Exploring stakeholders’ views on the Change4Life ‘Sugar Smart’ campaign and school food to improve children’s diets: two qualitative studies

Abstract

There is a current childhood obesity pandemic and a high prevalence of dental caries amongst children worldwide. This thesis comprises two studies which provide an in-depth qualitative exploration of stakeholders’ views on the impact of the national Change4Life ‘Sugar Smart’ campaign, and the influence of school food on children’s diets in Newcastle upon Tyne. In 2017, twenty-seven telephone interviews were conducted with parents, one-year post ‘Sugar Smart’ campaign. Key findings were: a reported raised awareness of child sugars intake by parents and children; ‘hidden sugars’ were a barrier to reducing sugars intake; and, reported household shopping changes including reduced purchasing of ‘sugary’ drinks and breakfast cereals. The national campaign was helpful in raising awareness of the impacts of Free Sugars, one-year postcampaign. However, a more integrated approach is needed to increase the impact and sustainability of future health marketing campaigns. A number of parents who participated in the ‘Sugar Smart’ campaign evaluation reported a difficulty in reducing their child’s Free Sugars intake when their children were at school. This finding warranted further research, therefore, a second study was designed to explore stakeholder views on school food contribution to the diets of children. Three schools in Newcastle upon Tyne were recruited. Focus groups were conducted with parents and children. Head teachers, canteen staff and employees of Newcastle City Council who are involved in school food provision were interviewed. Identified themes included puddings being a controversial addition to school dinners, a preference for school dinners over packed lunches, and the ability of school dinners to encourage children to try new foods. Communication between stakeholders needs to be improved, and clearer, more consistent messages about the importance of nutritionally balanced school meals are needed. This research highlights that a diverse range of initiatives are needed across different settings to improve children’s diets. A single approach to achieving positive improvement is unlikely to be successful. To ensure the environments which children interact with allow easy and accessible healthy food and drink choices, there is a need for change within legislation and policy, as well as the development of whole school approaches. All stakeholders involved should prioritise the health of children and work together to achieve a positive improvement of children’s diets