Free School Breakfast Initiative Data Augmentation and Analysis
Lead Research Organisation:
CARDIFF UNIVERSITY
Department Name: Sch of Social Sciences
Abstract
Breakfast is commonly referred to as the most important meal of the day, especially for children. It provides an opportunity to consume healthy foodstuffs such as fruit and grains and is associated with better weight management and cognitive functioning. Unfortunately, a significant number of children in the UK skip breakfast or eat poor quality food such as chocolate and crisps. Such breakfast skipping has been found to be more common amongst obese children and those from poorer backgrounds. School breakfast schemes have been implemented to try to encourage breakfast eating and the adoption of a healthy diet from an early age. It is also thought that his can result in improved performance in school. Previous evaluations of such schemes have suffered from a number of methodological shortcomings.
This study draws on data collected in a large national evaluation of the Welsh Assembly Primary School Free Breakfast Initiative, which provided the opportunity for schools and pupils to have a free healthy breakfast. The study included 111 schools that were randomly selected to either start the scheme immediately or in 12 months time. Questionnaires and interviews assessed breakfast skipping and the amount of healthy and healthy food eaten, attitudes to breakfast, school behaviour and memory, concentration and attention. This information was collected before the schemes began and 12 months later. Results indicate the scheme was effective in increasing the consumption of healthy food items at breakfast, and positive attitudes towards breakfast. But additional important analyses will not be conducted without investment in linking these results to other sources of data and subsequent analyses.
With additional funding it will be possible to identify free school meal entitlement, educational performance data, and postcodes for each pupil in the study. It will also be possible to examine additional detailed dietary nutritional information collected from pupils during the study. This will allow an examination of whether such interventions can improve the nutritional quality of school pupil?s diets and whether they can address health inequalities. It will also be possible to examine the relationship between children?s diets and future educational performance over time. This will provide important information for both the education and health sector in developing interventions to improve children?s diets and tackle rising levels of obesity. It will also provide important information on whether routine education and health data can be utilized in future public health initiatives.
This study draws on data collected in a large national evaluation of the Welsh Assembly Primary School Free Breakfast Initiative, which provided the opportunity for schools and pupils to have a free healthy breakfast. The study included 111 schools that were randomly selected to either start the scheme immediately or in 12 months time. Questionnaires and interviews assessed breakfast skipping and the amount of healthy and healthy food eaten, attitudes to breakfast, school behaviour and memory, concentration and attention. This information was collected before the schemes began and 12 months later. Results indicate the scheme was effective in increasing the consumption of healthy food items at breakfast, and positive attitudes towards breakfast. But additional important analyses will not be conducted without investment in linking these results to other sources of data and subsequent analyses.
With additional funding it will be possible to identify free school meal entitlement, educational performance data, and postcodes for each pupil in the study. It will also be possible to examine additional detailed dietary nutritional information collected from pupils during the study. This will allow an examination of whether such interventions can improve the nutritional quality of school pupil?s diets and whether they can address health inequalities. It will also be possible to examine the relationship between children?s diets and future educational performance over time. This will provide important information for both the education and health sector in developing interventions to improve children?s diets and tackle rising levels of obesity. It will also provide important information on whether routine education and health data can be utilized in future public health initiatives.
Technical Summary
The recently completed cluster randomised trial of the Welsh Assembly Government s Free School Breakfast Initiative (FSBI) collected data at baseline, 4-6 month and 12 month follow-up, from approximately 4350 Year 5 and 6 children in 111 schools across Wales. A nested cohort of 1975 children completed measures at baseline and at least one other round of data collection. Outcome measures included assessments of cognitive function, attitudes towards breakfast and dietary behaviour. Further data were also collected from sub-samples of participants using comprehensive measures of dietary intake. The proposed study will augment the existing study dataset through nutrient intake coding of dietary intake data, linkage with education databases to obtain free school meal entitlement, SAT and GCSE performance data, postcode, and via linkage with census and health databases to output area socioeconomic indicators and future health outcome data. This data augmentation will then allow the following research questions to be addressed in a series of statistical analyses:
a) What is the impact of the FSBI in terms of cognitive outcomes, attitudes towards breakfast and dietary intake?
b) What is the impact of the intervention upon social gradients in diet, cognitive outcomes and attitudes?
c) Is the impact of the intervention moderated by socio-economic status and/or other contextual ecological factors, such as school policies, health promoting school status, etc.?
d) Analysis of response bias in parent questionnaires, by response time (first mailing or after reminder(s)), gender of pupil, dietary intake, socio-economic status.
e) Comparison of parental report and pupil self-report data.
f) Does the FSBI improve levels of consumption of adequate breakfasts amongst 9-11 year olds? (i.e. over 20% of daily energy intake).
g) Does the FSBI improve the balance of macronutrients within the diets of 9-11 year olds?
h) Does the FSBI improve intake of micronutrients within the diets of 9-11 year olds? (e.g., calcium, iron, vitamin C).
i) How do variations in breakfast composition (e.g. glycemic load) influence cognitive performance?
j) Are (i) breakfast and (ii) all day dietary behaviour at baseline associated with subsequent cognitive measures and school performance. Is this relationship confounded with or moderated by socio-economic status and/or other contextual ecological factors?
k) Are attitudes towards breakfast at baseline predictive of subsequent breakfast eating behaviour?
l) Are changes in breakfast and all day dietary behaviour associated with changes in cognitive outcomes?
a) What is the impact of the FSBI in terms of cognitive outcomes, attitudes towards breakfast and dietary intake?
b) What is the impact of the intervention upon social gradients in diet, cognitive outcomes and attitudes?
c) Is the impact of the intervention moderated by socio-economic status and/or other contextual ecological factors, such as school policies, health promoting school status, etc.?
d) Analysis of response bias in parent questionnaires, by response time (first mailing or after reminder(s)), gender of pupil, dietary intake, socio-economic status.
e) Comparison of parental report and pupil self-report data.
f) Does the FSBI improve levels of consumption of adequate breakfasts amongst 9-11 year olds? (i.e. over 20% of daily energy intake).
g) Does the FSBI improve the balance of macronutrients within the diets of 9-11 year olds?
h) Does the FSBI improve intake of micronutrients within the diets of 9-11 year olds? (e.g., calcium, iron, vitamin C).
i) How do variations in breakfast composition (e.g. glycemic load) influence cognitive performance?
j) Are (i) breakfast and (ii) all day dietary behaviour at baseline associated with subsequent cognitive measures and school performance. Is this relationship confounded with or moderated by socio-economic status and/or other contextual ecological factors?
k) Are attitudes towards breakfast at baseline predictive of subsequent breakfast eating behaviour?
l) Are changes in breakfast and all day dietary behaviour associated with changes in cognitive outcomes?
