Building on successes and learning from challenges: A comprehensive evaluation of the school food and nutrition policy in Nova Scotia

Sustainable and comprehensive policies are needed to produce population-level changes in health and health equity, including in childhood nutrition. Recent literature, including studies conducted by members of this team, suggests a need to better understand policy implementation. In 2006, Nova Scotia (NS) became one of the first provinces in Canada to launch a food and nutrition policy (FNP) to provide standards for foods and beverages served and sold in schools. As part of a provincial chronic disease strategy, a revised FNP will be released in 2015, offering a timely opportunity to evaluate its implementation and the change in school food environments. With a baseline assessment of the original FNP underway and the implementation of the revised FNP forming a new population health intervention, our research seeks to undertake a system-level evaluation of the revised FNP. First, we will describe system-level policy dissemination and determine the internal and external capacity that supports/prevents policy implementation in schools through consultations with internal stakeholders, a document review and follow-up key-informant interviews. Second, we will assess the school-level factors that influence adoption of the FNP through school case studies (including a document review, interviews and observations) and a photovoice project to elicit youth voice. Finally, we will measure changes in school food environments with comparison to our baseline data collection in progress with an online survey and an audit of the school food environment to assess nutrition practices ant the costs of implementation. Findings from this work will allow us to understand the complex school system factors required for effective policy implementation to increase the potential for impact on children's nutrition, health and health equity.