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

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dc.contributor.authorOlstad, Dana Lee
dc.contributor.authorRaine, Kim
dc.contributor.authorProwse, Rachel
dc.contributor.authorTomlin, Dona
dc.contributor.authorKirk, Sara
dc.contributor.authorMcIsaac, Jessie-Lee D.
dc.contributor.authorMâsse, Louise C.
dc.contributor.authorCaswell, Susan
dc.contributor.authorHanning, Rhona
dc.contributor.authorMilford, Todd
dc.contributor.authorNaylor, Patti-Jean
dc.date.accessioned2020-11-05T20:02:44Z
dc.date.available2020-11-05T20:02:44Z
dc.date.copyright2019en_US
dc.date.issued2019
dc.description.abstractBackground Recreation 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. Methods Recreation 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). Results There 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). Conclusions Significant 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.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipWe acknowledge the students and staff who acted as Research Coordinators and Assistants and assisted with data collection and entry, along with participating facility managers, staff and vendors; EPL could not have been carried out without their willing participation. We are also grateful to Yun Yun Lee for her excellent assistance in preparing tables and figures for this manuscript. This study was funded by the Heart and Stroke Foundation of Canada. The study funder had no role in the design of the study, in the collection, analysis and interpretation of the data, or in writing the manuscript. LCM received salary support from the BC Children’s Hospital Research Institute.en_US
dc.identifier.citationOlstad, D. L., Raine, K. D., Prowse, R. J. L., Tomlin, D., Kirk, S. F., McIsaac, J.-L. D., …Naylor, P.-J. (2019). Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environmentsin recreation and sport facilities. International Journal of Behavioral Nutrition and Physical Activity, 16(51). https://doi.org/10.1186/s12966-019-0811-8en_US
dc.identifier.urihttps://doi.org/10.1186/s12966-019-0811-8
dc.identifier.urihttp://hdl.handle.net/1828/12311
dc.language.isoenen_US
dc.publisherInternational Journal of Behavioral Nutrition and Physical Activityen_US
dc.subjectChildrenen_US
dc.subjectFood environmentsen_US
dc.subjectRecreation and sport facilitiesen_US
dc.subjectPolicyen_US
dc.subjectCapacity buildingen_US
dc.subjectPublic healthen_US
dc.titleEat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environmentsin recreation and sport facilitiesen_US
dc.typeArticleen_US

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