school canteen research paper

• Research article
• Open access
• Published: 16 October 2018

Consumption habits of school canteen and non-canteen users among Norwegian young adolescents: a mixed method analysis

• Arthur Chortatos   ORCID: orcid.org/0000-0002-1052-329X 1 ,
• Laura Terragni 1 ,
• Sigrun Henjum 1 ,
• Marianne Gjertsen 1 ,
• Liv Elin Torheim 1 &
• Mekdes K Gebremariam 2 , 3  

BMC Pediatrics volume  18 , Article number:  328 ( 2018 ) Cite this article

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Food/drinks available to adolescents in schools can influence their dietary behaviours, which once established in adolescence, tend to remain over time. Food outlets’ influence near schools, known to provide access to unhealthy food/drinks, may also have lasting effects on consumption behaviours. This study aimed to gain a better understanding of the consumption habits of adolescents in the school arena by comparing different personal characteristics and purchasing behaviours of infrequent and regular school canteen users to those never or seldom using the canteen.

A convergent mixed methods design collected qualitative and quantitative data in parallel. A cross-sectional quantitative study including 742 adolescents was conducted, with data collected at schools via an online questionnaire. Focus group interviews with students and interviews with school administrators formed the qualitative data content. Quantitative data were analysed using descriptive statistics and logistic regression; thematic content analysis was used to analyse qualitative data.

Sixty-seven percent of adolescents reported never/rarely using the school canteen (NEV), whereas 13% used it ≥2 times per week (OFT). When the two groups were compared, we found a significantly higher proportion of the NEV group were female, having parents with a high education, and with a high self-efficacy, whilst a significantly higher proportion of the OFT group consumed salty snacks, baked sweets, and soft-drinks ≥3 times per week, and breakfast at home < 5 days in the school week. The OFT group had significantly higher odds of purchasing food/drink from shops near school during school breaks and before/after school compared to the NEV group (adjusted odds ratio (aOR) = 1.80, 95% CI 1.07–3.01, and aOR = 3.61, 95% CI 2.17–6.01, respectively). The interviews revealed most students ate a home packed lunch, with the remainder purchasing either at the school canteen or at local shops.

Conclusions

Students using the canteen often are frequently purchasing snacks and sugar-soft drinks from shops near school, most likely owing to availability of pocket money and an emerging independence. School authorities must focus upon satisfying canteen users by providing desirable, healthy, and affordable items in order to compete with the appeal of local shops.

Peer Review reports

The school environment is an arena where many dietary norms and habits are established which potentially affect the individual throughout their future lives [ 1 ]. Owing to the considerable amount of time adolescents spend at school during the average weekday, it has been estimated that approximately one third of their food and drink is consumed in the school environment [ 2 , 3 ].

Environments which encourage a high energy intake and sedentary behaviour amongst adolescents are termed obesogenic environments, and such environments are considered to be one of the main elements behind the rapid increase in overweight and obesity among children and adolescents [ 4 ].

In this regard, the local food environment of schools, including arenas such as supermarkets and convenience stores close to the schools, is an environmental influence potentially affecting the quality of the food intake of attending adolescents [ 5 ]. Providing healthy food and drinks to adolescents in schools via canteens or vending machines plays an important role in modelling a healthy diet, particularly for those who may not have access to healthy food outside school hours, thereby making school nutrition policies a powerful tool for improving students’ nutritional status and academic achievement [ 6 ]. Yet in the school environment, foods consumed are not always obtained from on-campus sources. Research upon supermarkets and convenience stores located in the vicinity of schools has reported that these venues provide an increased accessibility to unhealthy foods and drink for school-going adolescents [ 7 ].

The Øvre Romerike region, located in the eastern part of Norway, has a total area of 2,055,550 km 2 , and composed of 6 municipalities housing approximately 100,000 people [ 8 ]. The 2016 average net income for all households in the region was 456,667 NOK, compared to the national average of 498,000 NOK for the same period [ 9 ]. In our recent investigation upon adolescents in Øvre Romerike, we reported that 33% of participants purchased food or drink in their school canteen at least once a week [ 10 ]. In addition, 27% and 34% of participants reported purchasing food and drinks from shops around schools one or more times a week, either during school breaks or on their way to or from school, respectively [ 10 ].

Investigations on adolescent behaviour in Norway and elsewhere have reported similar results, whereby approximately 30% of school-going adolescents visit local food stores for nourishment, whilst the majority are consuming their lunches at school [ 11 , 12 ].

In Norway, the average school day includes a lunch period in the middle of the day [ 13 ], and most students travel to school with a home packed lunch, usually consisting of bread slices with various toppings [ 14 , 15 ]. School canteens are often run by catering staff, with students in need of more practical education sometimes included in food preparation and selling. It is not uncommon for the canteen to be managed on a daily or occasional basis by students together with a teacher as a part of their education. School canteens most commonly offer baguettes, waffles, milk (regular or chocolate), juice, cakes and, perhaps, fruit [ 16 , 17 ]. The Norwegian Directorate of Health regularly publishes guidelines concerning school meals and eating environments, with the most recent published in 2015 [ 18 ]. The latest guidelines offer suggestions regarding topics such as length of meal times, hygiene, fresh water accessibility, the absence of sugar-rich foods and drinks, and the reduction of saturated fats on offer. The guidelines are published as a tool to assist school administration in their management of school canteens.

Eating behaviour amongst adolescents is a complex theme often involving an interplay of multiple influences and factors such as peer influence [ 19 ] and a desire to socialise whilst eating [ 20 ], a combination which often leans toward unhealthy eating practices. Furthermore, it is not uncommon for young Norwegian teens to receive pocket money [ 21 ], and this emerging autonomy aided by pocket money increases the prospect for a disruption of dietary behaviour established in the home [ 22 ].

As the school food environment has such a significant impact on food choices [ 23 , 24 ], a better understanding of adolescent’s consumption behaviour demands further attention. In particular, understanding student’s shift away from home packed lunches and canteen foods towards the appeal of off-campus shop food is necessary for implementing the successful promotion of healthier lunch alternatives at school.

The aim of the present study was to gain a better understanding of the consumption habits of adolescents in the Norwegian school lunch arena. Unlike previous ESSENS studies, here we use quantitative data combined with qualitative interviews among adolescents and school administration, in order to explore the purchasing behaviour and lifestyle demographics of the sample grouped as frequent and infrequent school canteen users compared to those never or rarely using the canteen.

Design and sample

The participants in this study were students and staff from eleven secondary schools participating in the Environmental determinantS of dietary behaviorS among adolescENtS (ESSENS) cross-sectional study [ 10 , 25 ]. Recruitment of students and staff was initiated by our making contact with principals of the twelve secondary schools in the Øvre Romerike district, after first having received permission from district school leaders. The school principals were each sent a letter detailing key elements of the proposed intervention, as well as information regarding the ESSENS study, together with a permission form requesting their school’s participation. Of the twelve secondary schools invited to participate in the study, eleven accepted the invitation.

In this mixed method approach, our sample were grouped as being part of either a quantitative or qualitative data source.

Recruitment of sample

Quantitative recruitment.

In October 2015 we recruited 8th grade adolescents for participation in a questionnaire survey. An informative letter was sent home with all 1163 adolescents in the 8th grade (average age of 12–13 years) from the 11 participating schools, containing a consent form for signing and with additional questions relating to parental education levels. A total of 781 (67%) received parental consent for participation. As the range of ages of the sample represents the lower end of the adolescent scale (10–19 years), the use of the term ‘adolescent’ here implies ‘young adolescent’. A total of 742 adolescents (64% of those invited and 95% of those with parental consent) participated in the survey. Quantitative data collection took place between October and December 2015.

Qualitative recruitment

Recruitment of adolescents to participate in the qualitative part of the study was also facilitated by approaching principals of district schools as described above, and was completed between October 2015 and January 2016. Six of the 11 participating schools were selected for qualitative data collection based upon criteria such as location (being in one of the six municipalities of Øvre Romerike), and size (based upon number of students attending). The aim was to include schools with a varied profile, with proximity to city centers, shops, and collective transport as determining factors. Thereafter a selection process for participation in the focus groups was conducted, whereby two students per class were sought after, representing both sexes. Further inclusion criteria stipulated that the students be in the 9th grade, had attended Food and Health classes, and currently lived in the Øvre Romerike area with either one or both parents.

Data collection

Quantitative data.

A web-based questionnaire was used to collect data from the adolescents, using the LimeSurvey data collection tool. The questionnaires were answered at school, taking approximately 30–45 min to complete, and queried respondents about their nutritional intake, parental rules regarding food and drink consumption, students’ school canteen and surrounding shop use, physical activity, and sedentary behaviour habits. Research group members were present during data collection to answer questions and make sure the adolescents responded independently from each other. The questionnaire relating to food behaviours completed by the sample is available online (see Additional file 1 : Appendix 1 ESSENS questionnaire relating to food behaviours).

A pilot test of the survey was conducted parallel with this process in a neighboring municipality with similar age students from the 8th grade ( n  = 23). The students spent approximately 30–40 min to complete the survey, and then provided feedback regarding comprehension. The questionnaire was subsequently shortened and some questions rephrased for clarity. The results of the pilot test were not included in the final results.

Qualitative data

Focus group interviews were conducted over a period of 10 weeks, from November 2015 to January 2016. Focus group settings were favoured as they provide a more relaxed setting for data collection, facilitating the flow of a natural conversation amongst peers, especially when adult researchers interact with young subjects [ 26 ].

Six focus group interviews including a total of 55 students (29 girls, 26 boys) from the 9th grade with an average age of 13–14 years were conducted. Interviews had a duration of approximately 60 min. In addition, interview sessions with headmasters and teachers for the 9th grade students from the participating schools were also conducted. Interviews with 6 teachers (4 women and 2 men) and 6 headmasters (3 women and 3 men) were conducted from October 2015 to January 2016. The interviews with principals and teachers were each conducted separately.

Qualitative data collection took place at the selected schools using an audio recorder, with a semi-structured interview guide used for the interviews, partially inspired by a previous study conducted amongst 11–13 year old Norwegian adolescents [ 27 ]. The main themes explored by the focus group sessions were students’ eating habits, their definition of healthy and unhealthy food, attitudes towards and their impact upon diet and physical activity, as well as the student’s assessment of opportunities and barriers attached to health-promoting behaviour. School administration interviews probed food availability and meals served at the school, as well as physical activity options available for students at the schools. The interview guides used for the focus groups and the school administration are available online (see Additional file 2 : Appendix 2 Interview guide for focus group interviews, and Additional file 3 : Appendix 3 Interview guide for headmasters and teachers).

Interviews were transcribed verbatim, with names of the participants and of the schools anonymised. Interviews were analysed using a thematic analysis approach [ 28 ]. Codes were developed after an initial reading of all the transcripts and were based on the main interview questions, prior research, and emergent concepts from the current data. The initial codes were discussed among researchers and a codebook was developed. The codes were further refined during coding of subsequent transcripts. Codes were then successively grouped into general themes. The data analysis was supported by the use of NVivo software (version 10.0; QSR International, Cambridge, Mass).

Pilot testing of the intended focus group question guide was performed in October 2015 in a school belonging to a neighbouring district. After written consent was obtained from the principal of the school, 6 students from the 9th grade were selected by a 9th grade teacher from the school. Three girls and 3 boys were included in the focus group pilot test. A moderator conducted the focus group following an interview guide in order to test comprehension and flow of the planned themes. The pilot test proved effective and consequently no changes were made to the interview guide. Data from the pilot testing was not included in the results of the study.

Recruitment of school staff for participation in in-depth interviews was also facilitated by the agreement with administrative school leaders as described above. A written invitation was sent to principals and teachers of the 9th grade classes from the same 6 schools participating in focus group interviews. Those agreeing were later contacted by phone to arrange a place and time for the interview.

Pilot testing of school staff interviews was performed in October 2015 in a school belonging to a neighbouring district. Two interviews were conducted with one headmaster and one teacher separately in order to assess the comprehension and flow of the various themes probed, as well as the time used for the interview. Data from the pilot testing was not included in the results of the study.

The following measures obtained from the questionnaire were used in the quantitative analyses of the present study.

Sociodemographic measures

Two questions assessing parental education (guardian 1 and guardian 2) were included on the parental informed consent form for the adolescent. Parental education was categorised as low (12 years or less of education, which corresponded to secondary education or lower) or high (13 years or more of education, which corresponded to university or college attendance). The parent with longest education, or else the one available, was used in analysis. Participants were divided into either ethnic Norwegian or ethnic minority, with minorities defined as those having both parents born in a country other than Norway [ 29 ].

• Dietary behaviours

Frequency of carbonated sugar-sweetened soft-drink intake (hereafter referred to as soft-drinks) during weekdays was assessed using a frequency question with categories ranging from never/seldom to every weekday. Weekday frequency was categorised as less than three times per week and three or more times per week.

The questions assessing the intake of soft-drinks have been validated among 9- and 13-year-old Norwegians using a 4-day pre-coded food diary as the reference method, and moderate Spearman’s correlation coefficients were obtained [ 30 ].

Consumption of fruits and vegetables (raw and cooked) were assessed using frequency questions with eight response categories ranging from never/seldom to three times per day or more. These were further categorised as less than five times per week and five or more times per week. The questions assessing intake of fruits and vegetables have been validated among 11-year-olds with a 7-day food record as the reference method and were found to have a satisfactory ability to rank subjects according to their intake of fruits and vegetables [ 31 ].

The consumption of snacks [sweet snacks (chocolate/sweets), salty snacks (e.g. potato chips), and baked sweets (sweet biscuits/muffins and similar)] was assessed using three questions with seven response categories ranging from never/seldom to two times per day or more. These were further categorised as less than three times per week and three or more times per week. Acceptable to moderate test-retest reliability have been obtained for these measures of dietary behaviours in a previous Norwegian study conducted among 11-year-olds [ 27 ].

Self-efficacy related to the consumption of healthy foods was assessed using a scale with six items [e.g. Whenever I have a choice of the food I eat. .., I find it difficult to choose low-fat foods (e.g. fruit or skimmed milk rather than ‘full cream milk’)]. Responses were further categorised as those with ‘high’ self-efficacy (score of 3.5 or higher, from a scale of 1–5) or ‘low’ self-efficacy (under 3.5, from a scale of 1–5). The scale has been found to have adequate reliability and factorial validity among 13-year-olds [ 32 ].

Adolescents’ breakfast consumption was assessed using one question asking the adolescents on how many schooldays per week they normally ate breakfast. The answers were categorised as those eating breakfast 5 times per week or less than 5 times per week. This question has shown evidence of moderate test-retest reliability (percentage agreement of 83 and 81% respectively for weekday and weekend measures) and moderate construct validity (percentage agreement of 80 and 87% respectively for weekday and weekend measures) among 10–12 year old European children [ 27 ].

Food/drink purchases in school environment

The adolescents were asked how often they purchased foods or drinks from school canteens and on their way to and from school (answer categories ranging from ‘never’ to ‘every day’). The frequency of purchase of food/drinks at the school canteen were then re-categorised into ‘never/rarely’, ‘once per week’, or ‘two or more times per week’. The frequency of purchase of food/drinks at off-campus food stores were re-categorised into ‘never/rarely’, or ‘one or more times per week’. They were also asked about the presence of food sales outlets (e.g. supermarket, kiosk, or gas station) in a walking distance from their school (with answer categories ‘none’, ‘yes, one’, ‘yes, two’, and ‘yes, more than two’), with results categorised as ‘less than 3’ or ‘3 or more’.

Further details regarding data collection and methodology in the ESSENS study have been described previously [ 10 ]. Ethical clearance for the study was obtained from the Norwegian Social Science Data Service (NSD 2015/44365). Written informed consent was obtained from all parents of participating students.

