Co-design of a sustainable and acceptable implementation intervention to maximise the impact of whole school approaches to food within primary schools

共同设计可持续且可接受的实施干预措施，以最大限度地发挥小学全校食物处理方法的影响

• 批准号: MR/V003860/1
• 负责人: Maria Bryant
• 金额: $ 19.29万
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV003860%2F1
• 关键词: Co; design; sustainable; acceptable; implementation

Background: Children consume a third of their food at school, providing an opportunity to promote healthy diets and reduce levels of obesity. The World Health Organisation and UK government recommend that schools adopt approaches across the whole school day that support children to make healthy food choices, offering consistency in the quality of foods provided, eating culture, education about diet, and use of food to learn. In reality, uptake is poor, partly due to lack of direction on how to use such an approach, but also because schools work in highly complex environments with multiple competing demands, and influences from wider factors like national policy, cultural beliefs, population characteristics, costs and catering requirements.Methods: We will design a practical and acceptable intervention to help primary schools adopt whole school approaches to food. This will be done in partnership with key people (stakeholders) including head teachers, teachers, staff, children, parents, school governors, local businesses, and local and national government, by:1. Hosting stakeholders workshops in Bradford, Leeds, Newcastle and Belfast to discuss factors influencing what children eat during the school day. We will ask people to consider potential influencing factors at school (e.g. space needed to provide lunch), in the community (e.g. cultural influences on eating practices) and from wider society (e.g. government policies on free-school meals). We will encourage discussion on how these factors relate to each other and use this information to build a picture called a 'systems map', providing a richer understanding of the local and wider influences on children's food choice. The map may also help to identify parts of the system most likely to respond to intervention and whether adding an intervention in one part (e.g. a packed lunch policy) is likely to cause positive or negative adaptations in others (food eaten at home).2. Inviting stakeholders to take part in designing an intervention. This will involve consideration of the factors identified in our system maps. Based on existing discussion with people who work in schools, we do not expect the intervention to involve excess paperwork or expense for schools. Instead, it might include visual resources (like websites or videos) to support schools to include children in decision making, and to improve the food environment. It could also consider changes to catering decisions or specific activities such as embedding catering staff more across the school, growing food in schools, teaching with food, avoiding using food as reward/or punishment, and consistent food messages. To ensure the intervention supports schools without excessive burden, acceptability and potential barriers will be a key consideration during development. Importantly, we will focus on developing an intervention that has the best chance of supporting those in greatest need.3. Seeking feedback about our draft intervention ideas from our wider stakeholder group. We will share the draft with stakeholders and ask them to rate its acceptability and how easily they can be used by schools. A form will also be used for stakeholders to consider which parts of the intervention they feel can be applied across all schools and which may be less transferable. We will then make any required improvements before fully developing the intervention and its resources.Impact and dissemination: The intervention has the potential to improve dietary options extending beyond the school day. It is important that it is evaluated so that, if successful, it can become standard practice. We will therefore engage with key decision makers and advocates, including Public Health England, School Food Matters (a national organisation supporting schools) and the Department of Education. We will share our findings widely, including with schools, children and parents, and will develop plans to test its impact on food choice.

儿童在学校消耗三分之一的食物，这为促进健康饮食和减少肥胖水平提供了机会。世界卫生组织和英国政府建议学校在整个上学期间采取支持儿童做出健康食物选择的方法，提供食物质量的一致性，饮食文化，饮食教育以及使用食物进行学习。事实上，采用率很低，部分原因是缺乏如何使用这种方法的指导，但也因为学校在高度复杂的环境中工作，有多种相互竞争的需求，以及国家政策、文化信仰、人口特征、成本和餐饮要求等更广泛因素的影响。方法：我们将设计一种实用且可接受的干预措施，帮助小学采用全校食物方法。这将与包括校长、教师、工作人员、儿童、家长、学校管理者、当地企业以及地方和国家政府在内的关键人员（利益攸关方）合作，通过以下方式完成：1.在布拉德福德、利兹、纽卡斯尔和贝尔法斯特举办利益攸关方讲习班，讨论影响儿童上学期间饮食的因素。我们将要求人们考虑学校（例如提供午餐所需的空间），社区（例如对饮食习惯的文化影响）和更广泛的社会（例如政府对免费学校餐的政策）的潜在影响因素。我们将鼓励讨论这些因素是如何相互关联的，并利用这些信息来构建一个称为“系统地图”的图片，从而更深入地了解当地和更广泛的影响儿童的食物选择。地图还可以帮助识别系统中最有可能对干预做出反应的部分，以及在一个部分中添加干预（例如盒装午餐政策）是否可能导致其他部分（在家吃的食物）的积极或消极适应。邀请利益攸关方参与设计干预措施。这将涉及考虑我们的系统图中确定的因素。根据与在学校工作的人进行的现有讨论，我们预计干预措施不会涉及过多的文书工作或学校费用。相反，它可能包括视觉资源（如网站或视频），以支持学校将儿童纳入决策，并改善食品环境。它还可以考虑改变餐饮决策或具体活动，例如在学校中更多地嵌入餐饮工作人员，在学校种植食物，用食物教学，避免使用食物作为奖励/或惩罚，以及一致的食物信息。为了确保干预措施支持学校而不造成过度负担，可接受性和潜在障碍将是发展过程中的一个关键考虑因素。重要的是，我们将集中精力制定一项干预措施，最有可能支持那些最需要帮助的人。寻求更广泛的利益相关者群体对我们的干预想法草案的反馈。我们将与利益相关者分享草案，并请他们评价其可接受性以及学校使用的容易程度。还将使用一份表格，供利益攸关方考虑他们认为干预措施的哪些部分可以适用于所有学校，哪些部分可能不太可转让。然后，我们将在充分开发干预措施及其资源之前进行任何必要的改进。影响和传播：干预措施有可能改善学校以外的饮食选择。重要的是要对其进行评估，以便如果成功，它可以成为标准做法。因此，我们将与关键的决策者和倡导者，包括公共卫生英格兰，学校食品问题（支持学校的国家组织）和教育部。我们将广泛分享我们的发现，包括与学校，儿童和家长，并将制定计划来测试其对食物选择的影响。

项目成果

Understanding school food systems to support the development and implementation of food based policies and interventions.

了解学校食品系统以支持基于食品的政策和干预措施的制定和实施。

• DOI: 10.1186/s12966-023-01432-2
• 发表时间: 2023-03-13
• 期刊: INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY
• 影响因子: 8.7
• 作者: Bryant, Maria;Burton, Wendy;O'Kane, Niamh;Woodside, Jayne V.;Ahern, Sara;Garnett, Phillip;Spence, Suzanne;Sharif, Amir;Rutter, Harry;Baker, Tim;Evans, Charlotte E. L.
• 通讯作者: Evans, Charlotte E. L.