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1. Cluster randomised controlled trial of an online intervention to improve healthy food purchases from primary school canteens: a study protocol of the ‘click & crunch’ trial

Author

Karen Campbell, Rachel Sutherland, Luke Wolfenden, Nicole Nathan, Sze Lin Yoong, Chris Rissel, Penny Reeves, Rebecca Wyse, Tessa Delaney, Pennie Gibbins, Kylie Ball, Kirsty Seward, Rachel Zoetemeyer, John Wiggers, Chris Oldmeadow, and Kathryn Reilly

Subjects
Medicine
Abstract

Introduction School canteens are the most frequently accessed take-away food outlet by Australian children. The rapid development of online lunch ordering systems for school canteens presents new opportunities to deliver novel public health nutrition interventions to school-aged children. This study aims to assess the effectiveness and cost-effectiveness of a behavioural intervention in reducing the energy, saturated fat, sugar and sodium content of online canteen lunch orders for primary school children.Methods and analysis The study will employ a cluster randomised controlled trial design. Twenty-six primary schools in New South Wales, Australia, that have an existing online canteen ordering system will be randomised to receive either a multi-strategy behavioural intervention or a control (the standard online canteen ordering system). The intervention will be integrated into the existing online canteen system and will seek to encourage the purchase of healthier food and drinks for school lunch orders (ie, items lower in energy, saturated fat, sugar and sodium). The behavioural intervention will use evidence-based choice architecture strategies to redesign the online menu and ordering system including: menu labelling, placement, prompting and provision of feedback and incentives. The primary trial outcomes will be the mean energy (kilojoules), saturated fat (grams), sugar (grams) and sodium (milligrams) content of lunch orders placed via the online system, and will be assessed 12 months after baseline data collection.Ethics and dissemination The study was approved by the ethics committees of the University of Newcastle (H-2017–0402) and the New South Wales Department of Education and Communities (SERAP 2018065), and the Catholic Education Office Dioceses of Sydney, Parramatta, Lismore, Maitland-Newcastle, Bathurst, Canberra-Goulburn, Wollongong, Wagga Wagga and Wilcannia-Forbes. Study results will be disseminated through peer-reviewed publications, reports, presentations at relevant national and international conferences and via briefings to key stakeholders. Results will be used to inform future implementation of public health nutrition interventions through school canteens, and may be transferable to other food settings or online systems for ordering food.Trial registration number ACTRN12618000855224.

Published
2019
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2. CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: protocol of a randomised controlled trial

Author

Nicole Lubans, Tameka Small, Jessica Pinfold, Christopher M. Williams, Rachel Sutherland, Luke Wolfenden, Rebecca Wyse, John Wiggers, Peter Butler, Kathryn Reilly, Tessa Delaney, Kay Smith, Nicole Nathan, Sarah Preece, and Sze Lin Yoong

Subjects
medicine.medical_specialty, Dieticians, education, Psychological intervention, Audit, Health Promotion, law.invention, Randomized controlled trial, law, Intervention (counseling), Protocol, Medicine, Humans, Child, health care economics and organizations, Protocol (science), Government, Medical education, Schools, business.industry, Public health, Health Policy, Food Services, Health Plan Implementation, General Medicine, Diet, Research Design, Child, Preschool, Management Audit, PUBLIC HEALTH, New South Wales, business
Abstract

Introduction 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 and analysis 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. Ethics and dissemination 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. Trial registration number ACTRN12613000543785.

Published
2015

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