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Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales

Moore, Graham F. ORCID:, Murphy, Simon ORCID:, Chaplin, Katherine, Lyons, Ronan A., Atkinson, Mark and Moore, Laurence ORCID: 2014. Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales. Public Health Nutrition 17 (6) , pp. 1280-1289. 10.1017/S1368980013003133

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Objectives: Universal interventions may widen or narrow inequalities if disproportionately effective among higher or lower socio-economic groups. The present paper examines impacts of the Primary School Free Breakfast Initiative in Wales on inequalities in children's dietary behaviours and cognitive functioning. Design: Cluster-randomised controlled trial. Responses were linked to free school meal (FSM) entitlement via the Secure Anonymised Information Linkage databank. Impacts on inequalities were evaluated using weighted school-level regression models with interaction terms for intervention × whole-school percentage FSM entitlement and intervention × aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention × individual FSM entitlement. Setting Fifty-five intervention and fifty-six wait-list control primary schools. Subjects: Approximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up. Results: School-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (b = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term b = 1·76; 95 % CI 0·36, 3·16). An interaction between intervention and household-level deprivation was not significant. Despite no main effects on breakfast skipping, a significant interaction was observed, indicating declines in breakfast skipping in more deprived schools (interaction term b = −0·07; 95 % CI −0·15, −0·00) and households (OR = 0·67; 95 % CI 0·46, 0·98). No significant influence on inequality was observed for the remaining outcomes. Conclusions: Universal breakfast provision may reduce socio-economic inequalities in consumption of healthy breakfast items and breakfast skipping. There was no evidence of intervention-generated inequalities in any outcomes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
L Education > LB Theory and practice of education > LB1501 Primary Education
Additional Information: The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence .
Publisher: Cambridge University Press (CUP)
ISSN: 1368-9800
Funders: ESRC, MRC
Date of First Compliant Deposit: 30 March 2016
Last Modified: 11 Nov 2023 14:43

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