title: Assessment of the School Nutrition Environment: A Study in Australian Primary School Canteens.
abstract: BACKGROUND
  Schools represent a valuable setting for interventions to improve children's diets, as they offer structured opportunities for ongoing intervention. Modifications to the school food environment can increase purchasing of healthier foods and improve children's diets. This study examines the availability of healthy food and drinks, implementation of pricing and promotion strategies in Australian primary school canteens, and whether these varied by school characteristics.
  
  
  METHODS
  In 2012 and 2013, canteen managers of primary schools in the Hunter New England region of New South Wales reported via telephone interview the pricing and promotion strategies implemented in their canteens to encourage healthier food and drink purchases. A standardized audit of canteen menus was performed to assess the availability of healthy options. Data were analyzed in 2014.
  
  
  RESULTS
  Overall, 203 (79%) canteen managers completed the telephone interview and 170 provided menus. Twenty-nine percent of schools had menus that primarily consisted of healthier food and drinks, and 11% did not sell unhealthy foods. Less than half reported including only healthy foods in meal deals (25%), labeling menus (43%), and having a comprehensive canteen policy (22%). A significantly larger proportion of schools in high socioeconomic areas (OR=3.0) and large schools (OR=4.4) had primarily healthy options on their menus. School size and being a Government school were significantly associated with implementation of some pricing and promotion strategies.
  
  
  CONCLUSIONS
  There is a need to monitor canteen environments to inform policy development and research. Future implementation research to improve the food environments of disadvantaged schools in particular is warranted.
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle. Electronic address: serene.yoong@hnehealth.nsw.gov.au.
authors.forename: Sze Lin
authors.initials: SL
authors.lastname: Yoong
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle.
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Nathan
authors.affiliation: Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Wyse
authors.affiliation: Hunter New England Population Health.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Preece
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle; George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Williams
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Sutherland
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle.
authors.forename: John H
authors.initials: JH
authors.lastname: Wiggers
authors.affiliation: Hunter New England Population Health.
authors.forename: Tessa M
authors.initials: TM
authors.lastname: Delaney
authors.affiliation: Hunter New England Population Health; Faculty of Health, School of Medicine and Public Health, University of Newcastle; Hunter Medical Research Institute, Newcastle.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards; D005515:Food Labeling; D063427:Food Quality; D005522:Food Services / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009517:New South Wales; D012574:Schools / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires