title: Changes in school environment, awareness and actions regarding overweight prevention among Dutch secondary schools between 2006-2007 and 2010-2011.
abstract: BACKGROUND
  Schools can be an important setting for the prevention of overweight. This nation-wide survey investigated changes in the obesogenity of the school environment, the awareness of schools regarding overweight, school health policy, and actions taken by schools to prevent overweight.
  
  
  METHODS
  In 2006/2007 and 2010/2011, questionnaires were sent to all Dutch secondary schools, (n = 1250 and n = 1145, response rate 44% and 33% respectively, repeated data for 187 schools).
  
  
  RESULTS
  The percentage of schools with vending machines for soft drinks (~90%) and sweets (~80%) remained fairly stable, whereas slightly more schools indicated to have a canteen (87%-91%). The food supply was reported to be healthier in 2010/2011 compared to 2006/2007. Canteens and/or vending machines offered more often fresh fruits (+8%), sandwiches (+11%), water (+11%) and salad (+7%) and less often sugar sweetened soft drinks (-10%). However, unfavorable changes such as an increase in the supply of pizza slices (+13%) and milk and yoghurt drinks with added sugar (+12%) were also reported. Between 2006/2007 and 2010/2011, the presence of water coolers increased (12% versus 33%) as well as facilities for physical activity (67% versus 77%). However, more schools had vending places of unhealthy foods in the vicinity (73% versus 85%). Compared to 2006/2007, a higher percentage of schools indicated that they have taken actions to stimulate healthy eating behavior (72% versus 80%) or to prevent overweight (34% versus 52%) in 2010/2011. Less schools indicated that they expect to pay more attention to overweight prevention in the near future (56% versus 43%), but none of them expected to pay less attention.
  
  
  CONCLUSIONS
  Several aspects of the school environment changed in a positive way. However, schools should be encouraged to contribute to the prevention of overweight, or to continue to do so.
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA Bilthoven, The Netherlands. saskia.van.den.berg@rivm.nl
authors.forename: Saskia W
authors.initials: SW
authors.lastname: van den Berg
authors.forename: Jochen
authors.initials: J
authors.lastname: Mikolajczak
authors.forename: Wanda J E
authors.initials: WJ
authors.lastname: Bemelmans
mesh_terms: D000293:Adolescent; D001364:Awareness; D002648:Child; D005509:Food Dispensers, Automatic / Q000706:statistics & numerical data; D005522:Food Services / Q000706:statistics & numerical data; D005523:Food Supply / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D009426:Netherlands; D016134:Organizational Policy; D050177:Overweight / Q000517:prevention & control*; D012574:Schools / Q000706:statistics & numerical data*; D012931:Social Environment