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BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Development of the ‘Canteen Scan’: an online tool to monitor implementation of healthy canteen guidelines

Authors: I. J. Evenhuis, N. L. W. J. Wezenbeek, E. L. Vyth, L. Veldhuis, M. P. Poelman, D. Wolvers, J. C. Seidell, C. M. Renders

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

To improve the availability and accessibility of healthier food and drinks in schools, sports and worksites canteens, national Guidelines for Healthier Canteens were developed by the Netherlands Nutrition Centre. Until now, no tool was available to monitor implementation of these guidelines. This study developed and assessed the content validity and usability of an online tool (the ‘Canteen Scan’) that provides insight into and directions for improvement of healthier food products in canteens.

Methods

The Canteen Scan was developed using a three-step iterative process. First, preliminary measures and items to evaluate adherence to the guidelines were developed based on literature, and on discussions and pre-tests with end-users and experts from science, policy and practice. Second, content validity of a paper version of the Canteen Scan was assessed among five end-users. Third, the online Canteen Scan was pilot tested among end-users representing school canteens. Usability was measured by comprehensibility, user-friendliness, feasibility, time investment, and satisfaction.

Results

The content validity of the Canteen Scan was ensured by reaching agreement between stakeholders representing science, policy and practice. The scan consists of five elements: 1) basic conditions (e.g. encouragement to drink water and availability of policy regarding the guidelines), 2) product availability offered on displays (counter, shelf) and 3) in vending machines, 4) product accessibility (e.g. promotion and placement of products), and 5) an overall score based on the former elements and tailored feedback for creating a healthier canteen. The scan automatically classifies products into healthier or less healthy products. Pilot tests indicated good usability of the tool, with mean scores of 4.0–4.6 (5-point Likert scale) on the concepts comprehensibility, user-friendliness and feasibility.

