individuals to provide financial support and nutrition expertise to their institutions. Mass media campaigns in the outer setting may influence child and parental food choices. Conclusion School administrators describe that government-led, CSO supported policy development using a whole-of-society approach has implications for improving nutrition policy implementation. Our findings demonstrate the use of a deterministic implementation framework in the pre-implementation phase of school nutrition policy development.

scholarly journals "It's huge in First Nation culture for us, as a school, to be a role model": Facilitators and Barriers Affecting School Nutrition Policy Implementation in Alexander First Nation

2017 ◽  
Vol 12 (2) ◽  
pp. 43-63 ◽  
Author(s):  
Kris Murray ◽  
Alexander Research Committee ◽  
Anna Farmer ◽  
Katerina Maximova ◽  
Noreen Willows
Keyword(s):  
Policy Implementation ◽  
Policy Development ◽  
Role Model ◽  
Nutrition Policy ◽  
School Nutrition ◽  
First Nation ◽  
Community Members ◽  
Staff Members ◽  
Wild Game ◽  
Health Programming

This mixed-methods community-based participatory research generated knowledge of school staff perceptions of the facilitators of and barriers to implementation of a Canadian First Nation school’s healthy nutrition policy. Themes derived from seven qualitative staff interviews were integrated with quantitative data derived from 28 staff surveys. The Medicine Wheel was used to describe results, as it provided a non-hierarchical and relational way to categorize all components and stakeholders of nutrition policy implementation. Factors that facilitated policy implementation were associated with the school environment, including the nutritional quality of foods sold or offered at school, administrative support, and foundational health programming prior to policy development. Staff identified the school as a role model for community members and as a key facilitator of policy implementation (for example, in leading health initiatives, providing a place for nutritious food and physical activity opportunities, and acting as a health resource for all community members). Barriers included inconsistency between staff members in policy implementation, uncertainty about staff members’ role in policy implementation, and lack of school communication with parents regarding the policy. One of the informative barriers from a First Nation perspective was the perceived misalignment of traditional foods, such as bannock or wild game, served at First Nation cultural events with federally derived nutrition standards that emphasize a low-fat diet. Results suggest strengthening school nutrition policy implementation by increasing staff nutrition education and certainty of their roles as policy facilitators, advocates, and enforcers; improving communication with families; having supportive school health programming; and ensuring the school, community, and home environment all reinforce healthy eating.

Alexander First Nations Parents’ Perceptions of a School Nutrition Policy

2020 ◽  
Vol 81 (2) ◽  
pp. 66-71 ◽  
Author(s):  
Christina Gillies ◽  
Anna Farmer ◽  
Katerina Maximova ◽  
Noreen D. Willows ◽  
Keyword(s):  
Policy Implementation ◽  
First Nations ◽  
Structured Interview ◽  
Nutrition Policy ◽  
School Nutrition ◽  
Healthy Foods ◽  
Promotion Strategy ◽  
Food Programs ◽  
Health Promotion Strategy ◽  
Survey Responses

Purpose: A school nutrition policy (SNP) is one promising school-based health promotion strategy to improve the food environments of First Nations children. The aim of this study was to explore First Nations parents’ perceptions of a SNP. Methods: A process evaluation of policy implementation was conducted using a mixed-methods design. Parents (n = 83) completed a 19-question survey to capture their perceptions of the policy. Survey responses informed questions in an 11-question semi-structured interview guide. Transcripts from interviews with parents (n = 10) were analyzed using content analysis to identify barriers and facilitators to policy implementation. Results: Parents were supportive of the SNP and the school’s food programs, which they perceived as helping to address community concerns related to nutrition. However, some parents opposed the restriction of unhealthy foods at school celebrations and fundraisers. In addition, despite being aware of the SNP, parents were unable to demonstrate an understanding of the SNP content. Finally, parents struggled to provide their children with healthy foods to bring to school due to lack of affordable and accessible food in the community. Conclusions: Although SNPs may be well-received in First Nations communities, their implementation must be supported by parent involvement and consideration of wider socioeconomic conditions.

scholarly journals Can Monitoring Make It Happen? An Assessment of How Reporting, Monitoring, and Evaluation Can Support Local Wellness Policy Implementation in US Schools

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 193
Author(s):  
Lindsey Turner ◽  
Yuka Asada ◽  
Julien Leider ◽  
Elizabeth Piekarz-Porter ◽  
Marlene Schwartz ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Policy Development ◽  
Child Nutrition ◽  
Monitoring And Evaluation ◽  
School Nutrition ◽  
Wellness Policy ◽  
Cost Study ◽  
Child Nutrition Programs ◽  
Local Wellness Policy ◽  
Nationally Representative

