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

Bibliographic Data

ID15095366
AuthorsGraham Moore (0000-0002-6136-3978, corresponding author), Graham F Moore, Simon Murphy (0000-0003-3589-3681), Katherine Chaplin (0000-0003-1261-9938, University of Bristol), Ronan A Lyons (0000-0001-5225-000X), Mark Atkinson (0000-0002-4242-5459), M D Atkinson (0000-0003-4237-3588), Lindsey Moore (0000-0003-2182-823X), Laurence Moore
Year2014
Volume17
Issue6
Pages1280-1289
Publication date2014-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980013003133
PMID24476560
PMCIDPMC4014862
OpenAlexW2123498727
LanguageEN
Citations received18
References cited44

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

Cluster randomised controlled trial · Consumption (sociology · Entitlement (fair division · Environmental health · Inequality · Intervention (counseling · Meal · Psychological intervention · School meal · Sociology · Child Nutrition and Feeding Issues · Demography · Food Security and Health in Diverse Populations · Mathematics · Medicine · Nursing · Obesity, Physical Activity, Diet · Psychology