Abstract
Background
Establishing healthy lifelong eating habits in young people is important in influencing short and long-term health. Adolescents, have an increased desire for autonomy and it is important to establish healthy habits as they become independent in their food choices. Schools are an ideal setting to improve diet, as they can reach young people over a prolonged period and a considerable portion of their daily energy intake occurs during school hours. However, research shows that many school food environments are unhealthy. In New Zealand, the canteen is a popular food provision, particularly in secondary schools, that is susceptible to providing food and beverages that do not meet Government healthy food and drink recommendations. Therefore, the objectives of this research were to establish what proportion of schools follow the Government’s Healthy Food and Drink Guidance and explore the barriers and enablers to providing healthy food and beverages in New Zealand secondary school canteens.
Methods
An online survey was sent to all secondary schools (n=333). The number of schools that responded was (n=37). The survey assessed whether schools had a canteen, a policy guiding the healthiness of food and beverages sold in the canteen and whether the principles of Government’s Healthy Food and Drink Guidance were being followed. Of the schools that responded to the survey, 24 schools were purposively selected to invite stakeholders involved with school canteens (Principals, Canteen Managers etc) to be interviewed about the canteen policies. Ten semi-structured online (Zoom) interviews and one interview by email, totalling 11 stakeholders representing 6 schools and one external catering company, were completed between February 2022 and June 2022 year. The interviews were transcribed and analysed using a Reflexive Thematic Analysis approach.
Results Four key themes were developed. Theme 1 Action oriented school policies that are based on healthy eating principles can facilitate healthier canteens highlighted the use and characteristics of policies. If schools do have a policy, it is brief and does not specify how to
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use The Healthy Food and Drink Guidance. The subtheme Mandatory policies are more enforceable highlighted that mandated policies are more enforceable. Theme 2 Multiple component opt-in programs or interventions facilitate a healthier school food provision shows that opt-in government interventions or programs (such as Ka Ora, Ka Ako) with funding, monitoring, and incentives improve the targeted food provision area. The subtheme Health-enhancing changes in the school environment has flow-on effect to canteens showed that these changes can also affect the entire school food environment. Theme 3 Healthy canteens get lost in the "pecking order" of what's important highlights that while schools and individual key stakeholders may believe healthy eating is important, participants also articulated that other factors related to well-being and education were more important to address within the schools limited resources. Because of this, the low prioritisation of healthy eating was a barrier. Theme 4 People’s values, attitudes and beliefs may help and hinder the healthiness of canteens explores the role champions have in influencing the healthiness of the canteen. Champions have a positive attitude, value healthy eating and are capable in their role- all of which improves the healthiness of the canteen. Subtheme 1 Meet student preferences while providing healthy food considered how catering to student taste preferences while trying to provide healthy food was a common barrier many champions worked hard to overcome. The final subtheme A collaborative approach can overcome barriers to healthy canteens identified the benefits of a collaborative approach to overcome barriers.
Conclusions Across New Zealand, few secondary schools report following the healthy eating principles outlined in the Government’s Healthy Food and Drink Guidance. The healthiness of foods and beverages sold in secondary school canteens is influenced by the presence and detail of school food and nutrition policies, Government mandates to implement these policies, Government programmes and other funded initiatives in the wider school environment, the priorities of the school and the values attitudes and beliefs of key stakeholders including principals, canteen employees and students. Government interventions can positively impact the canteen and other school food provisions. Specifically, Ka Ora, Ka Ako has provided insight into government interventions' effectiveness and possible flow-on effects on canteens and other food provisions. Some important recommendations have been made at the Government and School level that will not only have a positive change in the Canteen but the entire school food environment. The Government should consider mandating, monitoring and evaluating school food and nutrition policies that encompass Government Guidelines and
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apply to all food and beverages provided at school. The mandates should be coupled with resources and support such as funding and Nutritionists. Despite the possible impact of Government interventions, schools need to withstand the change in Government leadership and policy and, therefore, should develop their own tailored made policy. Creating and implementing school policies should encompass a whole-school approach