US school districts participating in federal child nutrition programs are required to develop a local wellness policy (LWP). Each district is allowed flexibility in policy development, including the approaches used for policy reporting, monitoring, and evaluation (RME). The aim of this convergent mixed-methods study was to quantitatively examine RME provisions in policies among a nationally representative sample of districts in the 2014–2015 school year in order to examine whether policies were associated with RME practices in those districts, and to qualitatively examine perceived challenges to RME practices. Data were compiled through the School Nutrition and Meal Cost Study and the National Wellness Policy Study. In multivariable regression models accounting for demographics, survey respondents were significantly more likely to report that their district had informed the public about LWP content and implementation, if there was a relevant policy provision in place. Having a strong policy (as compared to no policy) requiring evaluation was associated with reports that the district had indeed evaluated implementation. Having definitive/required provisions in policies was significantly associated with actual use of RME practices. RME activities are an important part of policy implementation, and these results show that policy provisions addressing RME activities must be written with strong language to require compliance. In interviews with 39 superintendents, many reported that RME activities are challenging, including difficulty determining how to monitor and show impact of their district’s wellness initiatives. Furthermore, the qualitative results highlighted the need for vetted tools that are freely available, widely used, and feasible for districts to use in assessing their progress toward meeting the goals in their LWPs.

Gaps in Nutrition Policy Implementation in Childcare Centres in The Edmonton Metropolitan Region: A Cross-Sectional Survey

2021 ◽  
pp. 1-8
Author(s):  
Marjorie Rafaela Lima Do Vale ◽  
Anna Farmer ◽  
Rebecca Gokiert ◽  
Geoff Ball ◽  
Katerina Maximova
Keyword(s):  
Policy Implementation ◽  
Policy Development ◽  
Statistical Tests ◽  
Nutrition Policy ◽  
Metropolitan Region ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Writing Evaluation ◽  
Additional Support ◽  
Implementation Resources

Purpose: To describe (i) nutrition policies in childcare centres, (ii) the resources and processes used to enable policy implementation, and (iii) the association between policy implementation and childcare centres’ or administrators’ characteristics. Methods: Between October 2018 and June 2019 a web-based survey that addressed nutrition policy, policy implementation, and sociodemographic characteristics was sent to eligible childcare programs (centre-based and provided meals) in the Edmonton (Alberta) metropolitan region. The survey was pretested and pilot tested. Statistical tests examined the relationship between policy implementation with centres’ and administrators’ characteristics. Results: Of 312 childcare centres that received the survey invitation, 43 completed it. The majority of centres had a nutrition policy in place (94%). On average, centres had about 9 of the 17 implementation resources and processes assessed. Most often administrators reported actively encouraging the implementation of the nutrition policy (n = 35; 87%) and least often writing evaluation reports of the implementation of the nutrition policy (n = 9; 22%). Administrator’s education level was associated with implementation total score (p = 0.009; Kruskal-Wallis). Conclusion: Most childcare centres had a nutrition policy in place, but many lacked resources and processes to enable policy implementation. Additional support is required to improve nutrition policy development and implementation.

First Nations students’ perceptions of school nutrition policy implementation: A mixed methods study

2018 ◽  
Vol 75 (5) ◽  
pp. 533-540 ◽  
Author(s):  
Christina Gillies ◽  
Anna Farmer ◽  
Katerina Maximova ◽  
Noreen D. Willows ◽  
Keyword(s):  
Mixed Methods ◽  
Policy Implementation ◽  
First Nations ◽  
Nutrition Policy ◽  
School Nutrition ◽  
Mixed Methods Study ◽  
Perceptions Of School

scholarly journals Examining local-level factors shaping school nutrition policy implementation in Ontario, Canada

2013 ◽  
Vol 17 (6) ◽  
pp. 1290-1298 ◽  
Author(s):  
Michelle M Vine ◽  
Susan J Elliott
Keyword(s):  
Policy Implementation ◽  
User Satisfaction ◽  
Local Level ◽  
Nutrition Policy ◽  
School Nutrition ◽  
Structured Interviews ◽  
Vice Principals ◽  
Local Agencies ◽  
The Cost