Statistical analyses

The study sample was divided into three groups, those who reported ‘never or rarely’ using the school canteen (NEV), those using the canteen once per week (SEL), and those reporting use of the school canteen ‘two or more times during the week’ (OFT). Results are presented as frequencies (%), with chi-square tests performed to examine differences in sociodemographic, behavioural, and dietary characteristics between the three groups. A further logistic regression analysis was performed to assess the adjusted associations between canteen use and dietary habits (salty snacks, baked sweets, soft-drinks, and home breakfast frequency). Adjustment was made for significant sociodemographic and behavioural characteristics (gender, parental education, self-efficacy) and shop use (during school break and before/after school). Logistic regression was also used to explore the adjusted association between visiting shops during school breaks or before/after school (‘never/rarely’, ‘one or more times per week’), and use of canteen (NEV, SEL, OFT). Results are presented as crude odds ratios (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (95% CIs). Cases with missing data were excluded from relevant analyses. Because schools were the unit of measurement in this study, we checked for clustering effect through the linear mixed model procedure. Only 3% of the unexplained variance in the dietary behaviours investigated was at the school level, hence adjustment for clustering effect was not done.

A significance level of 0.05 was used. All analyses were performed using SPSS 24.0 (IBM Corp, Armonk, NY, USA).

Sample demographics

The mean age of the survey sample was 13.6 years ±0.3 standard deviation, 53% of participants were females, and 60% had parents with a high level of education (≥13y, Table  1 ). The proportion of adolescents who never or rarely used the school canteen was 67.4%. When comparing demographics and behavioural characteristics for the sample grouped as those using the school canteen never/rarely (NEV), those using the canteen once a week (SEL, 19.7%), and those using the canteen two or more times a week (OFT, 12.9%), we found a significantly higher proportion of the NEV group were female, having parents with a high education, and with a high self-efficacy.

Canteen use and dietary habits

When analysing the dietary habits for the sample grouped by frequency of canteen use, a significantly higher proportion of the OFT group reported consuming salty snacks, baked sweets, and soft-drinks ≥3 times per school week, and a significantly higher proportion of the NEV group reported eating breakfast 5 days in the school week compared to the SEL and OFT groups (Table  2 ). A multiple logistic regression was conducted to assess whether these significant associations between canteen use and dietary behaviours persisted after adjustment for gender, parental education, self-efficacy, and use of shops (both during and before/after school). The difference between NEV, SEL, and OFT adolescents regarding baked sweets thereafter became non-significant. However, the difference between NEV and OFT adolescents regarding salty snacks, soft-drinks, and breakfast consumption remained significant, indicating that adolescents using the canteen ≥2 times per week had increased odds for consuming salty snacks and soft-drinks (aOR 2.05, 95% CI 1.07–3.94, p  < 0.03, and aOR 2.32, 95% CI 1.16–4.65, p  < 0.02, respectively, data not shown). Additionally, the OFT group had reduced odds of consuming breakfast at home daily (aOR 0.48, 95% CI 0.28–0.80, p  = 0.005, data not shown). No significant differences between the three groups were found for the other food items explored.

School environment

When comparing the frequency of food purchases at shops during school breaks or on the way to/from school for the NEV, SEL, and OFT groups, we found that a significantly higher proportion of OFT adolescents reported purchasing food/drink from a shop near school either during school breaks or else before or after school, one or more times during the week (Table  3 ). Logistic regression analyses revealed that the OFT group had significantly higher odds of purchasing food/drink from a shop near school, either during school breaks or else before or after school, than the NEV group (aOR = 1.80, 95% CI 1.07–3.01, and aOR = 3.61, 95% CI 2.17–6.01, respectively, Table  4 ).

Results of focus group and interview analyses

The data from the focus group interviews indicated that students were aware of issues related to food and health. A number of the relevant themes which emerged are outlined below.

Student’s lunch habits

The majority of students confirmed that most foods consumed at school were brought from home. Some students, however, stated that the other option was to purchase foods from either the canteen or local shops:

Interviewer: ….do you bring a packed lunch from home regularly? Boy2: We usually tend to buy something from the canteen. Girl5: It’s kind of both in a way. Girl5: Yes. Ehm, it is usually both, there are many who have food with them also. Also you are free to buy something. Boy1: Yes, that’s common…there are quite a few who tend to buy food at the canteen and, yes, the shop.

One teacher suggested it was the presence of pocket money that determined the source of a student’s lunch:

Teacher1: It is an incredibly large amount of money they have to buy canteen food with, especially in the 8th grade…so that means they do not have so much food with them from home, but buy it instead.

Types of foods purchased at school canteen, students’ impression of canteen

In response to the types of foods available for purchase at the canteen, student’s representing different schools reported similar food items. Overall, the students at all schools expressed a level of dissatisfaction with the healthiness of the food/drinks offered by the canteen:

Interviewer: What is the most popular items people buy [at the canteen]? Boy2: Mainly toasted sandwiches Boy2: And wraps Boy3: Eh, maybe a baguette with ham and cheese Boy1: Whole-wheat bread with cheese and ham. Capsicum maybe. Boy2: There are many different drinks one can buy, as well as yoghurt of various kinds. There is also a main thing available too, such as a baguette, pizza, or something similar. Boy2: There are many who buy toasted sandwiches and wraps. Interviewer: What can be done better in order to make other students or yourselves eat healthier from the school’s part?. Girl3: They can begin to sell more fruit and such at the canteen. Boy4: We could have healthier drink offers [from the canteen]…such as smoothies… Girl2:…and switch chocolate milk with plain milk. Boy3: [The canteen] should have healthier alternatives, not just unhealthy white-flour baguettes …with a little cheese, bit of ham and a little butter…..

Peer influence, perceived peer self-efficacy regarding healthy eating

There were questions designed to assess if students perceived other students as being more concerned with healthy eating. Those bringing food from home or considered ‘sporty’ were often perceived as eating healthy food, with the overall impression that those perceived as eating healthy tended to not purchase food at the canteen:

Interviewer: …do you think there are some in your class then, that are more concerned with eating healthy than others? Boy3: Yes, there are. Interviewer: Who are they then? Boy3: Those who ski. Interviewer: How do you know that? Or, what is it that makes them stand out? Boy2: They….don’t buy food at the canteen. Boy4: They eat healthy food Boy1: Those that eat relatively healthy food as a rule usually prepare food themselves.

A number of school staff commented upon the influence some students’ lunch habits had upon others:

Teacher6: …if there is one who begins to drop home brought food because it is boring, it become contagious over other’s behaviour I think, and then it isn’t cool to eat home packed lunches. They are at a very vulnerable age, and very affected by such things I believe. Teacher2: …(food choices are affected by) what food they have at home, how much money they have in their pocket, and what their friends eat. I think it is these three things. And I think some….won’t bring out their home packed lunch because it is not cool enough.

Prices, timing, and permission for visiting shops

In many instances, it was reported that although leaving school grounds was not allowed during school hours in individual school policy, many students frequently did so in order to visit local food shops during breaks. There were reports of shop visits outside school hours as well (before/after school). Some students also discussed the cheaper prices at the shops, as compared to the school canteen, as being an incentive to purchase from shops.

Girl2: We have some in the class that shoot off to the shops to buy some sort of fast food every day. Interviewer: So you are allowed to leave the school in your free time to buy food? Girl2: No, but after school or right before. Girl4:......They go over [to the shops] when the lunch break starts, then you see them come back when everyone has to go outside then. Boy4: Because then there are no teachers out......and then it is easy to take a trip to the shops and... Boy1: Buy cheaper things. Because they sell at a high price here.

The paradox between students visiting shops in school hours, although not allowed, was also pointed out by school staff:

Teacher1: …no, it is not allowed (to go to the shops), but there are some that do it anyway. Headmaster6: ...of course the schools must represent counterculture in some way….so our students go to the shops…and then they make use of the offers that are there…as long as they have money from home. Teacher2: …and they prefer to go (to the shops) in a group at the same time, because it is social and fun.

Types of foods purchased in shops

When questioned about the types of items purchased at the shops, the majority were in consensus that unhealthy snacks such as sweets, baked goods, and soft-drinks were mainly purchased. No participant mentioned the purchase of healthy food from the shops.

Interviewer: What do people mostly buy there then? You mentioned sweet buns..[Looks at Girl1] Boy2: Both sweet buns and doughnuts. Girl1: There are many that buy candy after school and such. Boy4: There are always some who always have money and always buy candy and such. Just like one I know who bought 1 kg of gingerbread dough here after school one day and sat down and ate it. Girl2: Mostly those….soft drinks Girl1: Soft drinks Boy1: Candy and ice-tea. Boy2: People don’t buy food at the shop…most buy themselves candy.

Adherence of school administration to guidelines for school meals

When school staff were asked about the implementation of the latest guidelines from the Norwegian Directorate of Health, most pointed out that they already offered the suggested timespan suggested for lunch, whilst others had yet to read the document.

Teacher1: We have heard there is something new that has come, but we have not spent a lot of time discussing it amongst ourselves. Teacher2: No, no relationship with them (new guidelines). I'm not sure. We do not sell sodas and juice in the cafeteria, but they [students] have it from home. Teacher3: Hehe, I don’t think I’ve seen them, no…(laughs). Headmaster1: So, what we do is to make sure that they have a good place to eat and that they have peace….we offer supervision and they do have a long enough lunch break, is it 20 minutes they should have? Headmaster2: I just have to be honest, I do not think we have come far with these.

We found the NEV group were mainly female, having a high self-efficacy regarding the consumption of healthy foods, and with parents having an education over 12 years. By contrast, the OFT adolescents had a significantly higher proportion of males consuming salty snacks, baked sweets, and soft-drinks 3 or more times a week, as well as consuming breakfast less than 5 times a week when compared to the other groups, also when controlling for gender, parental education, self-efficacy, and use of shops (both during and before/after school).

When comparing the frequency of purchasing food and drink from local shops for these groups, we found the OFT group had a significantly higher proportion purchasing food/drink from shops near the school, both during the school break as well as before or after school, one or more times per week. Logistic regression analyses revealed the OFT group had nearly twice the odds for visiting shops during the school break, and significantly higher odds for visiting shops before/after school than the NEV group of adolescents.

Of the adolescents featured in this sample, females were revealed as more likely to never or rarely use the school canteen, a finding supported by previous research amongst adolescents [ 33 , 34 ]. That females have been previously reported as having a greater self-efficacy related to healthy eating [ 35 ] may help to explain this result, although another study involving over 1200 students of comparable age found no significant difference in self-efficacy regarding gender [ 36 ]. As 67% of the sample stated that they never or rarely use the school canteen, this then begs the question of what form of lunch this group are consuming. Many of the interviews have mentioned the consumption of home packed lunches, and studies of school lunch habits amongst Norwegian adolescents have previously detailed the importance and predominance of the home packed lunch in Norwegian culture [ 37 , 38 ], with over 60% of young Norwegians reporting a packed lunch for consumption at school, a proportion similar to the results we present here. This figure is also consistent with global reports examining school lunch eating practises [ 39 ].

Our results profile the OFT group as being mostly male, skipping breakfast, with a high frequency of shop visits during and on the way to/from school, and with a higher frequency of snacks, baked sweets, and soft-drinks, elements which have featured in previous studies regarding adolescent consumer behaviour [ 12 , 40 , 41 , 42 , 43 ]. A clear association between adolescents skipping breakfast and subsequent purchases of foods from shops and fast food outlets, usually on the way to or from school [ 42 , 44 , 45 , 46 ], in addition to other health-compromising behaviours [ 47 ] have been previously reported.

Although direct questions regarding pocket money were absent from our study, its role in the behaviour of this sample is evident from statements mentioning money use in the school administration interviews as well as alluded to in focus group interviews. Additionally, it stands to reason that adolescents using the school canteen often (i.e. the OFT group) would be equipped with money in order to make such purchases, as financial purchases are the norm in Norwegian secondary schools [ 48 ]. Research directed upon adolescents and pocket money has presented a number of findings that support our results regarding the OFT group, whereby access to spending money was associated with an increase of nutritionally poor food choices by adolescents, such as the increased consumption of fast-foods, soft-drinks, and unhealthy snacks off campus [ 40 , 41 , 42 , 43 , 49 , 50 , 51 , 52 , 53 ]. These results may also be indicative of a gender imbalance in regards to pocket money provisions, where some studies report upon more males than females receiving pocket money [ 54 , 55 ].

The mean age of this sample previously has been described as a stage in life of an emerging autonomy for young individuals, an autonomy which is exercised in terms of disposable income use and consumption of foods away from home [ 42 , 56 , 57 ]. This period of emerging autonomy may also manifest unhealthy eating behaviours as a strategy to forge identity amongst adolescents [ 58 ]. Frequent mention by students and staff in this study of themes relating to peer influence and defiance of school rules support the link between rebelliousness and unhealthy eating. Moreover, it has been reported previously that foods independently purchased by adolescents are often unhealthy, forbidden or frowned upon by parents, and express a defiant period of appearing ‘cool’ among peers, especially amongst males [ 37 , 59 , 60 , 61 ], all of which support our findings here, particularly regarding gender, self-efficacy, and peer influence.

Value for money and dissatisfaction with the school canteen were frequently mentioned in the focus group interviews, and are elements that may be affecting choices made by the groups in this study. Statements concerning student dissatisfaction with canteen prices and/or the limited healthy options available have also appeared in previous research [ 35 , 37 , 38 , 42 ]. That many of the school administrators interviewed seemed barely aware of the guidelines published by the Norwegian Directorate of Health is an alarming result, and likely adds some degree of weight upon student discontent with the school canteen. Although nearly all reports from the focus groups indicate the shops were used for unhealthy purchases, the possibility that shop purchases are a result of some adolescent’s need for healthier lunch alternatives cannot be dismissed completely.

The focus group interviews together with the quantitative data support the notion of healthy eaters avoiding the school canteen, opting instead for a home packed lunch. This view is further supported by previous reports that home prepared lunches help contribute to a healthy dietary pattern [ 39 , 62 , 63 ]. Furthermore, it has been reported that students consuming a lunch from home have significantly lower odds of consuming off-campus food during the school week [ 41 ], which further concurs with the results presented here.

By contrast, those often using the canteen – which, by all reports, could improve the healthiness of items offered – are using the off-campus shops often, purchasing mainly unhealthy snacks and drinks.

The strengths of the study include a large sample size with a high response rate at the school level, and moderate response rate at the parental level. Using a mixed method approach also provides a more comprehensive assessment of adolescent school lunch behaviours, allowing a fuller understanding of this and other adolescent food-behaviour settings by contrasting the adolescent’s own experiences with quantitative results. That the quantitative material, based on cross-sectional data, precludes any opportunity for causal inference to be made may be one of the prime weaknesses of this study. Quantitative data regarding adherence to national policy regarding school canteens, pocket money and what items it was spent upon, as well as data regarding the content and frequency of home packed lunch consumption, were also lacking from the study, where inclusion of these elements in the various analyses would have considerably strengthened the quality of results. Furthermore, reliance upon self-reported data may have led to issues regarding validity and reliability, particularly with a sample of young adolescents.

We found the majority of adolescents (67.4%) in this sample rarely or never used the school canteen. Those adolescents using the school canteen two or more times a week were also the group most likely to be purchasing food/drink from a shop near the school, either during school breaks or before/after school. This group also tended to skip breakfast and consume snacks and soft-drinks more frequently compared to the adolescents who rarely or never used the school canteen. These findings highlight a lack of satisfaction of items available for consumption at the school canteen, with adolescents intending to use the school canteen preferring instead the shops for foods that are cheaper and more desirable. Future strategies aimed at improving school food environments need to address the elements of value for money and appealing healthy food availability in the school canteen, as well as elements such as peer perception and self-identity attained from adolescent food choices, especially in contrast to the competitiveness of foods offered by nearby food outlets.

