Toolbox of Research, Reports, ResourcesThis is a featured page

Please add to this toolbox of research, reports and resources. It is meant to be an "evergreen, constantly updated document. You can comment on this toolbox by using the "thread" tool at the bottom of this page or you can add to or edit the page using the "easy edit" tool found at the just above this text.

Further, we invite you to join us in discussing the "mini-summaries" we are developing for many of the sub-sections of this document. These concise summaries will be prepared in draft form by experts and practitioners as a definition or description of what we know about that specific topics. We will then elaborate upon, illustrate and discuss these topics in webinars and more extensive documents that will form part of a glossary, encyclopedia and handbook on school nutrition. Please join us in these conversations by reviewing the draft mini-summaries page.

This list of research, reports and educational/planning resources has organized in accordance with a standard framework or outline used to describe comprehensive approaches, coordinated agency-school programs and whole school strategies to address broad health, social, safety and other issues.

List of Research References, Reports and Resources

This document presents the findings of an ongoing scan of the research literature as well as the Internet. In the list of web-linked research references found below, we have identified major case studies and research reviews. In the listing of web-linked reports and resources (educational, planning, policy and training tools), we have tried to provide a time-saving and convenient resources for the school health community. While much further examination and further searching is required, we hope that this listing provides a quick start for program planning and development. The listing is presented under these headings:
A. Understanding the Problem: (Prevalence, nature, aspects of the problem, behaviour theories that explain it)
B. Impact of the School Environment on the Problem (Influence of the physical and social environment, role of school in preventing and models describing school approaches)
C. Effect of Comprehensive Approaches, Coordinated Programs, Whole School Strategies Comprehensive Approaches (Multi-issue, multi-level, multi-system programs) Effectiveness of Coordinated Programs and Services (School-Agency Programs, Whole School Strategies (School staff only Programs) on health, nutrition/aspects of nutrition and learning
D. Use of Individual Evidence-based Interventions (Including Policy, Instruction, Services, Social Support, Physical Environment Interventions)
E. Implementation and Sustainability (Including Evidenced-based, Practical and Strategic Implementation Strategies, diffusion or education change theories, Capacity-building/Continuous Improvement Strategies and Strategic Consideration of System/Agency/School Characteristics
F Consideration of Local Community Context
G. Consideration of and Integration within the Constraints and Educational Mandate of the School
H Questions related to Future and Current Research


A Understanding the Problem

A-1 Prevalence & Nature of the Problem Among Young People

This sub-section lists items that explain the problems associated with nutrition among young people and approaches that seem to be more effective or efficient. A holistic approach to behaviour change is often suggested by the research evidence.

ResearchReports & Resources
Overview

Jacobs Starkey L, Johnson-Down L, Gray-Donald K. Food Habits of Canadians: Comparison of intakes in adults and adolescents to Canada's Food Guide to Healthy Eating. Can J Diet Prac Res 2001; 62(3):61-69.

Larson NI, Story M, Wall M, Neumark-Sztainer D. (2006) Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns. J Am Diet Assoc. 2006 Nov;106(11):1816-24

Duffey KJ, Popkin BM. (2007) Shifts in patterns and consumption of beverages between 1965 and 2002.
Obesity (Silver Spring). 2007 Nov;15(11):2739-47

Storey ML, Forshee RA, Anderson PA. (2004) Associations of adequate intake of calcium with diet, beverage consumption, and demographic characteristics among children and adolescents. J Am Coll Nutr. 2004 Feb;23(1):18-33.


Temple NJ, Steyn NP, Myburgh NG, Nel JH. (2006) Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa. Nutrition. 2006 Mar;22(3):252-8.


Welsh JA, Cogswell ME, Rogers S, et al. Overweight among low-income preschool children associated with the consumption of sweet drinks: Missouri, 1999-2002. Pediatrics. 2005;115(2):223-229.

Wechsler H, McKenna ML, Lee SM, et al. The role of schools in preventing childhood obesity. The State Education Standard. 2004;5(2):4-12.

Bowman SA, Gortmaker SL, Ebbeling CB, et al. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics. 2004;113(1):112-118.

Greenhalgh J, Dowey AJ, Horne PJ, Fergus Lowe C, Griffiths JH, Whitaker CJ. (2009) Positive- and negative peer modelling effects on young children's consumption of novel blue foods. Appetite. 2009 Jun;52(3):646-53. Epub 2009 Mar 6.

Worsley A. (2005) Children's healthful eating: from research to practice. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S135-43. Review.

Burgess-Champoux TL, Rosen R, Marquart L, Reicks M. (2008) The development of psychosocial measures for whole-grain intake among children and their parents. J Am Diet Assoc. 2008 Apr;108(4):714-7.

Risvas G, Panagiotakos DB, Chrysanthopoulou S, Karasouli K, Matalas AL, Zampelas A. (2008) Factors associated with food choices among Greek primary school students: a cluster analysis in the ELPYDES study. J Public Health (Oxf). 2008 Sep;30(3):266-73. Epub 2008 May 22.

Burrows A R, Díaz B E, Sciaraffia M V, Gattas Z V, Montoya C A, Lera M L. (2008) [Dietary intake and physical activity in school age children] Rev Med Chil. 2008 Jan;136(1):53-63. Epub 2008 Apr 30. Spanish.

Kusano-Tsunoh A, Nakatsuka H, Satoh H, Shimizu H, Sato S, Ito I, Fukao A, Hisamichi S. (2001) Effects of family-togetherness on the food selection by primary and junior high school students: family-togetherness means better food. Tohoku J Exp Med. 2001 Jun;194(2):121-7.

Veuglers PJ, Fitzgerald AL, Johnston E. Dietary intake and risk factors for poor diet quality among children in Nova Scotia. Can J Pub Health 2005; 96 (3):212.
Health Organization. Nutrition—Controlling the global obesity epidemic. Updated 9/3/03. Available at www.who.int/nutrition/topics/obesity/en/. Accessed December 29, 2004.

Canada’s Food Guide
Contains recommended guidelines for healthy diet, as well as resources for educators. (Health Canada)

World Health Organization. 1998. Healthy Nutrition: An Essential Element of a Health Promoting School. (Report)

American Dietetic Association, Society for Nutrition Education, and American School Food Service Association: Nutrition Services: An Essential Component of Comprehensive School Health Programs Journal of Nutrition Education and Behavior
Volume 35, Issue 2, March-April 2003, Pages 57-67

Canadian Journal of Public Health Special Supplement Understanding the Forces that Influence Our Eating Habits: What We Know and Need to Know
A series of articles, commissioned by the Office of Nutrition Policy and Promotion and published in a special supplement to the Canadian Journal of Public Health (CJPH), summarize existing literature on the determinants of healthy eating, identify gaps in knowledge and offer recommendations for research to enhance the evidence base on the determinants of healthy eating. (Health Canada)

Heart and Stroke Foundation of Canada, (1999). Report Card on Health, Toronto ON, Author

Canadian Guidelines for Body Weight Classification in Adults - Quick Reference Tool
Summarizes research on health body weights.(Health Canada)

Call to Action: Creating a Healthy School Nutrition Environment
Position paper positioning schools as part of a community wide effort. (Ontario Society of Nutrition Professionals in Public Health)



A-2 Specific Aspects, Conditions or Sub-Populations related to this issue

Sugared and Caffinated Beverages

Harrington S. (2008) The role of sugar-sweetened beverage consumption in adolescent obesity: a review of the literature. J Sch Nurs. 2008 Feb;24(1):3-12. Review.

Forshee RA, Storey ML. (2003) Total beverage consumption and beverage choices among children and adolescents. Int J Food Sci Nutr. 2003 Jul;54(4):297-307

Storey ML, Forshee RA, Anderson PA. (2006) Beverage consumption in the US population. J Am Diet Assoc. 2006 Dec;106(12):1992-2000

LaRowe TL, Moeller SM, Adams AK. (2007) Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc. 2007 Jul;107(7):1124-33.

Bowman SA. (2002) Beverage choices of young females: changes and impact on nutrient intakes. J Am Diet Assoc. 2002 Sep;102(9):1234-9.

Rampersaud GC, Bailey LB, Kauwell GP. (2003) National survey beverage consumption data for children and adolescents indicate the need to encourage a shift toward more nutritive beverages. J Am Diet Assoc. 2003 Jan;103(1):97-100.

Kral TV, Stunkard AJ, Berkowitz RI, Stallings VA, Moore RH, Faith MS. (2008) Beverage consumption patterns of children born at different risk of obesity. Obesity (Silver Spring). 2008 Aug;16(8):1802-8. Epub 2008 May 29

West DS, Bursac Z, Quimby D, Prewitt TE, Spatz T, Nash C, Mays G, Eddings K. (2006) Self-reported sugar-sweetened beverage intake among college students. Obesity (Silver Spring). 2006 Oct;14(10):1825-31.

Knight CA, Knight I, Mitchell DC. (2006) Beverage caffeine intakes in young children in Canada and the US. Can J Diet Pract Res. 2006 Summer;67(2):96-9

Marshall TA, Eichenberger Gilmore JM, Broffitt B, Levy SM, Stumbo PJ. (2003) Relative validation of a beverage frequency questionnaire in children ages 6 months through 5 years using 3-day food and beverage diaries. J Am Diet Assoc. 2003 Jun;103(6):714-20; discussion 720.


Calcium Intake

Barr SI. (1994) Associations of social and demographic variables with calcium intakes of high school students. J Am Diet Assoc. 1994 Mar;94(3):260-6, 269; quiz 267-8.
Food Labelling

Bergen D, Yeh MC. (2006) Effects of energy-content labels and motivational posters on sales of sugar-sweetened beverages: stimulating sales of diet drinks among adults study. J Am Diet Assoc. 2006 Nov;106(11):1866-9

Pirouznia M. (2000) The correlation between nutrition knowledge and eating behavior in an American school: the role of ethnicity. Nutr Health. 2000;14(2):89-107

A-3 Behaviour Theories that Explain the Problem


B Impact, Role of the School and Models/Frameworks

B-1 Impact of School's Social and Physical Environment

This sub-section examines the impact of the social and physical environment of the school as a place in which students and staff spend considerable time. Physical conditions and facilities in the school can contribute to health. As well, prevailing social norms, beliefs and misconceptions from the media and the community can be either reproduced or debunked in the school social environment.


ResearchReports & Resources
van der Horst K, Timperio A, Crawford D, Roberts R, Brug J, Oenema A. (2008) The school food environment associations with adolescent soft drink and snack consumption. Am J Prev Med. 2008 Sep;35(3):217-23. Epub 2008 Jul 10

Wechsler H, Brener ND, Kuester S, et al. Food service and foods and beverages available at school: results from the school health policies and programs study 2000. J of Sch Health. 2001;71(7):313-324.

James J, Thomas P, Cavan D, et al. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomized controlled trial. BMJ. 2004;328:1237-1241.

Kubik MY, Lytle LA, Hannan PJ, et al. The association of the school food environment with dietary behaviors of young adolescents. Am J Public Health. 2003;93(7):1168-1173.

Snyder MP, Story M, and Trenkner LL. Reducing fat and sodium in school lunch programs: the LUNCHPOWER! Intervention study. J of Am Diet Assoc. 1992;92(9):1087-1091.

Wills W, Backett-Milburn K, Gregory S, Lawton J. (2005) The influence of the secondary school setting on the food practices of young teenagers from disadvantaged backgrounds in Scotland. Health Educ Res. 2005 Aug;20(4):458-65. Epub 2004 Oct 26.


Public Health Research, Education & Development Program. 2003. Young people and healthy eating: A systematic review on barriers and facilitators. Effective Public Health Practice Project. (Review)


B-2 Realistic Role of the School, Models Describing that Role

ResearchReports/Resources
Realistic Role relative to the Educational Mandate and Constraints of the Schools and School System



Models/Frameworks that Describe the Schools Role


C Comprehensive Approaches. Coordinated Agency-School Programs, Whole School Strategies


This sub-section examines holistic, contextual and comprehensive approaches include the whole child, all children (especially vulnerable), developmental stages/life course, clusters of behaviours and conditions(eg mental health, crime, tobacco, sexual risk-taking, dropouts), community and systems context analysis, synergistic combination of strategies and initiatives (e.g. police officers, safe schools, character education, early childhood programs), multi-level , intersectorial strategies, programs and policies


Mini-Summary:
(To comment on or edit this mini-summary, go to this sub-page that contains the draft versions of our mini-summaries)

Multiple school-based and school-linked interventions (policies, programs, services, practices) can promote healthy eating and prevent nutrition or dietary problems. Several interventions can combined into "multi-intervention programs" and can be delivered through schools by educators and by other agencies, nutrition professionals, voluntary and community-based organizations as well as parents, students and volunteers. These interventions can be grouped into several elements, components or domains; including policy, instruction, preventive services, social supports and a healthy physical environment. Comprehensive approaches can link nutrition/diet to other health, social and economic issues such as mental health, poverty or physical activity and recognize that school-based efforts need to be supported by multi-level actions taken by school boards/health authorities and other agencies as well as health, education and other ministries/departments in governments and by research, monitoring and knowledge management organizations. Coordinated school nutrition programs delivered by education, health, social service and nutrition agencies can focus on nutrition in general or specific aspects such as over-eating, food safety, height/weight screening at age of school entry, disordered eating, food security and healthy dietary practices such as eating fruits/vegetables or reducing salt intake. Whole school strategies can combine efforts within the school such as policies on food sales and fund raising, nutrition education, student/school activities, parent involvement, healthy cafeterias, adequate time for eating lunch and staff wellness activities.

High quality research studies have reported short-term (1-3 years) changes to student nutrition knowledge, attitudes and specific eating or physical activity behaviours as a result of multiple intervention school nutrition programs using comprehensive approaches, coordinated programs and whole school strategies delivered in controlled studies.
However, these changes in knowledge, skills, attitudes and behaviours do not necessarily affect body weight or prevent overweight/obesity.
These case studies are available in peer reviewed journals, literature reviews and systematic reviews. Authoritative reports and better practice guidelines have been published by governments, international agencies and school nutrition advocates. Good quality educational programs, curriculum guides, policy guidelines, school self-assessment tools and training materials are available from several countries. Current challenges related to these multi-intervention programs include implementation and sustainability, coordination between systems, agencies and professionals, maintaining a whole child, holistic view of nutrition and diet while addressing specific problems such as overweight/obesity, food security, food safety or other problems. Research challenges include; knowing more about systems readiness, performance and capacity, measurement questions in self-reporting vs direct measures, understanding the benefits to student learning and school effectiveness and how to influence life time eating habits. (First draft posted Oct 29-09)


C-1 Comprehensive Approaches

ResearchReports & Resources
Worsley A. (2005) Children's healthful eating: from research to practice. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S135-43. Review.

Muller M, Danielzik S, Pust S. School- and family-based interventions to prevent overweight in children. Proceedings of the Nutrition Society. 2005 May:64(2):249-54.

Hilgers KK, Akridge M, Sheetz JP, Kinane DE. Childhood obesity and dental development. Pediatric Dentistry. 2006 Jan-Feb; 28(1):18-22.

Lister-Sharp D, Chapman S, Stewart-Brown S, Sowden A. 1999. Health promoting schools and health promotion in schools: Two systematic reviews. Health Technology Assessment. 3(22). (Review)

Micucci S. 2004. Environmental interventions to improve nutrition and increase physical activity in children and youth. Effective Public Health Practice Project. (Review)

Ciliska D. 2004. Interventions to improve nutritional intake in children and youth. Effective Public Health Practice Project. (Review)

Ontario Public Health Research, Education & Development Program. 2003. Young people and healthy eating: A systematic review on barriers and facilitators. Effective Public Health Practice Project. (Review)

Veugelers P, Fitzgerald A. 2005. Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. American Journal of Public Health. 432-435. (Random Controlled Trial)

World Health Organization. 1998. Healthy Nutrition: An Essential Element of a Health Promoting School. (Report)

Thorogood M, Simera I, Dowler E, Summerbell C, Brunner E.A systematic review of population and community dietary interventions to prevent cancer.Nutrition Research Reviews2007;20(1):74-88

Pietinen P, Nissinen A, Vartianinen E, Tuomilehto A, Uusitalo U, Ketola A, Moisio S, Puska P, 1988, "Dietary changes in the North Karelia Project (1972-1982)", Journal of Preventive Medicine, Mar;17(2):183-93.

Jeffery RW, Gray CW, French SA, Hellerstedt WL, Murray D, Luekker RV, Blackburn H, 1995, "Evaluation of weight reduction in a community intervention for cardiovascular disease risk: changes in body mass index in the Minnesota Heart Health Program", Int Journal Obes Rel Metab Disord, Jan;19(1):30-9.

Kelder SH, Perry CL, Lytle LA, Klepp KI (1995) Community-wide youth nutrition education: long-term outcomes of the Minnesota Heart Health Program. Health Educ Res. 1995 Jun;10(2):119-31.

Luepker RV, Murray DM, Jacobs DR Jr, Mittelmark MB, Bracht N, Carlaw R, Crow R, Elmer P, Finnegan J, Folson AR, et al, 1994, "Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program", American Journal of Public Health, Sep;84(9):1383-93.

Gortmaker SL, Cheung LW, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N. (1999) Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. Arch Pediatr Adolesc Med. 1999 Sep;153(9):975-83.

Haerens L, Deforche B, Maes L, Cardon G, Stevens V, De Bourdeaudhuij I. (2006) Evaluation of a 2-year physical activity and healthy eating intervention in middle school children. Health Educ Res. 2006 Dec;21(6):911-21. Epub 2006 Oct 10.

Nahas MV, de Barros MV, de Assis MA, Hallal PC, Florindo AA, Konrad L. (2009) Methods and participant characteristics of a randomized intervention to promote physical activity and healthy eating among brazilian high school students: the Saude na Boa project. J Phys Act Health. 2009 Mar;6(2):153-62.

Hoelscher DM, Evans A, Parcel GS, Kelder SH. (2002) Designing effective nutrition interventions for adolescents.The integration of school nutrition program into health promotion and prevention of lifestyle-related diseases in Japan. Asia Pac J Clin Nutr. 2008;17 Suppl 1:349-51. Review

Sahay TB, Ashbury FD, Roberts M, Rootman I. (2006) Effective components for nutrition interventions: a review and application of the literature.An economic evaluation of the expanded food and nutrition education program. J Nutr Educ Behav. 2008 May-Jun;40(3):134-43

Carleton RA, Sennett L, Gans KM, Levin S, Lefebvre C, Lasater TM. (1991) The Pawtucket Heart Health Program. Influencing adolescent eating patterns. Ann N Y Acad Sci. 1991;623:322-6.

Graham D, Appleton S, Rush E, McLennan S, Reed P, Simmons D. (2008) Increasing activity and improving nutrition through a schools-based programme: Project Energize. 1. Design, programme, randomisation and evaluation methodology.A community-driven obesity prevention and intervention in an elementary school. J Ky Med Assoc. 2008 Mar;106(3):104-8.
J Am Diet Assoc. 2002 Mar;102(3 Suppl):S52-63. Review.

Nakamura T. (2008) The integration of school nutrition program into health promotion and prevention of lifestyle-related diseases in Japan.
Health Promot Pract. 2006 Oct;7(4):418-27. Epub 2006 Aug 23. Review

Dollahite J, Kenkel D, Thompson CS. (2008) An economic evaluation of the expanded food and nutrition education program.
Public Health Nutr. 2008 Oct;11(10):1076-84. Epub 2008 Jan 15

Perman JA, Young TL, Stines E, Hamon J, Turner LM, Rowe MG. (2008) A community-driven obesity prevention and intervention in an elementary school J Ky Med Assoc. 2008 Mar;106(3):104-8.

List of Comprehensive (Multi-issue, multi-level) Programs (From PHAC Best Practices Portal)

Effectiveness of Coordinated Programs and Services on Overall Health on Nutrition/Eating Habits
This sub-section examines coordinated, multi-intervention programs. Where possible, we differentiate between Coordinated School-Community Programs (CSHP) and Whole-School Programs (HPS) involving only school-based personnel.

ResearchReports & Resources
On Health Overall (that including Nutrition & Eating)

Ontario Public Health Research, Education & Development. 1999. Effectiveness of School-Based Interventions in Reducing Adolescent Risk Behaviour: A Systematic Review of Reviews. Hamilton, ON. (Review)

Lister-Sharp D, Chapman S, Stewart-Brown S, Sowden A. 1999. Health promoting schools and health promotion in schools: Two systematic reviews. Health Technology Assessment. 3(22). UK: University of York. (Review)

Stewart-Brown, S. (2006). What is the Evidence on School Health Promotion in Improving School Health or Preventing Disease and Specifically What is the Effectiveness of the Health Promoting Schools Approach?

On Nutrition, Eating & Diet in General

Flynn, M.A., McNeil, D.A., Maloff, B., Mutasingwa, D., Wu, M., Ford, C (2006) Reducing obesity and related chronic disease risk in children and youth: A synthesis of evidence with 'best practice' recommendations Obesity Reviews Vol 7: 1, 7-66

Haerens L, De Bourdeaudhuij I, Maes L, Vereecken C, Brug J, Deforche B. (2007) The effects of a middle-school healthy eating intervention on adolescents' fat and fruit intake and soft drinks consumption.
Public Health Nutr. 2007 May;10(5):443-9

Day ME, Strange KS, McKay HA, Naylor PJ. (2008) Action schools! BC--Healthy Eating: effects of a whole-school model to modifying eating behaviours of elementary school children. Can J Public Health. 2008 Jul-Aug;99(4):328-31.


Birnbaum AS, Lytle LA, Story M, Perry CL, Murray DM.(2002) Are differences in exposure to a multicomponent school-based intervention associated with varying dietary outcomes in adolescents? Health Educ Behav. 2002 Aug;29(4):427-43.

Boon CS, Clydesdale FM. A review of childhood and adolescent obesity interventions. Critical Reviews in Food Science & Nutrition. 2005; 45(7-8):511-25.

Veugelers PJ, Fitzgerald AL. Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. Am J Public Health. 2005 Mar; 95(3):432-5.

US Centers for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating. MMWR Recommendations and Reports. 1996;45(RR-9):1-33.

Sharma M. School-based interventions for childhood and adolescent obesity. Obes Rev. 2006 Aug; 7(3):261-9.

Cole K, Waldrop J, D’Auria J, Garner H. An integrative research review: effective school-based childhood overweight interventions. Journal for Specialists in Pediatric Nursing: JSPN. 2006 Jul; 11(3):166-77.

Shaya FT, MPH, Flores D, Confidence M. Gbarayor MPH, Jingshu W (2008) School-Based Obesity Interventions: A Literature Review Journal of School Health 78 (4) , 189–196 doi:10.1111/j.1746-1561.2008.00285.x

Thomas, H., Ciliska, D., Wilson-Abra, J., Micucci, S., Dobbins, M., Dwyer, J. (2004). Effectiveness of physical activity enhancement and obesity prevention programs in children and youth. Health Canada.

Thomas, J., Sutcliffe, K., Harden, A., Oakley, A., Oliver, S., Rees, R., et al. (2003). Children and healthy eating: A systematic review of barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. http://eppi.ioe.ac.uk)

Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A.Young people and healthy eating: a systematic review of research on barriers and facilitators.London:University of London, Institute of Education, Social Science Research Unit, EPPI-Centre.2002

Story, M. (1999). School-based approaches for preventing and treating obesity. International Journal of Obesity, 23, S43-S51.

Campbell, K., Waters, E., O'Meara, S., & Summerbell, C. D. (2001). Interventions for preventing obesity in children. The Cochrane Library. Oxford: Update Software.

Contento, I. R., Balch, G. I., Bronner, Y. L., Lytle, L. A., Maloney, S. K., Olson, C. M., et al. (1995). The effectiveness of nutrition education and implications for nutrition education policy, programs, and research: A review of research. Journal of Nutrition Education, 27, 2 27-420. WHO, Copenhagen, Denmark.

Pilant VB; American Dietetic Association. (2006) Position of the American Dietetic Association: local support for nutrition integrity in schools. J Am Diet Assoc. 2006 Jan;106(1):122-33.

Lytle LA, Kubik MY, Perry C, Story M, Birnbaum AS, Murray DM. (2006) Influencing healthful food choices in school and home environments: results from the TEENS study. Prev Med. 2006 Jul;43(1):8-13. Epub 2006 May 11

Rajgopal R, Cox RH, Lambur M, Lewis EC. (2002) Cost-benefit analysis indicates the positive economic benefits of the Expanded Food and Nutrition Education Program related to chronic disease prevention. J Nutr Educ Behav. 2002 Jan-Feb;34(1):26-37

Ritchie A. (2001) Nutrition education and promotion in primary schools. Aust J Holist Nurs. 2001 Oct;8(2):39-44. Review.

Malone SK. (2005) Improving the quality of students' dietary intake in the school setting. J Sch Nurs. 2005 Apr;21(2):70-6. Review.


World Health Organization. 1997. Promoting Health Through Schools. Report of a WHO Expert Committee on Comprehensive School Health Education and Promotion. Geneva, Switzerland (Report)

Allensworth D, Lawson E, Nicholson L, Wyche J. (eds). 1997. Schools and Health: Our Nation's Investment. Washington, DC: National Academy of Sciences. (Report)

Nutbeam D, St. Leger L. 1998. Effective School Health Promotion. Towards Health Promoting Schools. Commonwealth of Australia.(Report)

Food for Thought: Schools and Nutrition
Summary of programs and services that can be delivered through schools to promote healthy eating and nutrition. (Health Canada, Canadian Association for School Health)


  • Nutrition Tools for Schools© (ON) aims to help school communities work through a step-by-step process of creating a healthy school nutrition environment. Practical tools and resources are included to help the school carry out many different activities that support healthy eating in classrooms, schools and within the community external to the school. This whole school approach fits within the comprehensive school health model that many public health units are using to guide their work with schools. Developed as a collaborative venture between several Health Departments, It is currently being used by 33 of the 36 Health Departments in Ontario. The Power Point presentation, included as an attachment below, provides more information on this excellent resource. A wiki dedicated to sharing more about NTS, including implementation and evaluation related efforts, has been established at: http://nutritiontoolsforschools.wikifoundry.com/.


Healthy Food in Schools
This website provides e Manitoba School Nutrition Handbook; Guidelines for Foods Available in K to 12 Schools in Manitoba and more. (Manitoba Health Ministry)

Newfoundland School Healthy Eating Handbook
Contains advice on healthy foods, nutrition education, web resources for families and healthy fundraising tips. (Newfoundland Health Department)

Making it Happen – Healthy Eating at Schools
An in-depth, online how-to resource to help parents, policymakers, teachers and the entire school community to review current school nutrition policy and make plans for healthy changes. In addition it offers a series of helpful information resources. (BC Health Ministry)

Community-School Multi-Intervention Programs (From PHAC Best Practices Portal)

Five-a-Day Power Plus, Six-a-Day


Whole School Multi-Intervention Programs (From PHAC Best Practices Portal_

  • Menu of Choices (from OPHEA - Ontario Physical and Health Education Association) is an online resource that takes the form of a dynamic website, www.MenuofChoices.ca. Menuofchoices.ca provides the latest quality information and supports to understand, plan and address healthy eating key messages in the school community for grades k-12. The website encourages the entire school community to take a proactive approach to addressing the healthy eating behaviours of children and youth.

Effect on Specific Risks, Behaviours and Conditions
This sub-section examines specific risks and behaviours related to nutrition, diet and eating habits. These include obesity, eating disorders, consumption of salt and sugar and other factors, behaviours and conditions.


ResearchReports & Resources
Effect on Obesity/Overweight/Overeating

Stice, E., Shaw, H., Marti, C.N. (2006). A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work. Psychological Bulletin. 5, 667-691.

Connelly, J.B., Duaso, M.J., Butler, G. (2007). A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: A realistic synthesis of the evidence. Public Health. 510-517.

Kropski, J.A., Keckley, P.H., Jensen, G.L. (2008). School-based obesity prevention programs: An evidence-based review. Obesity. 5, 1009-1018.

Kelly,S.A., Melnyk,B.M. (2008). Systematic review of multicomponent interventions with overweight middle adolescents: Implications for clinical practice and research. Worldviews on Evidence-based Nursing. 3, 113-135.

Luttikhuis HO, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD (2009) Interventions for treating obesity in children Cochrane Database of Systematic Reviews, Issue 4, 2009

Connelly J B, Duaso M J, Butler G.A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: a realistic synthesis of the evidence.Public Health2007;121(7):510-517

Effect on Obesity/Overweight Lissau I.Prevention of overweight in the school arena.Acta Paediatrica2007;96(Supplement 454):12-18

Stice E, Shaw H, Marti C N.A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work.Psychological Bulletin2006;132(5):667-691

Spiegel SA, Foulk D. (2006) Reducing overweight through a multidisciplinary school-based intervention. Obesity (Silver Spring). 2006 Jan;14(1):88-96.

Snethen J A, Broome M E, Cashin S E.Effective weight loss for overweight children: a meta-analysis of intervention studies.Journal of Pediatric Nursing2006;21(1):45-56

Summerbell CD, Ashton V, Campbell KJ, Edmunds L, Kelly S, Waters E. Interventions for treating obesity in children. The Cochrane Database of Systematic Reviews 2003, Issue 3

Collins C E, Warren J M, Neve M, McCoy P, Stokes B.Systematic review of interventions in the management of overweight and obese children which include a dietary component.International Journal of Evidence-Based Healthcare2007;5:2-53

Flodmark C E, Marcus C, Britton M.Interventions to prevent obesity in children and adolescents: a systematic literature review.International Journal of Obesity2006;30(4):579-589

Gibson L J, Peto J, Warren J M, dos Santos Silva I.Lack of evidence on diets for obesity for children: a systematic review.International Journal of Epidemiology2006;35(6):1544-1552

Doak C M, Visscher T L, Renders C M, Seidell J C.The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes.Obesity Reviews2006;7(1):111-136

McArthur, D.B. (1998). Heart healthy eating behaviors of children following a school-based intervention: A meta-analysis. Issues in Comprehensive Pediatric Nursing, 21(1), 35-48.

Stuart W P, Broome M E, Smith B A, Weaver M.An integrative review of interventions for adolescent weight loss.Journal of School Nursing2005;21(2):77-85

Ciliska D. 2004. Effective Public Health Practice Project. Summary Statement. Public Health Research, Education & Development Program. (Review)

Inge Lissau (2007) Prevention of overweight in the school arena Acta Paediatrica Volume 96 Issue s454 Page 12 - April 2007

C. M. Doak, T. L. S. Visscher, C. M. Renders and J. C. Seidell. (2006) The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obesity Reviews 7:1, 111–136

Effect on Diabetes


Micucci S, Thomas H, Vobar J. 2002. The Effectiveness of School-based Strategies for the Primary Prevention of Obesity and for Promoting Physical Activity and/or Nutrition, the Major Risk Factors for Type 2 Diabetes. A Review of Reviews. Toronto, ON: Ontario Public Health Association. (Review)

Macaulay AC, Paradis G, Potvin L, Cross EJ, Saad-Haddad C, McComber A, Desrosiers S, Kirby R, Montour LT, Lamping DL, Leduc N, Rivard M. (1997) The Kahnawake Schools Diabetes Prevention Project: intervention, evaluation, and baseline results of a diabetes primary prevention program with a native community in Canada. Prev Med. 1997 Nov-Dec;26(6):779-90.

Effect on Eating Disorders and Disordered Eating (eg unhealthy dieting)

Pokrajac-Bulian A, Zivcić-Becirević I, Calugi S, Dalle Grave R. (2006) School prevention program for eating disorders in Croatia: a controlled study with six months of follow-up. Eat Weight Disord. 2006 Dec;11(4):171-8.

Berger U, Ziegler P, Strauss B. (2008) [Barbie goes PriMa: formative evaluation of a school-based program for the primary prevention of anorexia nervosa developed for girls up to the age of 12] Z Psychosom Med Psychother. 2008;54(1):32-45. German.

Raich RM, Sánchez-Carracedo D, López-Guimerà G, Portell M, Moncada A, Fauquet J. (2008) A controlled assessment of school-based preventive programs for reducing eating disorder risk factors in adolescent Spanish girls. Eat Disord. 2008 May-Jun;16(3):255-72. Erratum in: Eat Disord. 2008 Jul-Sep;16(4):362

Ontario Public Health Research, Education & Development Program. The effectiveness of primary prevention of eating disorders. Effective Public Health Practice Project. (Review)

Pratt BM, Woolfenden SR. Interventions for preventing eating disorders in children and adolescents. The Cochrane Database of Systematic Reviews 2002, Issue 2

Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. (2006) Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc. 2006 Apr;106(4):559-68.

Elliot DL, Moe EL, Goldberg L, DeFrancesco CA, Durham MB, Hix-Small H. (2006) Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use. J Sch Health. 2006 Feb;76(2):67-73

McVey G, Gusella J, Tweed S, Ferrari M. (2009) A controlled evaluation of web-based training for teachers and public health practitioners on the prevention of eating disorders. Eat Disord. 2009 Jan-Feb;17(1):1-26.

