Co-design of a systems wide approach (CONNECTS-Food) to promote adoption of whole-school approaches to food

Objective: To co-design a systems approach aimed at promoting wide scale adoption of whole-school approaches to food in UK primary schools to improve school food environments, food provision and dietary intake in children. Design: A systems framework (Action Scales Model) was used to guide the co-design of the systems approach. The process involved identifying leverage points within the UK primary school food system that, if influenced, could alter the way in which the system functions. Actions were then agreed upon to influence those leverage points. Setting: Co-design workshops were held online between September 2021 and February 2022. Participants: Members of the co-design team comprised 12 school stakeholders (headteachers, school food improvement officers, catering leads, representatives of UK school food organisations, and a dietician) and a team of researchers with expertise in school food, systems thinking and intervention development. Our partnership board included decision makers and advocates of the whole-school approach to food in England and Northern Ireland. Results: Identified leverage points included the priorities of headteachers, who are instrumental in instigating whole-school approach to food adoption. Direction from local and national policy makers was also identified. Actions to influence these leverage points included providing direct support to schools (through an online resource) and encouraging policy makers to monitor adoption of the approach. Conclusion: The methods described here can be replicated by others to promote adoption of whole-school approaches to food in other contexts and contribute to the growing literature on developing systems wide approaches to promote adoption of public health initiatives.