Conclusion

The Canteen Scan provides insight into the extent to which canteens meet the Dutch Guidelines for Healthier Canteens. It also provides tailored feedback to support adjustments towards a healthier canteen and with the scan changes over time can be monitored. Pilot tests show this tool to be usable in practice.
Literature
1.
WHO. World statistics 2016: monitoring health for the SDG's. Geneva: WHO press; 2016.
2.
Withrow D, Alter DA. The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obes Rev. 2011;12(2):131–41.CrossRefPubMed
3.
Engeland A, Bjorge T, Tverdal A, Sogaard AJ. Obesity in adolescence and adulthood and the risk of adult mortality. Epidemiology. 2004;15(1):79–85.CrossRefPubMed
4.
Grosso G, Bella F, Godos J, Sciacca S, Del Rio D, Ray S, Galvano F, Giovannucci EL. Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk. Nutr Rev. 2017;75(6):405–19.CrossRefPubMed
5.
Seidell JC, Halberstadt J. The global burden of obesity and the challenges of prevention. Ann Nutr Metab. 2015;66(Suppl 2):7–12.CrossRefPubMed
6.
Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J. Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act. 2006;3:9.CrossRefPubMedPubMedCentral
7.
James P, Seward MW. James O’Malley a, Subramanian S, block JP: changes in the food environment over time: examining 40 years of data in the Framingham heart study. Int J Behav Nutr Phys Act. 2017;14(1):84.CrossRefPubMedPubMedCentral
8.
Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: concepts and measures. AJHP. 2005;19(5):330–3. iiPubMed
9.
10.
Poti JM, Slining MM, Popkin BM. Where are kids getting their empty calories? Stores, schools, and fast-food restaurants each played an important role in empty calorie intake among US children during 2009-2010. J Acad Nutr Diet. 2014;114(6):908–17.CrossRefPubMed
11.
Rozin P, Scott S, Dingley M, Urbanek JK, Jiang H, Kaltenbach M. Nudge to nobesity I: minor changes in accessibility decrease food intake. Judgm Decis Mak. 2011;6(4):323.
12.
Arno A, Thomas S. The efficacy of nudge theory strategies in influencing adult dietary behaviour: a systematic review and meta-analysis. BMC Public Health. 2016;16(1):676.CrossRefPubMedPubMedCentral
13.
Story M, Kaphingst KM, Robinson-O'Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health. 2008;29:253–72.CrossRefPubMed
14.
Chriqui JF, Pickel M, Story M. Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review. JAMA Pediatr. 2014;168(3):279–86.CrossRefPubMed
15.
Lytle LA, Sokol RL. Measures of the food environment: a systematic review of the field, 2007–2015. Health & Place. 2017;44:18–34.CrossRef
16.
van Kleef E, Otten K, van Trijp HC. Healthy snacks at the checkout counter: a lab and field study on the impact of shelf arrangement and assortment structure on consumer choices. BMC Public Health. 2012;12:1072.CrossRefPubMedPubMedCentral
17.
Seymour JD, Yaroch AL, Serdula M, Blanck HM, Khan LK. Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review. Prev Med. 2004;39(Suppl 2):S108–36.CrossRefPubMed
18.
Grech A, Allman-Farinelli M. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices. Obes Rev. 2015;16(12):1030–41.CrossRefPubMed
19.
Ni Mhurchu C, Vandevijvere S, Waterlander W, Thornton LE, Kelly B, Cameron AJ, Snowdon W, Swinburn B. Informas: Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally. Obes Rev. 2013;14:108–19.CrossRefPubMed
20.
Keller C, Markert F, Bucher T. Nudging product choices: the effect of position change on snack bar choice. Food Qual Pref. 2015;41:41–3.CrossRef
21.
Thaler RH, Sunstein CR. Nudge: improving decisions about health, wealth and happiness. Londen: Penguin Books; 2009.
22.
23.
Thapa JRL. C. P.: behavioral economics in the school lunchroom: can it affect food supplier decisions? A systematic review. Int Food Agri Man Rev. 2014;17(Special Issue A):178–208.
24.
Reisch LA, Sunstein CR, Gwozdz W. Beyond carrots and sticks: Europeans support health nudges. Food Policy. 2017;69:1–10.CrossRef
25.
Tyrrell RL, Greenhalgh F, Hodgson S, Wills WJ, Mathers JC, Adamson AJ, Lake AA. Food environments of young people: linking individual behaviour to environmental context. J Public health (Oxf). 2016;
26.
Paulussen KT, M. : Dagelijks eten. Een consumentenonderzoek tbv het Project Goede Voeding van het Voedingscentrum. GfK; 2011.
27.
28.