McVey G, Tweed S, Blackmore E. (2007) Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program. Body Image. 2007 Jun;4(2):115-36. Epub 2007 Mar 7

Effects on Food Security (School Meal Programs)

Greenhalgh T, Kristjansson E, Robinson V.Realist review to understand the efficacy of school feeding programmes. BMJ 2007;335:858

Dwyer JT, Hewes LV, Mitchell PD, Nicklas TA, Montgomery DH, Lytle LA, Snyder MP, Zive MM, Bachman KJ, Rice R, Parcel GS. (1996) Improving school breakfasts: effects of the CATCH Eat Smart Program on the nutrient content of school breakfasts. Prev Med. 1996 Jul-Aug;25(4):413-22.

Centers for Disease Control and Prevention (CDC). Evaluation of a fruit and vegetable distribution program--Mississippi, 2004-05 school year. MMWR Morb Mortal Wkly Rep. 2006 Sep 8;55(35):957-61.

Effects on Healthier, Balanced Diet and Specific Behaviours & Conditions (eg Eating more fruits & vegetables, Less salt, less sugar, less fat etc)

Ellis RM, Ellis RC. (2007) Impact of a traffic light nutrition tool in a primary school. J R Soc Promot Health. 2007 Jan;127(1):13-21.

Effect on Food Selection Knowledge, Skills Hawthorne KM, Moreland K, Griffin IJ, Abrams SA. (2006) An educational program enhances food label understanding of young adolescents. J Am Diet Assoc. 2006 Jun;106(6):913-6. Savige GS. (2005) E-learning: a nutritionally ripe environment. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S230-4. Review.

Effects on Consumption of Fruits & Vegetables

Ciliska, D., Miles, E., O’Brien, M.A., Turl, C., Tomasik, H.H., Donovan, U., et al. (2000). Effectiveness of community-based interventions to increase fruit and vegetable consumption. Journal of Nutrition Education and Behavior, 32(6), 341-352. www.health-evidence.ca

Knai C, Pomerleau J, Lock K, McKee M.Getting children to eat more fruit and vegetables: a systematic review.Preventive Medicine2006;42(2):85-95

French SA, Stables G.(2003) Environmental interventions to promote vegetable and fruit consumption among youth in school settings.(Review) Prev Med. 2003 Dec;37(6 Pt 1):593-610

Stables GJ, Young EM, Howerton MW, Yaroch AL, Kuester S, Solera MK, Cobb K, Nebeling L. (2005) Small school-based effectiveness trials increase vegetable and fruit consumption among youth. J Am Diet Assoc. 2005 Feb;105(2):252-6.

Newell SA, Huddy AD, Adams JK, Miller M, Holden L, Dietrich UC. (2004) The tooty fruity vegie project: changing knowledge and attitudes about fruits and vegetables. Aust N Z J Public Health. 2004 Jun;28(3):288-95.

Effect on Consumption of Sugared Beverages

Lo E, Coles R, Humbert ML, Polowski J, Henry CJ, Whiting SJ. (2008) Beverage intake improvement by high school students in Saskatchewan, Canada.
Nutr Res. 2008 Mar;28(3):144-50.

Nelson MC, Neumark-Sztainer D, Hannan PJ, Story M (2009) Five-year longitudinal and secular shifts in adolescent beverage intake: findings from project EAT (Eating Among Teens)-II. J Am Diet Assoc. 2009 Feb;109(2):308-12.

Marshall TA, Levy SM, Broffitt B, Warren JJ, Eichenberger-Gilmore JM, Burns TL, Stumbo PJ (2003) Dental caries and beverage consumption in young children. Pediatrics. 2003 Sep;112(3 Pt 1):e184-91.

Rajeshwari R, Yang SJ, Nicklas TA, Berenson GS. (2005) Secular trends in children's sweetened-beverage consumption (1973 to 1994): the Bogalusa Heart Study. J Am Diet Assoc. 2005 Feb;105(2):208-14.

Sichieri R, Paula Trotte A, de Souza RA, Veiga GV (2009) School randomised trial on prevention of excessive weight gain by discouraging students from drinking sodas. Public Health Nutr. 2009 Feb;12(2):197-202. Epub 2008 Jun 18

Wiecha JL, Finkelstein D, Troped PJ, Fragala M, Peterson KE. (2006) School vending machine use and fast-food restaurant use are associated with sugar-sweetened beverage intake in youth. J Am Diet Assoc. 2006 Oct;106(10):1624-30

Blum JE, Davee AM, Beaudoin CM, Jenkins PL, Kaley LA, Wigand DA. (2008) Reduced availability of sugar-sweetened beverages and diet soda has a limited impact on beverage consumption patterns in Maine high school youth. J Nutr Educ Behav. 2008 Nov-Dec;40(6):341-7

Huffman L, West DS. (2007) Readiness to change sugar sweetened beverage intake among college students. Eat Behav. 2007 Jan;8(1):10-4. Epub 2006 May 30.

Blum JW, Jacobsen DJ, Donnelly JE (2005) Beverage consumption patterns in elementary school aged children across a two-year period. J Am Coll Nutr. 2005 Apr;24(2):93-8.

Effect on Consumption of More Whole Grains

Burgess-Champoux TL, Chan HW, Rosen R, Marquart L, Reicks M. (2008) Healthy whole-grain choices for children and parents: a multi-component school-based pilot intervention. Public Health Nutr. 2008 Aug;11(8):849-59. Epub 2007 Dec 7.

Effect on Portion Size

Hartstein J, Cullen KW, Reynolds KD, Harrell J, Resnicow K, Kennel P; STOPP T2D Prevention Study Group. (2008) Impact of portion-size control for school a la carte items: changes in kilocalories and macronutrients purchased by middle school students. J Am Diet Assoc. 2008 Jan;108(1):140-4.

Kelley E, Ashley B, Getlinger MJ, Nitzke S. (2008) A lesson on "how much should I eat?" helps learners understand and apply MyPyramid recommendations. J Nutr Educ Behav. 2008 Mar-Apr;40(2):116-7.

Effect on Lower Salt Consumption

Nandha B, Krishnamoorthy K. (2007) School-based health education campaign--a potential tool for social mobilization to promote the use of DEC-fortified salt towards elimination of lymphatic filariasis. Health Educ Res. 2007 Aug;22(4):539-46. Epub 2006 Oct 11.

Yokota K, Harada M, Wakabayashi Y, Inagawa M, Oshima M, Toriumi S, Hirose K, Shiina Y, Yamagishi K, Renshe C, Ikeda A, Yao M, Noda H, Tanigawa T, Tanaka S, Kurokawa M, Imano H, Kiyama M, Kitamura A, Sato S, Shimamoto T, Iso H. (2006) [Evaluation of a community-based health education program for salt reduction through media campaigns]Ecological strategies to promote healthy body image among children. J Sch Health. 2008 Jul;78(7):359-67

Yoshida T, Kouda K, Nakamura H, Nishio N. (2008) Taste development from health education among schoolchildren: a two-year intervention study. J Physiol Anthropol. 2008 Jan;27(1):1-5.
Nippon Koshu Eisei Zasshi. 2006 Aug;53(8):543-53. Japanese

Evans RR, Roy J, Geiger BF, Werner KA, Burnett D. (2008)


Effect on School Meal, Snack Preparation Habits and Skills


Effect on Food Shopping Habits and Skills



Effects on Water Consumption

Laurence S, Peterken R, Burns C. (2007) Fresh Kids: the efficacy of a Health Promoting Schools approach to increasing consumption of fruit and water in Australia.
Health Promot Int. 2007 Sep;22(3):218-26. Epub 2007 Jun 20.



Effects on Food Safety, Food Handling Skills


Effects on Prevention of Food Allergies Incidents

LeBovidge JS, Timmons K, Rich C, Rosenstock A, Fowler K, Strauch H, Kalish LA, Schneider LC. (2008) Evaluation of a group intervention for children with food allergy and their parents. Ann Allergy Asthma Immunol. 2008 Aug;101(2):160-5.

Imai T. (2005) Provision against food allergy in the school lunch program in Japan] Arerugi. 2005 Oct;54(10):1197-202. Japanese.

Rosecrans AM, Gittelsohn J, Ho LS, Harris SB, Naqshbandi M, Sharma S. (2008) Process evaluation of a multi-institutional community-based program for diabetes prevention among First Nations. Health Educ Res. 2008 Apr;23(2):272-86. Epub 2007 Jul 16

Young MC, Muñoz-Furlong A, Sicherer SH. (2009) Management of food allergies in schools: a perspective for allergists. J Allergy Clin Immunol. 2009 Aug;124(2):175-82, 182.e1-4; quiz 183-4. Epub 2009 Jun 3. Review

Rous T, Hunt A. (2004) Governing peanuts: the regulation of the social bodies of children and the risks of food allergies. Soc Sci Med. 2004 Feb;58(4):825-36

Effects of Diet on Cancer

Ammerman, A., Lindquist, C., Hersey, J., et al. (2001). The efficacy of interventions to modify dietary behaviour related to cancer risk. Evidence Report/Technology Assessment No. 25: AHRQ. http://www.ahrq.gov/clinic/epcix.htm

Effects of Gender-based Programs

Neumark-Sztainer D, Flattum CF, Story M, Feldman S, Petrich CA. (2008) Dietary approaches to healthy weight management for adolescents: the New Moves model. Adolesc Med State Art Rev. 2008 Dec;19(3):421-30, viii. Review

Effects of Ethnic/Faith-based Programs

Effect on Other Special Needs (Athletes, Vegetarians, etc) Reading KJ, McCargar LJ, Marriage BJ. (1999) Adolescent and Young Adult Male Hockey Players: Nutrition Knowledge and Education. Can J Diet Pract Res. 1999 Summer;60(3):166-169.

Effects of Diet and Healthy Eating On Learning

Florence MD, Asbridge M, Veugelers, PJ (2008) Diet Quality and Academic Performance Journal of School Health 78 (4) , 209–215 doi:10.1111/j.1746-1561.2008.00288.x (Educational achievement and school effectiveness)

Shilts MK, Lamp C, Horowitz M, Townsend MS. (2009) Pilot study: EatFit impacts sixth graders' academic performance on achievement of mathematics and english education standards. J Nutr Educ Behav. 2009 Mar-Apr;41(2):127-31

Programs from PHAC Best Practices Portal

The Student Body: a teacher training module designed to help alert teachers (and parents) to the factors that can trigger unhealthy dieting among children, and ways to prevent it. www.aboutkidshealth.ca/thestudentbody.

From the Body Image Coalition of Peel (www.bodyimagecoalition.org): Every Body is a Somebody: Facilitator's Guide (or Bien dans TA peau in French) was designed to promote healthy body image, positive self-esteem, and a non-dieting approach to eating. This active learning program provides background information for the facilitator and activities to be used with adolescents. The effectiveness of this program has been evaluated with middle school girls using a classroom format and a nurse-led peer support format, and has been shown to improve global self-esteem, body satisfaction, and eating attitudes and behaviours.















Discussion Paper on Household and Individual Food Insecurity
This paper presents an examination of issues pertaining to the inclusion of direct and indirect indicators of food insecurity in a national nutrition monitoring system, focusing on individual- and household-level food insecurity that arises in the context of financial resource constraints. (Health Canada)
































































































































  • Sip Smart! BC
    is a new, educational program that helps teach children in grades 4 to 6 about sugary drinks and about making healthy drink choices. Sip Smart! BC is led by the BC Pediatric Society and the Heart and Stroke Foundation of BC & Yukon and is funded by ActNOW BC via the BC Healthy Living Alliance.

  • Drop the Pop (Northwest Territories)
    The Drop the Pop School Award recognizes schools that support healthy eating for their students. This type of award is based on similar campaigns found in other provinces. The program is also operating in the Yukon, Alberta and other Canadian jurisdictions







D. Evidence-based Single Interventions/Programs This sub-section examines single intervention programs in five areas with various aspects; policy (school board, other agencies), instruction (curriculum, educational materials and methods, teacher training, etc), health and other services (screening, early identification, school clinics, access to youth friendly services, case coordination and referrals etc); social support (parent involvement, peer programs, working with local media, working with social media etc), phtsical environment (school grounds, facilities, transportation etc)

D-1 Policy Interventions

Mini-Summary:
(To comment on or edit this mini-summary, go to this sub-page that contains the draft versions of our mini-summaries)

“School nutrition policy” includes policies, laws, regulations/by-laws and formal procedures promoted, adopted and implemented by national agencies/federal departments, health, education and other provincial/territorial ministries, health authorities and school boards, schools and professional guidelines/codes of conduct established relevant professions. Such policy-making organizations are governed by elected officials or appointed trustees who are required to report regularly to the public. Other agencies, such as schools or appointed officials can establish procedures, practices or programs that are similar to policy, but since they are not directly accountable to the public, they cannot be defined as public policy.

Most current research and popular references to “school nutrition policy” are actually referring to regulations on food sales and services in schools. However, school nutrition policy should be established in school, public health and other systems to cover several other topics, including:
  • Overall philosophy, goals for nutrition, diet, healthy eating
  • Defined roles/goals for their agency and employees as well as their role in working with others
  • Food Security/School Meals
  • Food services in schools (Minimum requirements for cafeterias, school meal programs, food handlling)
  • Height & Weight Screening on school entry
  • Nutrition education (Guidelines, obligatory and recommended learning objectives, obligation to inform parents)
  • Nutritionist/Dietitian services (eg early identification and referral procedures, counselling services for overweight/obese children, role of community nutritionist in working with schools)
  • Restricting or reducing sales of competitive (unhealthy) foods
  • Promoting or subsidizing sales of healthy foods in schools
  • Food Safety
  • Food Allergies
  • Food Production (Use of transfat, additives, food imports. modified food etc)
  • Policies related to Social Norms (eg · advertising food to children near schools, food sales to children on outlets near schools, food at school events for children & parents, · fund raising activities involving children, sponsorship by food companies or food industries, school recognition programs, school gardening programs)
Many groups such as the American Dietetic Association (ADA), the Society for Nutrition Education (SNE), and the American School Food Service Association (ASFSA) take the position that comprehensive nutrition services should be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. In this definition, we suggest that SN policy should guide all of the programs, practices and services that comprise this comprehensive approach as well as be a specific component of that approach. (First draft posted here on Oct 29-09)

ResearchReports/Resources
D-1 Policy Interventions

Foster GD, Sherman S, Borradaile KE, Grundy KM, Vander Veur SS, Nachmani J, Karpyn A, Kumanyika S, Shults J. (2008) A policy-based school intervention to prevent overweight and obesity. Pediatrics. 2008 Apr;121(4):e794-802.

Cullen KW, Watson K, Zakeri I, Ralston K. (2006) Exploring changes in middle-school student lunch consumption after local school food service policy modifications. Public Health Nutr. 2006 Sep;9(6):814-20.

US Department of Agriculture, Food and Nutrition Service. Children’s diet in the mid-1990s: dietary intake and its relationship with school meal participation. 2001.

NGA Center for Best Practices. Issue brief: preventing obesity in youth through school-based efforts. National Governors Association. February 4, 2003.

Simone A. French, PhD, Mary Story, PhD, Jayne A. Fulkerson, PhD and Anne Faricy Gerlach, MPH, RD (2005) Food Environment in Secondary Schools: À La Carte, Vending Machines, and Food Policies and Practices July 2003, Vol 93, No. 7 | American Journal of Public Health 1161-1168

Gary D. Foster, Sandy Sherman, Kelley E. Borradaile, Karen M. Grundy, Stephanie S. Vander Veur, Joan Nachmani, Allison Karpyn, Shiriki Kumanyika, Justine Shults, (2008) A Policy-Based School Intervention to Prevent Overweight and Obesity, PEDIATRICS Vol. 121 No. 4 April 2008, pp. e794-e802 (doi:10.1542/peds.2007-1365)

Mary L. Mckenna (2007) Issues in Implementing: School Nutrition Policies, Canadian Journal of Dietetic Practice and Research, Volume 64, Number 4 / Winter 2003

Claudia Probart Elaine McDonnell, Terryl Hartman J. Elaine Weirich Lisa Bailey-Davis (2006) Factors Associated with the Offering and Sale of Competitive Foods and School Lunch Participation, Journal of the American Dietetic Association Volume 106, Issue 2, February 2006, Pages 242-247

Klazine van der Horst, Anna Timperio, David Crawford, Rebecca Roberts, Johannes Brug, Anke Oenema (2008) The School Food Environment: Associations with Adolescent Soft Drink and Snack Consumption, American Journal of Preventive Medicine, Volume 35, Issue 3, September 2008, Pages 217-223

Karen W. Cullen, Jill Hartstein, Kim D. Reynolds Maihan Vu, Ken Resnicow, Natasha Greene, Mamie A. WhiteImproving the School Food Environment: Results from a Pilot Study in Middle Schools, Journal of the American Dietetic Association Volume 107, Issue 3, March 2007, Pages 484-489

Meenakshi M. Fernandes (2008) The Effect of Soft Drink Availability in Elementary Schools on Consumption, Journal of the American Dietetic Association Volume 108, Issue 9, September 2008, Pages 1445-1452

Buscher, L.A., Martin, K.A., Crocker, S. (2001). Point-of-purchase messages framed in terms of cost, convenience, taste and energy improve healthful snack selection in a college foodservice setting. Journal of the American Dietetic Association, 101(8), 909-913.

