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

Moore, G. F., Murphy, S., Chaplin, K., Lyons, R. A., Atkinson, M. and Moore, L. (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. (doi:10.1017/S1368980013003133)

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Abstract

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:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lyons, Prof Ronan and Moore, Professor Laurence
Authors: Moore, G. F., Murphy, S., Chaplin, K., Lyons, R. A., Atkinson, M., and Moore, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:Public Health Nutrition
Publisher:Cambridge University Press
ISSN:1368-9800
ISSN (Online):1475-2727
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in Public Health Nutrition 2014
Publisher Policy:Reproduced under a Creative Commons License

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