Acceptability and feasibility of strategies to promote healthy dietary choices in UK secondary school canteens: a qualitative study

Abstract

Objective To explore the acceptability and feasibility of choice architecture strategies for dietary change in UK secondary school canteens from the perspectives of pupils, school staff and catering providers through qualitative focus groups and interviews. Results Three focus groups with adolescents (n = 15; mean age 13.7 years; standard deviation 1.9) and eight interviews with school staff and caterers recruited from one school and catering provider in Coventry UK were undertaken. The most acceptable choice architecture strategies for intervening to drive healthy dietary choices are those that make use of proximity and positioning, on the basis that convenience was one of the main drivers for food/drink selections. Acknowledging adolescents’ desire for autonomy and for food to be familiar and predictable was considered important in enhancing acceptability. Challenges to the feasibility of nudge strategies included concerns about behavioural issues, increased food waste, and a decline in uptake of canteen purchases. The design of food choice architecture interventions for secondary school settings should consider the specific characteristics of this age group and setting to ensure successful implementation.

“We think about the quantity more”: factors influencing emerging adults’ food outlet choice in a university food environment, a qualitative enquiry

“…Consistent with other recent studies [43,53], a mismatch between individual budgets and food prices (as an environmental factor) influences students' decision to settle on food outlets offering cheaper food options. The mismatch impels young people to focus on the need for quantity and satiety as found for adolescents in Coventry, U.K. [54]. Even though cheaper food options per-se may not necessarily be unhealthy [42,55], there is overwhelming evidence suggesting that cheap foods are generally not healthy or sustainable with healthy foods found to be largely expensive [56] and especially in LICs [57].…”

Improving adolescents' dietary behaviours in the school-setting: challenges and opportunities

“…For example, in a US study, the majority of adolescents (93.7%) reported taste as important when they were selecting food items in the school canteen (65) . Similarly, in a UK study, taste was reported as a priority among adolescents (69) . Therefore, this may create challenges to encouraging adolescents to choose healthier items in school, as research suggests that adolescents tend to associate healthier options with being of poorer taste (54,69,70) .…”

“…Similarly, in a UK study, taste was reported as a priority among adolescents (69) . Therefore, this may create challenges to encouraging adolescents to choose healthier items in school, as research suggests that adolescents tend to associate healthier options with being of poorer taste (54,69,70) . UK school catering staff have also shared the view that adolescents are seen to opt for the less healthy items and have expressed concerns that excluding these unhealthy foods from the school lunch menu would severely compromise their sales (71) .…”

“…Therefore, if not offered on menus, adolescents may choose to bring a packed lunch as an alternative to buying food in school (71) , negatively impacting on the financial viability of school canteens. Moreover, UK adolescents and caterers suggested that if healthy items in school tasted better, they would be more appealing to purchase (69) . However, caterers felt that to provide school meals that appealed to adolescents, compromising the healthiness of the meals would be required (69) .…”

“…Moreover, UK adolescents and caterers suggested that if healthy items in school tasted better, they would be more appealing to purchase (69) . However, caterers felt that to provide school meals that appealed to adolescents, compromising the healthiness of the meals would be required (69) . In addition to taste, visual appeal (49,69,72,73) , familiarity (59,66,73) and quality (67) of items served within school have been cited as influential factors on adolescents' food choices.…”