French, S.A., Story, M., Jeffery, R.W., Snyder, P.,Eisenberg, M., Sidebottom, A., et al. (1997). Pricing strategy to promote fruit and vegetable purchase in high school cafeterias. Journal of the American Dietetic Association, 97(9), 1008-1010.

Jeffery, R.W., French, S.A., Raether, C., Baxter, J.E. (1994). An environmental intervention to increase fruit and salad purchases in a cafeteria. Preventive Medicine, 23, 788-792

French SA, Wechsler H.(2004) School-based research and initiatives: fruit and vegetable environment, policy, and pricing workshop. Prev Med. 2004 Sep;39 Suppl 2:S101-7.

Schmid TL, Pratt M, Howze E, 1995, "Policy as Intervention: Environmental and Policy Approaches to the Prevention of Cardiovascular Disease", American Journal of Public Health, 85:1207-1211. 208-213 (2007)

Sherry JS. (2008) An evaluation of elementary school nutrition practices and policies in a southern Illinois county. J Sch Nurs. 2008 Aug;24(4):222-8.

Mâsse LC, Frosh MM, Chriqui JF, Yaroch AL, Agurs-Collins T, Blanck HM, Atienza AA, McKenna ML, Igoe JF. (2007) Development of a School Nutrition-Environment State Policy Classification System (SNESPCS). Am J Prev Med. 2007 Oct;33(4 Suppl):S277-91

French SA, Wechsler H (2004) School-based research and initiatives: fruit and vegetable environment, policy, and pricing workshop. Prev Med. 2004 Sep;39 Suppl 2:S101-7. Review.

Metos J, Nanney MS. (2007) The strength of school wellness policies: one state's experience. J Sch Health. 2007 Sep;77(7):367-72.

Walton M, Pearce J, Day P. (2009) Examining the interaction between food outlets and outdoor food advertisements with primary school food environments. Health Place. 2009 Sep;15(3):811-8. Epub 2009 Feb 14

Whatley Blum JE, Davee AM, Devore RL, Beaudoin CM, Jenkins PL, Kaley LA, Wigand DA. (2007) Implementation of low-fat, low-sugar, and portion-controlled nutrition guidelines in competitive food venues of Maine public high schools. J Sch Health. 2007 Dec;77(10):687-93.

Wharton CM, Long M, Schwartz MB. (2008) Changing nutrition standards in schools: the emerging impact on school revenue. J Sch Health. 2008 May;78(5):245-51. Review.

Finkelstein DM, Hill EL, Whitaker RC. (2008) School food environments and policies in US public schools. Pediatrics. 2008 Jul;122(1):e251-9.

Wechsler H, Brener ND, Kuester S, Miller C. (2001) Food service and foods and beverages available at school: results from the School Health Policies and Programs Study 2000. J Sch Health. 2001 Sep;71(7):313-24.

Malone SK. (2005) Improving the quality of students' dietary intake in the school setting. J Sch Nurs. 2005 Apr;21(2):70-6. Review.

Snelling AM, Korba C, Burkey A. (2007) The national school lunch and competitive food offerings and purchasing behaviors of high school students. J Sch Health. 2007 Dec;77(10):701-5.

Rideout K, Levy-Milne R, Martin C, Ostry AS. (20070 Food sales outlets, food availability, and the extent of nutrition policy implementation in schools in British Columbia. Can J Public Health. 2007 Jul-Aug;98(4):246-50

Hercberg S, Chat-Yung S, Chaulia M. (2008) The French National Nutrition and Health Program: 2001-2006-2010. Int J Public Health. 2008;53(2):68-77.

Izumi BT, Rostant OS, Moss MJ, Hamm MW. (2006) Results from the 2004 Michigan Farm-to-School Survey. J Sch Health. 2006 May;76(5):169-74.

Richards R, Darling H, Reeder AI. (2005) Sponsorship and fund-raising in New Zealand schools: implications for health. Aust N Z J Public Health. 2005 Aug;29(4):331-6.

Serrano E, Kowaleska A, Hosig K, Fuller C, Fellin L, Wigand V. (2007) Status and goals of local school wellness policies in Virginia: a response to the child nutrition and WIC Reauthorization Act of 2004. J Nutr Educ Behav. 2007 Mar-Apr;39(2):95-100.

Howell Davies O, Suleiman S, Nicholas J, Bradbury J, Msebele S, Prior G, Hall L, Wreford S, Jarvis L, McGee A, Poulter J, Nelson M. (2008) Food portion weights in primary and secondary school lunches in England. J Hum Nutr Diet. 2008 Feb;21(1):46-62.

Cooke L, Sangster J, Eccleston P. (2007) Improving the food provided and food safety practices in out-of-school-hours services. Health Promot J Austr. 2007 Apr;18(1):33-8

Maddock J, Maglione C, Barnett JD, Cabot C, Jackson S, Reger-Nash B.(2007) Statewide implementation of the 1% or Less Campaign. Health Educ Behav. 2007 Dec;34(6):953-63. Epub 2006 Dec 15


Centre for Science in the Public Intyerest (2007) ARE SCHOOLS MAKING THE GRADE? SCHOOL NUTRITION POLICIES ACROSS CANADA OCTOBER Ottawa, ON, Author

The School Food Sales and Policies Provincial Report
Examines the status of food sales in BC schools. (BC Health Ministry)

Consistent national school food guidelines needed for healthier children Position paper. (Dietitians of Canada)

Centers for Disease Control and Prevention. Report on US School Nutrition Policies, 2006

Nutrition Guidelines for Schools
by Public Health Nutritionists of Saskatchewan Research Centre.

Une nouvelle politique fut adopte au Québec qui limite la consommation des produits néfaste afin d’améliorer la nutrition des élèves dans les écoles. http://www.infobourg.com/sections/chemises/afficheChemise.php?idChemise=33&id=10094

Since the spring of 2003, the School Healthy Eating Policy Project (an initiative of the PEI Healthy Eating Alliance) has worked with the three school boards of Prince Edward Island to develop healthy eating policies using a consultative process. PEI School Nutrition Policies for elementary (Grades 1-6) and consolidated (Grades 1-8) schools now exist in all three school boards.

The Dietitians of Canada developed School Food and Nutrition Recommendations for the Ontario Ministry of Education Regarding Snacks and Beverages Dispensed by Vending Machines which accompanied this Policy and Program Memorandum The Ontario Ministry of Education’s Healthy Schools plan includes policy direction on daily physical activity, healthy foods and beverages in elementary school vending machines, anaphylaxis, Community Use of Schools, swimming survival programs, health and physical education curriculum and a high school cardiopulmonary resuscitation program.

  • The Dietitians of BC have created a draft document entitled Tips and Recipes for School Food Services: Meeting the Guidelines for Food and Beverage Sales in BC Schools. http://healthyeatingatschool.ca/wp-content/uploads/TipsRecipes_Sep08.pdf This new resource has been created to assist people who prepare food for sale to students in implementing the Guidelines. It includes tips on how to choose healthy recipes, substitutions to make favourite recipes healthier and a selection of recipes that meet the Guidelines. If you would like to provide feedback on its suitability you can complete the questionnaire in the resource.
  • Dial-A-Dietitian isa free nutrition information line for British Columbians funded by the B.C. Ministry of Health. Dial-A-Dietitian specializes in easy-to-use nutrition information for self-care, based on current scientific sources
  • Manitoba School Nutrition Information Line helps school communities with guidelines and policies? Call 1-888-547-0535 toll free (MB only) to get assistance from the school nutrition support team.
  • Center for Weight and Health, University of California, Berkeley. (2007). Dollars and sense: The financial impact of selling healthier school foods. Retrieved January 21, 2008 from http://www.cnr.berkeley.edu/cwh/PDFs/Dollars_and_Sense_FINAL_3.07.pdf
  • Healthy Fundraising for Schools guide from BC: http://www.dashbc.org/upload/Healthy%20Fundraising.pdf


ResearchReports & Resources
D-2 Instructional Interventions (Focus on general as well as specific skills, specific functional knowledge, normative beliefs, teacher skills, support for instruction, better scope/sequence of curricula)

Fahlman MM, Dake JA, McCaughtry N, Martin J. (2008) A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children. J Sch Health. 2008 Apr;78(4):216-22.

Contento I, Balch G I, Bronner Y L, Lytle L A, Maloney S K, Olson C M, Swadener S S.The effectiveness of nutrition education and implications for nutrition education policy, programs, and research: a review of research.Journal of Nutrition Education1995;27(6):277-418

Perez-Rodrigo, C. & Aranceta, J. (2001). School-based nutrition education: Lessons learned and new perspectives. [Review] [73 refs]. Public Health Nutrition, 4, 131-139.

Perez-Rodrigo, C. & Aranceta, J. (2003). Nutrition education in schools: Experiences and challenges. European Journal of Clinical Nutrition, 57(9), 582.

Moore JB, Pawloski LR, Goldberg P, Kyeung MO, Stoehr A, Baghi H. (2009) Childhood obesity study: a pilot study of the effect of the nutrition education program Color My Pyramid. J Sch Nurs. 2009 Jun;25(3):230-9. Epub 2009 Apr 10.

Olson CM, Devine CM, Frongillo EA Jr. (1993) Dissemination and use of a school-based nutrition education program for secondary school students. J Sch Health. 1993 Oct;63(8):343-8.

Rossiter M, Glanville T, Taylor J, Blum I. (2007) School food practices of prospective teachers. J Sch Health. 2007 Dec;77(10):694-700.

Kozłowska-Wojciechowska M, Uramowska-Zyto B, Jarosz A, Makarewicz-Wujec M. (2002) [Impact of of school children's nutrition education program on the knowledge and nutritional behavior of their parents] Rocz Panstw Zakl Hig. 2002;53(3):253-8. Polish

Matvienko O. (2007) Impact of a nutrition education curriculum on snack choices of children ages six and seven years. J Nutr Educ Behav. 2007 Sep-Oct;39(5):281-5.

Kreisel K. (2004) Evaluation of a computer-based nutrition education tool. Public Health Nutr. 2004 Apr;7(2):271-7

McVey G, Gusella J, Tweed S, Ferrari M. (2009) A controlled evaluation of web-based training for teachers and public health practitioners on the prevention of eating disorders. Eat Disord. 2009 Jan-Feb;17(1):1-26.

Powers AR, Struempler BJ, Guarino A, Parmer SM. (2005) Effects of a nutrition education program on the dietary behavior and nutrition knowledge of second-grade and third-grade students. J Sch Health. 2005 Apr;75(4):129-33.

Agozzino E, Esposito D, Genovese S, Manzi E, Russo Krauss P. (2007) [Evaluation of the effectiveness of a nutrition education intervention performed by primary school teachers] Ann Ig. 2007 Jul-Aug;19(4):315-24. Italian

Fraser J, Alexander C, Simpkins B, Temperley J. (2003) Health career promotion in the New England area of New South Wales: a program to support high school career advisers. Aust J Rural Health. 2003 Aug;11(4):199-204.

Gordon LV, Haynes DK. (1982) Parental participation in nutrition education homework. J Am Diet Assoc. 1982 Oct;81(4):445-8.

Little JC, Perry DR, Volpe SL. (2002) Effect of nutrition supplement education on nutrition supplement knowledge among high school students from a low-income community. J Community Health. 2002 Dec;27(6):433-50

Kulik TB, Wrońska I. (2001) Education on rational nutrition of elementary school children in the city of Lublin. Ann Univ Mariae Curie Sklodowska Med. 2001;56:375-80.

Saladin G, Provencher HJ, Sévigny J, Desaulniers M. (1982) [Evaluation of a nutrition education program in kindergartens] Can J Public Health. 1982 Mar-Apr;73(2):95-100. French.

Weiss EH, Kien CL. (1987) A synthesis of research on nutrition education at the elementary school level. J Sch Health. 1987 Jan;57(1):8-13. Review.

Brenowitz N, Tuttle CR. (2003) Development and testing of a nutrition-teaching self-efficacy scale for elementary school teachers. J Nutr Educ Behav. 2003 Nov-Dec;35(6):308-11.

Hawthorne KM, Moreland K, Griffin IJ, Abrams SA. (2006) An educational program enhances food label understanding of young adolescents. J Am Diet Assoc. 2006 Jun;106(6):913-6.

Savige GS. (2005) E-learning: a nutritionally ripe environment. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S230-4. Review.

Abdel Gawwad ES, Fetohy EM, Fiala L, Al Orf SM, Al Saif M. (2006) Impact evaluation of nutrition education intervention for an elementary school in riyadh city. J Egypt Public Health Assoc. 2006;81(1-2):75-97

Struempler BJ, Raby A. (2005) Pizza Please: an interactive nutrition evaluation for second and third grade students. J Nutr Educ Behav. 2005 Mar-Apr;37(2):94-5. No abstract available.

CASH and several other organizations have published a lesson plan gateway and student webquests on nutrition education.

The [Mission Nutrition] program from the Dietitains of Canada supports teachers with credible curriculum-based resources, easy-to-use lesson plans, and fun student activities. Freggie Tales (Bilingual): Provides children with the opportunity to learn about fruits and vegetables in a fun and exciting manner Virtual grocery store Canadian Diabetes Association The Teach Nutrition web site, published by the Dairy Farmers of Ontario has several nutrition education programs, each with several lesson plans, for teachers.
Discover Healthy Eating! A Teacher's Resource for Grades 1-8
(http://www.peelregion.ca/health/eating/htmfiles/healthy-eating.htm) Is an elementary school teacher targeted resource that supports the (ON) healthy eating component of the Healthy Living Strand in the Ontario Curriculum, Grades 1-8: Health and Physical Education (1998). It contains background information, glossaries, activities and handouts specific to each grade level. It was developed in cooperation with three southern ON Health Departments.

Virtual Kitchen
The Dietitians of Canada have published a A virtual kitchen revealing interesting nutrition facts about the foods.

Healthy Eating Resources for Yukon Schools
-, the Recreation and Parks Association for the Yukon is offering teachers healthy eating resources as well as training and support by a registered dietitian.

Teacher training workshops on a new healthy eating curriculum resource package Alberta Healthy Eating Resources for Teachers ; Amazing Little Cookbook for Kids and Moving Towards a Healthy U — a personal Logbook (a tool for parents and teachers).

The Menu of Choices Secondary School Resource
was developed as part of an OPHEA Initiative. Two additional curriculum supplements for Ophea's School Nutrition Initiative Menu of Choices Secondary School Resource have been developed for Family Studies and Business Studies and are nowavailable for free download.

Discover Healthy Eating
is a Grade 1-8 curriculum support resource developed by Toronto Public Health, York Region Health Services and Region of Peel Health Department This curriculum support resource offers a choice of teaching activities that correspond to the Health and Physical Education Curriculum (1998).

Smiling Within:
a curriculum linked resource created by local nutritionists and the Nutrition Education Resource Centre at Acadia University in Nova Scotia, is intended for teachers and peer educators working with students between grades primary to 6. This user-friendly guide allows teachers to introduce/supplement body image and healthy lifestyle information (i.e. healthy eating and physically active living) in class without additional searching for information and lesson planning.

Healthy Eating Alliance of PEI produces a list of curriculum resource and school-based materials and ideas to promote healthy eating in school.

Drop the Pop is a NWT program to reduce the sale of sugary drinks in schools.

Dairy Farmers of Canada
is active across Canada in the areas of school nutrition by way of producing curriculum support materials, Web-related support, teacher training, conducting scientific research, advising on school-related health policies and programs, offering school and nutrition related reports and literature reviews and coordinating school milk programs. Activities vary per jurisdictions. In partnership with local University research teams, conduct research with students to describe eating and physical activity patterns. (Alberta and Ontario). There are two reports pending that have been submitted to the Canadian Journal of Dietetic Research and the Canadian Journal of Public Health. Act as support and catalyst to schools wishing to establish school milk programs and offer nutrition and health seminars and educational materials for parents. Offer recognition awards for teachers & schools to support quality nutrition education. Also offer periodic continuing education events in nutrition and health for those working within the school health sector (B.C. Manitoba, Ontario).

Several jurisdictions within DFC offer nutrition and health education resource materials and supports, including the Dairy Farmers of Canada – Ontario who offer a series of curriculum matched, evaluated resources and workshop opportunities for Ontario schools. Links to the other PT jurisdictions of DFC are available througheducational resources’ .

