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Open AccessArticle

Understanding System-Level Intervention Points to Support School Food and Nutrition Policy Implementation in Nova Scotia, Canada

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Healthy Populations Institute, Dalhousie University, PO Box 15000, Halifax, NS B3H 4R2, Canada
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Faculty of Education, Mount Saint Vincent University, 166 Bedford Highway, Halifax, NS B3M 2J6, Canada
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MRC Epidemiology Unit/CEDAR, University of Cambridge, Cambridge CB2 1TN, UK
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School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(5), 712; https://doi.org/10.3390/ijerph16050712
Received: 21 January 2019 / Revised: 18 February 2019 / Accepted: 20 February 2019 / Published: 27 February 2019
(This article belongs to the Special Issue Complex Interventions for Public Health Improvement)
Supporting the implementation of school food and nutrition policies (SFNPs) is an international priority to encourage healthier eating among children and youth. Such policies can improve equitable access, resources, and supports for healthy eating. However, despite the potential impact of SFNPs, several implementation barriers have been reported. This study sought to examine the system-level intervention points within a school food system using a complex systems framework. We conducted semi-structured interviews with various stakeholders working to influence the school food system in Nova Scotia, Canada. We sought to understand their roles and experiences with the SFNP by applying the Intervention Level Framework (ILF), a novel, solutions-oriented approach to better understand how complex systems function. Participants (n = 33) included teachers, parents, cafeteria workers, public health staff and non-profit organizations. Interview transcripts were first coded, then themed and finally analyzed using the ILF, resulting in three intervention points within the school food system. These were defined as: (1) Actors and Elements, (2) System Regulation and Interconnections and (3) Purpose and Values. We concluded that understanding the interactions between these system levels and stakeholder roles can help to inform the development of relevant policy strategies that better support healthier school food environments in this jurisdiction. View Full-Text
Keywords: school food; complex systems; child and youth health; nutrition; environment; Intervention Level Framework; public health school food; complex systems; child and youth health; nutrition; environment; Intervention Level Framework; public health
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McIsaac, J.-L.D.; Spencer, R.; Stewart, M.; Penney, T.; Brushett, S.; Kirk, S.F. Understanding System-Level Intervention Points to Support School Food and Nutrition Policy Implementation in Nova Scotia, Canada. Int. J. Environ. Res. Public Health 2019, 16, 712.

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