AbstractObjectiveIncreasing numbers of overweight and obese youth draw attention to the school as an important setting for targeted nutrition interventions, given that it is where they spend a majority of their waking time. The objective of the present study was to explore local-level factors shaping the implementation of a school nutrition policy.DesignIn-depth, semi-structured interviews were conducted in person or via the telephone (a maximum of 60 min). An interview guide was informed by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, research objectives and literature. Key themes centred on policy implementation, including facilitators and barriers (i.e. resources, capacity), user satisfaction (i.e. students) and communication strategies.SettingSecondary schools in Ontario, Canada.SubjectsTwenty-two participants from local agencies supporting school nutrition programming (n8) and secondary-school principals, vice principals and teachers (n14) from nine schools across three Ontario school boards.ResultsResults are organized according to environments outlined in the ANGELO framework. The cost of healthy food for sale, revenue loss (economic), proximity of schools to off-site food outlets (physical), the restrictive nature of policy, the role of key stakeholders (political), the role of stigma and school culture (sociocultural) act as local-level barriers to policy implementation.ConclusionsGaps in policy implementation include the high cost of food for sale and subsequent revenue generation, the close proximity of internal and external food environments, the need for consultation and communication between stakeholders, and strategies to reduce stigma and improve the school nutrition culture.

scholarly journals Stakeholder Perspectives on Barriers and Facilitators on the Implementation of the 1000 Days Plus Nutrition Policy Activities in Ghana

2021 ◽  
Vol 18 (10) ◽  
pp. 5317
Author(s):  
Anne Galaurchi ◽  
Samuel T. Chatio ◽  
Paula Beeri ◽  
Abraham R. Oduro ◽  
Winfred Ofosu ◽  
...  
Keyword(s):  
Well Being ◽  
Nutrition Policy ◽  
Civil Society Organizations ◽  
Barriers And Facilitators ◽  
Policy Framework ◽  
Economic Productivity ◽  
Stakeholder Perspectives ◽  
Nutrition Policies ◽  
Policies And Programs ◽  
Implementation Resources

Optimizing nutrition in the preconception and 1000 days periods have long-term benefits such as higher economic productivity, reduced risk of related non-communicable diseases and increased health and well-being. Despite Ghana’s recent progress in reducing malnutrition, the situation is far from optimal. This qualitative study analyzed the maternal and child health nutrition policy framework in Ghana to identify the current barriers and facilitators to the implementation of nutrition policies and programs relating to the first 1000 days plus. Data analyzed included in-depth interviews and focus group discussions conducted in Ghana between March and April 2019. Participants were composed of experts from government agencies, civil society organizations, community-based organizations and international partners at national and subnational levels. Seven critical areas were identified: planning policy implementation, resources, leadership and stakeholders’ engagement, implementation guidance and ongoing communication, organizational culture, accountability and governance and coverage. The study showed that, to eradicate malnutrition in Ghana, priorities of individual stakeholders have to be merged and aligned into a single 1000 days plus nutrition policy framework. Furthermore, this study may support stakeholders in implementing successfully the 1000 days plus nutrition policy activities in Ghana.

School-Based Nutrition Programs for Adolescents in Dodoma, Tanzania: A Situation Analysis

2021 ◽  
pp. 037957212110207
Author(s):  
Colette Rector ◽  
Nadhira Nuraini Afifa ◽  
Varun Gupta ◽  
Abbas Ismail ◽  
Dominic Mosha ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Ad Hoc ◽  
School Administrators ◽  
School Nutrition ◽  
Overweight And Obesity ◽  
School Meals ◽  
Nutrition Interventions ◽  
Double Burden ◽  
School Based ◽  
Sanitation And Hygiene

Background: Tanzania has a double burden of malnutrition, including a high prevalence of undernutrition and an increasing prevalence of overweight and obesity among adolescents. Schools present a valuable opportunity to reach a large section of the country’s adolescent population with nutrition-oriented interventions. Objective: The objective of this study was to assess the current state of adolescent school nutrition interventions in Dodoma, Tanzania, with emphases on 3 potential school-based nutrition interventions, school vegetable gardens, school meals, and education (on nutrition, agriculture, and water, sanitation, and hygiene). Methods: Focus group discussions were conducted with several regional and district-level governmental stakeholders, including health, education, and agricultural officers. Ten public secondary schools were visited, and interviews with school administrators, teachers, students, and parents were conducted. Results: All stakeholders interviewed supported interventions to improve school-based nutrition, including school gardens, school feeding, and nutrition education. All 10 schools visited had some experience providing school meals, but parents’ contributions were essential for the program’s sustainability. Most schools visited had land available for a school garden program, but water availability could be challenging during certain times of the year. The teachers interviewed expressed that the curriculum on nutrition education was highly theoretical and did not allow students to practice the knowledge and skills they learned in the classroom. Conclusions: The current school-based approach to tackling the double burden of adolescent malnutrition in Dodoma is localized and ad hoc. To leverage the potential of schools as a platform for nutrition interventions, integrated and policy-mandated interventions are needed.

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