Eating + Activity Tracker
Online tool to track daily eating and physical activity (Dietitians of Canada)


D-3 Health, Nutrition, School Food and Other Services Interventions

Kubik MY, Story M, Rieland G. (2007) Developing school-based BMI screening and parent notification programs: findings from focus groups with parents of elementary school students. Health Educ Behav. 2007 Aug;34(4):622-33. Epub 2006 May 31.

Raizman DJ, Montgomery DH, Osganian SK, Ebzery MK, Evans MA, Nicklas TA, Zive MM, Hann BJ, Snyder MP, Clesi AL. (1994) CATCH: food service program process evaluation in a multicenter trial. Health Educ Q. 1994;Suppl 2:S51-71

Harris CV, Neal WA. (2009) Assessing BMI in West Virginia schools: parent perspectives and the influence of context. Pediatrics. 2009 Sep;124 Suppl 1:S63-72

Bankhead C, Brett J, Bukach C, Webster P, Stewart-Brown S, Austoker J. The impact of screening on future health promoting behaviours and health beliefs: a systematic review. HTA 2003;7:no 42.

Caldera D, Burrell L, Rodriguez K, Crowne SS, Rohde C, Duggan A. (2007) Impact of a statewide home visiting program on parenting and on child health and development. Child Abuse Negl. 2007 Aug;31(8):829-52. Epub 2007 Sep 5.

Northrup KL, Cottrell LA, Wittberg RA. (2008) L.I.F.E.: a school-based heart-health screening and intervention program. J Sch Nurs. 2008 Feb;24(1):28-35. Review.

Resnicow K, Cross D, Lacosse J, Nichols P. (1993) Evaluation of a school-site cardiovascular risk factor screening intervention. Prev Med. 1993 Nov;22(6):838-56.

Demerath E, Muratova V, Spangler E, Li J, Minor V, Neal W. School-based obesity screening in rural Appalachia. Preventive Medicine. 2003 Dec; 37(6 Pt 1): 553-60.

Carrel AL, Clark RR, Peterson SE, Nemeth BA, Sullivan J, Allen DB. Improvement of fitness, body composition, and insulin sensitivity in overweight children in a school-based exercise program: a randomized, controlled study. Arch Pediatr Adolesc Med. 2005 Oct; 159(10):996-7.

Brosnan CA, Upchurch SL, Meininger JC, Hester LE, Johnson G, Elissa MA. Student nurses participate in public health research and practice through a school-based screening program. Public Health Nursing. 2005 May-Jun;22(3):260-6.

A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions (2007)

Jasaitis A, 1997, "School-based health clinics: the role for nutrition", Journal of American Dietetic Association, Oct;97(10 Suppl 2):S117-119

Resnicow K, Cross D, Lacosse J, Nichols P. (1993) Evaluation of a school-site cardiovascular risk factor screening intervention. Prev Med. 1993 Nov;22(6):838-56.

Abood DA, Black DR, Coster DC. (2008) Evaluation of a school-based teen obesity prevention minimal intervention. J Nutr Educ Behav. 2008 May-Jun;40(3):168-74



D-4 Social Support Interventions (See also School Nutrition Activities)

Janosz, M., Georges, P., Parent, S. (1998). L’environnement éducatif à l’école secondaire : un modèle théorique pour guider l’évaluation du milieu. Revue Canadienne de Psycholo-Éducation, 27(2), 285-306. (Review)

Haines J, Neumark-Sztainer D, Perry CL, Hannan PJ, Levine MP. (2006) V.I.K. (Very Important Kids): a school-based program designed to reduce teasing and unhealthy weight-control behaviors. Health Educ Res. 2006 Dec;21(6):884-95. Epub 2006 Oct 23.

Jordan KC, Erickson ED, Cox R, Carlson EC, Heap E, Friedrichs M, Moyer-Mileur LJ, Shen S, Mihalopoulos NL. (2008) Evaluation of the Gold Medal Schools program. J Am Diet Assoc. 2008 Nov;108(11):1916-20.

DeBar LL, Schneider M, Ford EG, Hernandez AE, Showell B, Drews KL, Moe EL, Gillis B, Jessup AN, Stadler DD, White M; HEALTHY Study Group. (2009) Social marketing-based communications to integrate and support the HEALTHY study intervention. Int J Obes (Lond). 2009 Aug;33 Suppl 4:S52-9.

Valaitis R, O'Mara L. (2005) Enabling youth participation in school-based computer-supported community development in Canada. Health Promot Int. 2005 Sep;20(3):260-8. Epub 2005 Mar 11.

Krukowski RA, West DS, Siddiqui NJ, Bursac Z, Phillips MM, Raczynski JM. (2008) No change in weight-based teasing when school-based obesity policies are implemented. Arch Pediatr Adolesc Med. 2008 Oct;162(10):936-42

Haines J, Neumark-Sztainer D, Morris B. (2008) Theater as a behavior change strategy: qualitative findings from a school-based intervention. Eat Disord. 2008 May-Jun;16(3):241-54.

Fridrici M, Beyer A, Lohaus A. (2008) [Getting through to adolescents "online". The use of web-based programs for stress-prevention in youth] Prax Kinderpsychol Kinderpsychiatr. 2008;57(1):39-59. German

Smith SC, Kalina L. (2004) Evaluation of the Kids' Shop Smart tour. Can J Diet Pract Res. 2004 Spring;65(1):10-4.

Folta SC, Goldberg JP, Economos C, Bell R, Landers S, Hyatt R. (2006) Assessing the use of school public address systems to deliver nutrition messages to children: Shape up Somerville--audio adventures. J Sch Health. 2006 Nov;76(9):459-64; quiz 482-4

He M, Callaghan C, Evans A, Mandich G. (2009) Healthy eating champions award for elementary schools. Can J Diet Pract Res. 2009 Summer;70(2):101-4.

Mellanby AR, Rees JB, Tripp JH. (2000) Peer-led and adult-led school health education: a critical review of available comparative research. Health Educ Res. 2000 Oct;15(5):533-45. Review.

Kelder S, Hoelscher DM, Barroso CS, Walker JL, Cribb P, Hu S. (2005) The CATCH Kids Club: a pilot after-school study for improving elementary students' nutrition and physical activity. Public Health Nutr. 2005 Apr;8(2):133-40.


Bisset SL, Potvin L, Daniel M, Paquette M. (2008) Assessing the impact of the primary school-based nutrition intervention Petits cuistots--parents en réseaux. Can J Public Health. 2008 Mar-Apr;99(2):107-13.


Story M, Lytle LA, Birnbaum AS, Perry CL. (2002) Peer-led, school-based nutrition education for young adolescents: feasibility and process evaluation of the TEENS study. J Sch Health. 2002 Mar;72(3):121-7.

Buller DB, Morrill C, Taren D, Aickin M, Sennott-Miller L, Buller MK, Larkey L, Alatorre C, Wentzel TM. (1999) Randomized trial testing the effect of peer education at increasing fruit and vegetable intake. J Natl Cancer Inst. 1999 Sep 1;91(17):1491-50

Ellis RM, Ellis RC. (2007) Impact of a traffic light nutrition tool in a primary school. J R Soc Promot Health. 2007 Jan;127(1):13-21.


Bergen D, Yeh MC. (2006) Effects of energy-content labels and motivational posters on sales of sugar-sweetened beverages: stimulating sales of diet drinks among adults study. J Am Diet Assoc. 2006 Nov;106(11):1866-9

Dawson J, Dwyer JJ, Evers S, Sheeshka J. (2006) Eat smart! Workplace Cafeteria Program evaluation of the nutrition component. Can J Diet Pract Res. 2006 Summer;67(2):85-90.

Parental Involvement: Informing, Educating, Involving, Supporting Parents

Nader PR, Sellers DE, Johnson CC, Perry CL, Stone EJ, Cook KC, Bebchuk J, Luepker RV. (1996) The effect of adult participation in a school-based family intervention to improve Children's diet and physical activity: the Child and Adolescent Trial for Cardiovascular Health. Prev Med. 1996 Jul-Aug;25(4):455-64

Evans AE, Dave J, Tanner A, Duhe S, Condrasky M, Wilson D, Griffin S, Palmer M, Evans M. (2006) Changing the home nutrition environment: effects of a nutrition and media literacy pilot intervention. Fam Community Health. 2006 Jan-Mar;29(1):43-54.

Harrington KF, Franklin FA, Davies SL, Shewchuk RM, Binns MB. (2005) Implementation of a family intervention to increase fruit and vegetable intake: the Hi5+ experience. Health Promot Pract. 2005 Apr;6(2):180-9.


Petchers MK, Hirsch EZ, Bloch BA. (1987)The impact of parent participation on the effectiveness of a heart health curriculum. Health Educ Q. 1987 Winter;14(4):449-60.


Garcia-Dominic O, Wray LA, Treviño RP, Hernandez AE, Yin Z, Ulbrecht JS. (2009) Identifying Barriers That Hinder Onsite Parental Involvement in a School-Based Health Promotion Program. Health Promot Pract. 2009 Apr 1. [Epub ahead of print]


Bert SC, Farris JR, Borkowski JG. (2008) Parent training: implementation strategies for adventures in parenting. J Prim Prev. 2008 May;29(3):243-61.


McLennan JD, Leon T, Haffey S, Barker LA. (2009) Exporting a Canadian parenting education program to the Dominican Republic. Public Health Nurs. 2009 Mar-Apr;26(2):183-91.


Larijani B, Fakhrzadeh H, Hamidi A, Heshmat R, Pourebrahim R. (2007) Household cardiovascular health education. A school-based approach. Saudi Med J. 2007 Apr;28(4):643-5.

Crockett SJ, Mullis R, Perry CL, Luepker RV. (1989) Parent education in youth-directed nutrition Interventions. Prev Med. 1989 Jul;18(4):475-91. Review.


Renaud L, Mannoni C. (1997) [Study of parental participation in curricular and extracurricular activities] Can J Public Health. 1997 May-Jun;88(3):184-91. French.


Perry CL, Luepker RV, Murray DM, Kurth C, Mullis R, Crockett S, Jacobs DR Jr. (1988) Parent involvement with children's health promotion: the Minnesota Home Team. Am J Public Health. 1988 Sep;78(9):1156-60.


Kozłowska-Wojciechowska M, Uramowska-Zyto B, Jarosz A, Makarewicz-Wujec M. (2002) [Impact of of school children's nutrition education program on the knowledge and nutritional behavior of their parents] Rocz Panstw Zakl Hig. 2002;53(3):253-8. Polish

Renaud L, Mannoni C. (1997) [Study of parental participation in curricular and extracurricular activities] Can J Public Health. 1997 May-Jun;88(3):184-91. French.

Perry CL, Luepker RV, Murray DM, Kurth C, Mullis R, Crockett S, Jacobs DR Jr. (1988) Parent involvement with children's health promotion: the Minnesota Home Team.

Nader PR, Sellers DE, Johnson CC, Perry CL, Stone EJ, Cook KC, Bebchuk J, Luepker RV. (1996) The effect of adult participation in a school-based family intervention to improve Children's diet and physical activity: the Child and Adolescent Trial for Cardiovascular Health. Prev Med. 1996 Jul-Aug;25(4):455-64

Am J Public Health. 1988 Sep;78(9):1156-60.
Heinrichs N, Bertram H, Kuschel A, Hahlweg K. (2005) Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: barriers to research and program participation. Prev Sci. 2005 Dec;6(4):275-86

Price SM, Huhman M, Potter LD. (2008) Influencing the parents of children aged 9-13 years: findings from the VERB campaign. Am J Prev Med. 2008 Jun;34(6 Suppl):S267-74.


Murphy M, Polivka B. (2007) Parental perceptions of the schools' role in addressing childhood obesity.
J Sch Nurs. 2007 Feb;23(1):40-6

Horne PJ, Hardman CA, Lowe CF, Tapper K, Le Noury J, Madden P, Patel P, Doody M.(2009) Increasing parental provision and children's consumption of lunchbox fruit and vegetables in Ireland: the Food Dudes intervention

Pearson N, Biddle SJ, Gorely T.(2009) Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr. 2009 Feb;12(2):267-83. Epub 2008 Jun 18.

Boutelle KN, Birkeland RW, Hannan PJ, Story M, Neumark-Sztainer D (2007) Associations between maternal concern for healthful eating and maternal eating behaviors, home food availability, and adolescent eating behaviors. J Nutr Educ Behav. 2007 Sep-Oct;39(5):248-56.

Eur J Clin Nutr. 2009 May;63(5):613-8. Epub 2008 May 21.
Petchers MK, Hirsch EZ, Bloch BA, 1987, "The impact of parent participation on the effectiveness of a heart health curriculum", Health Education Quarterly, Winter;14(4):449-60

Karcher MJ. (2008) The study of mentoring in the learning environment (SMILE): a randomized evaluation of the effectiveness of school-based mentoring. Prev Sci. 2008 Jun;9(2):99-113. Epub 2008 Feb 23.

Special Events/School Activities


Mini-Summary:
(To comment on or edit this mini-summary, go to this sub-page that contains the draft versions of our mini-summaries)

School nutrition activities create social support for healthy eating during and after the school day and in the evening. These activities engage students, staff and parents in learning about nutrition in a variety of ways. They include student cooking clubs after school, parent cooking classes in the evenings and special school events such as Health Fairs that feature healthy eating. These activities can be linked to the formal classroom as a co-curricular activity or as independent, extra-curricular activities. Regardless of the link to the curriculum, these activities are an important part of a comprehensive approach, coordinated school-agency programs and effective whole school strategies to promote healthy diet and nutrition. The goal of these activities is to increase social support for healthier behaviours, increase access to supportive social networks or to help to denormalize unhealthy behaviours or change normative beliefs. The types of programs that can be included in this school nutrition activities category include:
  • Student leadership programs (including advocacy for changes in school or community)
  • Student Clubs and other Extra-curricular or after school programs
  • Co-curricular activities (school, class or groups of students conducting projects that increase awareness about the issue. Health Fairs are an example of this type of activity.)
These specific school activities can also be incorporated into larger scale, longer-term student and school programs that have a youth, parent of community development focus. These include:
  • Peer helper programs
  • Mentoring programs (from adults or older students)
  • Intergenerational programs
  • Schools working closely with community-based, voluntary health and self-help organizations
  • Schools working with local media, businesses, ethnic minority community organizations and new media organizations (First draft posted here on Oct 29-09)

Kelley E, Ashley B, Getlinger MJ, Nitzke S. (2008) A lesson on "how much should I eat?" helps learners understand and apply MyPyramid recommendations. J Nutr Educ Behav. 2008 Mar-Apr;40(2):116-7.

Perry CL, Zauner M, Oakes JM, Taylor G, Bishop DB. (2002) Evaluation of a theater production about eating behavior of children. J Sch Health. 2002 Aug;72(6):256-61.

Bisset SL, Potvin L, Daniel M, Paquette M. (2008) Assessing the impact of the primary school-based nutrition intervention Petits cuistots--parents en réseaux. Can J Public Health. 2008 Mar-Apr;99(2):107-13.

Walters LM, Stacey JE. (2009) Focus on food: development of the Cooking with Kids experiential nutrition education curriculum. J Nutr Educ Behav. 2009 Sep-Oct;41(5):371-3.

Thonney PF, Bisogni CA. (2006)Cooking Up Fun! A youth development strategy that promotes independent food skills. J Nutr Educ Behav. 2006 Sep-Oct;38(5):321-3.

Racine S, St-Onge M. (2000) [Collective kitchens: the way to promote mental health] Can J Commun Ment Health. 2000 Spring;19(1):37-62. French

Bergen D, Yeh MC. (2006) Effects of energy-content labels and motivational posters on sales of sugar-sweetened beverages: stimulating sales of diet drinks among adults study. J Am Diet Assoc. 2006 Nov;106(11):1866-9

Ellis RM, Ellis RC. (2007) Impact of a traffic light nutrition tool in a primary school. J R Soc Promot Health. 2007 Jan;127(1):13-21


Folta SC, Goldberg JP, Economos C, Bell R, Landers S, Hyatt R. (2006) Assessing the use of school public address systems to deliver nutrition messages to children: Shape up Somerville--audio adventures. J Sch Health. 2006 Nov;76(9):459-64; quiz 482-4

FOWLKES BH , RAY P, HUDGENS T (1999)
School-Based Health Fairs used in Planning Comprehensive School-Wide Nutrition Education Programs Journal of the American Dietetic Association Volume 99, Issue 9, Supplement 1, September 1999, Page A41

Robinson-O'Brien R, Story M, Heim S. (2009) Impact of garden-based youth nutrition intervention programs: a review. J Am Diet Assoc. 2009 Feb;109(2):273-80. Review.