Abbreviations

Adjusted odds ratio

Confidence interval

Crude odds ratio

Environmental determinantS of dietary behaviorS among adolescENtS study

Adolescents never or rarely using the school canteen

Norwegian kroner

Adolescents using the school canteen two or more times a week

Adolescents using the school canteen once a week

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Acknowledgements

The ESSENS study is a collaborative project between OsloMet – Oslo Metropolitan University and the public health project Folkehelseforum Øvre Romerike (FØR). We would like to thank all the participants who took part in this study.

The study was supported by internal funds from OsloMet – Oslo Metropolitan University.

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Arthur Chortatos, Laura Terragni, Sigrun Henjum, Marianne Gjertsen & Liv Elin Torheim

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Mekdes K Gebremariam

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AC conducted the data analyses and wrote the first draft of this manuscript. MKG2 designed the study, led the project planning and implementation of the intervention, and participated in data collection and analyses. LT1, SH, MG1, LET2 and MKG2 substantially contributed to the conception, design, and implementation of the study, as well as providing content to the final manuscript. MG1 recruited participants, conducted and transcribed focus group interviews, and contributed to data analyses. All authors have critically read and given final approval of the final version of the manuscript.

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Additional file 1:.

Appendix 1. ESSENS questionnaire relating to food behaviours ESSENS Study. (DOCX 33 kb)

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Appendix 2. Interview guide for focus group interviews. (DOCX 13 kb)

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Appendix 3. Interview guide for headmasters and teachers. (DOCX 14 kb)

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Chortatos, A., Terragni, L., Henjum, S. et al. Consumption habits of school canteen and non-canteen users among Norwegian young adolescents: a mixed method analysis. BMC Pediatr 18 , 328 (2018). https://doi.org/10.1186/s12887-018-1299-0

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ORIGINAL RESEARCH article

Factors that influence food choices in secondary school canteens: a qualitative study of pupil and staff perspectives.

• 1 Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
• 2 Education Authority, Armagh, United Kingdom

Background: Adolescence is recognised as a period of nutritional vulnerability, with evidence indicating that United Kingdom adolescents have suboptimal dietary intakes with many failing to meet dietary recommendations. Additionally, adolescence is a time of transition when they become more independent in their dietary choices and begin to develop their own sense of autonomy and are less reliant on their parent’s guidance, which is reported to lead to less favourable dietary behaviours. Reducing the prevalence of poor dietary intakes and the associated negative health consequences among this population is a public health priority and schools represent an important setting to promote positive dietary behaviours. The aim of this school-based study was to explore the factors and barriers which influence food choices within the school canteen and to identify feasible strategies to promote positive dietary behaviours within this setting.

Methods: Thirteen focus groups with 86 pupils in Year 8 ( n  = 37; aged 11–12 years) and Year 9 ( n  = 49; aged 12–13 years) in six secondary schools across Northern Ireland, United Kingdom were conducted. Additionally, one-to-one virtual interviews were conducted with 29 school staff [principals/vice-principals ( n  = 4); teachers ( n  = 17); and caterers ( n  = 7)] across 17 secondary schools and an Education Authority (EA) senior staff member ( n  = 1). Focus groups and interviews were audio-recorded, transcribed, and analysed following an inductive thematic approach.

Results: Using the ecological framework, multiple factors were identified which influenced pupils’ selection of food in the school canteen at the individual (e.g., time/convenience), social (e.g., peer influence), physical (e.g., food/beverage placement), and macro environment (e.g., food provision) level. Suggestions for improvement of food choices were also identified at each ecological level: individual (e.g., rewards), social (e.g., pupil-led initiatives), physical (e.g., labelling), and macro environment (e.g., whole-school approaches).

Conclusion: Low-cost and non-labour intensive practical strategies could be employed, including menu and labelling strategies, placement of foods, reviewing pricing policies and whole-school initiatives in developing future dietary interventions to positively enhance adolescents’ food choices in secondary schools.

Introduction

Globally, adolescent overweight and obesity has increased significantly ( 1 ) and is now recognised as one of the most urgent public health challenges ( 2 ). This issue is particularly prevalent within the United Kingdom, with >30% of adolescents (aged 11–15 years) impacted by overweight or obesity ( 3 ). The negative physical ( 4 , 5 ) and psychological ( 4 – 6 ) health implications associated with adolescent obesity are well-documented. Additionally, challenges also exist with reversing adolescent obesity, with 80% of obese adolescents likely to remain obese in adulthood ( 7 ), increasing the risk of further poor health outcomes in later life ( 8 ). Thus, determining effective preventative measures to mitigate the risk of obesity among this population is crucial to improve current and future health and minimise long-term obesity-related medical costs ( 9 ).

Less healthful dietary behaviours during adolescence, such as the overconsumption of energy-dense, nutrient-poor foods, can increase short ( 10 ) and long-term ( 11 ) obesity risk. United Kingdom adolescents’ dietary habits are of concern, with The National Diet and Nutrition Survey indicating suboptimal dietary behaviours among this population, including inadequate consumption of fruit and vegetables ( 12 ), low fibre intakes ( 13 ), excessive fat and sugar intakes ( 13 ) and higher energy intake also among those with overweight or obesity ( 14 ). As children transition to adolescents, they can become more susceptible to consuming an unbalanced diet ( 15 ) and dietary behaviours acquired during this period can persist into adult life ( 16 ). Therefore, dietary intervention during adolescence is essential to offset trends of declining dietary quality and establish healthy eating behaviours that can be sustained across the lifespan.

Adolescents are required to spend 190 days each year in school ( 17 ). Given the continuous contact time schools provide to this population, this setting represents a promising environment to deliver dietary interventions ( 18 ). School-based interventions are cost-effective ( 19 ) and offer the opportunity to reach the majority of adolescents, irrespective of socio-economic status or ethnical background ( 20 ). Moreover, adolescents’ consume a substantial proportion of their daily energy intakes in school (up to 1–2 meals per day) ( 21 , 22 ). However, despite consistent efforts to determine the most effective school-based interventions to improve adolescents’ dietary intakes, outcomes remain short-term ( 23 ).

In Northern Ireland (NI), records suggest that more than half of adolescents (54–63%) typically consume school meals (provided by schools) at lunchtime ( 24 ) as opposed to a packed lunch (brought from home) or sourcing items from nearby food outlets. Mandatory food-based standards ( 25 ) are in place in NI schools to ensure pupils have access to a healthy and balanced school meal ( 26 ), which is of particular benefit to those who may have limited access to nutritious food outside school. However, although secondary schools provide healthier options compliant with the school-food standards, many adolescents continue to purchase the less nutritious items from the menu on offer ( 27 ), highlighting the need to explore alternate influential factors on adolescents’ lunchtime food choices. In addition to improved food provision, nutritional education is also compulsory in NI secondary schools (post-primary) for adolescents in Key Stage 3 (aged 11–14 years) ( 28 ), albeit, adolescents’ nutritional knowledge often has minimal impact on their food choices ( 29 ). Thus, identifying additional opportunities within the school-setting to promote positive dietary change is of importance. As pupils progress from primary to secondary education, parental control over their eating behaviours lessens and their propensity towards their dietary decisions become more independent-based ( 15 ). It is therefore pertinent to gain insight into the principal factors influencing adolescents’ school-based food choices as they develop increasing nutritional autonomy during this transitional period to optimise engagement and success of future school-based dietary interventions.

Research suggests that adolescents’ food choices within the school canteen can be influenced by various food-related factors, including available items, quality, appearance, taste, cost, value for money and peer pressure to opt for specific foods and canteen-related factors such as food hygiene, school menu and price displays, queue length and seating availability ( 30 ). More recent work has revealed adolescents’ favour take away items in the school canteen and associate ‘main meals’ as food to be consumed within the home environment ( 31 ).

In order to better understand the multiple levels of influence on adolescents’ food choices, Story et al. ( 32 ) proposed an ecological framework to consider their eating behaviours under four broad levels of influence to include individual (intrapersonal), social environmental (interpersonal), physical environmental, and macro level to aid in the design of appropriate nutrition interventions targeted at this population.

The difficulties associated with changing health behaviours are well recognised ( 33 ). When designing interventions, early involvement of stakeholders and the target user is recommended ( 34 ). In addition, although often under-utilised, qualitative research methodologies may assist in informing and optimising the design of interventions ( 35 ). Gaining further understanding of NI adolescents’ perspectives on the factors influencing their food choices within school and their suggestions on how best to address these factors through school-based strategies is needed if effective interventions to enhance positive dietary behaviours in this population are to be achieved. Additionally, a paucity of information exists on United Kingdom school staff’s perspectives on adolescents’ school-based food choices and their recommendations for improvement, limiting the ability for comparisons between key stakeholder groups to be examined. Furthermore, to aid in successful intervention design, consulting with school staff may provide researchers with a better understanding of any existing implementation practicalities to consider, such as schools’ academic priorities, available resources and the need to avoid over-burdening staff ( 36 ).

The aim of this study was to explore the primary factors influencing adolescents’ food choices within the school canteen environment from the pupil and school staff perspective. Additionally, a secondary aim was to identify feasible strategies to encourage healthful food choices amongst adolescents within the school-setting.

Study design

Qualitative research methods were selected to provide insight into the complexity of individuals’ food-related behaviours ( 37 ), in addition to their interactive nature to facilitate in-depth exploration of topics raised that is less possible with quantitative surveys ( 38 , 39 ). Focus groups with pupils and one-to-one interviews with school staff were conducted to capture participants’ perspectives, attitudes, and experiences ( 40 , 41 ). The reporting of this study is aligned with the consolidated criteria for reporting qualitative research (COREQ; Supplementary Table S1 ) ( 42 ). This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by Ulster University’s Research Ethics Committee (FCBMS-20-016-A; REC/20/0031). Written informed consent was obtained from all participants and their parents/ guardians.

Sample selection and recruitment

School pupils.

Year 8 (aged 11–12 years) and Year 9 (aged 12–13 years) pupils in seven purposively sampled ( 43 ) mixed-gender secondary schools in NI were invited to take part in this study. Year 8 (aged 11–12 years) and year 9 (aged 12–13 years) pupils were the focus as they had recently transitioned to secondary school and had become exposed to making independent food choices in the school canteen. Pupils who purchased food in the school canteen regularly (at least once each week) were eligible to participate. Schools were contacted via email or telephone and following agreement from the school principal, information sheets, assent and consent forms were distributed by a senior teacher to eligible pupils and asked to discuss with their parents/guardians. Participants who returned completed assent and consent forms were selected by a senior teacher to participate in the focus group.

School staff

A purposive sample ( 43 ) of school staff from a range of socio-economic (assessed using number of free school meals) and geographically diverse mixed-gender secondary schools ( n  = 17) across NI were invited to participate in this study. All grades of staff were eligible to participate including principals/vice principals and teaching staff from a range of subject disciplines. School catering staff included supervisors and caterers. Additionally, as the EA has responsibility for school meal provision in a large proportion of NI secondary schools, one senior EA staff member was invited to participate. School staff were contacted via email or telephone, and following agreement, information sheets and consent forms were distributed.

Data collection

Pupils participated in mixed-gender focus groups and staff in one-to-one interviews, which were conducted independently by a researcher trained in qualitative research (L.D.D, PhD researcher, not affiliated with schools). Similar semi-structured discussion guides were used for the focus groups and interviews ( Table 1 ) to ensure consistency and facilitate comparability between the pupils’ and staff’s perspectives. All focus groups and interview discussions were facilitated by the researcher using the topic guide to explore key issues. To enhance interaction and active listening during the discussions, notes were made directly after each session to enrich the data collected ( 40 ). Focus groups and interviews were undertaken until data saturation had been reached ( 44 ).

Table 1 . Semi-structured discussion guide for pupils focus groups and school staff interviews.

Mixed-gender focus groups of 5–8 pupils were conducted between May and June 2021 within the school (classroom or hall) and during school hours under observation from a senior teacher. All pupils were reminded prior to commencing the focus groups that the information they provided would remain anonymous and would not be shared with their parents or school staff. The topic guide ( Table 1 ) was designed and developed based on a review of the area and pilot tested on a small group of Year 8 pupils in different schools to test the questions for level of comprehension to optimise clarity of questions ( 45 ). Focus group sessions were on average 30 min duration (range 12–43 min).

One-to-one interviews were conducted remotely with school staff via Microsoft Teams or by telephone call at a suitable time for each participant between October and December 2020. Interview questions were pilot tested with one teacher in a different school to test suitability of questions. Interviews took on average 30 min (range 9–57 min).

Data analysis

Focus groups and interviews were audio-recorded and transcribed verbatim. Transcripts were uploaded to NVivo 12 Pro Software (QSR International) for data management and analysed following the six phases of reflexive thematic analysis using an inductive approach ( 46 ). Codes were independently applied to quotes throughout each transcript by a member of the research team (L.D.D). To minimise the risk of bias and ensure correct interpretation of quotes, transcripts and codes were critically reviewed, discussed and confirmed by the research team (A.J.H and A.M.G). Quotes representing similar views were then clustered together and assigned initial sub-themes (L.D.D), which were reviewed by the research team (A.J.H and A.M.G) and refined before reaching consensus on the potential sub-themes. Each sub-theme was then mapped to each level of the ecological model, namely: individual (intrapersonal), social environment (interpersonal), physical environment, and macro environment ( 32 ). Quotes that were most reflective of the sub-themes were selected for inclusion.

Participant and school characteristics

Of the seven purposively sampled schools, six schools expressed an interest in participating and one did not respond to the study invitation. 86 pupils participated in 13 focus groups across the six schools ( n  = 4 urban; n  = 2 rural) throughout three different district council areas in NI, with six focus groups undertaken with Year 8 pupils ( n  = 24 female; n  = 13 males) and seven with Year 9 pupils ( n  = 28 female; n  = 21 males). All six schools were co-educational and mixed-gender. Free school meal entitlement across the schools ranged from 21 to 53%.

Of the 35 participants who received initial invitations, 29 participated in this study (four did not respond to the study invitation; one did not return the consent form; one was excluded as they did not have recent experience in a secondary school). The final sample of 29 (24 females, 5 males) comprised principals ( n  = 2), vice-principals ( n  = 2), teachers ( n  = 17), catering staff ( n  = 7) sampled across 17 secondary schools, and a senior staff member ( n  = 1) in the EA. The schools were in urban ( n  = 14) and rural ( n  = 3) environments located within eight of 11 district council areas in NI. 16 schools were co-educational (mixed-gender) with one school being female only. Free school meal entitlement in these schools ranged from 7 to 54%.

The key sub-themes identified from the pupils’ and staff’s responses and exemplar quotes are reported in Tables 2 , 3 using under the four levels of the ecological framework: individual (intrapersonal), social environment (interpersonal), physical environment, and macro environment ( 32 ).

Table 2 . Pupils’ and school staff’s perceptions on the influences of adolescents’ dietary choices in the school canteen.

Table 3 . Pupils’ and school staff’s views on strategies to encourage selecting healthier options in the school canteen.

Influences on pupils’ food choices in the school canteen

Individual (intrapersonal).

Exemplar quotes to illustrate the following sub-themes are shown in Table 2 .

Internal motivations

Pupils’ personal preferences, in addition to taste, appearance and habitual intakes, were important factors that influence their food choices in the school canteen. These factors often took precedence over the healthiness of the food items on offer, with many pupils commenting that options which were perceived to be less healthy were more tasteful. Pupils’ also commented that if they did not like the choices available, they may have not have lunch in the canteen that day.

‘I just pick what I like’ (P14, FG2, F)

School staff had similar perceptions regarding personal preferences and reinforced that pupils were more likely to select items which were less healthy. School staff also reported that the appearance, familiarity and taste of the food were important when selecting items in the canteen and that these factors may act as barriers to pupils choosing alternate food options.

