title: School food policy at Dutch primary schools: room for improvement? Cross-sectional findings from the INPACT study.
abstract: BACKGROUND
  Schools can play an important role in the prevention of obesity, e.g. by providing an environment that stimulates healthy eating habits and by developing a food policy to provide such an environment. The effectiveness of a school food policy is affected by the content of the policy, its implementation and its support by parents, teachers and principals. The aim of this study is to detect opportunities to improve the school food policy and/or implementation at Dutch primary schools. Therefore, this study explores the school food policy and investigates schools' (teachers and principals) and parents' opinion on the school food policy.
  
  
  METHODS
  Data on the schools' perspective of the food policy was collected from principals and teachers by means of semi-structured interviews. In total 74 principals and 72 teachers from 83 Dutch primary schools were interviewed. Data on parental perceptions about the school food policy were based on a cross-sectional survey among 1,429 parents from the same schools.
  
  
  RESULTS
  Most principals (87.1%) reported that their school had a written food policy; however in most cases the rules were not clearly defined. Most of the principals (87.8%) believed that their school paid sufficient attention to nutrition and health. Teachers and principals felt that parents were primarily responsible to encourage healthy eating habits among children, while 49.8% of the parents believed that it is also a responsibility of the school to foster healthy eating habits among children. Most parents reported that they appreciated the school food policy and comply with the food rules. Parents' opinion on the enforcement of the school food policy varied: 28.1% believed that the school should enforce the policy more strongly, 32.1% was satisfied, and 39.8% had no opinion on this topic.
  
  
  CONCLUSIONS
  Dutch primary schools could play a more important role in fostering healthy eating habits among children. The school food policy could be improved by clearly formulating food rules, simplifying supervision of the food rules, and defining how to enforce the food rules. In addition, the school food policy will only influence children's dietary behaviour if both the school and the parents support the policy.
authors.affiliation: IVO Addiction Research Institute, Heemraadssingel 194, Rotterdam, DM 3021, The Netherlands. vanansem@ivo.nl
authors.forename: Wilke Jc
authors.initials: WJ
authors.lastname: van Ansem
authors.forename: Carola Tm
authors.initials: CT
authors.lastname: Schrijvers
authors.forename: Gerda
authors.initials: G
authors.lastname: Rodenburg
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Schuit
authors.forename: Dike
authors.initials: D
authors.lastname: van de Mheen
mesh_terms: D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D018673:Nutrition Policy; D009765:Obesity / Q000517:prevention & control; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012574:Schools / Q000458:organization & administration*; D011795:Surveys and Questionnaires