Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities

International Journal of Behavioral Nutrition and Physical Activity

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[1] 0000 0000 8644 1405, grid.46078.3d, School of Public Health and Health Systems, University of Waterloo, 200 University Ave West, N2L 3G1, Waterloo, ON, Canada;0000 0001 2186 9504, grid.260303.4, Faculty of Education and Department of Child and Youth Study, Mount Saint Vincent University, 166 Bedford Hwy, B3M 2J6, Halifax, NS, Canada;0000 0001 2288 9830, grid.17091.3e, BC Children’s Hospital Research Institute, School of Population and Public Health, University of British Columbia, 4480 Oak Street, V6H 3V4, Vancouver, BC, Canada;0000 0004 1936 7697, grid.22072.35, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada;0000 0004 1936 8200, grid.55602.34, Healthy Populations Institute, Dalhousie University, Stairs House, PO Box 15000, 6230, South Street, B3H 4R2, Halifax, NS, Canada;0000 0004 1936 9465, grid.143640.4, Department of Curriculum and Instruction, Faculty of Education, University of Victoria, PO Box 1700, STN CSC, V8W 2YW, Victoria, BC, Canada;0000 0004 1936 9465, grid.143640.4, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015 Stn CSC, V8W 3P1, Victoria, BC, Canada;grid.17089.37, School of Public Health, University of Alberta, 11405 87 Avenue NW, T6G 1C9, Edmonton, AB, Canada;

关键词: Children;    Food environments;    Recreation and sport facilities;    Policy;    Capacity building;    Public health;   

DOI  :  10.1186/s12966-019-0811-8

来源: publisher

【 摘 要 】

BackgroundRecreation and sport facilities often have unhealthy food environments that may promote unhealthy dietary patterns among children. In response, some Canadian provinces have released voluntary nutrition guidelines for recreation and sport facilities, however implementation has been limited. Organizational capacity building may overcome barriers to implementing guidelines. Eat, Play, Live was a randomized controlled trial embedded within a natural experiment that tested the impact of an 18 month capacity building intervention (CBI) in enhancing implementation of provincial nutrition guidelines, and whether nutrition guidelines were associated with positive changes. Primary outcomes were facility capacity, policy development and food environment quality.MethodsRecreation and sport facilities in three guideline provinces were randomized into a guideline + CBI (GL + CBI; n = 17) or a guideline only comparison condition (GL-ONLY; n = 15). Facilities in a province without guidelines constituted a second comparison condition (NO-GL; n = 17). Facility capacity, policy development, and food environment quality (vending and concession) were measured and compared at baseline and follow-up across conditions using repeated measures ANOVA and Chi-square statistics. Healthfulness of vending and concession items was rated as Do Not Sell (least nutritious), Sell Sometimes or Sell Most (most nutritious).ResultsThere were significant time by condition effects, with significant increases in facility capacity (mean ± SD: 30.8 ± 15.6% to 62.3 ± 22.0%; p <  0.01), nutrition policy development (17.6% developed new policies; p = 0.049), overall quality of the concession food environment (14.7 ± 8.4 to 17.5 ± 7.2; p <  0.001), and in the proportion of Sell Most (3.7 ± 4.4% to 11.0 ± 9.0%; p = 0.002) and Sell Sometimes vending snacks (22.4 ± 14.4% to 43.8 ± 15.8%; p <  0.001) in GL + CBI facilities, with a significant decline in Do Not Sell vending snacks (74.0 ± 16.6% to 45.2 ± 20.1%; p <  0.001).ConclusionsSignificant improvements in facility capacity, policy development and food environment quality occurred in recreation and sport facilities that were exposed to nutrition guidelines and participated in a CBI. Outcomes did not improve in facilities that were only passively or not at all exposed to guidelines. Ongoing capacity building may enhance implementation of voluntary nutrition guidelines, however food environments remained overwhelmingly unhealthy, suggesting additional scope to enhance implementation.Trials registrationClinical trials registration (retrospectively registered): ISRCTN14669997 Jul 3, 2018.

【 授权许可】

CC BY