Exploring the impact of nutrition guidelines for publically funded recreation and sport facilities in Canada: an overview of the Eat, Play, Live study design

All of the following outcome measures will be assessed at baseline (Nov 2015-June 2016) and follow-up (Sept 2017-Feb 2018):
1. Facility Organizational Capacity is measured by an audit tool specifically designed for recreation facilities (a self-assessment of the current environment and level of capacity to address healthy eating within recreation facilities)
2. Policy Development is measured by the policy question on the above capacity audit tool along with a purpose built questionnaire that requests information about:
2.1. The status of facility level policy for the provision of healthy food
2.2. How provincial nutrition guidelines are addressed in the policy
2.3. The key food environment issues addressed in the policy
3. Food Environment - a reliable (test-retest and inter-rater reliability ≥ 0.88) four-step process will be used to audit the contents of two randomly selected snack and two randomly selected beverage vending machines per facility (Naylor et al, 2010). For each item present, a Research Assistant will record information on product brand, variety/type, size, flavour and price. This information will be used to calculate the proportion of products classified as: Sell Most (nutrient-dense; lower in sodium, sugar and fat), Sell Sometimes (source of essential nutrients; higher in sodium, sugar, and/or fat), and Do Not Sell (energy-dense and nutrient-poor; high in sodium, sugar, and/or fat) (BC Ministry of Health, 2014), using an online automated classification tool called the Brand Name Foodlist (https://bnfl.healthlinkbc.ca/) which uses BC’s food classification scheme to provide a consistent basis for cross-province comparisons
4. Food Environment - the concession food environment will be measured objectively using the Nutrition Environment Measures Survey–Restaurant (NEMS-R; fast casual version) (Lesser, Hunnes et al. 2012). The marketing questions will be enhanced with a valid and reliable checklist developed in Alberta that identifies food/beverage ad location (e.g. jerseys, scoreboards) and content (e.g. logos, appealing images) (Prowse et al 2018)
5. Patron Purchasing Patterns are measured using sales records for the products sold in vending machines and concession(s) will be collected for two weeks during baseline and follow-up

1. Meeting Minutes from Regional Teleconferences: During the 18-month intervention, meetings will be held quarterly with researchers, the Provincial Coordinator and representatives from CBI facilities; each will include a short verbal report from participating facilities that addresses activities to date, spin-off activities, issues and facilitators or barriers. Meeting minutes will be recorded and a facility events and activities list created
2. Facility Plans and 6 Month Reports: Each facility will submit their plan for activities they intend to complete along with a short report summarizing activities and events they actually did complete every 6 months. The research team will review these documents and summarize key activities on the facility events and activities list
3. Semi-Structured Interviews and Focus Groups with Recreation Administrators and Staff: These will explore elements of the context and CBI that facilitate and/or inhibit implementation. At each intervention facility, we will invite administrators (n = 18) and the staff identified by the administrator as ‘most involved’ in the nutrition policy change strategy to participate in individual semi-structured interviews. Interviews will be taped and transcribed verbatim