title: Implementing the Alberta nutrition guidelines for children and youth in a recreational facility.
abstract: OBJECTIVE
  In this mixed-methods case study, we explored factors influencing the adoption and implementation of the Alberta Nutrition Guidelines for Children and Youth within recreational facilities, and assessed the impact of their implementation on the food environment.
  
  
  METHODS
  Qualitative data were generated via interviews, observations, and document reviews. The quality of the food environment was assessed using validated and newly developed food environment assessment tools.
  
  
  RESULTS
  Whereas few barriers existed in terms of adopting the guidelines, implementing them proved much more challenging. Implementation was impeded by concerns about the lack of profitability of healthy items, time, and resource constraints. Guidelines that do not restrict the availability of unhealthy options are better accepted by stakeholders. Implementation of the guidelines supported creation of a healthy food environment, but the availability of healthy items remained very limited within the concession (16%) and vending machines (20%), and children continued to purchase primarily unhealthy items.
  
  
  CONCLUSIONS
  Findings suggest that children choose healthy options insufficiently when unhealthy items are present. Thus, although introducing the nutrition guidelines in a nonrestrictive format may have been advantageous in some ways, they should be strengthened over time so that they recommend near or total elimination of unhealthy options.
authors.affiliation: Alberta Institute for Human Nutrition, and Department of Agricultural, Food and Nutritional Science and Centre for Health Promotion Studies, University of Alberta, Edmonton.
authors.forename: Dana Lee
authors.initials: DL
authors.lastname: Olstad
authors.forename: Jessica R L
authors.initials: JR
authors.lastname: Lieffers
authors.forename: Kim D
authors.initials: KD
authors.lastname: Raine
authors.forename: Linda J
authors.initials: LJ
authors.lastname: McCargar
mesh_terms: D000293:Adolescent; D000416:Alberta; D002648:Child; D005509:Food Dispensers, Automatic; D005518:Food Preferences; D005522:Food Services; D006284:Health Plan Implementation; D006801:Humans; D018673:Nutrition Policy; D011998:Recreation; D012946:Social Welfare