Abstract
Abstract Background Adequate calcium intake in childhood is essential in optimising peak bone mass, however, children's milk consumption is decreasing in Ireland and in other developed countries. The School Milk Scheme (SMS) promotes children's milk consumption by providing subsidised milk to schools. It is managed by the National Dairy Council in Ireland, who also design and distribute accompanying educational resources. The aim of this analysis is to identify the factors influencing the implementation of the SMS in Irish primary schools. Methods This research was conducted as part of an evaluation of the EU School Fruit, Vegetables and Milk Scheme in Ireland. Process evaluations of the implementation of the SMS were conducted through direct observation. Observational data were triangulated with data from feedback questionnaires, collected among school staff members, parents and children in 1st, 3rd and 5th class. Quantitative data were descriptively analysed. Qualitative data from observations and interview comments were coded deductively to domains of the Theoretical Domains Framework (TDF). Results SMS implementation was observed in eight schools. Questionnaires were completed by 15 staff members and 50 parent-child dyads from 17 schools. Factors influencing implementation of the SMS were identified across 10 TDF domains. Teachers’ awareness of the SMS educational resources was the most common barrier to their use. Reliability of milk deliveries and having adequate storage for the refrigeration of milk were key factors in influencing programme implementation and acceptability of milk among children. Conclusions This analysis identified a range of barriers and facilitators to the implementation of the SMS in Irish primary schools. Teachers are key stakeholders in the delivery of the SMS, highlighting the importance of clear communication between intervention managers and primary school staff members in supporting the implementation of the educational component of the SMS. Key messages • This analysis identified areas in which further support may be necessary for the future implementation of the SMS in Irish primary schools. • The factors identified across 10 domains of the TDF may also be applicable to other dietary interventions implemented in school settings.
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