TY - JOUR AU - Fudla, Hadiyati AU - Pratiwi, Azizah Ajeng AU - Tarmizi, Nurul Azma Ahmad AU - Meiyetriani, Eflita AU - Pramesthi, Indriya Laras AU - Ananda, Aziz Jati Nur AU - Anggraini, Roselynne AU - Iswarawanti, Dwi Nastiti AU - Ermayani, Evi PY - 2022/01/03 Y2 - 2024/03/28 TI - A Mixed-Methods Exploration of Implementation of a Healthy School Canteen Program after a Year Intervention JF - Open Access Macedonian Journal of Medical Sciences JA - Open Access Maced J Med Sci VL - 10 IS - T8 SE - Public Health Education and Training DO - 10.3889/oamjms.2022.9483 UR - https://oamjms.eu/index.php/mjms/article/view/9483 SP - 58-68 AB - <p><strong><span data-contrast="none">Background:</span></strong><span data-contrast="none"> Previous studies have shown that adolescents </span><span data-contrast="auto">prefer</span><span data-contrast="none"> less healthy food and their eating </span><span data-contrast="auto">habits</span><span data-contrast="none"> will affect their nutritional status in adulthood and old age. School canteen is a part of food retailing and provisioning that influence the diet quality of the adolescents. Healthy school canteen intervention is recommended as one of the public health strategies in supporting the development of healthy diet behavior.</span><span data-ccp-props="{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}">&nbsp;</span></p><p><strong><span data-contrast="none">Objectives:</span></strong><span data-contrast="none"> To evaluate the effects </span><span data-contrast="auto">of a healthy</span><span data-contrast="none"> school canteen intervention program among middle school children.</span><span data-ccp-props="{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}">&nbsp;</span></p><p><strong><span data-contrast="none">Methods:</span></strong><span data-contrast="none"> A mixed-methods research design including focus group interviews for teachers and principal, observation on school canteen, a survey for food handlers and food testing for hazardous chemicals. Thematic analysis of focus group data and descriptive analyses of survey data were conducted. Four schools were selected as intervention </span><span data-contrast="auto">groups</span><span data-contrast="none"> and four schools as positive control </span><span data-contrast="auto">groups</span><span data-contrast="none">. Data collection phase took place between April 22 and May 2, 2019.</span><span data-ccp-props="{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}">&nbsp;</span></p><p><strong><span data-contrast="none">Results: </span></strong><span data-contrast="none">Only one school out of eight schools that had written commitment </span><span data-contrast="auto">and a food</span><span data-contrast="none"> safety team. In intervention school 50% of food handlers use personal protective equipment and 25% of food handlers received training. </span><span data-contrast="auto">In the positive</span><span data-contrast="none"> control group, none of the food handlers used personal protective equipment and they had not received any training. Food handlers in the positive control group have a higher rate of correct answers. Only 2 out of 4 schools in the intervention group had nutritious foods available in the canteen and 3 out of 4 schools in the positive control group. None of the school canteens were found positive for </span><span data-contrast="auto">metanil</span><span data-contrast="none"> yellow. Higher positive findings for Rhodamin B, Formaldehyde and Borax (33.3%, 60.0%, 33.3%, respectively) in the control group compared to the control group (28.6%, 27.3%, and 28.6%, respectively).</span><span data-ccp-props="{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559739&quot;:160,&quot;335559740&quot;:240}">&nbsp;</span></p><p><strong><span data-contrast="none">Conclusions: </span></strong><span data-contrast="none">Intervention </span><span data-contrast="auto">groups</span><span data-contrast="none"> have been slightly more successful in creating healthy school </span><span data-contrast="auto">canteens</span><span data-contrast="none">, as they had a slightly better total score in the observation sheet compared to the schools from the positive control group. Collaboration with another stakeholder such as Primary Health Center (PHC) can be </span><span data-contrast="auto">thought of as a</span><span data-contrast="none"> solution to train food </span><span data-contrast="auto">handlers</span><span data-contrast="none"> about healthy practice while handling the food.</span></p> ER -