Exploring Specialist Schools food and identifying evidenced-based interventions to support healthier food choices: a mixed methods study (CHOICE)

Research Question

What are key stakeholder perspectives of Specialist School food, and what evidenced-based interventions exist to support healthier food choices in Specialist Schools? Background

Children and Young People (CYP) attending Specialist Schools have the highest levels of need in Education, and often have at least one health condition.

The food and drink (henceforth food) that CYP consume in school is important for their health. There is limited research on whether Specialist School food meets the wide-ranging needs of pupils. It is vital to identify opportunities for improving Specialist School food to help reduce increased risk of poor health, overweight, and obesity in CYP with learning disability, and of underweight in those with eating and drinking difficulties.

Aims 1. to explore stakeholders’ perspectives on school food.

2. to identify what evidenced-based interventions exist to support healthier food choices for CYP attending Specialist Schools. Methods A mixed methods approach in two work packages (WP) will be employed.

WP 1: a case study approach. Four North East of England Specialist Schools will be purposefully sampled (including primary and secondary schools). Selected schools will provide diversity in population, location, school catering models, and educational provision type. WP1 Objectives and methods (addressing Aim 1):

1. To describe current school food in Specialist Schools. Study design: document review and schools menu review; method: freely accessible data from websites.

2. To explore key stakeholders’ perspectives on Specialist School food (including parents/carers; health and educational professionals, and school catering staff). Study design: qualitative. Method: focus groups and interviews including topics such as use of school food standards, food provision/policy for pupils with eating and drinking difficulties, challenges, and facilitators in supporting healthy food choices.

3. To understand factors that influence choices related to school food consumption made by young people attending Specialist Schools. Study design: qualitative. Method: focus groups, including topics such as foods on offer, perceptions of healthy foods, and factors influencing food choices. WP 2: a scoping review, following the Joanna Briggs Institute framework and reported according to PRISMA-ScR.

WP2 Objectives and methods (addressing Aim 2):

1. To identify the existing evidence-base on interventions to support healthier food choices amongst CYP attending Specialist School (a narrative scoping review) 2. To consider how the identified interventions were developed (using MRC taxonomy)

3. To identify the intended action/effects of the interventions and what would replication of each as designed entail? (using TIDieR/ TIDierR-PHP/AACTT)

4. To identify any intervention evaluation and describe any health outcomes (description of evaluation and primary/secondary outcomes) Timeline 1st Sept-Feb 2024 Anticipated impact and dissemination

For pupils and schools, an infographic and short, animated video. For academics, a final report, peer-reviewed publications, and conference presentation(s). A logic model will be developed. Two stakeholder dissemination events are planned at local (face-to-face) and national (online) level. Findings will generate evidence for future intervention development and piloting. If effective, novel school-food interventions will improve CYP’s health and well-being.