Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales. Issue 6 (3rd December 2013)

• Record Type: Journal Article
• Authors: Moore, Graham F; Murphy, Simon; Chaplin, Katherine; Lyons, Ronan A; Atkinson, Mark; Moore, Laurence
• Is Part Of: Public health nutrition. Volume 17:Issue 6(2014)
• Page Start: 1280
• Page End: 1289
• Publication Date: 2013-12-03
• Subjects: Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980013003133
• Languages: English
• ISSNs: 1368-9800

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="abs1" sec-type="general"> <title>Objectives</title> <p>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.</p> </sec> <sec id="abs2" sec-type="general"> <title>Design</title> <p>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.</p> </sec> <sec id="abs3" sec-type="general"> <title>Setting</title> <p>Fifty-five intervention and fifty-six wait-list control primary schools.</p> </sec> <sec id="abs4" sec-type="subjects"> <title>Subjects</title> <p>Approximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up.</p> </sec> <sec id="abs5" sec-type="results"> <title>Results</title> <p>School-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (<italic>b</italic> = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term <italic>b</italic> = 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 <italic>b</italic> = −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.</p> </sec> <sec id="abs6" sec-type="conclusion"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>