Time and convenience

Many pupils identified time restrictions as being a major barrier when making food choices as they have limited time for lunch break and many preferred convenient, ‘grab-and-go’ options as they preferred to maximise their free time with peers and participate in lunchtime activities. Additionally, the length of queue in the canteen was also commonly cited, with pupils’ opting for meals which had shorter queues, which may influence choice and possibly discourage pupils from eating in the canteen or skipping their lunchtime meal.

‘If there’s big long queues, I just say forget it and not eat’ (P79, FG11, M)

This was similar to school staff’s views, who suggested that the queues were a factor which influenced food choices in the canteen and this issue was identified to be of greater importance for male pupils who prioritised socialising outside at lunchtime and were less likely to be waiting in queues. School staff also described how in more recent years, pupils’ choices have gradually changed over the years from selecting more traditional sit-down meals in the canteen to more convenient, portable and on-the-go options.

Financial motivations

Both pupils and staff commonly reported that price, value for money and portion size influenced food choice. For example, fruit options were reported to be of a small portion size and lower satiety value, thus, not good value for money, and therefore limited the selection of these items. Additionally, pupils reported that food items were expensive, with one pupil noting that on occasions, money allocated from ‘free school meal entitlement’ was insufficient to cover the cost of lunch. Financial motivations were identified as a key theme reported by five out of six schools regardless of whether the school was located in an area deemed to be rural or urban.

‘Not everyone can afford spending like £3 a day on lunch’ (P62, FG9, M)

School staff also commented that they believed that pupils had a budget to purchase lunch and that the cost of food items and value for money was an important factor in their choice of food. It was noted by staff that dissatisfaction with food choice for value for money was perceived to increase the number of pupils opting for a packed lunch. School staff also commented that male pupils prioritise purchasing food which seemed to have larger portion sizes.

Nutritional knowledge

Pupils’ reported different views on the importance of understanding the nutritional value and composition of foods and whether the food was a healthy choice. Some pupils stated that they were unaware of which foods and meals were healthier, whereas, others were very aware of the healthier options. Both groups stated that this would not be a primary factor to influence their food choices.

‘I do not mind if its healthy or not, it does not influence me’ (P17, FG3, M)

School staff agreed that they did not believe that nutritional knowledge was a key factor in influencing food choices of most pupils and reported that other factors, such as taste preferences, familiarity and convenience were more of a priority whilst in school. Nutrition education forms part of the curriculum for all secondary (post-primary) school pupils in NI for Year 8–10 (aged 11–14 years), however, staff reported that this knowledge was not considered to be sufficient to change their behaviour and translate into more positive health behaviours in the canteen.

Social environmental (interpersonal)

Peer influence.

Peers were consistently identified as a major influence on pupils’ food choices. Pupils reported feeling pressurised to select similar items in the canteen to those of their peer group to avoid negative comments. Both male and female pupils expressed concerns about how their peers viewed them when making their individual food choices and that selecting certain food items in the canteen may not be considered socially acceptable.

‘Like today, one person got pizza and then everyone else just got the pizza, it’s just what everyone else gets, you have to get’ (P22, FG4, F)

Peer influence was also the most dominant, reoccurring sub-theme within this level (social environmental) among school staff. School staff shared the view that pupils’ want to emulate their peers and aim to conform to what is perceived to be acceptable eating behaviours in an attempt to avoid standing out and to preserve a positive social status. In addition, catering staff reported viewing peer-induced choices in the canteen, with pupils selecting similar items to their friends.

Home influence

No pupils made reference to the influence of eating habits at home impacting on food choice in the school canteen. However, school staff expressed that eating habits established at home are reflective of pupils’ food behaviours in school and that both schools and parents need to promote positive eating behaviours to pupils simultaneously for the message to be impactful, as schools alone were considered to be insufficient to achieve sustainable positive dietary change.

Physical environmental

Placement of food and beverages.

The location and ease of access to food and beverage items in the canteen was noted as being influential on food choice. Pupils’ acknowledged that healthier options were usually in a less prominent position in the canteen and often placed out of sight, having a direct influence on their purchasing decisions.

‘The apples are sort of out of the way, so you would not pick an apple because the biscuits are there, so you would just pick a biscuit’ (P14, FG2, F)

School staff also recognised the impact of product placement on pupils’ food choice and cited that they are likely to opt for the food items which they observe first in the canteen.

Menu options and pricing information

Pupils indicated that they were often unaware of what foods were available on the menu in the canteen daily. This uncertainty of the menu was reported to impact on purchasing decisions, for example, pupils opting for a packed lunch or skipping their school meal. Pupils also noted dissatisfaction with clarity of pricing information and thus difficulties arose when choosing meals.

‘You do not really know how much something is going to cost until you go to pay for it so you do not [buy it]’ (P84, FG13, M)

The majority of school staff members did not comment on school menus and pricing information in influencing adolescents’ food choice. A few school staff reported that lunchtime menus were displayed in their schools, however, considered them to be ineffective or overlooked by pupils.

Macro environment

Exemplar quotes to illustrate the following sub-theme are provided in Table 2 .

Food provision

Pupils and school staff both cited food availability in the canteen as having a direct influence on the item’s pupils were consuming daily. Pupils also perceived there to be a lack of variety served in the canteen and that the options provided can often be repetitive. According to school staff, the canteen offered a good range of food options.

Strategies to encourage selecting healthier options in the school canteen setting

Exemplar quotes to illustrate the following sub-themes are provided in Table 3 .

Taster opportunities

To encourage the selection of healthier items in the school canteen, pupils’ and school staff recommended providing pupils with the option to sample certain food items prior to purchasing them to minimise financial risk.

Autonomy in food choice

Some pupils reported that combined food items in the canteen were off-putting, for example, mixed vegetable dishes and pre-made fruit salads. To counteract this barrier of improved food choices and to facilitate a higher uptake of these items in the canteen, pupils suggested that options be served separately to allow independent, self-selection of these items.

School staff did not directly comment on pupil’s autonomy to promote positive food decisions in the school canteen.

Rewards and incentives

The opportunity to receive rewards as a strategy to engage pupils in healthy eating practises in the canteen was a common, reoccurring sub-theme. Social rewards (e.g., trips, queue skips, extended lunchbreaks, sports activities, non-uniform day, and homework exemption pass), financial rewards (e.g., vouchers, discounted/free canteen items), and recognition rewards (e.g., certificates, awards/credit points) were reported as suitable incentives by pupils to encourage healthier choices in the school canteen. It was clear from the discussions that the concept of tracking their progress could stimulate further interaction with a reward scheme and incorporating in a competitive element at both individual and class group level.

‘A VIP pass to the front of the line’ (P32, FG5, M)

School staff’s views reflected pupils’ in that they also recommended the use of social, financial, and recognition rewards to incentivise pupils to select healthier choices and considered that this would encourage pupils, in particular younger pupils, to be more proactive in their food-based decision making.

Exemplar quotes to illustrate the following sub-theme are provided in Table 3 .

Pupil-led initiatives

Pupils did not make suggestions on how their friends (e.g., pupil-led initiatives) could be a strategy for encouraging the selection of healthier items in the school canteen.

School staff recommended utilising peer networks as an effective means of facilitating positive food choices among adolescents and felt pupils were more likely to resonate with information provided by their peers than those delivered by staff. More specifically, school staff advocated for schools to implement specific roles for senior pupils to act as healthy eating ambassadors within the school to promote healthy eating.

When pupils were asked how best to promote selecting healthier options in the canteen, displaying nutritional labels was highlighted as a means of facilitating their ability to make informed decisions about food choices. Both male and female pupils recommended visual labelling schemes, for example, symbols or icons. Pupils also suggested that schools applying the traffic-light colour-coding system to food items in the canteen and to the school menus would be useful. In addition to nutritional labelling, pupils stated the importance of general food labelling, such as the food item name and ingredients.

‘Colours would help because if you say put the unhealthy options maybe in red, it would maybe drive us towards the green’ (P59, FG9, F)

School staff also proposed labelling of foods and menus as an efficient strategy to facilitate positive food behaviours in the canteen. They suggested colour-coding and visual labelling, but urged the need for caution on calorie/energy labelling, stating concerns of the impact this may have on pupils who may already be weight conscious. School staff suggested that traffic-light labelling in particular would be applicable in the canteen setting and commented that pupils would be familiar with this scheme as it is covered early in the compulsory Home Economics Key Stage 3 (pupils aged 11–14 years) school curriculum. However, it was also noted that labelling schemes may be onerous on the canteen staff and adversely impact on their daily duties and should be considered.

Improved information accessibility

Another recommendation raised by the pupils was making menu and pricing information accessible in the canteen to enable them to make informed choices. Pupils suggested placing visual, eye-catching menu and pricing displays on the canteen walls that they could read readily whilst queueing. Additional menu and pricing information around the school, in classrooms, on school apps, websites and social media was also cited. Some pupils also advocated for healthy eating posters to be displayed in school, whilst others felt they would not be impactful. In addition, they expressed their desire to pre-order their meals, and to have knowledge in advance of what food items were going to be available daily.

School staff suggested further promotion of the school menus, for example, sending them to parents and uploading them on to the school apps, websites and social media platforms. School staff also recommended placing posters in different locations throughout the school.

Placement manipulations

Pupils and staff both commented on making improvements to where healthier food items were situated in the canteen. Pupils advocated for the healthier food items to be clearly visible in the canteen, whilst school staff advised ensuring that the healthier items were positioned more prominently and first in line in the serving area, as pupils can have their foods selected before having the opportunity to view the healthier options available.

Special offers

Applying special offers and reducing the price of the healthier items in the canteen was a view shared by both pupils and school staff. The concept of a healthy meal deal was reported amongst both pupils and school staff to allow pupils the opportunity to afford, for example, a healthy main meal, snack item and beverage.

‘If the healthy foods were just really cheap that would drive people towards them because people go for the cheap’ (P59, FG9, F)

Increasing the variety of foods on offer in the canteen was noted among pupils, with some pupils advocating for more healthy options, such as additional fruit and salad items.

School staff discussed restricting the sale of the less healthy options. However, it was also acknowledged that although the provision of healthy food items was a priority, it was important to recognise that the canteen was a business and there was a need to find a balance between serving the healthier options and those in demand by pupils in order to maintain pupil uptake and preserve the overall financial viability of the canteen.

Whole-school approach and educational practices

Pupils did not advocate for further input from school staff to encourage healthy eating or their nutrition-based education as strategies to promote improved food choices in the school canteen.

As Home Economics is a non-compulsory subject for pupils beyond Key Stage 3 education (pupils aged 11–14 years), principals and teachers suggested a whole-school, cross-curricular approach to delivering nutrition education to pupils which should involve other departments incorporating the promotion of healthy eating into their subjects. Some examples included the English department assigning pupils written tasks on the topic of healthy eating and the art department incorporating healthy eating poster campaigns as part of the curriculum. It was noted that as a start to have even one stand-alone lesson across a number of taught subjects would facilitate pupils thinking more about their food choices and could prove beneficial. School staff also acknowledged that healthy eating promotion should not be limited to the Home Economics department and suggested additional whole-school, educational strategies to promote healthy eating such as delivering talks during assemblies and educating parents.

‘It would be a good idea to have at least one initiative, whole-school, a year and try and drive that message home, because in that way you’re targeting the whole-school population rather than those just in Home Economics’ (P8, T, F)

This study explored pupils’ (aged 11–13 years) and school staff’s perspectives on the main factors influencing adolescents’ canteen-based food choices and how best to encourage this population to select healthier food items within this environment. This qualitative research has identified several influential factors on food choices and recommended strategies for improvement to consider when designing future school-based interventions aiming to facilitate positive dietary behaviours among adolescents that are both acceptable to the target population and viewed as feasible for implementation by key school staff members.

In this present study, both pupils’ and school staff cited habitual intakes and personal preferences as important determinants of adolescents’ food choices within the school canteen. Food appearance and perceived taste were also identified as particularly salient factors, which can act as deterrents to selecting the healthier items available in the canteen. These findings support recent research by Glabska et al. ( 47 ) whereby adolescents considered sensory appeal of higher importance than health when determining food choices. Moreover, taste has consistently been identified in the literature to motivate adolescents’ school-based food choices irrespective of gender or location ( 30 , 48 – 52 ). Opportunities to sample items served in the school canteen free of charge was a strategy proposed by participants in the present study, which aligns with previous United Kingdom research ( 53 ) reporting that 9–10-year-old advocated for exposure to new foods through school ‘taster sessions’.

The influence of queues on United Kingdom adolescents’ food choices in the school canteen has been reported from the early 2000s ( 38 , 54 ). Results from the present study confirm that queue length remains a prominent factor when making dietary decisions in the school canteen. Data from the present study also identified that long queues can negatively influence adolescents’ food choices, and in line with previous studies in the United Kingdom ( 55 ) and further afield ( 56 ), can act as a barrier to school meal uptake, with pupils’ often sacrificing their school lunch due to long waiting times. Thus, efforts to alleviate the impact of queue length at lunchtime, such as implementing staggered breaks for different year groups or, as suggested in the present study, providing queue skips as a reward for healthy eating, may be measures for schools to consider to both encourage the uptake of school meals and establish healthier dietary habits within this environment. Findings from the current study also correspond with past research ( 57 ) that adolescents’ can be more inclined to opt for the grab-and-go options available in the canteen. As grab-and-go foods tend to be ultra-processed with typically high fat, sugar and salt contents ( 58 ), it is important that schools provide alternate nutritious, readily available grab-and-go options to support healthy school-based food choices.

In accordance with previous literature, highlighting the influential role of peer social conformity in influencing adolescents’ dietary intakes ( 59 ), the present study further evidences that peer acceptance is also fundamental when considering food options in the school-setting, which can impede the selection of healthier items. Recent work has highlighted gender differences among this age group, with females having larger concern for peer perceptions than males in relation to their dietary behaviours in school ( 60 , 61 ). Interestingly, these gender disparities were not apparent in the present study, with both male and female pupils reporting feeling conscious and subject to disapproval from their peers if they opted for the healthier options, directly impacting their food choices in the school canteen. Given the perceived impact peers pose on purchasing decisions, school staff in the present study proposed involving peers in school-based strategies to promote positive dietary behaviours and particularly emphasised the opportunity to utilise senior peers in healthy eating school-based initiatives. In Australia, senior pupils have proven effective in role modelling healthful behaviours among the younger pupils in secondary school ( 62 ). Additionally, in America, a peer-led, school-based nutrition education intervention among adolescents was positively viewed and reported as feasible and acceptable among pupils, peer-leaders and teaching staff, with peer-leaders also citing improved dietary practices and awareness of healthy eating as a result of their role ( 63 ). However, the feasibility and acceptability of delivering a peer-led, school-based dietary intervention in secondary schools across NI is unknown, and thus, further investigation is warranted.

Whilst peers appear to have a significant role in influencing adolescents’ school-based dietary behaviours, school staff in the present study also cited the importance of home and parental influences in helping school’s shape adolescents’ dietary practices and were of the opinion that ‘ we can only do so much’ . This is comparable to an English study where secondary school headteachers and chairs of governors viewed parents as key influencers on adolescents’ lifestyle habits and that any measures taken by schools to improve these behaviours can either be supported or impaired by the home environment ( 64 ). Contrary to previous research ( 65 ), pupils’ in the present study did not acknowledge their parents or their home environment as an influential factor on their food choices in school, which may reflect how this population group place greater importance on expressing their own individual autonomy at this life stage. Future work to determine NI parents’/guardians’ perspectives on both their own and the school’s responsibilities in influencing adolescents’ food choices within the school-setting may be worthwhile.

