Impact of a Capacity-Building Intervention on Food Marketing Features in Recreation Facilities

Objective: To explore the impact of a capacity-building intervention (CBI) to support implementing provincial nutrition guidelines on food marketing in recreation facilities (RFs). Design: Randomized controlled trial within a natural experiment: food marketing in RFs from 3 guideline provinces randomly assigned to intervention (GL+CBI) or comparison (GL-ONLY) was compared with facilities in 1 province without guidelines (NO-GL). Food marketing was assessed by the Food and Beverage Marketing Assessment Tool for Settings. Setting: Canadian provinces with/without voluntary nutrition guidelines for RFs. Participants: 51 RFs. Intervention: 18-month CBI. Main Outcome Measures: Change in Food and Beverage Marketing Assessment Tool for Settings scores and marketing features between baseline and follow-up across groups. Analysis: Kruskal-Wallis with post hoc Mann-Whitney U tests. Results: No significant differences in food marketing features between baseline and follow-up across groups except for a change in food marketing frequency (P = 0.045). The increase in frequency in NO-GL (median, 6.0; interquartile range, -2.0 to 8.5) was significantly greater than changes in the GL+CBI (P = 0.033) and GL-ONLY sites (P = 0.049). Conclusions and Implications: Capacity-building was not associated with improved food marketing features potentially because of nonmandated nutrition guidelines, low priority for change, and vague or narrow facility goals and guidelines. Nutrition guidelines with specific unhealthy food marketing restrictions should be mandated and supported.