• Using behavioural insights to improve the healthiness of children’s packed lunches.

      Jackson, Jessica; Ward, Derek; Giles, David; Bunten, Amanda; Howell-Jones, Rebecca; Burgess-Allen, Jilla; University of Derby; Public Health England (Oxford University Press, 2017-10-20)
      Background Childhood obesity continues to rise in the UK from 9.3% in children aged 4-5 years to 19.8% by age 10-11. Only 1 in 100 school packed lunches meet national recommendations for school meals in England with 82% containing unhealthy snacks and 61% sugar sweetened drinks. Encouraging parents to identify healthier choices could reduce added sugar content and improve the healthiness of school lunches. Methods A cluster randomised controlled trial was implemented in 17 primary schools (8 intervention, 9 control) in England. The intervention comprised of 3 packs of materials delivered to parents who make children lunches (7-11 years). Materials were designed using behavioural-insights to raise awareness of added sugar and offer healthier options. The materials were delivered over a 4-week period in intervention schools. Photographs of the contents of the packed lunches were taken at 3 time points; 1719 pre-intervention, 1745 post-intervention & 1725 at 3 month follow-up. Visible items in each photograph were coded for nutritional content. A parental survey was conducted at post follow up to explore parental knowledge, attitudes and beliefs about healthier packed lunches. Results The coding and analysis is underway and findings will be presented in November. Presented data will describe group differences pre-intervention, post-intervention and follow up from the >5000 lunch boxes for 1) the number lunch boxes that contain surgery food; 2) the average number of sugary food items; 3) the average grams of sugar in lunch boxes; and 4) the proportion of lunch boxes that contain fruit or vegetables. Conclusions This study was funded by Public Health England to explore whether low cost, low intensive interventions can have a significant impact on changing health behaviours. There is a lack of evidence on improving the nutritional quality of packed lunches and if improvements are identified there are potential implications for child health, nutrition and obesity rates. Key messages: •The study aims to ascertain the effectiveness of a behavioural-insight informed intervention in changing the healthiness of packed lunches provided by parents of primary school aged children. •This low cost, low intensity intervention has the potential to improve the healthiness of primary school age children’s diets.
    • Using behavioural insights to reduce sugar in primary school children's packed lunches in derby; A cluster randomised controlled trial

      Bunten, Amanda; Porter, Lucy; Burgess-Allen, Jilla; Howell-Jones, Rebecca; Jackson, Jessica; Ward, Derek; Staples, Vicki; Staples, Paul; Rowthorn, Harriet; Saei, Ayoub; et al. (Elsevier BV, 2020-10-08)
      Children's packed lunches contain more sugar than school-provided meals. Interventions to improve the provision of healthier packed lunches have modest effects on lunch contents. This cluster randomised controlled trial tested an intervention to encourage healthier provision of packed lunches by parents of primary school children in Derby. Schools were randomised to intervention (n = 8) or control (n = 9) using blocked random allocation. In the intervention group, parents of children who brought packed lunches to school in years 3–6 (age 7–11 years) received three bundles of materials (including packed lunch planner, shopping list, information on sugar content of popular lunchbox items and suggestions for healthier swap alternatives) in bookbags/lunchboxes over a 4-week period. Control parents received no materials. Photos of lunchbox contents were taken at baseline, immediately post-intervention and at three-month follow-up. A parental survey aimed to assess capability, opportunity and motivation for packing a healthier lunchbox. No intervention effects were observed for primary outcomes (presence and number of sugary snacks or chilled sugary desserts). The intervention had a significant impact on one secondary outcome (increased number of healthier “swap” items suggested in intervention materials) immediately post-intervention, but this effect had disappeared at three-month follow-up. No intervention effects were found on survey variables. Parent comments revealed that materials were either received positively (as they reinforced existing behaviours) or negatively (as they were not perceived to be helpful or appropriate). The results of this study suggest that providing educational materials and resources to parents of primary school children in Derby was not sufficient to increase provision of healthier packed lunches. Future research should investigate how behavioural science can support families to improve the nutritional content of primary school children's lunchboxes.