These findings demonstrate that awareness (50%), adoption (14%), and implementation (6%) of the ANGCY were low among this sample of recreational facilities approximately one year following their release. Similarly, evidence from the Treatment Improvement Protocols (TIPs) evaluation project suggests that awareness of government-developed best practice guidelines for substance abuse treatment spread slowly, as only 45% of professionals working in the substance abuse field were aware of the TIPs approximately seven years following their release . Diffusion of tobacco control policies was also a lengthy process . Initiatives to address recreational facility food environments are very recent [23, 24], change will require support and thus it may not happen quickly [13, 14]. Awareness of the ANGCY on the part of recreational facilities may actually be high relative to the short period of time that has elapsed since their release, and considering the fact that few resources were directed toward dissemination.
Although just over half of facilities had made changes to improve the nutritional quality of foods offered, only a small proportion (11%) of these changes were motivated by the ANGCY. This survey was not intended to assess the extent or fidelity of implementation of the ANGCY, however open-ended responses suggest that implementation was incomplete. Notably, adoption and implementation were more likely among facilities with an "ANGCY champion", a finding common in many other contexts [38, 39]. Facilities with nutrition policies appeared to be more likely to adopt and implement the ANGCY, although it is not clear whether these policies were precipitated by, or existed prior to ANGCY adoption. These findings demonstrate that creating nutrition guidelines does not in itself constitute a sufficient stimulus for widespread change within the food environment of recreational facilities in the first year following their release. Similarly, awareness  and even adoption  of practice guidelines in other settings also did not guarantee their implementation. An important strength of the current study is its use of a mixed questionnaire which enabled further exploration of the distinct barriers to adoption and implementation of nutrition guidelines in this context.
It is unclear why facilities were less likely to implement the ANGCY if the priority for healthy eating was medium to high. Among the nine facilities deemed to have implemented the ANGCY, six indicated that healthy eating was a low priority. As was the case for adoption, it is possible that the change in priority is more relevant to implementation than the absolute priority, as the priority for healthy eating had increased among six of the nine implementers, and was unchanged in the other three. Furthermore, the survey was not designed to assess the extent of change made. Therefore, although these facilities had made ANGCY-motivated change, it is possible that these changes were minor, consistent with a low priority for healthy eating.
An extensive body of research supports the notion that the key attributes of innovations, as perceived by potential adopters, account for a significant proportion of the variability in adoption rates . Although other factors were also important, perceived negative characteristics of the ANGCY were consistently described as barriers to their adoption and implementation. These perceptions were strongly driven by the constructs of relative advantage and compatibility [28, 42], in which managers perceived that adopting and implementing the ANGCY would limit their profit-making ability. Given managers' limited knowledge of the ANGCY it is possible that some of these negative perceptions may be amenable to change through the provision of training and technical assistance  to enhance understanding and application of the ANGCY.
Food choices are primarily made on the basis of taste, cost and convenience, and to a lesser extent, health and variety [44, 45]. Individuals vary in the importance they ascribe to each of these dimensions [44, 45], however children are particularly vulnerable to external influences because they fail to take into account the future consequences of today's unhealthy dietary choices [46, 47]. In this study, the perceived higher costs of healthy foods emerged as a particularly salient barrier that limited the marketability, and hence the availability, of healthier options. This finding was not surprising, as one of the most powerful ways to modify food purchases is to change food pricing [48–51]. Indeed, when healthier foods are substituted for less healthy foods at competitive prices in both cafeterias  and vending machines [53–55], children's purchases of healthier foods increases with no loss of revenue . The threat of reduced profitability was also an important barrier to providing healthier food options in other studies of recreational facilities [13, 14, 23–25], however in spite of these fears, many recreational facilities intended to continue to offer healthier options [14, 23, 24]. This suggests that concerns related to profitability need not preclude adoption and implementation of the ANGCY.
Given that financial considerations figured prominently into the decision of managers not to adopt and implement the ANGCY, recreational facility managers could consider raising prices on less healthful foods to compensate for lowered prices of healthful options, and stipulate that food contractors do the same within negotiated contracts. This strategy may encourage substitution of healthy for unhealthy items while maintaining revenues [52, 57]. In addition, environmental changes that increase availability and promotion of lower fat foods lead to greater purchase of these items among adolescents, with no adverse effects on school revenues . Thus, pricing and environmental modifications analogous to those recommended in the ANGCY may act in a complementary manner to support purchase of healthy items by children without adversely affecting food service revenues. Success will, however, require a fundamental shift in the managerial role, from one in which managers simply respond to consumer demand, to one in which they endeavour to shape demand by actively manipulating food availability towards a healthier mix.
Findings from this study suggest that recreational facility managers may not recognize the contribution made by unhealthy community nutrition environments to childhood obesity. Instead, some managers held to a personal responsibility frame, holding parents responsible for what is a predictable response to toxic environmental conditions . Strategies to improve problem recognition should therefore be enacted prior to proceeding further with ANGCY adoption and implementation .
The dissemination strategy adopted by the provincial government for recreational facilities included mailing ANGCY resource binders to municipalities, presentations by government staff at educational events and posting the guidelines on the internet. Reliance on mailings and presentations has proven ineffective in other dissemination studies [41, 60–62], and appears to have had limited efficacy in this context as well. Conversely, comprehensive, resourced dissemination guided by theoretical constructs similar to those underlying the current study has been successful . Awareness and uptake of the ANGCY might be improved in recreational facilities by adapting successful dissemination strategies used in other settings. It is also possible that the time frame used in this study may have been too short to see widespread awareness, adoption and implementation of the ANGCY.