Design and evaluation of a multi-component audit and feedback intervention for implementation of healthy food policy in school canteens

Background: Uptake of healthy nutrition policies in school canteens nationally is poor, with many schools providing foods that are not recommend for regular sale and few providing sufficient healthy options. One promising intervention that has potential for achieving population-wide reach for school implementation of healthy nutrition policy in schools is audit and feedback. Methods: We developed a multi-component audit and feedback intervention to provide routine service support to school canteens in rural and remote locations of the Hunter New England Local Health District. The intervention aims to increase the proportion of school canteen menus compliant with recommendations from a state-wide healthy canteen policy (Fresh Taste @ School). The interventions involves four canteen menu audits, each followed by two modes of feedback: a written feedback report and at least one telephone support call, conducted four times – approximately once per term for one year. An evaluation framework was designed to rigorously test the effectiveness of the intervention, with schools randomly allocated to receive the intervention immediately or in 12 months. To assess the difference in menu composition between groups detailed menu assessments are conducted by trained dieticians, who are blinded to group status, prior to and after the completion of the intervention. Results: Seventy four schools have been enrolled in the program. Baseline characterises of schools were comparable between groups. There majority of schools were government schools (80%) with 59% of all canteens reporting a profit in the preceding year. Under Fresh Tastes @ School classifications there was a mean of 7 (SD6) items classified as banned or not recommended for regular sale. The majority of items (mean 30; SD14) were items that are recommended to not dominate the menu. The mean number of items encouraged for sale and which should fill the menu was 23 (SD14).Conclusion: A framework of delivery and robust evaluation for a remote support intervention for school canteens was developed. Follow up data will be available for presentation. (Abstract presented at Australian and New Zealand Obesity Society in conjunction with the Australian Lifestyle Medicine Association, Annual Scientific Meeting Novotel on Brighton Beach, Sydney Australia, 16—18 October 2014