Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW2109, Australia.
Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai400076, India.
Public Health Nutr. 2020 Oct;23(15):2840-2855. doi: 10.1017/S1368980019004865. Epub 2020 Apr 22.
Schools have been recognised as a potential setting for improving young peoples' food and beverage choices; however, many schools fail to adhere to healthy food and beverage policy standards. The current study aimed to explore the enablers and barriers to effective implementation of and compliance with school-based food and beverage policies.
Systematic review and meta-synthesis. Eight electronic databases were searched for articles in June 2019. Studies were eligible for inclusion if they reported on implementation and/or compliance of school-based food and/or beverage policies with outcomes relating to enablers and/or barriers. This review had no restrictions on study design, year of publication or language. Seventy-two full-text articles were assessed for eligibility, of which twenty-eight were included in this review.
Studies conducted globally that focused on schools.
School-based healthy food and beverage policies.
Financial (cost of policy-compliant foods, decreased profit and revenue), physical (availability of policy-compliant foods, close geographical proximity to unhealthy food outlets) and social (poor knowledge, understanding, and negative stakeholders' attitudes towards policy) factors were the most frequently reported barriers for policy implementation. Sufficient funding, effective policy communication and management, and positive stakeholders' attitudes were the most frequently reported enablers for policy implementation.
There is a need for better communication strategies, financial and social support prior to school-based food policy implementation. Findings of this review contribute to a thorough understanding of factors that underpin best practice recommendations for the implementation of school-based food policy, and inform those responsible for improving public health nutrition.
学校已被公认为改善年轻人食物和饮料选择的潜在场所；然而，许多学校未能遵守健康的食物和饮料政策标准。本研究旨在探讨有效实施和遵守基于学校的食物和饮料政策的促进因素和障碍。
系统评价和元综合。2019 年 6 月，对 8 个电子数据库进行了文章搜索。如果研究报告了与促进因素和/或障碍相关的基于学校的食物和/或饮料政策的实施和/或合规性以及结果，则符合纳入标准。本综述对研究设计、出版年份或语言没有限制。对 72 篇全文文章进行了资格评估，其中 28 篇文章被纳入本综述。
全球范围内针对学校开展的研究。
基于学校的健康食物和饮料政策。
财务因素（符合政策的食物成本、利润和收入减少）、物理因素（符合政策的食物供应、与不健康食品店的地理位置接近）和社会因素（对政策的了解、理解不足以及利益相关者的负面态度）是实施政策最常报告的障碍。充足的资金、有效的政策沟通和管理以及利益相关者的积极态度是实施政策最常报告的促进因素。
在实施基于学校的食物政策之前，需要更好的沟通策略、财务和社会支持。本研究的结果有助于深入了解支持最佳实践建议的实施基于学校的食物政策的因素，并为那些负责改善公共卫生营养的人提供信息。
