title: An Intervention To Enhance the Food Environment in Public Recreation and Sport Settings: A Natural Experiment in British Columbia, Canada.
abstract: BACKGROUND
  Publicly funded recreation and sports facilities provide children with access to affordable physical activities, although they often have unhealthy food environments that may increase child obesity risk. This study evaluated the impact of a capacity-building intervention (Healthy Food and Beverage Sales; HFBS) on organizational capacity for providing healthy food environments, health of vending machine products, and food policy development in recreation and sport facilities in British Columbia, Canada.
  
  
  METHODS
  Twenty-one HFBS communities received training, resources, and technical support to improve their food environment over 8 months in 2009-2010, whereas 23 comparison communities did not. Communities self-reported organizational capacity, food policies, and audited vending machine products at baseline and follow-up. Repeated-measures analysis of variance evaluated intervention impact.
  
  
  RESULTS
  Intervention and comparison communities reported higher organizational capacity at follow-up; however, improvements were greater in HFBS communities (p<0.001). Healthy vending products increased from 11% to 15% (p<0.05), whereas unhealthy products declined from 56% to 46% (p<0.05) in HFBS communities, with no changes in comparison communities. At baseline 10% of HFBS communities reported having a healthy food policy, whereas 48% reported one at follow-up. No comparison communities had food policies.
  
  
  CONCLUSIONS
  This is the first large, controlled study to examine the impact of an intervention to improve recreation and sport facility food environments. HFBS communities increased their self-rated capacity to provide healthy foods, healthy vending product offerings, and food policies to a greater extent than comparison communities. Recreation and sport settings are a priority setting for supporting healthy dietary behaviors among children.
authors.affiliation: 1 Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, British Columbia, Canada .
authors.forename: Patti-Jean
authors.initials: PJ
authors.lastname: Naylor
authors.affiliation: 2 Centre for Health Promotion Studies, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Dana Lee
authors.initials: DL
authors.lastname: Olstad
authors.affiliation: 1 Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, British Columbia, Canada .
authors.forename: Suzanne
authors.initials: S
authors.lastname: Therrien
mesh_terms: D000293:Adolescent; D001628:Beverages / Q000009:adverse effects*; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D057140:Fast Foods / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005509:Food Dispensers, Automatic / Q000706:statistics & numerical data*; D005518:Food Preferences; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D018673:Nutrition Policy; D009753:Nutritive Value; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011998:Recreation; D013177:Sports