{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:56:54Z","timestamp":1791291414652,"version":"4.3.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008036","name":"National Nutrition and Food Technology Research Institute","doi-asserted-by":"publisher","award":["Code 43011208"],"award-info":[{"award-number":["Code 43011208"]}],"id":[{"id":"10.13039\/501100008036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Nutrition\u2010Friendly School Initiative (NFSI) is a whole\u2010school approach designed to address the triple burden of malnutrition among school\u2010aged children. However, evidence on its implementation across diverse settings remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This scoping review followed Arksey and O\u2032Malley's framework and searched PubMed, Web of Science, Embase, Scopus, and gray literature sources for studies explicitly implementing the NFSI framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Sixteen records were included. Evidence suggests that NFSI implementation improves nutrition knowledge, dietary behaviors, and selected health outcomes, including BMI, stunting, and micronutrient status. Major facilitators included institutional commitment, multisectoral collaboration, and stakeholder engagement. Common barriers were limited resources, insufficient training, weak policy enforcement, and sociocultural resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice, and Equity<\/jats:title>\n                    <jats:p>Integrating NFSI principles into education and public health systems may strengthen school nutrition policies and reduce health inequities. Sustainable implementation requires cross\u2010sector collaboration, equitable resource allocation, supportive school food environments, and stronger monitoring systems, particularly in resource\u2010constrained settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The NFSI is a promising framework for promoting child nutrition and health, but stronger long\u2010term evaluations and more comprehensive implementation strategies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70189","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:27:12Z","timestamp":1791257232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Implementation of the Nutrition\u2010Friendly School Initiative (\n                    <scp>NFSI<\/scp>\n                    ): A Scoping Review of Strategies, Challenges, Barriers, and Facilitators"],"prefix":"10.1111","volume":"96","author":[{"given":"Maryam","family":"Karkhaneh","sequence":"first","affiliation":[{"name":"Department of Community Nutrition Faculty of Nutrition Sciences and Food Technology, National Nutrition &amp; Food Technology Research Institute (NNFTRI), Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Omidvar","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition Faculty of Nutrition Sciences and Food Technology, National Nutrition &amp; Food Technology Research Institute (NNFTRI), Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Zayeri","sequence":"additional","affiliation":[{"name":"Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahid Yazdi","family":"Feyzabadi","sequence":"additional","affiliation":[{"name":"Department of Health Management, Policy and Economics, School of Management and Medical Information Sciences Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5669-1591","authenticated-orcid":false,"given":"Hamid","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-4963","authenticated-orcid":false,"given":"Saeid","family":"Doaei","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition Faculty of Nutrition Sciences and Food Technology, National Nutrition &amp; Food Technology Research Institute (NNFTRI), Shahid Beheshti University of Medical Sciences  Tehran Iran"},{"name":"Unit of Nutrition and Cancer, Cancer Epidemiology Research Program Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL)  L'Hospitalet de Llobregat Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azam","family":"Doustmohammadian","sequence":"additional","affiliation":[{"name":"Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.24-0012"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/21665095.2020.1722721"},{"key":"e_1_2_10_4_1","unstructured":"Nutrition for Every Child UNICEF Nutrition Strategy 2020\u20132030 \u201cIn Brief \u201d(2020)."},{"issue":"1","key":"e_1_2_10_5_1","first-page":"1","article-title":"Why We Are Still Failing to Measure the Nutrition Transition","volume":"3","author":"Helen Walls D. 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