Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?

Abstract Background A school provided healthy lunch might help to improve the nutritional quality of children’s lunches. However, in the Netherlands, school lunch programs are not common. The aim of this study was to identify factors that promote or inhibit the implementation of a school lunch progr...

Full description

Bibliographic Details
Main Authors: Ellen van Kleef, S. Coosje Dijkstra, Jaap Seidell, Monique H. Vingerhoeds, Ilse A. Polet, Gertrude G. Zeinstra
Format: Article
Language:English
Published: BMC 2022-10-01
Series:Journal of Health, Population and Nutrition
Subjects:
Online Access:https://doi.org/10.1186/s41043-022-00328-4
_version_ 1828103737094176768
author Ellen van Kleef
S. Coosje Dijkstra
Jaap Seidell
Monique H. Vingerhoeds
Ilse A. Polet
Gertrude G. Zeinstra
author_facet Ellen van Kleef
S. Coosje Dijkstra
Jaap Seidell
Monique H. Vingerhoeds
Ilse A. Polet
Gertrude G. Zeinstra
author_sort Ellen van Kleef
collection DOAJ
description Abstract Background A school provided healthy lunch might help to improve the nutritional quality of children’s lunches. However, in the Netherlands, school lunch programs are not common. The aim of this study was to identify factors that promote or inhibit the implementation of a school lunch program at primary schools, from the viewpoint of school professionals. Methods A cross-sectional online survey was conducted among 204 primary school professionals. The normalization process theory and its four constructs (i.e. coherence, cognitive participation, collective action, reflective monitoring) were used to develop questions and interpret findings. Descriptive statistics were used for 14 multiple choice questions (yes, no, don’t know) and thematic content analysis for qualitative responses. Results Participants had a shared understanding about how a lunch program differed from current practices. Most participants had the same view on the rationale for implementation (coherence), such as equality among children. Sixty percent expected that a healthy school lunch will contribute to healthier eating by the children. Participants showed different degrees of cognitive participation (46% indicated that healthy school lunch is good idea). Commitment depended on their belief whether providing a healthy lunch was part of their responsibility as school and 30% expected a large effect on their daily work (collective action). When appraising school lunch implementation (reflective monitoring), participants’ concerns focused on feasibility and adaptability of a program in their own school. Conclusions The introduction of a school lunch program will require substantial effort, although there is considerable support and understanding about potential benefits. The findings point to a number of preconditions for large-scale introduction, including the need for support—both financially and organizationally—bottom-up involvement of teachers, children and parents and freedom to adapt the program.
first_indexed 2024-04-11T09:29:44Z
format Article
id doaj.art-10c1510ddca44e3ab90193ed1115fba7
institution Directory Open Access Journal
issn 2072-1315
language English
last_indexed 2024-04-11T09:29:44Z
publishDate 2022-10-01
publisher BMC
record_format Article
series Journal of Health, Population and Nutrition
spelling doaj.art-10c1510ddca44e3ab90193ed1115fba72022-12-22T04:31:54ZengBMCJournal of Health, Population and Nutrition2072-13152022-10-0141111110.1186/s41043-022-00328-4Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?Ellen van Kleef0S. Coosje Dijkstra1Jaap Seidell2Monique H. Vingerhoeds3Ilse A. Polet4Gertrude G. Zeinstra5Marketing and Consumer Behaviour Group, Wageningen UniversityFaculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamFaculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamFood, Health and Consumer Research, Wageningen Food and Biobased ResearchFood, Health and Consumer Research, Wageningen Food and Biobased ResearchFood, Health and Consumer Research, Wageningen Food and Biobased ResearchAbstract Background A school provided healthy lunch might help to improve the nutritional quality of children’s lunches. However, in the Netherlands, school lunch programs are not common. The aim of this study was to identify factors that promote or inhibit the implementation of a school lunch program at primary schools, from the viewpoint of school professionals. Methods A cross-sectional online survey was conducted among 204 primary school professionals. The normalization process theory and its four constructs (i.e. coherence, cognitive participation, collective action, reflective monitoring) were used to develop questions and interpret findings. Descriptive statistics were used for 14 multiple choice questions (yes, no, don’t know) and thematic content analysis for qualitative responses. Results Participants had a shared understanding about how a lunch program differed from current practices. Most participants had the same view on the rationale for implementation (coherence), such as equality among children. Sixty percent expected that a healthy school lunch will contribute to healthier eating by the children. Participants showed different degrees of cognitive participation (46% indicated that healthy school lunch is good idea). Commitment depended on their belief whether providing a healthy lunch was part of their responsibility as school and 30% expected a large effect on their daily work (collective action). When appraising school lunch implementation (reflective monitoring), participants’ concerns focused on feasibility and adaptability of a program in their own school. Conclusions The introduction of a school lunch program will require substantial effort, although there is considerable support and understanding about potential benefits. The findings point to a number of preconditions for large-scale introduction, including the need for support—both financially and organizationally—bottom-up involvement of teachers, children and parents and freedom to adapt the program.https://doi.org/10.1186/s41043-022-00328-4School lunch programImplementationNormalisation process theory
spellingShingle Ellen van Kleef
S. Coosje Dijkstra
Jaap Seidell
Monique H. Vingerhoeds
Ilse A. Polet
Gertrude G. Zeinstra
Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
Journal of Health, Population and Nutrition
School lunch program
Implementation
Normalisation process theory
title Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
title_full Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
title_fullStr Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
title_full_unstemmed Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
title_short Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?
title_sort which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the netherlands
topic School lunch program
Implementation
Normalisation process theory
url https://doi.org/10.1186/s41043-022-00328-4
work_keys_str_mv AT ellenvankleef whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands
AT scoosjedijkstra whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands
AT jaapseidell whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands
AT moniquehvingerhoeds whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands
AT ilseapolet whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands
AT gertrudegzeinstra whichfactorspromoteandprohibitsuccessfulimplementationandnormalizationofahealthyschoollunchprogramatprimaryschoolsinthenetherlands