Gonzalez W, Jones SJ, Frongillo EA. Restricting snacks in U.S. elementary schools is associated with higher frequency of fruit and vegetable consumption. J Nutr. 2009;139(1):142–4.CrossRefPubMed
29.
30.
Schippers EI: Reactie rapport RIVM Nederland de Maat, voortgangsrapportage 2011 Convenant Gezond Gewicht, motie Vendrik en Motie Wiegman [reaction report RIVM Netherlands the measure, progress report 2011, covenant healthy weight, resolution Vendrik and Wiegman]. https://​www.​rijksoverheid.​nl/​documenten:​ Rijksoverheid; retrieved access: 03 Feb 2017.
31.
Penney TL, Almiron-Roig E, Shearer C, McIsaac JL, Kirk SF. Modifying the food environment for childhood obesity prevention: challenges and opportunities. Proc Nutr Soc. 2014;73(2):226–36.CrossRefPubMed
32.
Mensink F, Schwinghammer SA, Smeets A: The healthy school canteen programme: a promising intervention to make the school food environment healthier. J Environ Public Health 2012, 2012:415746.
33.
Veldhuis L, Mensink F, Wolvers D. Guidelines for healthier canteens. Fact sheet. The Hague: Netherlands Nutrition Centre; 2017.
34.
Brink EJ, Postma-Smeets A, Stafleu A, Wolvers D. The wheel of five. Fact sheet. The Hague: Netherlands Nutrition Centre; 2016.
35.
de Silva-Sanigorski A, Breheny T, Jones L, Lacy K, Kremer P, Carpenter L, Bolton K, Prosser L, Gibbs L, Waters E, et al. Government food service policies and guidelines do not create healthy school canteens. Aust N Z J Public Health. 2011;35(2):117–21.CrossRefPubMed
36.
Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Prev Med. 2009;48(1):45–53.CrossRefPubMed
37.
Sacks G, Swinburn B, Kraak V, Downs S, Walker C, Barquera S, Friel S, Hawkes C, Kelly B, Kumanyika S, et al. A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention. Obes Rev. 2013;14:38–48.CrossRefPubMed
38.
Hirschman J, Chriqui JF. School food and nutrition policy, monitoring and evaluation in the USA. Public Health Nutr. 2013;16(6):982–8.CrossRefPubMed
39.
Lucas PJ, Patterson E, Sacks G, Billich N, Evans CEL. Preschool and school meal policies: an overview of what we know about regulation, implementation, and impact on diet in the UK, Sweden, and Australia. Nutrients. 2017;9(7):736.CrossRefPubMedCentral
40.
Wolfenden L, Nathan N, Janssen LM, Wiggers J, Reilly K, Delaney T, Williams CM, Bell C, Wyse R, Sutherland R, et al. Multi-strategic intervention to enhance implementation of healthy canteen policy: a randomised controlled trial. Implement Sci. 2017;12(1):6.CrossRefPubMedPubMedCentral
41.
WHO. School policy framework. Implementation of the WHO global strategy on diet, physical activity and health. Geneva: WHO press; 2008.
42.
L'Abbe M, Schermel A, Minaker L, Kelly B, Lee A, Vandevijvere S, Twohig P, Barquera S, Friel S, Hawkes C, et al. Monitoring foods and beverages provided and sold in public sector settings. Obes Rev. 2013;14(Suppl 1):96–107.CrossRefPubMed
43.
Matthews MA, Horacek TM. Vending machine assessment methodology. A systematic review. Appetite. 2015;90:176–86.CrossRefPubMed
44.
Gebremariam MK, Vaque-Crusellas C, Andersen LF, Stok FM, Stelmach-Mardas M, Brug J, Lien N. Measurement of availability and accessibility of food among youth: a systematic review of methodological studies. Int J Behav Nutr Phys Act. 2017;14(1):22.CrossRefPubMedPubMedCentral
45.
Glanz K, Sallis JF, Saelens BE, Frank LD. Nutrition environment measures survey in stores (NEMS-S): development and evaluation. Am J Prev Med. 2007;32(4):282–9.CrossRefPubMed
46.
Saelens BE, Glanz K, Sallis JF, Frank LD. Nutrition environment measures study in restaurants (NEMS-R): development and evaluation. Am J Prev Med. 2007;32(4):273–81.CrossRefPubMed
47.
Voss C, Klein S, Glanz K, Clawson M. Nutrition environment measures survey-vending: development, dissemination, and reliability. Health Promot Pract. 2012;13(4):425–30.CrossRefPubMed
48.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HCW. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737–45.CrossRefPubMed
49.
de Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: A practical guide: Cambridge University Press; 2011.
50.
Patrick DL, Burke LB, Gwaltney CJ, Leidy NK, Martin ML, Molsen E, Ring L. Content validity-establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 2-assessing respondent understanding. Value Health. 2011;14(8):978–88.CrossRefPubMed
51.
