The Food provision, cUlture and Environment in secondary schooLs (FUEL) study: Protocol of a mixed methods evaluation of national School Food Standards implementation in secondary schools and their impact on pupils' dietary intake and dental health

Marie Murphy, Miranda Pallan, Emma Lancashire, Rhona Duff, Ashley J. Adamson, Suzanne Bartington, Emma Frew, Tania Griffin, Kiya L. Hurley, Jayne Parry, Sandra Passmore, Vahid Ravaghi, Alice J. Sitch, Suzanne Spence, Maisie K. Rowland, Scott Wheeldon, Peymane Adab

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Abstract

Introduction Excess free sugar intake is associated with obesity and poor dental health. Adolescents consume substantially more free sugar than is recommended. National (UK) School Food Standards (SFS) are in place but are not mandatory in all schools, and their impact on the diets of secondary school pupils is unknown. We aim to evaluate how SFS and wider healthy eating recommendations (from the national School Food Plan (SFP)) are implemented in secondary schools and how they influence pupils' diets and dental health. Methods and analysis Secondary-level academies/free schools in the West Midlands, UK were divided into two groups: SFS mandated and SFS non-mandated. Using propensity scores to guide sampling, we aim to recruit 22 schools in each group. We will compare data on school food provision and sales, school food culture and environment, and the food curriculum from each group, collected through: school staff, governor, pupil, parent surveys; school documents; and observation. We will explore the implementation level for the SFS requirements and SFP recommendations and develop a school food typology. We aim to recruit 1980 pupils aged 11-15 years across the 44 schools and collect dietary intake (24-hour recall) and dental health data through self-completion surveys. We will compare free sugar/other dietary intake and dental health across the two SFS groups and across the identified school types. School type will be further characterised in 4-8 case study schools through school staff interviews and pupil focus groups. Evaluation of economic impact will be through a cost-consequence analysis and an exploratory cost-utility analysis. Ethics and dissemination Ethical approval was obtained from the University of Birmingham Ethical Review Committee (ERN_18-1738). Findings will be disseminated to key national and local agencies, schools and the public through reports, presentations, the media and open access publications. Trial registration number ISRCTN 68757496 (registered 17 October 2019).

Original languageEnglish
Article numbere042931
JournalBMJ Open
Volume10
Issue number10
Early online date16 Oct 2020
DOIs
Publication statusPublished - 16 Oct 2020

Funding

Funding This study is funded by the National Institute for Health Research (NIHR) Public Health Research programme (17/92/39). AJS is part-funded by the NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Competing interests MP, EL, AJA, SB, EF, TG, KH, JP, SP, VR, AJS and PA hold grants from the UK National Institute for Health Research (NIHR). PA is Chair of the NIHR Public Health Research Funding Committee. AJA is Director of the NIHR School for Public Health Research, a NIHR Senior Investigator and a member of both the School Food Plan Alliance and UK Prevention Research Partnership network Generating Excellent Nutrition in UK Schools (GENIUS). JP is Chair of a NIHR Fellowships selection committee. AJS is a grant holder for the Birmingham NIHR Biomedical Research Centre. SB is an elected member of Oxfordshire County Council.

Keywords

  • epidemiology
  • nutrition & dietetics
  • public health

ASJC Scopus subject areas

  • General Medicine

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