Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial

Abstract

Background Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children’s health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions. Methods Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) ‘Nourish’, ii) ‘Engage’, iii) ‘Nourish’ and ‘Engage’ and iv) Control (Delayed). ‘Nourish’ was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. ‘Engage’ was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured. Results Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6–7 years and n = 458 aged 10–11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6–7 and 10–11 year old pupils) who received the ‘Nourish’ intervention compared with those that did not (adjusted difference in mean = − 0.82; 95% CI -1.46, − 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The ‘Nourish’ intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10–11 year old pupils. The ‘Nourish’ intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed. Conclusions Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the ‘Nourish’ whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted. Trial registration National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312).

An Exploration of Nutritional Education within the Holiday Activities and Food Programme in England

“…Indeed, HAF leads explained that they delivered more than simply ‘nutritional’ education, and instead involved a range of food-related information, to improve families’ overall food literacy. This is promising as prior research has shown that school-based nutritional education interventions, which similarly demonstrate a whole-school approach are beneficial for improving a range of outcomes, including wellbeing, dietary intake, and cooking competence and confidence [ 18 ]. Moreover, the fact that providers considered food literacy to be additional to nutritional education suggests that some providers may have produced their own working definition of what they consider nutritional education.…”

“…Other child-focused cooking programmes have similarly demonstrated benefits surrounding cooking competence and willingness to try new foods, which is assumed to relate to the repeated exposure to foods during the sessions and improved self-efficacy [ 16 ]. Likewise, food education is a compulsory element of the school curriculum in England, and research on school-based nutritional education has found a whole-school approach, involving a range of repeated social and practical food experiences such as group education on food provenance, cooking and tasting experiences, to be beneficial for cooking competence, wellbeing and dietary change [ 17 , 18 ]. Finally, the school-dining experience affords opportunities for social interactions with peers, which has shown to improve well-being and dietary habits, including trying of foods and dining etiquette, through social learning and modelling [ 19 ]; such environments may therefore play a vital role in increasing children’s food literacy and cooking confidence within the HAF programme.…”

CooC11 and CooC7: the development and validation of age appropriate children’s perceived cooking competence measures

“…Prior to data analysis, where necessary, items were reversed coded so that a higher score indicated greater perceived cooking competence for all items. All analyses were conducted using IBM SPSS Statistics v25 and IBM SPSS Amos v25, with a significance level of 0.05. a larger study (Project Daire) [44]. For this sample, 50.32% were female.…”

“…CooC7 (6-7 year olds) Participants and procedure Sample 4: Data from 514 primary school children aged 6-7 completed baseline measurements as part of a larger study (Project Daire) [44], are used as Sample 4. For this sample, 48.63% were female.…”

Cook Like A Boss: An effective co-created multidisciplinary approach to improving children's cooking competence

“…Food Exposure and Willingness to try were adapted from Birch and Sullivan (1991) and Morgan et al (2010), previously used in a similar age group in Northern Ireland (Brennan et al, 2021). Children were presented with six images of vegetables and asked whether they had tasted the food before.…”