Viola A. (2006) Evaluation of the Outreach School Garden Project: building the capacity of two Indigenous remote school communities to integrate nutrition into the core school curriculum. Health Promot J Austr. 2006 Dec;17(3):233-

Stroink ML, Nelson CH. (2009) Aboriginal health learning in the forest and cultivated gardens: building a nutritious and sustainable food system. J Agromedicine. 2009;14(2):263-9.

McAleese JD, Rankin LL.(2007) Garden-based nutrition education affects fruit and vegetable consumption in sixth-grade adolescents. J Am Diet Assoc. 2007 Apr;107(4):662-5.












  • Planning Guide Health Fairs (1997) California Parents & Teachers Association http://abvo7.tk



D-5 Physical Environment Interventions (Including interventions that provide practical resources such as transportation, meals, etc)

Centers for Disease Control and Prevention. Evaluation of a fruit and vegetable distribution program—Mississippi, 2004-05 school year. MMWR-Morbidity & Mortality Weekly Report. 55(35): 957-61, 2006 Sep 8.


Olds , "Vending Machines: Effect on Student Snacking Attitudes/Behaviors", 1988, Journal of Nutrition Education, 20(2)



E Implementation and Sustainability

Use of Evidenced-based Implementation Strategies and Diffusion Research
This sub-section examines the use of research-based implementation strategies drawn from health promotion (eg PRECEDE planning model) or education (eg Concerns-based Adoption Model). We also looked for references and resources that described the use of "local mechanisms" such as training champions or truly engaging staff. As well, we looked to items that examined "local drivers" of change/resistance such provincial directives, local incidents or local personalities/relationships.

ResearchReports & Resources
E-1 Use of Evidence-based Planned Implementation Models

Intervention Mapping

Hoelscher DM, Evans A, Parcel GS, Kelder SH. (2002) Designing effective nutrition interventions for adolescents.

J Am Diet Assoc. 2002 Mar;102(3 Suppl):S52-63. Review.
Reinaerts EB, de Nooijer J, de Vries NK. (2007) Fruit and vegetable distribution program versus a multicomponent program to increase fruit and vegetable consumption: which should be recommended for implementation? J Sch Health. 2007 Dec;77(10):679-86.


Planning Tools such as PRECEDE-PROCEED


Practical Aspects of Implementation


Local Drivers of Implementation
(Incidents, Personalities, Relationships etc)




Practice-based Evidence in Nutrition [PEN] - Dietitians of Canada is currently developing a new service for members and other health professionals that will provide ready access to evidence-based practice guidance, tools and resources designed around knowledge pathways. A priority topic for the initial launch will be on obesity prevention and management.
E-2 Use of Diffusion and Education Change Knowledge/Theory

Levine E, Olander C, Lefebvre C, Cusick P, Biesiadecki L, McGoldrick D. (2002) The Team Nutrition pilot study: lessons learned from implementing a comprehensive school-based intervention. J Nutr Educ Behav. 2002 Mar-Apr;34(2):109-16.

Franks A, Kelder SH, Dino GA, Horn KA, Gortmaker SL, Wiecha JL, Simoes EJ. (2007) School-based programs: lessons learned from CATCH, Planet Health, and Not-On-Tobacco. Prev Chronic Dis. 2007 Apr;4(2):A33. Epub 2007 Mar 15.

Olson AL, Seidler AB, Goodman D, Gaelic S, Nordgren R. (2004) School professionals' perceptions about the impact of chronic illness in the classroom. Arch Pediatr Adolesc Med. 2004 Jan;158(1):53-8

Graham H, Zidenberg-Cherr S. (2005) California teachers perceive school gardens as an effective nutritional tool to promote healthful eating habits. J Am Diet Assoc. 2005 Nov;105(11):1797-800

Parcel, G.S., Perry, C.L., Kelder, S.H., Elder, J.P., Mitchell, P.D., Lytle, L. A., Johnson, C.C., and Stone, E.J. (2003). School climate and the institutionalization of the CATCH Program. Health Education and Behavior, 30 (4), August.

Gittelsohn J, Merkle S, Story M, Stone EJ, Steckler A, Noel J, Davis S, Martin CJ, Ethelbah B. (2003) School climate and implementation of the Pathways study. Prev Med. 2003 Dec;37(6 Pt 2):S97-106.

Cho H, Nadow MZ. (2004) Understanding barriers to implementing quality lunch and nutrition education. J Community Health. 2004 Oct;29(5):421-35


Mauriello LM, Driskell MM, Sherman KJ, Johnson SS, Prochaska JM, Prochaska JO. (2006) Acceptability of a school-based intervention for the prevention of adolescent obesity. J Sch Nurs. 2006 Oct;22(5):269-77

Davis M, Baranowski T, Resnicow K, Baranowski J, Doyle C, Smith M, Wang DT, Yaroch A, Hebert D. (2000) Gimme 5 fruit and vegetables for fun and health: process evaluation. Health Educ Behav. 2000 Apr;27(2):167-76

Lim YP. (2008) Sharing Singapore's experience in dietetic practice and school nutrition programmes. Asia Pac J Clin Nutr. 2008;17 Suppl 1:361-4. Review.


Cohall AT, Cohall R, Dye B, Dini S, Vaughan RD, Coots S. (2007) Overheard in the halls: what adolescents are saying, and what teachers are hearing, about health issues. J Sch Health. 2007 Sep;77(7):344-50. Erratum in: J Sch Health. 2007 Nov;77(9):644.


Molina BS, Smith BH, Pelham WE Jr. (2005) Development of a school-wide behavior program in a public middle school: an illustration of deployment-focused intervention development, stage 1. J Atten Disord. 2005 Aug;9(1):333-42.


Huhman M, Bauman A, Bowles HR. (2008) Initial outcomes of the VERB campaign: tweens' awareness and understanding of campaign messages. Am J Prev Med. 2008 Jun;34(6 Suppl):S241-8
Naylor PJ, Macdonald HM, Zebedee JA, Reed KE, McKay HA. (2006) Lessons learned from Action Schools! BC--an 'active school' model to promote physical activity in elementary schools. J Sci Med Sport. 2006 Oct;9(5):413-23. Epub 2006 Aug 1.

Kool B, Thomas D, Moore D, Anderson A, Bennetts P, Earp K, Dawson D, Treadwell N. (2008) Innovation and effectiveness: changing the scope of school nurses in New Zealand secondary schools. Aust N Z J Public Health. 2008 Apr;32(2):177-80

Kalafat J, Illback RJ, Sanders D Jr. (2007) The relationship between implementation fidelity and educational outcomes in a school-based family support program: development of a model for evaluating multidimensional full-service programs. Eval Program Plann. 2007 May;30(2):136-48. Epub 2007 Jan 26.


Reynolds KD, Buller DB, Yaroch AL, Maloy JA, Cutter GR. (2006) Mediation of a middle school skin cancer prevention program. Health Psychol. 2006 Sep;25(5):616-25.

Renaud L, Chevalier S, Dufour R, O"Loughlin J, Beaudet N, Bourgeois A, Ouellet D, 1997, "Evaluation of the implementation of an educational curriculum: optimal intervention for the adoption of an educational program of health in elementary schools", Canadian Journal of Public Health, Sep-Oct;88(5):351-3.

Olson CM, Devine CM, Frongillo EA Jr. (1993) Dissemination and use of a school-based nutrition education program for secondary school students. J Sch Health. 1993 Oct;63(8):343-8.

Rossiter M, Glanville T, Taylor J, Blum I. (2007) School food practices of prospective teachers. J Sch Health. 2007 Dec;77(10):694-700.

Reynolds KD, Franklin FA, Leviton LC, Maloy J, Harrington KF, Yaroch AL, Person S, Jester P. (2000) Methods, results, and lessons learned from process evaluation of the high 5 school-based nutrition intervention. Health Educ Behav. 2000 Apr;27(2):177-86.

Vecchiarelli S, Takayanagi S, Neumann C. (2006) Students' perceptions of the impact of nutrition policies on dietary behaviors. J Sch Health. 2006 Dec;76(10):525-31; quiz 540-2

Murphy M, Polivka B. (2007) Parental perceptions of the schools' role in addressing childhood obesity.
J Sch Nurs. 2007 Feb;23(1):40-6

Wilson LF. (2007) Adolescents' attitudes about obesity and what they want in obesity prevention programs. J Sch Nurs. 2007 Aug;23(4):229-38.

Aldinger C, Zhang XW, Liu LQ, Guo JX, Yu Sen Hai, Jones J. (2008) Strategies for implementing Health-Promoting Schools in a province in China. Promot Educ. 2008;15(1):24-9.
The Institute of Nutrition, Metabolism and Diabetes (INMD) is one of the 13 virtual institutes that make up the CIHR.INMD was designed to link researchers, scientists, community groups, and individuals from around the world who share an interest in enhancing health in relation to diet, digestion, excretion, and metabolism.

Effectiveness of Physical Activity Enhancement and Obesity Prevention Programs in Children and Youth
The purpose of this Health Canada funded systematic literature review is to provide some national policy direction related to the effectiveness of interventions for promoting healthy weight, preventing overweight/obesity and increasing physical activity among school aged children and youth.

Health Canada coordinated the development of a special supplement to the Canadian Journal of Public Health (CJPH), Understanding the Forces That Influence Our Eating Habits: What We Know and Need to Know,which was released in June 2005. One of the topics focused on the determinants of healthy eating related to “children and youth”, providing a synthesis of the literature and recommendations on appropriate research needed to fill evidence gaps.

E-3 Use of Capacity Building and Continuous Improvement Strategies to Build Sustainability
This sub-section also examines system, agency, school and professional capacity in areas such as coordinated policy, mechanisms for cooperation, assigning staff to coordination, regular monitoring and reporting, workforce development, planning for sustainability and strategic management of issues.

ResearchReports & Resources

Worsley A. (2005) Children's healthful eating: from research to practice. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S135-43. Review.

Perry CL, Sellers DE, Johnson C, Pedersen S, Bachman KJ, Parcel GS, Stone EJ, Luepker RV, Wu M, Nader PR, Cook K. (1997) The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation, and feasibility for elementary schools in the United States. Health Educ Behav. 1997 Dec;24(6):716-35.

Hoelscher DM, Feldman HA, Johnson CC, Lytle LA, Osganian SK, Parcel GS, Kelder SH, Stone EJ, Nader PR. (2004) School-based health education programs can be maintained over time: results from the CATCH Institutionalization study. Prev Med. 2004 May;38(5):594-606.

Lytle LA, Ward J, Nader PR, Pedersen S, Williston BJ. (2003) Maintenance of a health promotion program in elementary schools: results from the CATCH-ON study key informant interviews. Health Educ Behav. 2003 Aug;30(4):503-18.

Contento IR. (2008) Nutrition education: linking research, theory, and practice. Asia Pac J Clin Nutr. 2008;17 Suppl 1:176-9. Review Pérez-Rodrigo C, Aranceta J. (2003) Nutrition education in schools: experiences and challenges. Eur J Clin Nutr. 2003 Sep;57 Suppl 1:S82-5. Review.

O'Rourke TW. (1995) Creating capacity: a research agenda for school health education. J Sch Health. 1995 Jan;65(1):33-7.
Roberts-Gray C, Gingiss PM, Boerm M. (2007) Evaluating school capacity to implement new programs. Eval Program Plann. 2007 Aug;30(3):247-57. Epub 2007 Apr 19

Inchley J, Muldoon J, Currie C. (2007) Becoming a health promoting school: evaluating the process of effective implementation in Scotland. Health Promot Int. 2007 Mar;22(1):65-71. Epub 2006 Dec 18
Hoyle TB, Samek BB, Valois RF. (2008) Building capacity for the continuous improvement of health-promoting schools. J Sch Health. 2008 Jan;78(1):1-8.

Smith BJ, Potts-Datema W, Nolte AE. (2005) Challenges in teacher preparation for school health education and promotion. Promot Educ. 2005;12(3-4):162-4.

Hawe P, Stickney EK. (1997) Developing the effectiveness of an intersectoral food policy coalition through formative evaluation. Health Educ Res. 1997 Jun;12(2):213-25


Alfonso ML, Nickelson J, Hogeboom DL, French J, Bryant CA, McDermott RJ, Baldwin JA. (2008) Assessing local capacity for health intervention. Eval Program Plann. 2008 May;31(2):145-59. Epub 2008 Jan 24.


Levine J, Gussow JD. (1999) Nutrition professionals' knowledge of and attitudes toward the food industry's education and marketing programs in elementary schools. J Am Diet Assoc. 1999 Aug;99(8):973-6.

Contento IR, Koch PA, Lee H, Sauberli W, Calabrese-Barton A. (2007) Enhancing personal agency and competence in eating and moving: formative evaluation of a middle school curriculum--Choice, Control, and Change. J Nutr Educ Behav. 2007 Sep-Oct;39(5 Suppl):S179-86.


Webber LS, Johnson CC, Rose D, Rice JC. (2007) Development of ACTION! Wellness Program for Elementary School Personnel. Obesity (Silver Spring). 2007 Nov;15 Suppl 1:48S-56S
Heath EM, Coleman KJ. (20020 Evaluation of the institutionalization of the coordinated approach to child health (CATCH) in a U.S./Mexico border community. Health Educ Behav. 2002 Aug;29(4):444-60

Bere E, Veierød MB, Bjelland M, Klepp KI. (2006) Free school fruit--sustained effect 1 year later. Health Educ Res. 2006 Apr;21(2):268-75. Epub 2005 Oct 11.

Kirchofer G, Telljohann SK, Price JH, Dake JA, Ritchie M. (2007) Elementary school parents'/guardians' perceptions of school health service personnel and the services they provide. J Sch Health. 2007 Nov;77(9):607-14; quiz 645-6.


McCullum-Gomez C, Barroso CS, Hoelscher DM, Ward JL, Kelder SH. (2006) Factors influencing implementation of the Coordinated Approach to Child Health (CATCH) Eat Smart School Nutrition Program in Texas. J Am Diet Assoc. 2006 Dec;106(12):2039-44.


Dickin KL, Dollahite JS, Habicht JP. (2005) Nutrition behavior change among EFNEP participants is higher at sites that are well managed and whose front-line nutrition educators value the program. J Nutr. 2005 Sep;135(9):2199-205.

Bisset S, Potvin L. (2007) Expanding our conceptualization of program implementation: lessons from the genealogy of a school-based nutrition program. Health Educ Res. 2007 Oct;22(5):737-46. Epub 2006 Dec 2


McLeod PJ, Brawer J, Steinert Y, Chalk C, McLeod A. (2008) A pilot study designed to acquaint medical educators with basic pedagogic principles. Med Teach. 2008 Feb;30(1):92-3.

Marx E, Hudson N, Deal TB, Pateman B, Middleton K. (2007) Promoting health literacy through the health education assessment project. J Sch Health. 2007 Apr;77(4):157-63.


Singh AS, Chinapaw MJ, Brug J, van Mechelen W. (2009) Process evaluation of a school-based weight gain prevention program: the Dutch Obesity Intervention in Teenagers (DOiT). Health Educ Res. 2009 Oct;24(5):772-7. Epub 2009 Mar 20


Garcia-Dominic O, Wray LA, Treviño RP, Hernandez AE, Yin Z, Ulbrecht JS. (2009) Identifying Barriers That Hinder Onsite Parental Involvement in a School-Based Health Promotion Program. Health Promot Pract. 2009 Apr 1. [Epub ahead of print]


Whatley Blum JE, Davee AM, Devore RL, Beaudoin CM, Jenkins PL, Kaley LA, Wigand DA. (2007) Implementation of low-fat, low-sugar, and portion-controlled nutrition guidelines in competitive food venues of Maine public high schools. J Sch Health. 2007 Dec;77(10):687-93.


Dwyer JJ, Vavaroutsos D, Lutterman A, Hier M, Hughes M, Makarchuk MJ. (2006) Empowerment evaluation in redesigning a public health unit nutrition program. Can J Diet Pract Res. 2006 Spring;67(1):36-40.


Scarborough P, Rayner M, Stockley L, Black A. (2007) Nutrition professionals' perception of the 'healthiness' of individual foods. Public Health Nutr. 2007 Apr;10(4):346-53.


Santerre CR. (2005) X-train: teaching professionals remotely. J Nutr. 2005 May;135(5):1248-52


Arbeit ML, Serpas DC, Johnson CC, Forcier JE, Berenson GS. (1991) The implementation of a cardiovascular school health promotion program: utilization and impact of a school health advisory committee: the Heart Smart program. Health Educ Res. 1991 Dec;6(4):423-30.