Patrick DL, Burke LB, Gwaltney CJ, Leidy NK, Martin ML, Molsen E, Ring L. Content validity--establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1--eliciting concepts for a new PRO instrument. Value Health. 2011;14(8):967–77.CrossRefPubMed
52.
Miller C, Bodor JN, Rose D. Measuring the food environment: a systematic technique for characterizing food stores using display counts. J Environ Public Health. 2012;2012:707860.CrossRefPubMedPubMedCentral
53.
Farley TA, Rice J, Bodor JN, Cohen DA, Bluthenthal RN, Rose D. Measuring the food environment: shelf space of fruits, vegetables, and snack foods in stores. J Urban Health. 2009;86(5):672–82.CrossRefPubMedPubMedCentral
54.
Drennan J. Cognitive interviewing: verbal data in the design and pretesting of questionnaires. J Adv Nurs. 2003;42(1):57–63.CrossRefPubMed
55.
Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes. Obes Rev. 2013;14(2):110–28.CrossRefPubMed
56.
An R. Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments. Public Health Nutr. 2013;16(7):1215–28.CrossRefPubMed
57.
Vermeer WM, Steenhuis IHM, Poelman MP. Small, medium, large or supersize? The development and evaluation of interventions targeted at portion size. Int J Obes. 2014;38(S1):S13–8.CrossRef
58.
Netherlands Nutrition Centre, Netherlands Institute for Public Health and Environment. Dutch food and drink products database. In: The Hague; 2017.
59.
Engbers LH, van Poppel MN, Chin APMJ, van Mechelen W. Worksite health promotion programs with environmental changes: a systematic review. Am J Prev Med. 2005;29(1):61–70.CrossRefPubMed
60.
Foster GD, Karpyn A, Wojtanowski AC, Davis E, Weiss S, Brensinger C, Tierney A, Guo W, Brown J, Spross C, et al. Placement and promotion strategies to increase sales of healthier products in supermarkets in low-income, ethnically diverse neighborhoods: a randomized controlled trial. Am J Clin Nutr. 2014;99(6):1359–68.CrossRefPubMed
61.
Swanson M, Branscum A, Nakayima PJ. Promoting consumption of fruit in elementary school cafeterias. The effects of slicing apples and oranges. Appetite. 2009;53(2):264–7.CrossRefPubMed
62.
Cohen JW, Richardson SA, Cluggish SA, Parker E, Catalano PJ, Rimm EB. Effects of choice architecture and chef-enhanced meals on the selection and consumption of healthier school foods: a randomized clinical trial. JAMA Pediatr. 2015;169(5):431–7.CrossRefPubMedPubMedCentral
63.
Wansink B, Love K. Slim by design: menu strategies for promoting high-margin, healthy foods. Int J Hosp Manag. 2014;42:137–43.CrossRef
64.
Hanks AS, Just DR, Smith LE, Wansink B. Healthy convenience: nudging students toward healthier choices in the lunchroom. J Public Health (Oxf). 2012;34(3):370–6.CrossRef
65.
French SA, Jeffery RW, Story M, Breitlow KK, Baxter JS, Hannan P, Snyder MP. Pricing and promotion effects on low-fat vending snack purchases: the CHIPS study. Am J Public Health. 2001;91(1):112–7.CrossRefPubMedPubMedCentral
66.
French SA, Hannan PJ, Harnack LJ, Mitchell NR, Toomey TL, Gerlach A. Pricing and availability intervention in vending machines at four bus garages. J Occup Environ Med. 2010;52(Suppl 1):S29.CrossRefPubMedPubMedCentral
67.
Dayan E, Bar-Hillel M. Nudge to nobesity II: menu positions influence food orders. Judgm Decis Mak. 2011;6(4):333.
68.
Kelly B, King ML, Chapman Mnd K, Boyland E, Bauman AE, Baur LA. A hierarchy of unhealthy food promotion effects: identifying methodological approaches and knowledge gaps. Am J Public Health. 2015;105(4):e86–95.CrossRefPubMedPubMedCentral
69.
Gustafson A, Hankins S, Jilcott S. Measures of the consumer food store environment: a systematic review of the evidence 2000-2011. J Community Health. 2012, 37(4):897–911.
70.
van Nassau F, Singh AS, van Mechelen W, Brug J, Chinapaw MJ. Implementation evaluation of school-based obesity prevention programmes in youth; how, what and why? Public Health Nutr. 2015;18(9):1531–4.CrossRefPubMed
71.
Green SH, Glanz K. Development of the perceived nutrition environment measures survey. Am J Prev Med. 2015;49(1):50–61.CrossRefPubMed
Metadata
Title
Development of the ‘Canteen Scan’: an online tool to monitor implementation of healthy canteen guidelines
Authors
I. J. Evenhuis
N. L. W. J. Wezenbeek
E. L. Vyth
L. Veldhuis
M. P. Poelman
D. Wolvers
J. C. Seidell
C. M. Renders
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5974-8

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