Improving dietary intake during lunch through the provision of a healthy school lunch at Dutch primary schools: design of a pretest-posttest effectiveness study

Ellen Van Kleef,Frédérique C Rongen,Monique H Vingerhoeds,S Coosje Dijkstra,Jaap C Seidell

doi:10.1186/s12889-020-08807-1

Ellen Van Kleef, Frédérique C Rongen + Show 3 more

Open Access

https://doi.org/10.1186/s12889-020-08807-1

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Abstract

BackgroundSince there is a shift from eating lunch at home to eating lunch at primary schools in the Netherlands, providing a school lunch may be an important opportunity to improve the diet quality of Dutch children. Therefore, the aim of this Healthy School Lunch project is to encourage healthy eating behavior of children at primary schools by offering a healthy school lunch, based on the guidelines for a healthy diet. In this study, two research questions will be addressed. The first research question is: What and how much do children consume from a self-served school lunch and how do they evaluate the lunch? The second research question is: Do children compensate healthier school lunches by eating less healthy outside school hours? The purpose of this paper is to report the rationale and study design of this study.MethodsIn the Healthy School Lunch project children in grades 5–8 (aged 8–12 years) of three primary schools in the Netherlands will receive a healthy school lunch for a 6-month period. To answer research question 1, lunch consumption data will be collected at baseline and again at 3- and 6-months. This will be measured with lunch photos and questionnaires among children. To answer the second research question, a quasi-experimental, pre-test post-test intervention-comparison group design (3 intervention schools and 3 comparison schools) will be carried out. Potential compensation effects will be measured with a single brief questionnaire among parents at the three intervention and three comparison schools at month 6 of the lunch period. The school lunch will also be evaluated by parents (discussion groups) and teachers and support staff (brief questionnaires).DiscussionResults of this study will provide valuable information to influence future school lunch interventions and policies.Trial registrationThis study is registered at the Netherlands trial register (NTR): trialregister.nl, Trial NL7402 (NTR7618), registered retrospectively at 2018-11-13.

Highlights

Introduction and welcomeInformed written consent, explanation of discussion topic and rules, introduction of participants2) Parents’ general school lunch evaluationIndividual task: Rating of three statements Group discussion of task3) Perceptions of child’s eating and drinking during school Individual task: Rating of four statements lunchGroup discussion of task 4) QuestionnaireIndividual completion of questionnaire with demographics.‘My child prefers a home-brought lunch’ and ‘I prefer a home-brought lunch’
This was confirmed by a recent study that concluded that having a lower social economic position (SEP) was independently negatively associated with healthier diet among 5-year old children living in the Netherlands [9]
This study will be conducted to assess the impact of providing a healthy school lunch on dietary intake of children during lunch of primary schools in the Netherlands

Summary

Introduction

Introduction and welcomeInformed written consent, explanation of discussion topic and rules, introduction of participants2) Parents’ general school lunch evaluationIndividual task: Rating of three statements Group discussion of task3) Perceptions of child’s eating and drinking during school Individual task: Rating of four statements lunchGroup discussion of task 4) QuestionnaireIndividual completion of questionnaire with demographics.‘My child prefers a home-brought lunch’ and ‘I prefer a home-brought lunch’. Participants will be asked to indicate individually the level of disagreement or agreement to the statement ‘My child eats and drinks .... Children with a low social economic position (SEP) are likely to consume more energy-dense foods and beverages high in sugar, salt and saturated fat compared to children from middle- and high SEP groups [8]. This was confirmed by a recent study that concluded that having a lower SEP was independently negatively associated with healthier diet among 5-year old children living in the Netherlands [9]

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