Parcel GS, Perry CL, Kelder SH, Elder JP, Mitchell PD, Lytle LA, Johnson CC, Stone EJ. (2003) School climate and the institutionalization of the CATCH program. Health Educ Behav. 2003 Aug;30(4):489-502.

Jones SE, Costello S. (2008) The contribution of community parent advisors to improving health in school communities in a primary care trust in northern England. J Clin Nurs. 2008 Aug;17(16):2232-4. No abstract available.


McVey G, Gusella J, Tweed S, Ferrari M. (2009) A controlled evaluation of web-based training for teachers and public health practitioners on the prevention of eating disorders. Eat Disord. 2009 Jan-Feb;17(1):1-26.


Kubik MY, Lytle LA, Hannan PJ, Story M, Perry CL. (2002) Food-related beliefs, eating behavior, and classroom food practices of middle school teachers. J Sch Health. 2002 Oct;72(8):339-45.

Tanaka H, Ishikawa M, Adachi M. (2008) [Processes of sharing issues among participating groups in the form of a food and nutrition education network: the case of the "S Network"] Nippon Koshu Eisei Zasshi. 2008 Mar;55(3):147-55. Japanese.

Heinrichs N, Bertram H, Kuschel A, Hahlweg K. (2005) Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: barriers to research and program participation. Prev Sci. 2005 Dec;6(4):275-86

Sherwood-Puzzello CM, Miller M, Lohrmann D, Gregory P. (2007) Implementation of CDC's School Health Index in 3 midwest middle schools: motivation for change. J Sch Health. 2007 Aug;77(6):285-93.

Schmitz Bde A, Recine E, Cardoso GT, da Silva JR, Amorim NF, Bernardon R, Rodrigues Mde L. (2008) [Promotion of healthy eating habits by schools: a methodological proposal for training courses for educators and school cafeteria owners] Cad Saude Publica. 2008;24 Suppl 2:S312-22. Portuguese


Thibault I, Marquis M.(2006) [Nutrition education in schools] Can J Diet Pract Res. 2006 Winter;67(4):202-5. French.

Olson CM, Devine CM, Frongillo EA Jr.(1993) Dissemination and use of a school-based nutrition education program for secondary school students. J Sch Health. 1993 Oct;63(8):343-8.

Hausman AJ, Ruzek SB (1995) Implementation of comprehensive school health education in elementary schools: focus on teacher concerns. J Sch Health. 1995 Mar;65(3):81-6. Review.

Gingiss PL.(1992) Enhancing program implementation and maintenance through a multiphase approach to peer-based staff development. J Sch Health. 1992 May;62(5):161-6. Review.

Pérez-Rodrigo C, Aranceta J (2003) Nutrition education in schools: experiences and challenges. Eur J Clin Nutr. 2003 Sep;57 Suppl 1:S82-5. Review.

Gingiss PL.(1993) Peer coaching: building collegial support for using innovative health programs. J Sch Health. 1993 Feb;63(2):79-85. Review.

Han SS, Weiss B (2005) Sustainability of teacher implementation of school-based mental health programs.
J Abnorm Child Psychol. 2005 Dec;33(6):665-79. Review.

Dusenbury L, Brannigan R, Falco M, Hansen WB.(2003) A review of research on fidelity of implementation: implications for drug abuse prevention in school settings.Health Educ Res. 2003 Apr;18(2):237-56. Review.

Orwin RG.(2000) Assessing program fidelity in substance abuse health services research. Addiction. 2000 Nov;95 Suppl 3:S309-27. Review.

Cahill HW.(2007) Challenges in adopting evidence-based school drug education programmes. Drug Alcohol Rev. 2007 Nov;26(6):673-9. Review.

Elliott DS, Mihalic S.(2004) Issues in disseminating and replicating effective prevention programs. Prev Sci. 2004 Mar;5(1):47-53. Review.

Dane AV, Schneider BH (1998) Program integrity in primary and early secondary prevention: are implementation effects out of control? Clin Psychol Rev. 1998 Jan;18(1):23-45. Review.

Hawkins JD, Abbott R, Catalano RF, Gillmore MR. (1991) Assessing effectiveness of drug abuse prevention: implementation issues relevant to long-term effects and replication. NIDA Res Monogr. 1991;107:195-212. Review

Pérez-Rodrigo C, Aranceta J. (2003) Nutrition education in schools: experiences and challenges. Eur J Clin Nutr. 2003 Sep;57 Suppl 1:S82-5. Review

Han, S., & Weiss, B. (2005). Sustainability of teacher implementation of school-based mental health programs. Journal of Abnormal Child Psychology, 33(6), 665-679

Nove, T. (2002). Reorienting health services with capacity building: A case study of the core skills in health promotion project. Health Promotion International, Dec;17(4), 341-350.

Johnson, K., Hays, C., Daley, C., & Hayden Center. (2004). Building capacity and sustainable prevention innovations: A sustainability planning model. Evaluation and Program Planning, 27, 135-149

Swisher, J.D. (2000). Sustainability of prevention. Addictive Behaviors, 25, 965-973

Bond, L., Glover, S., Godfrey, C., Butler, H., & Patton, G.C. (2001). Building capacity for system-level change in schools: Lessons from the gatehouse project. Health Education and Behavior, 28(3), 368-383

Inchley, J., Muldoon, J., & Currie, C. (2007). Becoming a health promoting school: Evaluating the process of effective implementation in Scotland. Health Promotion International, 22(1), 65-71

Adams, J.D. (1988). Creating critical mass to support change, The OD Practitioner, 29(2)

Dressendorfer, R. H., Raine, K., Dyck, R. J., Plotnikoff, R. C., Collins-Nakai, R. L., McLaughlin, W. K. et al. (2005). A conceptual model of community capacity development for heart health promotion in the Alberta Heart Health Project. Health Promotion Practice, Jan;6(1), 31-36

Dusenbury, L., Brannigan, R., Hansen, W.B., Walsh, J., Falco, M. (2005). Quality of implementation: Developing measures crucial to understanding the diffusion of preventive interventions. Health Education Research, 20(3), 308-313.

Earl, L., Fullan, M. (2003). Using data in leadership for learning. Cambridge Journal of Education, Nov;33 (3), 384-394

Ebbesen, L.S., Health, S., Naylor, P.J., Anderson, D. (2004). Issues in measuring health promotion capacity in Canada: A multi-province perspective. Health Promotional International, 19(1), 85-94

Edge, K. (2005). Powerful public sector knowledge management: A school district example. Journal of Knowledge Management, 9(6), 42-52

Germann, K., Wilson, D. (2004). Organizational capacity for community development in regional health authorities: A conceptual model. Health Promotion International, Sep;19(3), 289-298

Hawe, P., Noort, M., King, L., Jordens, C. (1997). Multiplying health gains: The capital role of capacity building with health promotion programs. Health Policy, 39, 29-42.

Hord, S.M. (1997). Professional Learning Communities: Communities of Continuous Inquiry and Improvement. Austin, Texas: Southwest Educational Development Laboratory.

Ottoson, J.M., Streib, G., Thomas, J.C., Rivera, M., Stevenson, B. (2004). Evaluation of the National School Health Coordinator Leadership Institute. Journal of School Health, 74(5), 170-176.

Pluye, P., Potvin, L., Denis, J. L., Pelletier, J. (2004). Program sustainability: Focus on organizational routines. Health Promotion International, Dec;19(4), 489-500

Senge, P. (1990). The Fifth Discipline: The Art and Practice of the Learning Organization. Currency Doubleday.

Swerissen, H., Crisp, B.R. (2004). The sustainability of health promotion interventions for different levels of social organizations. Health Promotion International, 19(1), 123-130.

American Dietetic Association, 1991, "Position of the American Dietetic Association: nutrition education of health professionals", Journal of American Dietetic Association, May;91(5):611-3.

O'Toole TP, Anderson S, Miller C, Guthrie J. (2007) Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007 Oct;77(8):500-21.

Kubik MY, Lytle LA, Hannan PJ, Story M, Perry CL. (2002) Food-related beliefs, eating behavior, and classroom food practices of middle school teachers. J Sch Health. 2002 Oct;72(8):339-45.

Thibault I, Marquis M.(2006) [Nutrition education in schools] Can J Diet Pract Res. 2006 Winter;67(4):202-5. French.
Olson CM, Devine CM, Frongillo EA Jr.(1993) Dissemination and use of a school-based nutrition education program for secondary school students. J Sch Health. 1993 Oct;63(8):343-8.

Hausman AJ, Ruzek SB (1995) Implementation of comprehensive school health education in elementary schools: focus on teacher concerns. J Sch Health. 1995 Mar;65(3):81-6. Review.

Gingiss PL.(1992) Enhancing program implementation and maintenance through a multiphase approach to peer-based staff development. J Sch Health. 1992 May;62(5):161-6. Review.

Pérez-Rodrigo C, Aranceta J (2003) Nutrition education in schools: experiences and challenges. Eur J Clin Nutr. 2003 Sep;57 Suppl 1:S82-5. Review.

Gingiss PL.(1993) Peer coaching: building collegial support for using innovative health programs. J Sch Health. 1993 Feb;63(2):79-85. Review.

Han SS, Weiss B (2005) Sustainability of teacher implementation of school-based mental health programs.

Dusenbury L, Brannigan R, Falco M, Hansen WB.(2003) A review of research on fidelity of implementation: implications for drug abuse prevention in school settings.

Orwin RG.(2000) Assessing program fidelity in substance abuse health services research. Addiction. 2000 Nov;95 Suppl 3:S309-27. Review.

Cahill HW.(2007) Challenges in adopting evidence-based school drug education programmes. Drug Alcohol Rev. 2007 Nov;26(6):673-9. Review.

Elliott DS, Mihalic S.(2004) Issues in disseminating and replicating effective prevention programs. Prev Sci. 2004 Mar;5(1):47-53. Review.

Dane AV, Schneider BH (1998) Program integrity in primary and early secondary prevention: are implementation effects out of control? Clin Psychol Rev. 1998 Jan;18(1):23-45. Review.

Hawkins JD, Abbott R, Catalano RF, Gillmore MR. (1991) Assessing effectiveness of drug abuse prevention: implementation issues relevant to long-term effects and replication. NIDA Res Monogr. 1991;107:195-212. Review
J Abnorm Child Psychol. 2005 Dec;33(6):665-79. Review.

Health Educ Res. 2003 Apr;18(2):237-56. Review.


Steinert Y, Boillat M, Meterissian S, Liben S, McLeod PJ. (2008) Developing successful workshops: a workshop for educators. Med Teach. 2008;30(3):328-30

Wicklander MK. (2006) Implementing and evaluating the National Healthy School Program in England. J Sch Nurs. 2006 Oct;22(5):250-8. Review.
The Newfoundland survey on active healthy schools: an assessment tool covering physical activity and nutrition in schools. See: www.lsb.ca/PR/Healthy%20Schools%20Needs%20Assessment.pdf Manitoba recently conducted a 2006 survey of school nutrition policies.

British Columbia The School Food Sales and Policies Provincial Report [127KB] examines the status of food sales in BC schools;

The Department of Health and PEI Healthy Eating Alliance are currently finalizing success indicators for the policy development work including such indicators as: - % schools adhering to specific elements in regulations (e.g. providing 20 minutes for lunch); - % schools providing only foods from “Foods to Serve Most Often” or “Foods to Serve Sometimes” lists in policy regulations. - % students consuming healthy/less healthy choices at lunch. - Use of CCHS data to assess changes in BMI; - Qualitative assessment of policy acceptance and adherence.

The Canadian Community Health Survey (CCHS) Cycle 2.2 on Nutrition, a joint initiative between Statistics Canada and Health Canada, will provide population level nutrition data on Canadians of all ages.

The Canadian Institute of Health Research is funding an initiative to provide an enhanced opportunity for expert analysis of CCHS data, including one theme focused on the analysis of nutrient and food intake of Canadian children in relation to chronic disease.

E-4 Consideration of Systems Thinking, Characteristics and Change
This includes in-depth analysis of issues such as teacher work life and sociology of teachers, school improvement research, open, loosely-coupled, bureaucratic systems and more.

ResearchReports & Resources
US Centers for Disease Control and Prevention. School Health Index for Physical Activity, Healthy Eating, and a Tobacco-Free Lifestyle: A Self-Assessment and Planning Guide. Middle school/High school version. Atlanta, Georgia. 2002.

Cass Y, Price P, Rimes T. (2005) Finding the common ground: where health and educational agendas meet--the School Health Incentive Program (SHIP) grants scheme. Health Promot J Austr. 2005 Aug;16(2):134-7.

Schwartz M, Laughlin A (2008) Partnering with schools: a win-win experience. J Nurs Educ. 2008 Jun;47(6):279-82. Review.

Butler H, Bowes G, Drew S, Glover S, Godfrey C, Patton G, Trafford L, Bond L. (2008) Harnessing Complexity: Taking Advantage of Context and Relationships in Dissemination of School-Based Interventions. Health Promot Pract. 2008 Mar 19. [Epub ahead of print]


Gross S, Cohen HA, Kahan E. (2006) Survey of parents, nurses, and school principals on their perceptions of the controversial role of schools in health promotion. Pediatr Int. 2006 Feb;48(1):44-7.


Smith A, Coveney J, Carter P, Jolley G, Laris P. (2004) The Eat Well SA project: an evaluation-based case study in building capacity for promoting healthy eating. Health Promot Int. 2004 Sep;19(3):327-34.


Nollen NL, Befort CA, Snow P, Daley CM, Ellerbeck EF, Ahluwalia JS. (2007) The school food environment and adolescent obesity: qualitative insights from high school principals and food service personnel. Int J Behav Nutr Phys Act. 2007 May 18;4:18


Leurs MT, Bessems K, Schaalma HP, de Vries H. (2007) Focus points for school health promotion improvements in Dutch primary schools. Health Educ Res. 2007 Feb;22(1):58-69. Epub 2006 Jun 9.


Goh YY, Bogart LM, Sipple-Asher BK, Uyeda K, Hawes-Dawson J, Olarita-Dhungana J, Ryan GW, Schuster MA. (2009) Using community-based participatory research to identify potential interventions to overcome barriers to adolescents' healthy eating and physical activity. J Behav Med. 2009 Oct;32(5):491-502. Epub 2009 Jun 21


Simovska V. (2007) The changing meanings of participation in school-based health education and health promotion: the participants' voices. Health Educ Res. 2007 Dec;22(6):864-78. Epub 2007 Jun 25.


Bresson JL. (2007) [School-based nutrition programs and behaviour: what should we expect?] Arch Pediatr. 2007 Jun;14(6):721. Epub 2007 Apr 6. French. No abstract available.


Greenhalgh T, Kristjansson E, Robinson V. (2007) Realist review to understand the efficacy of school feeding programmes. BMJ. 2007 Oct 27;335(7625):858-61. Epub 2007 Oct 22. Review.


Wicklander MK. (2006) Implementing and evaluating the National Healthy School Program in England.
J Sch Nurs. 2006 Oct;22(5):250-8. Review. Tuohy, D., Coghlan, D. (1997). Development in schools: A systems approach based on organizational levels. Educational Management & Administration, 25(1), 65-77.

Weijck, J. (1982). Administering education in loosely-coupled school. Phi Delta Kappan, 63, 673-676.

Deschenes, M., Martin, C., Jomphe-Hill, A. (2003). Comprehensive approaches to school health promotion. How to achieve broader implementation. Health Promotion International, 18(4), 387-396.

Rowling, L., Jeffreys, V. (2006). Capturing complexity: Integrating health and education research to inform health-promoting schools policy and practice. Health Education Research, 21(5), 705-718.

Southwest Educational Development Laboratory. The Ecology of the School. Retrieved 8/17, 2006 from http://www.sedl.org/change/school/ecology.html

Hausman, A. J., Ruzek, S. B. (1995). Implementation of comprehensive school health education in elementary schools: Focus on teacher concerns. Journal of School Health, Mar;65(3), 81-86

Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10, 282-298.

Flannery, D.J., Torquati, J. (1993). An elementary school substance abuse prevention program: Teacher and administrator perspectives. Journal of Drug Education, 23(4), 387-397.

Schaafsma, H. (1997). A networking model of change for middle managers. Leadership & Organization Development Journal, 18(1), 41-49.

Berryhill, J.C., & Prinz, R.J. (2003). Environmental interventions to enhance student adjustment: Implications for prevention. Prevention Science, 4(2)

Payne, A.A., Gottfredson, D.C., & Gottfredson, G.D. (2006). School predictors of the intensity of implementation of school-based prevention programs: Results from a national study. Prevention Science, 7(2), 225-237

Alavi, S.B., McCormick, J. (2004). A cross-cultural analysis of the effectiveness of the Learning Organization model in school contexts. International Journal of Educational Management, 19(7), 408-416

Aldrich, H. E. (1971). Organizational boundaries and interorganizational conflict. Human Relations, Aug;24(4), 279-293

American Association of School Administrators. (1999). Systems thinking: Untangling the Gordian knots of systemic change. Strategies for School System Leaders on District Level Change, 6(1).