Ultimately, participants in this study cited that adolescents’ food choices are influenced by what is available to them. In NI, assisted by a checklist, individual schools are required to self-monitor their compliance with the school food standards ( 66 ). In a recent study, NI stakeholders’ commented that adherence to the school-based standards may be negatively impacted due to a lack of monitoring ( 15 ), thus, implementation of a systematic monitoring process or procedure may be beneficial to enhance the provision of nutritious foods across NI schools.

Based on findings from the present study, pupils would welcome more frequent information on school meal choices on the menu and food prices, which would assist with pre-planning their meals. In addition to suggesting improvements to menu and pricing information, some pupils advocated for a pre-order lunch system, which has been previously shown to increase the selection of fruit, vegetable and low-fat milk items among youth in US school canteens, however, more research is required with larger sample sizes and in alternate locations to generalise these findings ( 67 ).

Incorporating labelling schemes for items served in the canteen was a leading strategy recommended from both pupils and school staff to improve food choices. Pupils and staff suggested visual labels, with pupils placing emphasis on the usage of icons and symbols. This suggestion supports previous research ( 68 ) which showed subtle messaging around foods was more impactful than explicit messaging, with adults more likely to select healthier items labelled with a heart logo than those with labels stating ‘a healthy choice’. Discussions with pupils and school staff also indicated the potential usage of colour-coded labels including traffic-light labels. A study conducted in secondary schools in Belgium found that increasing the number of healthier beverages available and applying a traffic-light labelling scheme to all items, effectively reduced adolescents’ consumption of sugar-sweetened beverages (SSB’s; labelled red) in both the school canteen and vending machine ( 69 ). Nonetheless, the importance of consultation with catering staff in individual schools prior to the design and implementation of labelling schemes was acknowledged in the present study to ensure feasibility with caterer’s daily routines, which aligns with previous research ( 70 ) reporting that school staff’s time constraints acts as one of the most dominant challenges to the implementation of school-based healthy lifestyle programmes.

Both pupil and school staff participants had a level of awareness of how adolescents’ food choices can be dependent on the location of items in the canteen, hence, manipulating the placement of the healthier options to more visible and accessible locations was a desirable concept among both stakeholder groups. Placement manipulations are a form of ‘nudge intervention’ which are generally minimal cost to implement ( 71 ). Implementing placement manipulations has resulted in increased and decreased purchases of fruit pots and SSB’s/sweet-baked goods, respectively, within United Kingdom secondary school canteens, albeit the evidence was limited ( 71 ). Further, school staff perceived items positioned first in the canteen serving area can directly impact adolescents’ food choices, and therefore, proposed serving the healthier items first as an effective strategy to improve food selection. This strategy has proven effective in breakfast buffet lines, with >75% of individuals opting for the first items they encountered ( 72 ), which could be easily transferred for implementation within school canteens.

The concept of receiving rewards to engage adolescents’ in healthy food-related behaviours in the school canteen has been positively viewed as a suitable strategy among socially deprived NI adolescents (aged 11–12 years) ( 30 ). Our findings in this study address a gap in the literature by further confirming the acceptability and feasibility of reward schemes (social, financial and recognition rewards) as incentives to promote positive food choices in school from the perspectives of both adolescents and school staff from a range of socio-economically diverse schools located in numerous district locations across NI. Tangible and praise rewards have previously proven effective in achieving positive food choice change by increasing fruit and vegetable consumption among elementary school children, although tangible rewards were more effective in the short and longer-term ( 73 ).

Overall, in line with a recent review ( 74 ), this qualitative study has identified various influential factors impacting adolescents’ food choices in secondary school canteens, with many also acting as barriers to the selection of the healthier food items in this setting. Moreover, similar to previous research with key school stakeholders outside the United Kingdom ( 75 , 76 ). Participants in the present study perceived schools to be a viable setting to nurture healthy eating habits in adolescents and had clear ideas on practical and acceptable solutions, which could be implemented to better support adolescents making improved food choices in the school environment.

Strengths and limitations

A strength of this study is that we successfully recruited a relatively large sample of mixed-gender pupils and staff in schools with socio-economically diverse profiles across a wide range of geographical locations in NI, including both urban and rural areas, increasing the generalisability of these findings. Given the complexity of adolescents’ dietary behaviours, the recruitment of adolescents, principals, vice-principals, teachers, caterers and EA staff enabled a holistic view of the primary factors influencing adolescents’ food choices within the school-setting and novel suggestions for improvement within this environment to be obtained, whilst also facilitating comparisons between a range of key stakeholder groups to be investigated. To our knowledge, this is the first study to explore NI school staff’s perspectives on adolescents’ school-based food choices and their recommendations for feasible intervention components to facilitate improvements in their dietary behaviours within this setting and to also compare these with the views of adolescents across NI. Moreover, schoolteachers in this study were recruited across a variety of subject disciplines, reducing the risk of selection bias of individuals particularly interested in the promotion of healthy eating within their school.

When interpreting the results, several limitations should be considered. It must be acknowledged that although a large sample of pupils of mixed-gender ( n  = 52 female; n  = 34 male) were recruited to this study across 2-year groups, selection bias cannot be overlooked as only pupils who returned their study forms were eligible to be selected by a teacher for participation as the researcher (not affiliated with schools) was not involved in the selection process. Additionally, it is possible that pupils may have felt the need to provide desirable responses regarding their school’s food practises and their dietary behaviours, however, all pupils were informed by the researcher at the beginning of the focus groups that their responses would remain anonymous. Within the sample of pupils, 60% were female and 40% male, which is unlikely to introduce gender bias, however, it is important to note, that the participating school staff were predominantly female. Therefore, future work should consider achieving a gender-balanced sample by targeting male teachers within schools to encourage participation to determine if any gender differences may be present among school staff on this topic.

Collectively, this research highlights the complexity of the multilevel factors which influence adolescents’ food choices within the school canteen and identifies barriers to achieving healthier dietary behaviours. Involving pupils and school staff to explore these barriers has highlighted a number of possible practical solutions to improve food choice in school, in particular those that are low-cost and non-labour intensive. Using the ecological framework, suggestions for improvement of food choices were identified at the individual (e.g., rewards), social (e.g., pupil-led initiatives), physical (e.g., labelling) and macro environment (e.g., whole-school approaches) level. At macro level, it is recommended that schools may wish to review the pricing policy to consider offering for example meal deals or special offers, with clear menu and labelling strategies to improve information for pupils at the point of purchase and also consider the location and placement of foods on sale. Additionally, it may be beneficial to implement a whole-school initiative, for example, healthy eating days/themes in the canteen to encourage all pupils to make healthier choices. This study highlights the importance of early consultation with school stakeholders to identify the existing influential factors on adolescents’ school-based food choices and which strategies are viewed as both acceptable to the target population and suitable for implementation within the school-setting by key school staff members which should be considered in future intervention design. Further research is needed to determine the feasibility of implementing these intervention strategies within the school-setting and to test their effectiveness in practice.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving human participants were reviewed and approved by Ulster University Research Ethics committee FCBMS-20-016-A; REC/20/0031. Written informed consent to participate in this study was provided by the participants' legal guardian/next of kin.

Author contributions

LD, AH, and AG: conceptualisation, data coding, data analysis, and interpretation of findings. LD, AH, SB, and AG: methodology. LD and SB: recruitment. LD conducted the interviews and focus groups and drafted the manuscript. AH, SB, and AG critically reviewed the manuscript. All authors contributed to the article and approved the submitted version.

This study was undertaken as part of a PhD scholarship (LD) funded by the Department for the Economy (DfE).

Acknowledgments

The authors thank the participating schools, pupils, school staff and the Education Authority staff for their involvement in this study.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1227075/full#supplementary-material

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Keywords: pupil, school staff, food choice, secondary school, canteen, adolescence

Citation: Devine LD, Gallagher AM, Briggs S and Hill AJ (2023) Factors that influence food choices in secondary school canteens: a qualitative study of pupil and staff perspectives. Front. Public Health . 11:1227075. doi: 10.3389/fpubh.2023.1227075

Received: 22 May 2023; Accepted: 16 June 2023; Published: 14 July 2023.

Reviewed by:

Copyright © 2023 Devine, Gallagher, Briggs and Hill. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Alyson J. Hill, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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• v.11(1); 2022 Jan 31

The role of the school food environment in improving the healthiness of school canteens and readiness to reopen post COVID-19 pandemic: A study conducted in Indonesia

1 Alma Ata Graduate School of Public Health, University of Alma Ata, Yogyakarta, Indonesia

2 Alma Ata Center for Healthy Life and Foods (ACHEAF), University of Alma Ata, Yogyakarta, Indonesia

Resti K. Triastanti

3 Department of Nutrition, Faculty of Health Sciences, University of Alma Ata, Yogyakarta, Indonesia

Devita Anggraeni

Esti nurwanti, emma c. lewis.

4 Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, USA

Uriyoan Colon-Ramos

5 Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington DC, USA

Yunhee Kang

Miwa yamaguchi.

6 International Center for Nutrition and Information, National Institute of Health and Nutrition National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan

Joel Gittelsohn

Background: Indonesian school children spend one-third of their time in school, where they are exposed to a variety of foods at school canteens. However, the healthiness of school canteens is not yet well understood. This study was conducted to characterize the healthiness and quality of management of school canteens, and measure readiness of school canteens to reopen following COVID-19 closures.

Design and methods: Mixed methods were used to conduct a cross-sectional study. Data were collected from schools located in the Bantul District of Indonesia. Primary schools (n=152) were randomly selected, with a final sample size of 147. Data were collected using Google Forms, delivered via WhatsApp or e-mail. School canteens were classified as healthy if they had a Healthy Canteen Score (HCS) ≥10, or unhealthy if they had a HCS<10.

Results: Less than half (43.5%) of school canteens were deemed to be healthy. School canteens were more likely to be healthy if the canteen manager had a formal decision letter (OR=15.2; 95% CI=3.7-62.5); used print material messaging (OR=3.2 to 4.6 times); or received inspection by external officers periodically (OR=2.8; 95% CI=1.04-7.5). Readiness to reopen was 4.5 (OR=4.5; 95%CI: 1.1-17.9) times higher among schools that had their own canteen, and 4 (OR=3.9; 95% CI=1.1-13.8) times higher among schools located in rural areas, adjusting for the remaining variables.

Conclusions: School canteen healthiness can be improved by implementing national food policy and healthy school canteen standards accompanied by the existence of good management practices within schools, particularly following the COVID-19 pandemic.

Significance for public health

Indonesian school children spend one-third of their time in school, where they are exposed to a variety of foods at school canteens. The school food environment, therefore, plays a major role in determining children’s eating habits and may contribute to increased risk for childhood obesity. Due to the COVID-19 pandemic, most schools in Indonesia remain closed. Readiness to reopen school canteens post COVID-19 closures might vary between schools and may be associated with certain characteristics of the schools and how the school canteens are managed. Understanding determinants of school canteen healthiness, the importance of the quality of canteen management, and the readiness to reopen school canteens post COVID-19 closure can inform policymakers to help schools prepare to reopen and improve healthiness following the COVID-19 pandemic, as well as to aid in combating childhood obesity in this population.

Introduction

Childhood obesity is on the rise worldwide and is considered one of the most serious public health challenges of the 21 st century. 1 Among both children and adults, obesity is associated with increased risk for non-communicable diseases, 2–6 such as diabetes mellitus, hypertension, and kidney failure. 7 Consequently, obesity has contributed to a significant increase in morbidity and mortality. 8-11

In 2010, the prevalence of obesity among school children and adolescents in Indonesia was 10.4% in urban areas and 8.1% in rural areas. 12 Three years later, the prevalence increased significantly, with a prevalence of 17% in urban areas and 13.5% in rural areas. 13 Recent studies have shown that Indonesian school children are exposed to unhealthy food advertisements between 2 to 7 times more than their peers in other Asia-Pacific regions. 14 Obese children in Indonesia are characterized as being more sedentary, consuming less fruits and vegetables, and having higher intake of fast food and junk food compared to their non-obese peers. 15 , 16

Indonesian school children spend 7 to 10 hours per day at school. 17 This long time spent away from home increases the likelihood of school children purchasing food and beverages at their school’s canteen during the day. It is estimated that food and beverages purchased at school canteens contribute to 32.7% of total energy intake of schoolchildren’s diets. 18 Foods sold in Indonesian schools are predominantly calorie-dense and nutrient-poor, and are typically consumed in excess, 19 and 50% of the snack foods sold contain harmful chemicals. 20

In line with the rapid increase in childhood obesity seen in Indonesia over recent years, access to foods have significantly increased in type and availability. Snack food choices made by consumers are influenced by various factors: (1) food-related; (2) personal; and (3) socio-economic. One example of a personal factor is knowledge, which encompasses knowledge of nutrition, intelligence, perception, emotions, and extrinsic motivation. Education and knowledge are indirect factors that influence one’s behavior, and in the context of food, knowledge has the power to directly influence food purchasing and consumption choices. 21

The home food environment and the school food environment are the two most influential food environments for children’s eating behaviors. 22 Children tend to consume foods that are easily accessible; therefore, it is important for healthy snacks to be available in both the home and at school. In addition to the availability of healthy snacks, pocket money is also an influential factor in children’s snack choices. In Indonesia, it is typical for school children to receive an allowance of pocket money from their parents. The allowance is used to meet various needs, one of which includes buying snacks. One study conducted in West Java found that 81.5% of children’s allowances ranged from Rp. 1000.00-5000.00, 13.3% of children’s allowances ranged from Rp. 5500.00-10,000.00, 2% of children’s allowances ranged from Rp. 11,000.00-20,000.00, and 1.8% of children’s allowances were more than Rp. 21,000.00. 19 Therefore, children’s purchasing power is quite high.

Currently, the majority of foods sold at school canteens are fried, and the cleanliness of these food sources is typically poor. Based on a survey conducted in 640 primary schools across 20 Indonesian provinces, 60% of schools have their own canteen, and among those, more than 84% of the canteens do not meet hygiene and sanitation requirements. 23 As the end of the COVID-19 pandemic is still unpredictable, and daily new cases in Indonesia remain the highest among all member countries of The Association of Southeast Asian Nations (ASEAN), primary schools are currently closed and school canteens are not in operation. The readiness to reopen their canteen post COVID-19 may vary between schools, and this should be a great concern of Indonesian government to guide and help the schools. Currently, there is a gap in the understanding of how school canteens vary across urban and rural geographies in Indonesia, how school canteens are managed, and how the school food environment is associated with healthiness of foods purchased by Indonesian school children. The overall goal of the present study was to close this gap in the literature with the following aims: (1) to describe the characteristics of school canteens in Indonesia, including availability of healthy options; (2) to understand the general management of school canteens and how the quality of management is associated with canteen healthiness; and (3) to measure the readiness to reopen school canteens post COVID-19 pandemic.

Design and methods

The present study utilized a mixed-methods approach. First, we conducted a cross-sectional survey to assess the status of school canteens, policies related to the canteens, and additional factors. Second, in-depth interviews were conducted with several heads of primary schools to explore information on schools’ readiness to reopen their canteens following the COVID-19 pandemic. In-depth interviews were ended when obtained information was saturated.

Design and setting

This cross-sectional study was conducted within the Bantul district in central Java, Indonesia including 17 subdistricts, from January 2020 to May 2020. The 17 subdistricts were chosen to represent urban and rural areas within the overall district. There are a total of 395 primary schools located in the Bantul district, including both public and private schools, and both full-day and non-fullday schools. Ethical clearance was obtained from the Ethics Committee of Alma Ata University and informed consent was obtained from parents and teachers before data collection began.

