Purpose: In this mixed-methods case study, we explored factors influencing the adoption and implementation of the Alberta Nutrition Guidelines for Children and Youth within recreational facilities, and assessed the impact of their implementation on the food environment.
Methods: Qualitative data were generated via interviews, observations, and document reviews. The quality of the food environment was assessed using validated and newly developed food environment assessment tools.
Results: Whereas few barriers existed in terms of adopting the guidelines, implementing them proved much more challenging. Implementation was impeded by concerns about the lack of profitability of healthy items, time, and resource constraints. Guidelines that do not restrict the availability of unhealthy options are better accepted by stakeholders. Implementation of the guidelines supported creation of a healthy food environment, but the availability of healthy items remained very limited within the concession (16%) and vending machines (20%), and children continued to purchase primarily unhealthy items.
Conclusions: Findings suggest that children choose healthy options insufficiently when unhealthy items are present. Thus, although introducing the nutrition guidelines in a nonrestrictive format may have been advantageous in some ways, they should be strengthened over time so that they recommend near or total elimination of unhealthy options.