title: Effect of national recommendation on sweet selling as an intervention for a healthier school environment.
abstract: OBJECTIVE
  In 2007, the Finnish National Board of Education (FNBE) and the National Institute for Health and Welfare (THL) gave a national recommendation that Finnish upper comprehensive schools should not sell sweet products. The aim was to find out how the national recommendation changed the schools' selling of sweet products.
  
  
  METHODS
  This longitudinal survey was conducted in Finnish upper comprehensive school classes 7-9 (13-15-year-old pupils) in 2007 and 2010. All the schools (N=970) were invited to answer the questionnaire and 237 schools answered in both years (response rate 24%). The questionnaires contained questions concerning the selling of sweet and healthy products and school policy on sweet selling guidelines. Of the nine items in the questionnaire, three weighted sum scores were formed for oral health promotion: Exposure, enabling and policy (higher score indicating better actions). These sum scores were also trichotomized. Statistical significances of the changes were analyzed using nonparametric Wilcoxon's test, McNemar's test, and McNemar-Bowker's test.
  
  
  RESULTS
  Schools had decreased exposure of pupils to sweet products (p<0.001), more often provided oral health protecting items (p=0.047) and had improved their oral health-promoting policy (p<0.001). The selling of some sweet products, candies and soft drinks had decreased (p<0.001) whereas the selling of other sweet products had not changed (p=0.665). Schools tended to improve their exposure and policy status (p<0.001).
  
  
  CONCLUSIONS
  It is possible to improve school environments by means of a national recommendation. Other actions are needed both inside and outside schools in order to decrease the total consumption of sweet products among adolescents.
authors.affiliation: Licentiate in Dentistry, Department of Community Dentistry, University of Turku, Turku, Finland jaakko.j.anttila@utu.fi.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Anttila
authors.affiliation: Licentiate in Dentistry, Department of Community Dentistry, University of Oulu, Oulu, Finland.
authors.forename: Tatu
authors.initials: T
authors.lastname: Rytkönen
authors.affiliation: Licentiate in Dentistry, Department of Community Dentistry, University of Turku, Turku, Finland.
authors.forename: Rami
authors.initials: R
authors.lastname: Kankaanpää
authors.affiliation: Doctor of Philosophy, Department of Community Dentistry, FinnBrain study group, University of Turku, Turku, Finland.
authors.forename: Mimmi
authors.initials: M
authors.lastname: Tolvanen
authors.affiliation: Professor, Department of Community Dentistry, University of Turku, Turku, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Lahti
mesh_terms: D000293:Adolescent; D002182:Candy / Q000706:statistics & numerical data*; D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D003132:Commerce / Q000706:statistics & numerical data*; D019422:Dietary Sucrose / Q000008:administration & dosage; D005387:Finland; D005522:Food Services / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D018673:Nutrition Policy; D015397:Program Evaluation; D012572:School Health Services; D012931:Social Environment
chemical_list: D019422:Dietary Sucrose
keywords: Candy; Carbonated Beverages; Health Planning Guidelines; Health Promotion; National Recommendation; School Environment; School Policy; Schools; Sweet Selling