{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T19:44:02Z","timestamp":1774727042181,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Municipality of Sintra","award":["231980"],"award-info":[{"award-number":["231980"]}]},{"name":"Municipality of Sintra","award":["7819008155"],"award-info":[{"award-number":["7819008155"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Policy interventions in the school food environment can improve dietary behaviors. However, the literature describing its development and implementation is scarce. This manuscript aims to describe the process of co-creation, implementation, monitoring, and evaluation of a Healthy Snacks Policy, in the scope of Sintra Grows Healthy intervention. Through a community-based participatory research methodology, the co-creation of the Healthy Snacks Policy comprises six stages: snacks evaluation, feedback sessions, class assemblies, school community assemblies, school cluster policy approval, and process evaluation. Within one school year, a Healthy Snacks Policy was co-created, approved, incorporated in the school regulations, implemented, continuously monitored, and evaluated. Regarding snacks evaluation, 1900 snacks were evaluated at the beginning of the school year and 1079 at the end of the school year. There were three feedback sessions, twenty-two class assemblies, and three school community assemblies. Most teachers perceived that children began to consume healthier snacks (72%); 66% of the children were considered to have started eating healthier; and most families said \u201cyes or sometimes\u201d when asked whether their children started requesting healthier snacks (70%), trying new foods (63%), and noticing improvements in their eating habits (74%). The co-creation of a Healthy Snacks Policy establishes an approach to effectively implement existing guidelines for school food supplies, complying with national priority implementation recommendations.<\/jats:p>","DOI":"10.3390\/nu16193374","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T03:26:36Z","timestamp":1728012396000},"page":"3374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Co-Creation and Implementation of a Healthy Snacks Policy in Primary Schools: Data from Sintra Grows Healthy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7328-1817","authenticated-orcid":false,"given":"Telma","family":"Nogueira","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Nutri\u00e7\u00e3o, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Reynaldo dos Santos, Piso 4, 1649-028 Lisboa, Portugal"},{"name":"Instituto de Sa\u00fade Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"given":"Raquel J.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"C\u00e2mara Municipal de Sintra, Departamento de Educa\u00e7\u00e3o, Juventude e Desporto, Largo Dr. Virg\u00edlio Horta, 2714-501 Sintra, Portugal"}]},{"given":"Mariana Li\u00f1an","family":"Pinto","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Nutri\u00e7\u00e3o, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Reynaldo dos Santos, Piso 4, 1649-028 Lisboa, Portugal"}]},{"given":"Vit\u00f3ria","family":"Dias da Silva","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Nutri\u00e7\u00e3o, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Reynaldo dos Santos, Piso 4, 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-5035","authenticated-orcid":false,"given":"Paulo Jorge","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Egas Moniz, 1649-028 Lisboa, Portugal"},{"name":"Laborat\u00f3rio de Biomatem\u00e1tica, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Egas Moniz, ala C, Piso 0, 1649-028 Lisboa, Portugal"},{"name":"Instituto de Medicina Preventiva e Sa\u00fade P\u00fablica, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Egas Moniz, ala C, Piso 0, 1649-028 Lisboa, Portugal"}]},{"given":"Joana","family":"Sousa","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Nutri\u00e7\u00e3o, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Reynaldo dos Santos, Piso 4, 1649-028 Lisboa, Portugal"},{"name":"Instituto de Sa\u00fade Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edif\u00edcio Egas Moniz, 1649-028 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"ref_1","unstructured":"General Assembly of United Nations (1989). 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