Anderson, D., Plotnifoff, R.C., Raine, K., Cook, K. Smith, C., Barrett, L. (2004). Towards the development of scales to measure ‘will’ to promote heart health within health organizations in Canada. Health Promotion International, 19(4), 471-81

Austin, S.B., Fung, T., Cohen-Bearak, A., Wardle, K., Cheung, L.W.Y. (2006). Facilitating change in school health: A qualitative study of schools’ experiences using the School Health Index. Preventing Chronic Disease. Public Health Research, Practice and Policy. 3(2), 1-8.

Bellinger, G. (2004). Bureaucracy & Organizational Politics. Retrieved 6/25, 2006 from http://www.systems-thinking.org/bop/bop.htm

Boyd, W.L., Crowson R.L. (2002). The quest for a new hierarchy in education: From loose coupling back to tight?Journal of Educational Administration, 40(6), 521-533

Champagne, R., Leduc, N., Denis, J.L., Pineault, R. (1993). Organizational and environmental determinants of the performance of public health units. Soc Sci Med, 37(1), 85-95.

Church, A. H. (1994). The character of organizational communication: A review and new conceptualization. The International Journal of Organizational Analysis, Jan;2(1), 18-53.

Couglan, R. J. (1970). Social structure in relatively closed and open schools. Educational Administration Quarterly, May;6(2), 14-35.

Davies, P., Coates, G. (2005). Competing conceptions and values in school strategy: Rational planning and beyond. Educational Management Administration & Leadership, 33(1), 109-124

Fusarelli, L.D. (2002). Tightly-coupled policy in loosely coupled system: Institutional capacity and organizational change. Journal of Educational Administration,40(6), 561-575.

Goldman, K. D. (1994). Perceptions of innovations as predictors of implementation levels: The diffusion of a nationwide health education campaign. Health Education Quarterly, Winter;21(4), 433-445.

Goodman, R.M., McLeroy, K.R., Steckler, A.B., Hoyle, R.H. (1993). Development of level institutional scales for health promotion programs. Health Education Quarterly, 29(2), 161.178

Goodman, R.M., Steckler, A.B., Kegler, M.C. (1996). Mobilizing organizations for health enhancement: Theories of organizational change. In K. Glanz, M.F. Lewis & B.K, Rimers (eds.), Health Behavior and Health Education: Theory, Research and Practice (pp. 287-314). San Francisco: Jossey-Bass

Jones, R. A., Jimmieson, N. L., Griffiths, A. (2005). The impact of organizational culture and reshaping capabilities on change implementation success: The mediating role of readiness for change. Journal of Management Studies, Mar;42(2), 361-386.

Leischow, S.J., Milstein, B. (2006). Systems thinking and modeling for public health practice. American Journal of Public Health, 96(3), 403-405.

Lortie, D.C. (2002). School Teacher: A Sociological Study. Chicago, IL: University of Chicago Press.

Zeichner, K., Gore J. (1990). Teacher socialization in W.R. Houston (ed.) Handbook of Research on Teacher Education, New York, NY: Macmillan.

Melia, K.M. (1998). Learning and working: The occupational socialization of nurses. In Mackay, L., Soothill, K., Media, K. (eds.). Classic Texts in Health Care. Elsevier Health Sciences.

Robinson S.E. (2004). Punctuated equilibrium, bureaucratization, and budgetary changes in schools. Policy Studies Journal, 32(1), 25.

Schraeder, M., Tears, R.S., Jordan, M.H. (2005). Organizational culture in public sector organizations: Promoting change through training and leading by example. Leadership and Organization Development Journal, 26(6), 492-502.

Markova, D., Holland B.M., (2005). Appreciative inquiry: A strategy for change in systemic leadership that builds on organizational strengths, not deficits. School Administrator, 62(2), 30.





F Consideration of Local Context
We also looked to adaptations to local community contexts or higher risk populations.

ResearchReports & Resources
Shea S, Basch CE, Wechsler H, Lantigua R, 1996, "The Washington Heights-Inwood Healthy Heart Program: a 6-year report from a disadvantaged urban setting", American Journal of Public Health, Feb;86(2):166-71.

Hyndman B, (2000) Feeding the Mind, Ottawa: Breakfast for Learning, February 2000

Gore CJ, Owen N, Pederson D, Clarke A. (1996) Educational and environmental interventions for cardiovascular health promotion in socially disadvantaged primary schools. Aust N Z J Public Health. 1996 Apr;20(2):188-94.

Paradis G, O'Loughlin J, Elliott M, Masson P, Renaud L, Sacks-Silver G, Lampron G. (1995) Coeur en santé St-Henri--a heart health promotion programme in a low income, low education neighbourhood in Montreal, Canada: theoretical model and early field experience. J Epidemiol Community Health. 1995 Oct;49(5):503-12.

Bauer KW, Patel A, Prokop LA, Austin SB.(2006) Swimming upstream: faculty and staff members from urban middle schools in low-income communities describe their experience implementing nutrition and physical activity initiatives. Prev Chronic Dis. 2006 Apr;3(2):A37. Epub 2006 Mar 15.

Macaulay AC, Paradis G, Potvin L, Cross EJ, Saad-Haddad C, McComber A, Desrosiers S, Kirby R, Montour LT, Lamping DL, Leduc N, Rivard M. (1997) The Kahnawake Schools Diabetes Prevention Project: intervention, evaluation, and baseline results of a diabetes primary prevention program with a native community in Canada. Prev Med. 1997 Nov-Dec;26(6):779-90.

Tsey K, Whiteside M, Daly S, Deemal A, Gibson T, Cadet-James Y, Wilson A, Santhanam R, Haswell-Elkins MR. (2005) Adapting the 'family wellbeing' empowerment program to the needs of remote indigenous school children. Aust N Z J Public Health. 2005 Apr;29(2):112-6

Davis SM, Clay T, Smyth M, Gittelsohn J, Arviso V, Flint-Wagner H, Rock BH, Brice RA, Metcalfe L, Stewart D, Vu M, Stone EJ. (2003) Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren. Prev Med. 2003 Dec;37(6 Pt 2):S24-34.

Martens MK, Van Assema P, Paulussen TG, Van Breukelen G, Brug J. (2008) Krachtvoer: effect evaluation of a Dutch healthful diet promotion curriculum for lower vocational schools. Public Health Nutr. 2008 Mar;11(3):271-8. Epub 2007 Jul 3

Little JC, Perry DR, Volpe SL. (2002) Effect of nutrition supplement education on nutrition supplement knowledge among high school students from a low-income community. J Community Health. 2002 Dec;27(6):433-50

O'Brien M. (2008) School meals for better nutrition and bone health. J Fam Health Care. 2008;18(3):103-5

Marquis S, Thomson C, Murray A. (2001) Assisting people with a low income to start and maintain their own community kitchens. Can J Diet Pract Res. 2001 Fall;62(3):130-2.

Stroink ML, Nelson CH. (2009) Aboriginal health learning in the forest and cultivated gardens: building a nutritious and sustainable food system. J Agromedicine. 2009;14(2):263-9.

Engler-Stringer R, Berenbaum S. (2006) Food and nutrition-related learning in collective kitchens in three Canadian cities. Can J Diet Pract Res. 2006 Winter;67(4):178-83

Engler-Stringer R, Berenbaum S. (2007) Exploring food security with collective kitchens participants in three Canadian cities. Qual Health Res. 2007 Jan;17(1):75-84

Greenhalgh T, Kristjansson E, Robinson V. (2007) Realist review to understand the efficacy of school feeding programmes. BMJ. 2007 Oct 27;335(7625):858-61. Epub 2007 Oct 22. Review.

Gittelsohn J, Merkle S, Story M, Stone EJ, Steckler A, Noel J, Davis S, Martin CJ, Ethelbah B. (2003) School climate and implementation of the Pathways study. Prev Med. 2003 Dec;37(6 Pt 2):S97-106.

Greenhalgh T, Kristjansson E, Robinson V.Realist review to understand the efficacy of school feeding programmes.BMJ2007;335:858

Dwyer JT, Hewes LV, Mitchell PD, Nicklas TA, Montgomery DH, Lytle LA, Snyder MP, Zive MM, Bachman KJ, Rice R, Parcel GS. (1996) Improving school breakfasts: effects of the CATCH Eat Smart Program on the nutrient content of school breakfasts. Prev Med. 1996 Jul-Aug;25(4):413-22.

Temple NJ, Steyn NP, Myburgh NG, Nel JH. (2006) Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa. Nutrition. 2006 Mar;22(3):252-8.

Townsend MS, Johns M, Shilts MK, Farfan-Ramirez L. (2006) Evaluation of a USDA nutrition education program for low-income youth. J Nutr Educ Behav. 2006 Jan-Feb;38(1):30-41

Crone MR, Reijneveld SA, Willemsen MC, van Leerdam FJ, Spruijt RD, Sing RA. (2003) Prevention of smoking in adolescents with lower education: a school based intervention study. J Epidemiol Community Health. 2003 Sep;57(9):675-80
BREAKFAST FOR LEARNING Policy Paper on Child Nutrition
Presents rational for school meal programs. (Breakfast for Learning)

What is the relationship between child nutrition and school outcomes? Summarizes research on effects of school breakfast programs. (Breakfast for Learning)

The Nunavut Food Guide which is culturally appropriate and acknowledges the reality of the Inuit diet which combines Inuit foods, such as bone marrow for calcium, fat for vitamin A, and food available at the market. The food guide was developed collaboratively with the Government of Nunavut and various Inuit and community groups

Programs and Resources from PHAC Best Practices Portal
Child nourishment programs run to varying degrees in all P/T jurisdictions, more often in partnership and with the financial support of Breakfast For Learning. The following provides highlights:
  • Nutritional Grants in British Columbia are available for breakfast and snack programs. DASH, in partnership with Breakfast for Learning, administers these grants.
  • The BC School Fruit and Vegetable Snack Pilot Program was launched in September 2005. The goal of the program is to provide twice-weekly BC fruit or vegetable snacks to elementary school students, as well as information to teachers, students and their families to increase awareness and consumption of BC fruits and vegetables. Currently, ten schools receive free fruit and vegetables. An evaluation team is conducting a full evaluation of the pilot.
  • Yukon Food for Learning in partnership with Breakfast for Learning and the YK Department of Health and Social Services provides child nourishment programs in all Yukon schools.
  • Breakfast for Learning program in Alberta currently funds 243 schools for breakfast, lunch and/or snack programs which help feed over 10 000 Alberta children healthy meals and snacks daily.
  • The NWT Food First Foundation (FFF) is the territorial coalition that works closely with, and funds a part time coordinator through Breakfast for Learning. This group is currently working on the development of a website, and uses an allocation of funding from Breakfast for Learning to fund schools in the NWT and Nunavut. The NWT FFF consists of representatives such as nutritionists, Parent Advisory Councils, the Salvation Army and the Women’s Centre. Most of the members are located in Yellowknife at this time. This group is also interested in supporting schools in the development of school food policies. The NWT FFF currently funds schools for breakfast, lunch and/or snack programs, fundraises, and conducts advocacy work with Members of the Legislative Assembly to raise awareness of the nutritional needs of children.
  • In Manitoba child nourishment related activities include: Breakfast for Learning encourages and funds breakfast clubs (MB has a part- time provincial coordinator). Kids in the Kitchen programs run in some local schools (http://www.youville.ca/english/links.html); workshops are offered in the early stages of the programs and manuals available for participants. There is no official host for the program now and information can be accessed on line. Schools throughout Manitoba organize School Milk Programs. The school organizes milk delivery with a local dairy driver and a teacher or often parent volunteer co-ordinate activities in the school. Dairy Farmers provides a School Milk kit with activity ideas and incentives that make milk drinking fun. Approximately 75% of schools in MB offer their students milk programs.
  • The Ontario Ministry of Children and Youth Services (MCYS) funds the Student Nutrition Programs. In October 2005, the MCYS announced that the investment in student nutrition programs would increase from $4.5 million to an investment of $8.5 million annually. It has also moved to a decentralized program model. In 2005 a Nutrition Guidelines Working Group developed nutritional guidelines for the student nourishment program to assist program providers in planning and delivering healthy snacks and meals.
  • 5-10 a day – It’s the Healthy Way looks at promoting consumption of vegetables and fruit within communities and includes a healthy food grant program in middle schools in New Brunswick. In addition, the New Brunswick Healthy Minds School Nutritional Partnership Program provides funding to elementary schools to use for a variety of child nourishment related initiatives. A related report of interest on the Healthy Minds Program: a review of the pilot program Oct 1999 - March 2000. The Department of Agriculture, Fisheries and Aquaculture, New Brunswick Farm Products commission runs a subsidized milk program that is available to all NB schools.
  • In Nova Scotia there is new breakfast program funding that will ensure that all children at the elementary level will have access to breakfast before they start their school day. Nova Scotia Health Promotion and the Department of Education are working together with other partners including the Breakfast for Learning Advisory Council to determine the most effective way to offer this program. New funding is intended to assist, not replace, existing support.
  • Kids Eat Smart Foundation Newfoundland and Labrador is a non profit charitable organization established to foster the development of sustainable nutritious food programs for school children throughout the province. The government provides financial support to school feeding programs so too does Breakfast for Learning. Newfoundland and Labrador School Milk Foundation offers a school milk program
  • Club des petit dejeuners du Quebec’s (en anglais: Quebec Breakfast Clubs) runs breakfast programs in elementary schools in Quebec.



G. Consideration of Educational Mandate and Constraints of Schools

ResearchReports/Resources





H. Consideration of Future Research and Data Needs

H-1 Major knowledge/practice/policy questions and draft or existing research agendas

ResearchReports/Resources



H-2 Use of new research methods (beyond RCT’s)

ResearchReports/Resources



H-3 Methodological Issues and Questions

ResearchReports/Resources
Marshall TA, Eichenberger Gilmore JM, Broffitt B, Levy SM, Stumbo PJ. (2003) Relative validation of a beverage frequency questionnaire in children ages 6 months through 5 years using 3-day food and beverage diaries. J Am Diet Assoc. 2003 Jun;103(6):714-20; discussion 720.

Nicklas TA, O'Neil CE. (2000) Process of conducting a 5-a-day intervention with high school students: Gimme 5 (Louisiana).
Health Educ Behav. 2000 Apr;27(2):201-12


Lytle LA, Gerlach S, Weinstein AB. (2001) Conducting nutrition education research in junior high schools: approaches and challenges. J Nutr Educ. 2001 Jan-Feb;33(1):49-54

Winkler G, Noller B, Waibel S, Wiest M. (2005) BeKi--an initiative for nutrition education in childrenin the federal state of Baden-Württemberg: description, experiences, and considerations for an evaluation framework. Soz Praventivmed. 2005;50(3):151-60.


Fano TJ, Tyminski SM, Flynn MA. (2004) Evaluation of a collective kitchens program: using the Population Health Promotion Model. Can J Diet Pract Res. 2004 Summer;65(2):72-80.


Moore GF, Tapper K, Moore L, Murphy S. Cognitive, behavioral, and social factors are associated with bias in dietary questionnaire self-reports by schoolchildren aged 9 to 11 years. J Am Diet Assoc. 2008 Nov;108(11):1865-73.
Mellor JM,

Rapoport RB, Maliniak D. (2008) The impact of child obesity on active parental consent in school-based survey research on healthy eating and physical activity. Eval Rev. 2008 Jun;32(3):298-312. Epub 2008 Jan 25.


Blom-Hoffman J, Leff SS, Franko DL, Weinstein E, Beakley K, Power TJ. (2009) Consent Procedures and Participation Rates in School-Based Intervention and Prevention Research: Using a Multi-Component, Partnership-Based Approach to Recruit Participants. School Ment Health. 2009 Mar 1;1(1):3-15.


Penkilo M, George GC, Hoelscher DM. (2008) Reproducibility of the School-Based Nutrition Monitoring Questionnaire among fourth-grade students in Texas. J Nutr Educ Behav. 2008 Jan-Feb;40(1):20-7.

Harmon AH, Maretzki AN. (2006) Assessing food system attitudes among youth: development and evaluation of attitude measures. J Nutr Educ Behav. 2006 Mar-Apr;38(2):91-5.

Jansen W, Raat H, Zwanenburg EJ, Reuvers I, van Walsem R, Brug J. (2008) A school-based intervention to reduce overweight and inactivity in children aged 6-12 years: study design of a randomized controlled trial. BMC Public Health. 2008 Jul 25;8:257.











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