title: Improvement in primary school adherence to the NSW Healthy School Canteen Strategy in 2007 and 2010.
abstract: OBJECTIVE
  Since 2005, a government-endorsed strategy guiding food sold in New South Wales school canteens has been in place. This study describes the changes in school canteen food between 2007 and 2010 and characterises schools most likely to adhere to strategy guidelines.
  
  
  METHODS
  Menus obtained from a cohort of primary and central schools in the Hunter New England region of New South Wales were audited using a traffic light system of classification. Energy dense, nutrient-poor or 'red' items are restricted; 'amber' are to be selected carefully and healthier 'green' items are encouraged.
  
  
  RESULTS
  In 2007, 7% of schools had no red items on their menu. In 2010, this improved to 22% (P < 0.05). In 2010, small schools (OR = 1.9, 95% CI = 1.25-3.05, P = 0.003); lower socioeconomic schools (OR = 1.3, 95% CI = 1.02-1.78, P = 0.03); non-government (OR = 1.7, 95% CI = 1.22-2.23, P = 0.001) and rural schools (OR = 1.7, 95% Cl = 1.30-2.25, P < 0.001) had higher odds of having red items on the menu. No significant change occurred in the proportion of green foods listed for sale between 2007 and 2010.
  
  
  CONCLUSIONS
  Proportion of schools adhering to strategy guidelines had increased slightly, however, most continue to list red items for regular sale. SO WHAT? For health policies to improve public health they need implementation. Findings suggest more work is required, particularly in small schools, rural schools and non-government schools.
authors.affiliation: Bulahdelah Community Health, Hunter New England Local Health District, Richmond Road, Bulahdelah, NSW 2423, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Hills
authors.affiliation: Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Locked Bag No. 10, Wallsend, NSW 2287, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Nathan
authors.affiliation: NSW Biostatistical Officer Training Program, NSW Ministry of Health, 73 Miller St, North Sydney, NSW 2060, Australia.
authors.forename: Keira
authors.initials: K
authors.lastname: Robinson
authors.affiliation: NSW Biostatistical Officer Training Program, NSW Ministry of Health, 73 Miller St, North Sydney, NSW 2060, Australia.
authors.forename: Danushka
authors.initials: D
authors.lastname: Fox
authors.affiliation: Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Locked Bag No. 10, Wallsend, NSW 2287, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
mesh_terms: D005522:Food Services / Q000592:standards / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D009517:New South Wales; D009753:Nutritive Value; D012111:Residence Characteristics; D012574:Schools / Q000592:standards / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors