title: A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol.
abstract: BACKGROUND
  The implementation of healthy school canteen policies has been recommended as a strategy to help prevent unhealthy eating and excessive weight gain. Internationally, research suggests that schools often fail to implement practices consistent with healthy school canteen policies. Without a population wide implementation, the potential benefits of these policies will not be realised. The aim of this trial is to assess the effectiveness of an implementation intervention in increasing school canteen practices consistent with a healthy canteen policy of the New South Wales (NSW), Australia, government known as the 'Fresh Tastes @ School NSW Healthy School Canteen Strategy'.
  
  
  METHODS
  The parallel randomised trial will be conducted in 70 primary schools located in the Hunter region of New South Wales, Australia. Schools will be eligible to participate if they are not currently meeting key components of the healthy canteen policy. Schools will be randomly allocated after baseline data collection in a 1:1 ratio to either an intervention or control group using a computerised random number function in Microsoft Excel. Thirty-five schools will be selected to receive a multi-component intervention including implementation support from research staff, staff training, resources, recognition and incentives, consensus and leadership strategies, follow-up support and implementation feedback. The 35 schools allocated to the control group will not receive any intervention support as part of the research trial. The primary outcome measures will be i) the proportion of schools with a canteen menu that does not contain foods or beverages restricted from regular sale ('red' and 'banned' items) and ii) the proportion of schools where healthy canteen items ('green' items) represent the majority (>50%) of products listed on the menu. Outcome data will be collected via a comprehensive menu audit, conducted by dietitians blind to group allocation. Intervention effectiveness will be assessed using logistic regression models adjusting for baseline values.
  
  
  CONCLUSIONS
  The proposed trial will represent a novel contribution to the literature, being the first randomised trial internationally to examine the effectiveness of an intervention to facilitate implementation of a healthy canteen policy.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12613000311752.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.forename: Nicole
authors.initials: N
authors.lastname: Nathan
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Williams
authors.forename: Tessa
authors.initials: T
authors.lastname: Delaney
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Reilly
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.forename: Karen
authors.initials: K
authors.lastname: Gillham
authors.forename: Rachel
authors.initials: R
authors.lastname: Sutherland
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Bell
authors.forename: Libby
authors.initials: L
authors.lastname: Campbell
authors.forename: Serene
authors.initials: S
authors.lastname: Yoong
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wyse
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Janssen
authors.forename: Sarah
authors.initials: S
authors.lastname: Preece
authors.forename: Melanie
authors.initials: M
authors.lastname: Asmar
authors.forename: John
authors.initials: J
authors.lastname: Wiggers
mesh_terms: D002648:Child; D004032:Diet / Q000592:standards*; D005247:Feeding Behavior; D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009517:New South Wales; D012147:Restaurants; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools