title: CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: protocol of a randomised controlled trial.
abstract: BACKGROUND
  A number of jurisdictions internationally have policies requiring schools to implement healthy canteens. However, many schools have not implemented such policies. One reason for this is that current support interventions cannot feasibly be delivered to large numbers of schools. A promising solution to support population-wide implementation of healthy canteen practices is audit and feedback. The effectiveness of this strategy has, however, not previously been assessed in school canteens. This study aims to assess the effectiveness and cost-effectiveness of an audit and feedback intervention, delivered by telephone and email, in increasing the number of school canteens that have menus complying with a government healthy-canteen policy.
  
  
  METHODS
  Seventy-two schools, across the Hunter New England Local Health District in New South Wales Australia, will be randomised to receive the multicomponent audit and feedback implementation intervention or usual support. The intervention will consist of between two and four canteen menu audits over 12 months. Each menu audit will be followed by two modes of feedback: a written feedback report and a verbal feedback/support via telephone. Primary outcomes, assessed by dieticians blind to group status and as recommended by the Fresh Tastes @ School policy, are: (1) the proportion of schools with a canteen menu containing foods or beverages restricted for sale, and; (2) the proportion of schools that have a menu which contains more than 50% of foods classified as healthy canteen items. Secondary outcomes are: the proportion of menu items in each category ('red', 'amber' and 'green'), canteen profitability and cost-effectiveness.
  
  
  BACKGROUND
  Ethical approval has been obtained by from the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. The findings will be disseminated in usual forums, including peer-reviewed publication and conference presentations.
  
  
  BACKGROUND
  ACTRN12613000543785.
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Williams
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Nathan
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Tessa
authors.initials: T
authors.lastname: Delaney
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Sze Lin
authors.initials: SL
authors.lastname: Yoong
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Wiggers
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Preece
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lubans
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sutherland
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Pinfold
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Kay
authors.initials: K
authors.lastname: Smith
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Tameka
authors.initials: T
authors.lastname: Small
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Reilly
authors.affiliation: Hunter New England Area Health Service, Hunter New England Population Health, Newcastle, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Butler
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Wyse
authors.affiliation: Hunter Medical Research Institute, Newcastle, New South Wales, Australia School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Luke
authors.identifier: http://orcid.org/0000-0002-6178-3868
authors.initials: L
authors.lastname: Wolfenden
mesh_terms: D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D005522:Food Services / Q000592:standards*; D006284:Health Plan Implementation / Q000458:organization & administration*; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008330:Management Audit / Q000458:organization & administration*; D009517:New South Wales; D012107:Research Design; D012574:Schools / Q000592:standards*
keywords: PUBLIC HEALTH