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Christina Nash,Louise St-Denis
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Susan Caswell
Presentation Preference
Do support factors for implementing voluntary nutrition guidelines affect the healthfulness of recreation facility food environments? A Qualitative Comparative Analysis across three Canadian provinces
Names, Organizational Affiliations, and Locations of all Authors
S. Caswell 1, P-J Naylor 2, DL. Olstad 3, S. Kirk 4, J-L. McIsaac 4, L. Mâsse 5, K. Raine 6, R. Hanning 1
1University of Waterloo, Waterloo, ON, 2University of Victoria, Victoria, BC, 3University of Calgary, Calgary, AB, 4Dalhousie University, Halifax, NS, 5University of British Columbia, Vancouver, BC, 6University of Alberta, Edmonton, AB
Unhealthy food options are common in Canadian recreation facilities. Some provinces have instituted voluntary nutrition guidelines. However, it is not known what guideline implementation factors can best support transition to healthier food environments.
Objective(s)/Process or Summary of Content
To examine the relationships among implementation factors: guideline mobilization, facility context, and facility-level nutrition policy; and changes to food environment healthfulness in recreation facilities receiving capacity-building intervention (CBI) support.
Method(s)/Systemic Approach Used
Facilities across three provinces (BC n=7, AB n=6, NS n=4) enrolled in the capacity-building intervention arm of the Eat, Play, Live (EPL) study of voluntary nutrition guideline implementation were used to examine the relationship between implementation and impact. Intervention impact was assessed rating implementation factors: guideline mobilization, facility context, and facility-level nutrition policy rated from 1 (low) to 5 (high) using a cross-case analysis. Food environment changes in healthfulness were assessed using changes in observed proportions of vending and concession packaged products classified as Sell Most (SM), Sell Sometimes (SS), and Do Not Sell (DNS) and food environment rNEMS-R FS scores (Nutrition Environment Measures Survey-Restaurant reduced item audit Fast Summary) from baseline (T1) to intervention end (T2). A qualitative comparative analysis (QCA) examined factor rating combinations in relation to positive food environment changes.
QCA indicated that minimum ratings of mobilization 4/context 3/policy 3 were necessary to see reductions in vending %DNS products and mobilization 5/context 3/policy 4 or mobilization 4/context 4/policy 3 configurations were necessary to see reductions in concession %DNS products. The configuration necessary for increased rNEMS-R Fast Summary scores was mobilization 4/context 4/policy 3.
Higher ratings in all three implementation factors were necessary to support changes in environment. Efforts supporting the number and intensity of mobilization activities could have the greatest impact on food environment healthfulness.
Significance to Dietetics
Dietitians working in public health and policy can use these results to guide implementation supports for recreation facility nutrition guidelines.
Funded by
Heart and Stroke Foundation of Canada (PG16-047)
Original Work
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