The school environment was assessed using a questionnaire completed by a school administrator (e.g. principal)(see Additional file 4 : ISCOLE School Environment Questionnaire), and a direct audit of the school environment, performed by ISCOLE staff. The school administrator questionnaire was adapted from the healthy eating and physical activity modules of the Healthy School Planner [44 ] used in the Canadian School Health Action, Planning and Evaluation System (SHAPES) [45 (link)]. The questionnaire includes items related to school facilities, healthy eating and physical activity policies, extracurricular activities, frequency of physical education and breaks (recess), promotion of active transportation, and the availability of healthy and unhealthy foods in the cafeteria and vending machines. In addition, questions regarding food items sold as part of fundraising efforts were incorporated from the U.S. School Health Policies and Practices Study (SHPPS) [46 ]. Two additional questions were added by ISCOLE investigators to capture the number of days that students attend school during the academic year and the amount of class time mandated for physical education.
Specially trained ISCOLE study staff completed an environmental audit of each participating school. A single data collector performed each school audit. For at least 5% of the schools within a site, another similarly trained data collector performed a second, independent audit in order to determine item reliability and to monitor consistency in adhering to item definitions. The school audit tool was used to collect directly-observed information pertaining to the school built and food environments. Components of the audit tool addressing the school built environment were taken from the school audit tool used in the SPEEDY (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) study [47 (link),48 (link)], which has acceptable reliability (agreement between pairs of auditors range from 76% to 99% across components) and good construct validity (components of the tool were able to discriminate physical activity levels of children attending schools in the highest and lowest quintiles) [48 (link)]. A question regarding whether fast food restaurants were visible from any of the school entrances was added by ISCOLE investigators in order to better characterize the food environment of the area surrounding the school. Components of the audit tool addressing the à la carte school food environment were modified based on that used in the IDEA (Identifying Determinants of Eating and Activity) study [49 (link)]. The wording of choices, including examples of environmental features (e.g. “sidewalk” vs “footpath”) and customary food items, were adapted as necessary across ISCOLE sites. A photo dictionary was created to standardize data collection and capture unique features of the different countries.
Specially trained ISCOLE study staff completed an environmental audit of each participating school. A single data collector performed each school audit. For at least 5% of the schools within a site, another similarly trained data collector performed a second, independent audit in order to determine item reliability and to monitor consistency in adhering to item definitions. The school audit tool was used to collect directly-observed information pertaining to the school built and food environments. Components of the audit tool addressing the school built environment were taken from the school audit tool used in the SPEEDY (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) study [47 (link),48 (link)], which has acceptable reliability (agreement between pairs of auditors range from 76% to 99% across components) and good construct validity (components of the tool were able to discriminate physical activity levels of children attending schools in the highest and lowest quintiles) [48 (link)]. A question regarding whether fast food restaurants were visible from any of the school entrances was added by ISCOLE investigators in order to better characterize the food environment of the area surrounding the school. Components of the audit tool addressing the à la carte school food environment were modified based on that used in the IDEA (Identifying Determinants of Eating and Activity) study [49 (link)]. The wording of choices, including examples of environmental features (e.g. “sidewalk” vs “footpath”) and customary food items, were adapted as necessary across ISCOLE sites. A photo dictionary was created to standardize data collection and capture unique features of the different countries.
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