Sample size

In order to measure the proportion of schools with a healthy canteen, we conducted a cross-sectional survey. Based on the Education and Cultural Regional Office of Bantul and using a power of 95%, the estimated proportion of elementary schools with healthy canteen of 20%, the confidence limit of 5%, and design effect of 1, we obtained a minimum sample size of 152 needed using a sample size calculator. 24

We used a random number generator to conduct simple random sampling. 24 One hundred and fifty-two primary schools were randomly chosen out of 395 possible primary schools in the Bantul district. The list of primary schools was obtained from the Bantul district education office, and included 363 private and public primary schools, as well as 32 primary schools under the ministry of religion and ministry of education and culture.

Participants

Permission to collect data from the primary schools was obtained from the local government (District Ministry of Education Office) and each school principal. Informed consent was obtained from the principal of every school selected for this study prior to data collection.

Data collection

Informed consent was obtained in January 2020. Due to the COVID-19 pandemic, data were collected using Google Forms by trained students of the University of Alma Ata School of Nutrition. The Google Form was developed to consist of 52 structured questions. These electronic forms were sent and returned back using WhatsApp or e-mail to school principals or those who represented schools as respondents in this survey. Data were downloaded to an Excel spreadsheet before being analyzed. Out of 152 schools sampled for this survey, 147 (97%) schools responded and returned the completed form. The Google Form of this survey was included in this manuscript.

The in-depth interview was conducted by researchers by inviting several heads of elementary schools to attend a Zoom meeting. The results were then transformed into multiple transcripts for further analysis.

In order to measure the healthiness of school canteens, we developed a “Healthy Canteen Score” or HCS. The HCS is comprised of (1) existence of a school canteen + (2) availability of a nutrition curriculum for students + (3) school regulation on how foods are stored + (4) school regulation to ensure that foods are considered healthy + (5) school restrictions on sweetened, sugary, and salty foods + (6) school restrictions on sweetened or colored foods + (7) school regulations to ensure no unhealthy foods are being sold + (8) school regulations to restrict students from buying food outside of the school during the school day + (9) school decree on school canteen management + (10) school canteen supervision by the school supervisor + (11) outside school food canteen supervision. The scores ranged from 0 (zero) to 11 (eleven), with a mean of 8.9±1.6 (SD). We classified as healthy school canteens if HCS≥10 or unhealthy school canteens if HCS<10.

The HCS of 10 represents the 75 th percentile of the HCS.

Data analysis

We conducted descriptive analyses, both aggregated and stratified by public vs private, and urban vs rural location. We stratified school as rural-urban based on the Indonesian Statistic Agency classification. To examine the role of the quality of school canteen management on the school canteen healthiness, we treated the school healthiness variable as a dichotomous variable (healthy, not healthy), while all other independent variables were treated as categorical variables. Chi Square or Fisher Exact test (when expected values less than 5) was then used to see association between school canteen healthiness and each of all independent variables. To identify key factors contributing to school canteen healthiness, we ran multiple logistic regression models. All independent variables associated (P<0.05) with school canteen healthiness in bivariate analysis were included in the models. A backward approach was used to analyze different models and to see the goodness of fit of each model. A similar approach was used when we analyzed the school readiness to reopen canteens post COVID-19. We performed all data analyses using STATA v.15 MP (Stata Corp LLC, Texas, USA) with statistical significance acceptance at P<0.05 for all tests.

Primary school characteristics (n=147).

Factors associated with healthiness of school canteens in Indonesia (n=147).

^Chi square test

# Fisher exact test.

Characteristics of the selected elementary schools and their canteens

Of the 147 primary schools that were enrolled and completed the survey, about two-thirds (67.4%) were public and about onethird (32.6%) were private. Slightly more schools were located in rural areas (51%) than in urban areas (49%). Most (86.4%) schools had their own canteens, but only 36.7% of the school canteens were managed by the school itself, and 56.5% of school canteens offered no healthy foods. The majority (78.9%) of schools had a healthy nutrition curriculum available to students. More importantly, during the COVID-19 pandemic, most school canteens (98%) were closed ( Table 1 ).

Role of the quality of management of school canteens

The healthiness of school canteens did not differ by school status (public or private), school location (rural or urban), or opening status (open or closed) during the COVID-19 pandemic ( Table 2 ). However, HCS differed by management quality of school canteen ( Table 2 ). School canteens that were owned by the school, managed by trained managers, or were regularly supervised by the school or a government officer, had higher HCS scores. School canteens were also more likely to be healthy when regulations on preparation, storing, procurement, and restrictions on food and beverages, existed in the school ( Table 2 ). Whether foods and beverages were provided by the school or supplier was not important to determine healthiness of the school canteen ( Table 2 ).

Key factors contributing to school canteen healthiness

When a multivariable analysis was performed, we found that school canteen healthiness was positively associated with greater numbers of vendors. Canteen healthiness was inversely associated with the number of canteen vendors located ouside the school, such that the more vendors located outside the school, the less likely that the school canteen was healthy, adjusting for the remaining variables ( Table 3 ). School canteens whose manager had a formal decision letter as a canteen manager were 15 times (OR=15.2;95% CI=3.7-62.5) more likely to be healthy canteen than those who did not. School canteens were more likely to be healthy when schools (1) had restrictions on students buying foods outside of the school and (2) used messaging ( i.e ., pamphlet, banner, circular letter) to promote awareness of the restriction on buying foods outside the school. Schools that used print materials messaging were 3.2 to 4.6 times more likely to have healthy school canteens than those who used oral messaging, adjusting for the remaining variables. The availability of canteen management by external officers (Primary Health Services/ Health Office / Indonesian FDA) was also associated with canteen healthiness; those supervised by external officers were 2.8 (OR=2.8; 95% CI= 1.04-7.5) times more likely to have healthy a canteen than those who were not supervised by external officers ( Table 3 ). Canteen healthiness was not associated with school location (i.e., rural vs. urban) nor did it differ between public versus private schools.

Readiness to reopen school canteen post COVID-19 pandemic

As the end of the COVID-19 pandemic remains unpredictable and daily new cases in Indonesia remain high, almost all primary schools are closed and school canteens have not been operated since the mandated shutdown. When asked about readiness to reopen their school canteen, most schools felt they would be ready to reopen once provided with information on timing and government regulations. However, 18 (12.2%) were not ready to reopen. The readiness of the schools to reopen their school canteen was 4.5 (OR=4.5; 95%CI: 1.1-17.9) times higher among those that have their own canteen than among those that do not, and 4 (OR=3.9; 95% CI =1.1-13.8) times higher in rural areas than in urban areas, adjusting for other variables ( Table 4 ).

Key factors contributing to school canteen healthiness (n=147).

^Adjusted Odds Ratios were generated from a multiple logistic regression model adjusting for school status, school healthiness, and all other remaining variables.

Readiness to reopen school canteens post COVID-19 pandemic (n=147).

*Adjusted Odds Ratios were generated from a multiple logistic regression model adjusting for school status, school healthiness, and all other remaining variables.

A select few quotes referring to the readiness of schools to reopen their canteens are as follows:

“W e are ready to open the canteen if the school is allowed to reopen, but there is no order from the government”. ”Yes, we are ready at school, the canteen will be adjusted to the situation and we must add the handwashing facilities”.

Some schools said that they are not ready yet to open the canteen when the school reopens:

“....if school will reopen it takes a lot of adjustments, it takes rules for goverment on how to open a school, kids are a lot. I think it takes training first for the officers and the facilities are also added. Sometimes controlling children is difficult”

This is one of the first studies to describe school canteen healthiness and the readiness to reopen post COVID-19 in Indonesia. The results of this study may be important for improving the healthiness of school canteens when schools are reopened post-pandemic.

We found that canteen healthiness was positively associated with the number of vendors inside the school, and interestingly it was inversely associated with the number of vendors outside the school. We also found that school canteens were more likely to be healthy when there was an official school canteen manager who was responsible for enforcing proper regulations, and when supervision of canteens occurred regularly by school officers or government officials. Readiness to reopen post COVID-19 was higher among schools that have their own school canteens and are located in rural areas.

The more vendors inside the school, the more likely the school canteen was to be healthy. A previous study found that student’s food purchasing was positively and significantly associated with food availability in school canteens. 25–28 Thus, if school canteens provided only healthy foods, the probability of students purchasing unhealthy foods may be significantly reduced. 26 Having canteens inside the school also allows for easier management of the selection, preparation and cooking of the foods, and of the school standards of food quality and safety. The opposite is true when canteen vendors are located outside the school. A previous study demonstrated that overweight and obesity were more prevalent in noncompliant schools than in fully compliant schools in regards to obeying food regulations among school canteens. 29

Good management practice is an important aspect to school canteen healthiness. 29 At least three pilars of management should be fulfilled in order to ensure adequate governance for healthy school canteens. First, there should be a legal organization in which a school canteen manager has legal authority to independently govern and manage the school canteen according to existing regulations and standards for quality management. In the present study, we found that school canteens whose manager owned a decision letter for canteen management were 15 times more likely to be deemed healthy than those who did not. By owning a decision letter for canteen management, a manager could use their authority to independently and maximally improve school canteen healthiness.

Second, there should be rigorous regulations that fit the local standards for healthy school canteen management and that are continuously and properly relayed to all school stakeholders and especially to students. We found that the likelihood for having a healthy school canteen was 3 times to 4.6 times higher when restriction on students buy foods outside of the school was relayed using a circular letter or pamphlet/banner, as opposed to orally. A previous study in Brazil showed that more than two-thirds of canteens sold prohibited foods, such as sweetened beverages and candies, industrialized popcorn and salty snacks, even though most of the school canteen administrators reported knowing the Canteen Law. 30

Lastly, there should be frequent inspection or supervision especially from an independent party (external to the school) in order to ensure that school canteen managers comply with canteen regulations, laws, and other standards of health. Our study demonstrates that school canteens are 3 times more likely to be healthy if there is regular inspection or supervision by local external officers such as from the primary health centre or FDA. Previous studies have found that many schools fail to provide guidance on what must be served to improve the nutritional value of meals or foods in school canteens despite the country having clear school food policies 31 that most school canteen managers report having knowledge of. 30

Until the end of February 2021, almost all primary schools in Indonesia were still closed and education programs were being delivered to children online. Accordingly, almost all school canteens were also still closed. The readiness of schools to reopen school canteens post COVID-19 was 4.5 times higher among those who regulate their own canteens compared to those with externally regulated canteens. This may be due to the fact that those with their own canteens have more authority and flexibility in management. Furthermore, readiness to reopen was dependent on receiving information from the government regarding regulations for reopening. However, there has been no certain information about the end of COVID-19 pandemic and the government of Indonesia has not yet prepared regulations or guidelines for reopening school canteens following the COVID-19 pandemic.

It is interesting to note that readiness to reopen school canteens was 4 times higher among primary schools located in rural areas than those located in urban areas. This may be due to the evidence that the incidence of and mortality rates due to COVID-19 were significantly lower in rural areas than in urban areas. 32-34

The cross-sectional design is a limitation of this study as it restricts our ability to assign causation. A preferable design would be an experimental study such as a Randomized Cluster Controlled Trial to test the implementation of different policies to improve school canteen healthiness by taking culture, geographical and environmental factors into account. Findings could be enhanced by the inclusion of qualitative and observational studies of school canteens. There are plans for further qualitative data collection following the pandemic.

Conclusions

More than half of school canteens in this population were considered to be unhealthy, and we identified ways in which these school canteens could be improved, such as by enforcing national food policy and national healthy school canteen standards as well as good management practices. It is imperative that school canteens be adequately prepared to reopen following the pandemic, and considerations should be made to ensure canteens open with healthy options for school children to choose from. Future studies need to be conducted to formulate healthy school canteen standards and to examine the effect of certain management techniques on the healthiness of school canteens. Government regulations and guidelines should be designed especially targeting the post-COVID-19 reopening of school canteens in Indonesia.

Acknowledgments

The authors would like to thank the schools that agreed to participate in this study, as well as the research team.

Funding Statement

Funding: This study was funded by The University of Alma Ata.

Assessment of Food Quality in School Canteens: A Comparative Quantitative Study between Primary and Secondary Schools in Malaysia

Affiliation.

• 1 School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
• PMID: 34578887
• PMCID: PMC8471405
• DOI: 10.3390/nu13093009

Schools are an important food environment to cultivate and promote healthy food choices and practices among children and adolescents. The aim of the present study was to assess the type and quality of food and beverages sold in school canteens in public primary and secondary schools in Kelantan, Malaysia. Eligible schools were randomly selected from the list of all schools and detailed information of all food and beverage items sold in the school canteens were collected during school days. Food and beverages were classified based on food groups derived from the Malaysian Food Dietary Guideline and the Recommended Foods for Healthy Cafeteria Guideline. An assessment of the traffic-light nutrition food-labelling system of the total sugar content in all pre-packaged foods was also undertaken. A total of 568 food items were identified, with secondary school canteens selling a greater proportion of food items than the primary schools (55.5% vs. 44.5%). In terms of the main food groups, grains and cereal products represented the largest food group served (33-36%), followed by beverages (21-25%) and confectionary and sweet foods (12-13%). In contrast, the vegetable and fruit group represented the smallest proportion of food items sold (1-3%). Comparisons between primary and secondary schools showed a similar trend and pattern of food types and quality of foods sold, except for animal-based foods. A greater percentage of food items in this category was found among secondary schools (12.1%) versus primary schools (6.7%). When total sugar content of all pre-packaged foods was quantified based on the traffic-light nutrition-labelling system, almost one-third of foods and beverages were classified as high (29.1%). Confectionary (19.1%) and flavoured milk and fruit drinks (10.0%) both exceeded the recommended sugar levels of >22.5 g per 100 g and >11.25 mL per 100 m L, respectively. Only one of these packaged foods and beverages (0.9%) was classified as a healthy food choice. About a quarter of the food items available in school canteens were classified as prohibited based on a new revised list of prohibited food and beverage items. These findings indicate that, despite the Guidelines, a large number of unhealthy food items are being sold in school canteens. Hence, interventions such as sustainable healthy school canteen menus should be implemented to promote healthy food choices amongst school-aged children.

Keywords: food availability; food quality; school food environment; schools.

Publication types

• Comparative Study
• Diet / methods*
• Diet, Healthy
• Food Labeling
• Food Preferences
• Food Quality*
• Food Services*
• Nutrition Policy

Level of Satisfaction of Grade 12 Students on Canteen Services. A Quantitative Research

Akademische arbeit, 2022, 29 seiten, note: 12, lorraine manaig (autor:in), the problem and its background, introduction.

A canteen is a store that sells food and drink at an institution like a camp, college, or military base. Some are selling also personal items to personnel at an institution or school or camp etc. This is the area that created inside the school which order to secure and consider the nutrition of those students and the people surrounds in it. Moreover, is to have an enough active mind and body every day to fulfil such school activity.

According to some global related studies, most of the school councils make the financial decisions of everyday life in the schools as used by the employees and the students, in addition, the governing councils might have the authority to manage and engage the canteen services to empower and raise their funds. The canteen manager was given instruction by the school counsellors on products or they call it special fundraising events that should be included in order for them to increase profits. However, some of the students and parents demand on the food prices. According to Bartlby Research (2014), the prices are not enough or adequate to sell the products.

According to (Sigua, 2017), the Department of Education is responsible for giving and supporting the student’s health and well-being through its curriculum. Moreover, it encouraged the schools to implement some complete health programs, including food and health nutrition education. The researcher said the that canteen should serve as the place or venue for the development of eating habits, in addition the canteen should also serve as the laboratory for Home Economics which will provide hands on training for the students and employees on planning, purchasing, preparation of safe nutrition meals.

The purpose of this study is to encourage those Grade 12 Senior high school HUMSS students on how they study more to understand the qualities of the school canteen services. It is important to assure the proper sanitation of the equipment and tools used. Also to know the good facilities and services that given by different school. Moreover, to secure the safety of solid foods, beverages and other products that they sell for order to avoid health issues.

Theoretical Framework

According to Porral et al. (2018) this study examines whether the level of product involvement influences how emotions drive consumer satisfaction. Based on the Theory of the Hedonic Asymmetry, it is analyzed through Structural Equation Modeling (SEM) how emotions drive consumer satisfaction. A sample of 570 respondents was gathered for a high involvement product – wine –, while a sample of 431 consumers was collected for a low involvement product – a cup of coffee –. Results show that positive emotions exert a higher influence on satisfaction in low involvement products, rather than in high involvement products, suggesting that situational factors – such as the occasion of consumption – could be acting as qualifiers of pleasant emotions. Additionally, our findings support the moderating role of product involvement on the consumption-elicited emotions and satisfaction link.

Abbildung in dieser Leseprobe nicht enthalten

Figure 1: Research Paradigm

Statement of the Problem

1. How effective are those canteen services to the respondent in terms of: 1.1 Service 1.2 Menu 1.3 Facilities 2. What is the Level of Satisfaction of Grade 12 HUMSS students? 3. Is there significant relationship between the school canteen services and the level of satisfaction of Grade 12 HUMSS students of Laguna College of Business and Arts?

1. There is significant relationship between Canteen Services and the level of satisfaction of Grade 12 HUMSS students of Laguna College of Business and Arts on school canteen services.

Significance of the Study

The findings of the study may provide vital information regarding the Canteen services and its level of satisfaction experiencing by the grade 12 senior high school HUMSS students. The study may benefit the following:

Students. This would be helpful to have a particular anatomy of satisfaction of the canteen services. The outcomes would give awareness and knowledge about the students level of satisfaction and it would be able to assess.

Parents. This would give the parents ideas about their children level of satisfaction in the canteen services. They would be able to know on how the treatment given by the canteen staff to their children and how it affect to their children on consuming those products.

School Management . This may also helpful to give the school a detail depicted in terms of canteens services. The outcomes may give them new encouragement and motivations for the improvement and enhancement. It might also help the advancement of the good relationship of the school and students.

Future Researchers. This study will serve as a basis for those researchers as an additional information about the level of satisfaction on school canteen services of the senior high school students.

Scope and Limitations of the Study

The study looked into the level of satisfaction of senior high school HUMSS students on school canteen services of Laguna College of Business and Arts of Burgos St., Brgy. 3, Calamba City.

The object of the study is limited to sixty (60) senior high school HUMSS students who had a high or low level of satisfaction.

Definition of Terms

For a better understanding of this study, terms are defined operationally.

Canteen. A small store or restaurant especially in a factory or school where food and meals are sold.

Canteen Facility. It is the quality of the equipment or tools that the staff and students use.

Level of Satisfaction. This is the customer level of approval when comparing a product's perceived performance with his or her expectations.

Senior High School. This is a curriculum on which including grades 11 to 12 after Junior High School.

Services. This action of helping or doing work for someone and something.

REVIEW OF RELATED LITERATURE

This chapter presents the related literature and studies pertinent to the study or research. The knowledge secured from these studies previously conducted afforded the researcher a wide range of information and in-sight which furnish the background for the development of the study.

According to Marroquin and Brandt (2014) stated that even though services usually tend to be “naturally intangible” which means it cannot be remove or destroy, rather than an abject with the opposite nature, it might not be a clear feature after all. And it is the cause of many services or facilities that can provide an output that is compound by tangible components, such as product, equipment, physically entity and even staff. Moreover there are facility activities composed by two stages, and it is the interaction between the customer and the provider is being held, while the second stage might take time to take advantage to be visible actions. In addition they stated also that the best example for assumption in the service offered by a canteen catering provider, because it composed of wide variety of retailing foods and drinks. On the other hand of the studies in the country of Philippines, according to Omadto (2016), said that each of the canteen management and facilities follows a guidelines on their operational management set by the Department of Education through their order, the guidelines given to them was to rationalize the operation of the management of school canteens in the public and private academic system to ensure that the schools canteen shall help to eliminate malnutrition among their pupils. Moreover, school canteens may operate under a variety of management structures, a formal management agreement discussing the terms and the conditions in order to sign by the relevant management parties such as principal, school council, or the private contractor.

Based on Alger (2017), he mentioned that in Australia, school canteens are an integral or it is a fundamental part of the school environment, also it is the ideal site to encourage healthy eating. However, when the canteen is not supported in the school system, healthy menus maybe difficult to implement, moreover a range of influences such as: maintaining profit, reduced volunteer support and student choice negatively impacted what was sold on the canteen menu, the study indicated that offering a sustainable healthy school canteen menu largely depended on the support and resources provided by the school system. Although schools are the best places to implement solutions to over-nutrition and obesity since children and young adults spend most of their time in school and consequently, spend more time in school than at home. In addition, Adunna (2013) mentioned that when providing nutritious food and affordable, the canteen should focus on good management practices and be financially self-sustaining. Moreover, effective canteen management requires that everyone involved knows its goals and objectives and it is familiar with its policies canteen staff and committee develop an implementation plan to achieve policy everyday operational procedures.

It is indicated at the American International Journal of Contemporary Research (2014), that when the quality service of concept from the viewpoint of manufacturing service businesses, it must observed even it is difficult to derive or do a standard quality due to the intangibility and concurrency characteristics of the service, so that service quality can briefly or shortly described as a phenomenon considered within the context of customers expectation and perception about the service offered. Moreover, customer’s expectation and perception of the service will determine the quality of service, if the provided service does not exceed or meet the expectations of the customers, then specifically the service quality is low. However, Pineda (2013), he stated that the quality management practices in the school management in the Philippines, it is determined the level of effectiveness of the total quality service management between the quality of the practices of other institutions, likewise it is more on comparing other services.

The Service Quality Measurement or the “SERVQUAL” by the marketing scientist Parasuraman et al. According to him, it is stated that the service quality is nature a subjective concept, which means that understanding how the customer thinks about the service quality is essential to effective management. Moreover, the SERVQUAL models includes of five dimensions, they are tangibles, reliability, responsiveness, assurance, and empathy, the main goal of their study is to measure or determine the degree of the service quality and it depends on the customer’s expectation, SERVQUAL has been compare to the customer’s expectations before a service encounter and their perceptions of the actual service delivered, it is the commonly instrument or a method to measure consumers perceptions of service quality. However in the Philippines, Garcia (2017) et al, stated that in the Lyceum of the Philippine University seeks to examine the competitive and strategic advantage through evaluating its services to International students about their quality assurance of canteen services, the researchers conducted the descriptive method of the research which employs quantitative approaches, the findings revealed to their study are generally highly satisfied with majority of the services offered.

According to Kumaradeepan (2015) et al, he stated that customer satisfaction in marketing is the most common used instrument for a key performance of many business. Additionally, it is the measure of how the products and services supplied by a company meet or exceed customer expectation, likewise the expectation of the customer is based on the satisfaction with one-self along with customer loyalty is becoming a paramount factor in the businesses for their long-term and short-term survival. On the other hand, Manesh (2013) et al, stated that customer satisfaction is a state of mind where the customers think that the product features are compatible with their personal expectations, moreover, if the performance falls short of expectation, the customer dissatisfied and if it matches the expectation, the customer is satisfied. Otherwise, Surreal (2008), stated that in the Philippines, service quality is simple or the customer satisfaction the people generalize about the entire organization based on the moment of truth. Moreover, the underlying assumption is that customer perceptions of service encounters are important elements of customer satisfaction, perception of quality, and long-term loyalty, satisfying the moment of truth, one at a time, results in customers coming back.

Hamza (ND), express that customer expectation is the ideas and feeling of a customer toward the service or it product that depends what he or she needs from the product and expects it to do. Furthermore, the customer expectation about the product or service is the core of their satisfaction, every customer might have some kind of expectations about the performance, price, and quality, and once the product or service is capable of meeting or satisfying the customer’s expectation, it can be termed as customer satisfaction. According to the book of Tongo-Mosura and Crisostomo (2008), entitled “Marketing”, market success happens when marketers exceed the value offered by competitors. The customers will decide what products they will buy based on judgments about the values offered by several different suppliers. After buying the product, customer satisfaction depends on whether its perceived performance matches or exceeds expectations. Customers form expectations through discussion with other people, after buying a product, as well as the supplier’s marketing activities. One caution to companies is to avoid setting very high customer expectations through exaggerated promotional claims. When performance of the product or service falls short of expectations, this can lead to dissatisfaction. Therefore, the expected sales do not happen. Because today’s competition is too intense, it is not enough to match performance and expectations. Companies need to exceed expectations for commercial success to follow. When expectations are met, customers are delighted with the result. The concept of customer satisfaction helps to separate characteristics that cause dissatisfaction, satisfactions are delight.

Methodology

This chapter presents all the necessary information about the intended process of this study. This includes research design used in conducting the study. In addition, the research locale, respondents of the study, research instruments, and validation of instrument, data gathering procedures, and treatment of quantitative data are also discussed.

Research Design

According to Hale, M.S (2018), there are three main types of descriptive method, the first one is the observational, case-study, and survey methods. Furthermore, the researchers will used the survey method, under the descriptive research in order for the survey to be reliable and valid, it is important that the questions are constructed properly. In addition, the researchers will use this research method because they will aim to identify the level of satisfaction of the selected Senior High School Grade 12 HUMSS Students in the Laguna College of Business and Arts. Through its result, the researchers will identify if there is significant relationship between the two factors.

Research Locale

The data gathered will be from HUMSS Grade 12 Senior High School students of Laguna College of Business and Arts. The researchers will opt to conduct the study in Calamba City due to proximity. The schools involved in the study are from the SSP data in the Laguna College of Business and Arts.

Respondents of the Study

The respondents of this study will be the 60 selected Senior High School Grade 12 HUMSS students from the strand HUMSS in Laguna College of Business and Arts. The researchers set 100% as their respondents from the total population of 128. The respondents of the study are shown below:

Percentage Distribution of the Respondents

Table A. shows that the section of HUMSS Integrity has a total population of 42 students, while the HUMSS Creativity and Determination has an equal population of the students which is 43.

Instrumentation

The researchers will make and will use a questionnaire that emphasizes on the frequency in canteen services and level of satisfaction. The questionnaire will show the frequency in level of satisfaction wherein the respondents will choose from four choices: strongly disagree, disagree, agree and strongly agree. All in all, the questionnaire will have a total of 30 items. The questionnaire will be modified by the researchers for the accuracy of the results.

Data Gathering Procedure

The researchers will prepare a letter of approval regarding the distribution of the questions to the respondents to be approved by the adviser of the research. When approved, the researchers will begin the dissemination of the questionnaires to respondents and will retrieve the questionnaire right after. The researchers will discuss the content of the questionnaire to the respondents if necessary. Then, the researchers will gather the data and will analyze through the use of a certain statistical treatment of data. After analyzing the tabulated data, the researchers will arise in the relationships of canteen services and the level of satisfaction of the respondents.

Ethical Considerations

The ethical concerns will be followed by the researchers as those are taken into account throughout this paper. Consent will be asked wherein the confidentiality will be assured. All the necessary details will explain by the researchers for them to understand their role upon the completion of the study. Information personal to the respondents are assured to have its confidentiality.

Treatment of Quantitative Data

The researchers will use quantitative techniques in finding the answers that will suit to the statement of the problem.

Presentation, Analysis and Interpretation of Data

This chapter reveals the data gathered together with the corresponding data analysis and interpretation to determine if there was a significant relationship between Canteen Services and its level of satisfaction of the respondents. The data were presented in tabular forms organized in sequential manner, following the order of presentation of the specific problems in Chapter 1.

2. SOP 1. How effective are those canteen services to the respondent in terms of: 2.1 Service 2.2 Menu 2.3 Facilities

Level of effectiveness of Canteen Services in terms of Services

Legend: 3.25 - 4.00 Highly Effective (HE) 1.75 - 2.49 Slightly Effective (SE)

2.50 - 3.24 Effective (E) 1.00 - 1.74 Not Effective (NE)

Table 1.1 depicted the observation of the respondents in the quality of the canteen in terms of services. Furthermore, the computed general assessment was 2.962 and was verbally interpreted as “ Effective ” statement. Additionally, the indicator “ 2- The staffs show courtesy and politeness has the highest general assessment of 3.02 and was verbally interpreted as “ Effective ” . In contrary, the indicator “ 4 - The staffs keep their service consistently has the least general assessment of 2. 90 and verbally interpreted as “ Effective ”.

This implied that most of the respondents believed that services that they show courtesy and politeness general assessment that weighted 3.02 that verbally interpreted as “ Effective ” .

According to Adunna (2013) mentioned that when providing nutritious food and affordable, the canteen should focus on good management practices and be financially self-sustaining. Moreover, effective canteen management requires that everyone involved must know it goals and objectives and it is familiar with its policies canteen staff and committee develop an implementation plan to achieve policy everyday operational procedures.

Level of effectiveness of Canteen Services in terms of Menu

Legend: 3.25 - 4.00 Highly Effective (HE) 1.75 - 2.49 Slightly Effective (ME)

2.50 - 3.2 Effective (E) 1.00 - 1.74 Not Effective (NE)

Table 1.2 revealed the observation in canteen quality in terms of menu of the selected G12 HUMSS Students; the computed general assessment was 2. 774 and was verbally interpreted as “ Effective ” statement. Additionally, the indicator “2-The menu that they serve contains the nutritional value. ” has the highest general assessment of 3.02 and was verbally interpreted as “ Effective ” and was verbally interpreted as “ Effective ” . In contrary, the indicator 4 - The menu is affordable for the students.” has the least general assessment of 2. 17 and verbally interpreted as “ Slightly Effective ”

This implied that most of the respondents believed that the menu that they serve contains nutritional value by a computed general assessment that weighted 3.02 that scales “ Effective ” .

On the other hand of the studies in the country of Philippines, according to Omadto (2016), said that each of the canteen management and facilities follows a guideline on their operational management set by the Department of Education through their order, the guidelines given to them was to rationalize the operation of the management of school canteens in the public and private academic system to ensure that the schools canteen shall help to eliminate malnutrition among their pupils. Moreover, school canteens may operate under a variety of management structures, a formal management agreement discussing the terms and the conditions in order to sign by the relevant management parties such as principal, school council, or the private contractor.

Level of effectiveness of Canteen Services in terms of Facilities

Legend: 3.25 - 4.00 Highly Effective (HE) 1.75 - 2.49 Moderately Effective (SE)

Table 1.3 revealed the observation in canteen quality in terms of facilities of the selected G12 HUMSS students; the computed general assessment was 2. 876 and was verbally interpreted as “ Effective ” statement. Additionally, the indicator “ 1 -The utensils, tools and equipment used in the canteen are sanitized. ” has the highest computed general assessment of 3.08 and was verbally interpreted as “ Effective ” and was verbally interpreted as “ Effective ” . In contrary, the indicator “ 5 - The canteen is strategically situated in place where it is accessible and convenient to all students”. Have the least computed general assessment of 2. 75 and verbally interpreted as “ Effective ”.

This implied that most of the respondents believed that the facilities of canteen are utensils; tools and equipment used in the canteen are sanitized by a computed general assessment that weighted 3.08 that scales “ Effective ” .

According to Marroquin and Brandt (2014) stated that even though services usually tend to be “naturally intangible” which means it cannot be remove or destroy, rather than an abject with the opposite nature, it might not be a clear feature after all. And it is the cause of many services or facilities that can provide an output that is compound by tangible components, such as product, equipment, physically entity and even staff. Moreover, there are facility activities composed by two stages, and it is the interaction between the customer and the provider is being held, while the second stage might take time to take advantage to be visible actions. In addition, they stated also that the best example for assumption in the service offered by a canteen catering provider, because it composed of wide variety of retailing foods and drinks.

2. SOP 2. What is the level of satisfaction of Grade 12 HUMSS students?

Level of satisfaction in terms of Services

Legend: 3.25 - 4.00 Highly Satisfied (HS) 1.75 - 2.49 Moderately Satisfied (MS)

2.50 - 3.24 Satisfied (S) 1.00 - 1.74 Not Satisfied (NS)

Table -2.1 revealed the level of satisfaction in canteen in terms of services of the selected G12 HUMSS Students, the computed general assessment was 2. 968 and was verbally interpreted as “ Satisfied ” statement. Additionally, the indicator “ 4 -There are provisions for garbage disposal. ” has the highest computed general assessment of 3.07 and was verbally interpreted as “ Satisfied ” . In contrary, the indicator “ 2- Request/order of the clients are promptly accommodated and quickly served.” has the least computed general assessment of 2. 90 and verbally interpreted as “ Satisfied ” .

This implied that most of the respondents believed that the The services that they show has mean of 3.07 which are provisions for garbage disposal by a computed general assessment that weighted that scales “ Satisfied ” .

It is indicated at the American International Journal of Contemporary Research (2014), that when the quality service of concept from the viewpoint of manufacturing service businesses, it must observed even it is difficult to derive or do a standard quality due to the intangibility and concurrency characteristics of the service, so that service quality can briefly or shortly described as a phenomenon considered within the context of customers expectation and perception about the service offered. Moreover, customers expectation and perception of the service will determine the quality of service, if the provided service does not exceed or meet the expectations of the customers, then specifically the service quality is low. However, Pineda (2013), he stated that the quality management practices in the school management in the Philippines, it is determined the level of effectiveness of the total quality service management between the quality of the practices of other institutions, likewise it is more on comparing other services.

Level of satisfaction in terms of Menu

Table 2.2 revealed the level of satisfaction in canteen in terms of menu of the selected G12 HUMSS students; the computed general assessment was 2. 742 and was verbally interpreted as “ Satisfied ” statement. Additionally, the indicator “ 3 - Meals are cleaned and maintained fresh. ” has the highest computed general assessment of 2.90 and was verbally interpreted as “ Satisfied ” In contrary, the indicator “ 1- Meals are affordable . ” has the least computed general assessment of 2. 28 and verbally interpreted as “ Moderately Satisfied ”.

This implied that most of the respondents believed that the menu that they serve contains 2.90 are cleaned and maintained fresh by a computed general assessment that weighted that scale “ Satisfied ” .

Based on Alger (2017), he mentioned that in Australia, school canteens are an integral or it is a fundamental part of the school environment, also it is the ideal site to encourage healthy eating. However, when the canteen is not supported in the school system, healthy menus maybe difficult to implement, moreover a range of influences such as: maintaining profit, reduced volunteer support and student choice negatively impacted what was sold on the canteen menu, the study indicated that offering a sustainable healthy school canteen menu largely depended on the support and resources provided by the school system. Although schools are the best places to implement solutions to over-nutrition and obesity since children and young adults spend most of their time in school and consequently, spend more time in school than at home.

Level of satisfaction in terms of Facilities

Table -2.3 revealed the level of satisfaction in canteen in terms of facilities of the selected G12 HUMSS Students, the computed general assessment was 2 .854 and was verbally interpreted as “ Satisfied ” statement. Additionally, the indicator “ 2- There are enough tables and chairs for the clients. ” has the highest computed general assessment of 3.00 and was verbally interpreted as “ Observed” . In contrary, the indicator “ 3- Tables and chairs are kept clean and properly arranged for the next clients.” has the least computed general assessment of 2. 82 and verbally interpreted as “ Satisfied ”. This implied that most of the respondents believed that the facilities of canteen have 3.00 enough tables and chairs for the clients by a computed general assessment that weighted that scales “ Satisfied ” .

According to Galabo (2019), Tangibility defined as the related to an appeal of facilities, equipment, and material used by a service firm as well as to the appearance, moreover tangibles provide physical representations or image of the service that customers particularly new customers, will use to evaluate quality. However, assurance means the staff behavior will give customers confidence in the school canteen and that the employees are always courteous and have the necessary knowledge to respond to customers questions.

The Significant Relationship between the Canteen Services and the Level of Satisfaction of the Grade 12 HUMSS students of Laguna College of Business and Arts.

- Correlation s significant at the 0.05 level (two tailed)

Table 3 showed the test for significant relationship between the canteen services on the level of satisfaction of G12 HUMSS students on Laguna College of Business and Arts. The analysis generated a computed R Value of 0.7174 which was greater than the P Value of .00001 and was decided or interpreted as “significant”. Thus the null hypothesis was rejected. The result implies that the canteen services in terms of: services, menu and facilities about the level of satisfaction is connected with each other and it is important.

SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

This chapter presents the summary of findings, conclusions and recommendations based on the data gathered and presented.

Summary of Findings

Based on the data gathered and after careful and thorough analysis of the investigation, the following are the findings of the study in summarized form.

1. Level of effectiveness of Canteen Services

1.1 In terms of services, it has a general assessment was 2.962 and was verbally interpreted as “Effective” . The staffs show courtesy and politeness has the highest computed mean of 3.02 and was verbally interpreted as “ Effective ” . The staffs keep their service consistently has general assessment of 2. 90 and verbally interpreted as “ Effective ”.

1.2 In terms of menu, the general assessment was 2.774 and was verbally interpreted as “ Effective” . The menu that they serve contains the nutritional value has the highest computed general assessment of 3.02 and was verbally interpreted as “ Effective” . The menu is affordable for the students has the least computed general assessment of 2.17 and verbally interpreted as “ Slightly Effective ”.

1.3 In terms of facilities, the computed general assessment was 2.876 and was verbally interpreted as “ Effective” . The utensils, tools and equipment used in the canteen are sanitized has the highest computed general assessment of 3.08 and was verbally interpreted as “ Effective” . The canteen is strategically situated in place where it is accessible and convenient to all students have the least computed general assessment of 2.75 and verbally interpreted as “ Effective”.

2. Level of satisfaction of Canteen Services

2.1 In terms of service, the general assessment was 2.968 and was verbally interpreted as “ Satisfied” . There are provisions for garbage disposal has the highest general assessment of 3.07 and was verbally interpreted as “ Satisfied” . Request/order of the clients are promptly accommodated and quickly served has the least computed general assessment of 2.90 and verbally interpreted as “ Satisfied”.

2.2 In terms of menu, the computed general assessment was 2.742 and was verbally interpreted as “ Satisfied” . Meals are cleaned and maintained fresh has the highest computed general assessment of 2.90 and was verbally interpreted as “ Satisfied”. Meals are affordable has the least computed general assessment of 2.28 and verbally interpreted as “ Moderately Satisfied”.

2.3 In terms of facilities, the computed general assessment was 2.854 and was verbally interpreted as “ Satisfied”. There are enough tables and chairs for the clients has the highest general assessment of 3.00 and was verbally interpreted as “ Observed. Tables and chairs are kept clean and properly arranged for the next clients.” has the least computed general assessment of 2.82 and verbally interpreted as “ Satisfied”.

3. Relationship between the Level of Effectiveness and Level of Satisfaction of the students of Laguna College of Business and Arts.

Showed the test for significant relationship between the canteen services on the level of satisfaction of G12 HUMSS students on Laguna College of Business and Arts. The analysis generated a computed R Value of 0.7174 which was greater than the P Value of .00001 and was decided or interpreted as “significant”. Thus the null hypothesis was rejected. The result implies that the canteen services in terms of: services, menu and facilities about the level of satisfaction is connected with each other and it is important.

Conclusions

Based on the aforementioned findings of the study, the following conclusions are derived:

1.1 That the staffs show courtesy and politeness to their customers but the staffs did not kept their service consistently in terms of their services. 1.2 That the menu that they serve contains the nutritional value although menu is not affordable for the students. Still, it is worth bought for. 1.3 That the utensils, tools and equipment used in the canteen are sanitized when it comes to the effectives of facilities. However, based on the students the canteen is not strategically situated in place where it is accessible and convenient to all students. 2.1 That there are provisions for garbage disposal that the student satisfied but students noticed that they are not able to request/order of the clients are promptly accommodated and quickly served. 2.2 That meals are cleaned and maintained fresh but meals are not affordable. 2.3 That even though there are enough tables and chairs for the clients but they did not kept clean and properly arranged for the next clients

Recommendations

Based on the findings summarized and conclusions drawn, the following recommendations are hereby offered:

1. The staffs must find ways on how they improved their services in a way that they maintained the consistency of the services to the students and to the school administrators. 2. The canteen manager will be the one who in-charge for the changes of the prices of the menu to the affordable and cheapest price which might be implemented for the students to able them befit their budget and keep their nutrition healthy. 3. The school administration and management need take plans and action through assessment and look for the suggestions of the students to improved and enhanced the whole aspect of school canteen in terms of services, menu and facilities for the sake of students satisfaction. 4. For the further researches, this study is recommended and suggested for further study which may help the learners, teachers and parents to attain their satisfaction on the canteen services. Also for them to be aware on the safety of them on the canteen services.

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Level of Satisfaction of Grade 12 ABM Students in Food Services in the School Canteen of Bestlink College of the Philippines School Year 2018-2019

• Juvelyn Garcia
• John Kenneth Litang
• Hazel Villa
• Manuel Gutierez
• Crystel-Joy S. Tamon

Having a school canteen inside the campus is helpful and important for students. It makes access to buying foods easier and more accommodating rather than going outside. Bestlink College of the Philippines ensures to have its canteen inside the school that offers different food services to produce productive students. This study aims to assess the level of satisfaction of Grade 12 ABM students in the Food Services of School Canteen. The purpose of this study is to promote continuous patronage of the school canteen and recommend a more effective strategy in maintaining the satisfaction level of the students in its food services. This study used a qualitative-descriptive research design to assess the level of satisfaction of Grade12 ABM Students in the Food Services in the canteen. There were three variables identified affecting the level of satisfaction of Grade 12 ABM students. These were the nutrition of food, the price of food, and the cleanliness of food in the canteen. The data were gathered from distributed questionnaires to the respondents. The results of the study revealed that Grade 12 ABM students were satisfied in the food services in the school canteen on the following: (1) Nutrition of Food –foods that were served in the canteen meet the satisfaction of the Grade 12 ABM students in terms of taste, nutrition, and menus that promote healthy lifestyle. (2) Price of food –the price of food in the canteen is found to be reasonable per serving and meets the budget of the Grade 12 ABM students. (3) Cleanliness of the food –this included the neatness of the canteen staff, the area, the preparation and arrangement of the foods. The school canteen was found at its satisfactory level in terms of promoting the cleanliness of the food for the benefit of the students and other customers. The results of the study showed that the Bestlink Canteen has a satisfactory rate in terms of its Food Services. In line with this, the school administrators must maintain good standing in the level of satisfaction and implement more effective policies and guidelines for the canteen services to level up the satisfaction rate of the students and other customers. It was highly recommended to conduct a wider study about the satisfaction of the students in all strands to create more effective strategies and projects, promoting to continuously buy foods in the canteen.

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Anti-semitic attitudes of the mass public: estimates and explanations based on a survey of the moscow oblast.

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JAMES L. GIBSON, RAYMOND M. DUCH, ANTI-SEMITIC ATTITUDES OF THE MASS PUBLIC: ESTIMATES AND EXPLANATIONS BASED ON A SURVEY OF THE MOSCOW OBLAST, Public Opinion Quarterly , Volume 56, Issue 1, SPRING 1992, Pages 1–28, https://doi.org/10.1086/269293

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In this article we examine anti-Semitism as expressed by a sample of residents of the Moscow Oblast (Soviet Union). Based on a survey conducted in 1920, we begin by describing anti-Jewish prejudice and support for official discrimination against Jews. We discover a surprisingly low level of expressed anti-Semitism among these Soviet respondents and virtually no support for state policies that discriminate against Jews. At the same time, many of the conventional hypotheses predicting anti-Semitism are supported in the Soviet case. Anti-Semitism is concentrated among those with lower levels of education, those whose personal financial condition is deteriorating, and those who oppose further democratization of the Soviet Union. We do not take these findings as evidence that anti-Semitism is a trivial problem in the Soviet Union but, rather, suggest that efforts to combat anti-Jewish movements would likely receive considerable support from ordinary Soviet people.

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Land use changes in the environs of Moscow

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Savvino-storozhevsky monastery and museum.

Zvenigorod's most famous sight is the Savvino-Storozhevsky Monastery, which was founded in 1398 by the monk Savva from the Troitse-Sergieva Lavra, at the invitation and with the support of Prince Yury Dmitrievich of Zvenigorod. Savva was later canonised as St Sabbas (Savva) of Storozhev. The monastery late flourished under the reign of Tsar Alexis, who chose the monastery as his family church and often went on pilgrimage there and made lots of donations to it. Most of the monastery’s buildings date from this time. The monastery is heavily fortified with thick walls and six towers, the most impressive of which is the Krasny Tower which also serves as the eastern entrance. The monastery was closed in 1918 and only reopened in 1995. In 1998 Patriarch Alexius II took part in a service to return the relics of St Sabbas to the monastery. Today the monastery has the status of a stauropegic monastery, which is second in status to a lavra. In addition to being a working monastery, it also holds the Zvenigorod Historical, Architectural and Art Museum.

Belfry and Neighbouring Churches

Located near the main entrance is the monastery's belfry which is perhaps the calling card of the monastery due to its uniqueness. It was built in the 1650s and the St Sergius of Radonezh’s Church was opened on the middle tier in the mid-17th century, although it was originally dedicated to the Trinity. The belfry's 35-tonne Great Bladgovestny Bell fell in 1941 and was only restored and returned in 2003. Attached to the belfry is a large refectory and the Transfiguration Church, both of which were built on the orders of Tsar Alexis in the 1650s.  

To the left of the belfry is another, smaller, refectory which is attached to the Trinity Gate-Church, which was also constructed in the 1650s on the orders of Tsar Alexis who made it his own family church. The church is elaborately decorated with colourful trims and underneath the archway is a beautiful 19th century fresco.

Nativity of Virgin Mary Cathedral

The Nativity of Virgin Mary Cathedral is the oldest building in the monastery and among the oldest buildings in the Moscow Region. It was built between 1404 and 1405 during the lifetime of St Sabbas and using the funds of Prince Yury of Zvenigorod. The white-stone cathedral is a standard four-pillar design with a single golden dome. After the death of St Sabbas he was interred in the cathedral and a new altar dedicated to him was added.

Under the reign of Tsar Alexis the cathedral was decorated with frescoes by Stepan Ryazanets, some of which remain today. Tsar Alexis also presented the cathedral with a five-tier iconostasis, the top row of icons have been preserved.

Tsaritsa's Chambers

The Nativity of Virgin Mary Cathedral is located between the Tsaritsa's Chambers of the left and the Palace of Tsar Alexis on the right. The Tsaritsa's Chambers were built in the mid-17th century for the wife of Tsar Alexey - Tsaritsa Maria Ilinichna Miloskavskaya. The design of the building is influenced by the ancient Russian architectural style. Is prettier than the Tsar's chambers opposite, being red in colour with elaborately decorated window frames and entrance.

At present the Tsaritsa's Chambers houses the Zvenigorod Historical, Architectural and Art Museum. Among its displays is an accurate recreation of the interior of a noble lady's chambers including furniture, decorations and a decorated tiled oven, and an exhibition on the history of Zvenigorod and the monastery.

Palace of Tsar Alexis

The Palace of Tsar Alexis was built in the 1650s and is now one of the best surviving examples of non-religious architecture of that era. It was built especially for Tsar Alexis who often visited the monastery on religious pilgrimages. Its most striking feature is its pretty row of nine chimney spouts which resemble towers.

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