Understanding food provision and eating environments in English special schools

ISRCTN	ISRCTN15676161
DOI	https://doi.org/10.1186/ISRCTN15676161
Secondary identifying numbers	NIHR 164391

Submission date: 29/08/2024
Registration date: 20/09/2024
Last edited: 22/11/2024

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English Summary

Background and study aims
All state-funded schools in England must provide meals that meet standards, known as the School Food Standards (SFS). This includes special schools and alternative provision (AP) such as Pupil Referral Units. Pupils who attend special schools/AP often have poorer diets. They may also be at a higher risk of future health problems linked to diet. Schools can support children to make healthy meal choices. Yet, special schools/AP may experience different challenges than mainstream schools to do so. Many pupils attending these settings have special educational needs (SEN). There is a need to review the quality of food provided in these settings. This will help to understand how to improve food provision in the future. This study aims to assess the food provided in special schools/AP by reviewing its nutritional value and whether it meets the SFS. The study will explore what actions special schools/APs take to support healthy eating and will also explore the influences upon healthy food provision and eating environments. Finally, the study will explore whether the research methods are feasible and suitable for special schools/AP and pupils with SEN.

Who can participate?
6-8 special schools/AP settings in the West Midlands and Northeast of England

What does the study involve?
The team will collect menus and visit schools to observe the food available and assess it against the SFS. They will also evaluate the nutritional quality of the meals provided. In each setting, they will conduct in-depth interviews with key staff and governors, inquiring about the challenges of supporting healthy eating in schools. Parents and pupils will also be asked about their experiences with school food. The researchers will employ creative methods to ensure the inclusion of a diverse range of children. Additionally, they will review the inclusivity and suitability of their methods for all schools and pupils involved.

Public Involvement: Two public advisory groups will guide the study, encompassing a broad spectrum of individuals connected to school food. The Schools/Practice Advisory Group will consist of senior leaders, caterers, support workers, and representatives from Local Authorities and charities. Additionally, there will be a Child and Parent Group, from whom the team will seek advice on the study, including feedback on the findings and how best to meet the needs of children and parents participating in the research.

Sharing the Findings: The results of the study will be shared in a workshop with those involved in school meals in special schools/APs, including Local Authorities, the Department for Education, caterers, schools, parents, and pupils. The group will be asked to identify priorities for improving support for healthy eating. This will help the researchers develop an intervention to test in special schools or alternative provisions in the future. Additionally, a summary report will be created for schools, parents, and pupils, and a policy briefing will be prepared for government colleagues. This work aims to identify opportunities to better support healthy eating in special schools, addressing the increased risk of poor diet among pupils attending these schools and ultimately improving the future health of children.

What are the possible benefits and risks of participating?
Participants' views in this study will directly inform the development of future research aimed at supporting children in special schools or alternative provisions to maintain a healthy diet. The findings will be shared with schools, caterers, and government bodies, potentially influencing policies related to school food. No physical or emotional harm is anticipated as a result of participating in this research.

Where is the study run from?
This study is led by researchers at the University of Birmingham in partnership with researchers from the Universities of Northumbria and Edinburgh.

When is the study starting and how long is it expected to run for?
September 2023 to January 2025

Who is funding the study?
The National Institute for Health and Care Research (NIHR)

Who is the main contact?
Dr Marie Murphy (University of Birmingham), m.murphy.3@bham.ac.uk

Contact information

Dr Marie Murphy
Public, Scientific, Principal Investigator

Murray Learning Centre
University of Birmingham
Edgbaston
Birmingham
B15 2TT
United Kingdom

ORCID ID	0000-0003-1177-1890
Phone	+44 (0)121 415 8018
Email	m.murphy.3@bham.ac.uk

Study information

Study design	Mixed-methods observational study
Primary study design	Observational
Secondary study design	Cross sectional study
Study setting(s)	School
Study type	Other
Participant information sheet	Not available in web format, please use the contact details to request a participant information sheet
Scientific title	Understanding food provision and eating environments in English special schools: Assessment of nutritional quality of meals, and challenges in ideal provision and eating environments
Study acronym	FEAST
Study hypothesis	The aim is to assess the nutritional quality of meals, and challenges in optimal meal provision and eating environments in special/AP schools. The objectives are: 1. Assess the nutritional quality of food provided in special/AP schools and compliance with the SFS. 2. Understand the specific actions, challenges, and requirements for special/AP schools and caterers regarding healthy school food provision and creating supportive eating culture/environments. 3. Evaluate the feasibility of recruiting special/AP schools, pupils and staff and the most suitable qualitative methods for children attending special/AP schools.
Ethics approval(s)	Approved 03/09/2024, University of Birmingham Research Ethics Committee (Edgbaston, Birmingham, B15 2TT, United Kingdom; +44 (0)121 414 3344; s.l.cottam@bham.ac.uk), ref: ERN_2786-Jun2024
Condition	Assess the nutritional quality of meals, and challenges in optimal meal provision and eating environments in special/alternative provision schools
Intervention	A mixed methods observational study in special/AP schools comprising 1. An assessment of food provision (objective 1) 2. A qualitative study to explore support for/challenges with healthy eating in these schools (objective 2) 3. An evaluation of recruitment and qualitative data collection methods (objective 3) The expected outcomes are: 1. Mean percentage compliance with the SFS (objective 1) 2. Mean meal quality index score for school lunch (objective 2) 3. Challenges to healthy food provision/healthy eating support in these settings (objective 2) 4. Engagement metrics (i.e. meeting recruitment target; sample diversity; suitability of qualitative research methods) (objective 3)
Intervention type	Behavioural
Primary outcome measure	Mean compliance with the School Food Standards and mean meal quality index score for school lunches are measured using menu reviews and observations at one timepoint
Secondary outcome measures	1. Challenges to healthy food provision are measured using interviews and focus groups with young people, school staff, and parents at one timepoint 2. Engagement metrics are measured using participant feedback, reflective diaries, and research team discussions at one timepoint
Overall study start date	01/09/2023
Overall study end date	31/01/2025

Eligibility

Participant type(s)	Carer, Employee, Learner/student
Age group	Mixed
Lower age limit	4 Years
Sex	Both
Target number of participants	42-96
Participant inclusion criteria	1. Pupils (aged between 4-18 years old) at one of the 6-8 special/alternative provision schools in England recruited to the study 2. School staff/governors and catering managers at one of the 6-8 special/alternative provision schools in England recruited to the study 3. Parents of children attending one of the 6-8 special/alternative provision schools in England recruited to the study
Participant exclusion criteria	1. Unable to provide consent (or assent, for children under 16) 2. For children under 16, parental consent is also required
Recruitment start date	16/09/2024
Recruitment end date	31/12/2024

Locations

Countries of recruitment

England
United Kingdom

Study participating centres

University of Birmingham

Department of Applied Health Sciences
Murray Learning Centre
Edgbaston
Birmingham
B15 2TT
United Kingdom

University of Northumbria at Newcastle

Faculty of Health and Life Sciences
Ellison Building A
Ellison Place
Newcastle upon Tyne
NE1 8ST
United Kingdom

Sponsor information

University of Birmingham
University/education

Dr Birgit Whitman
Head of Research Governance & Integrity
Edgbaston
Birmingham
B15 2TT
England
United Kingdom

Phone	+44 (0)7814 650 003
Email	b.whitman@bham.ac.uk
Website	https://www.birmingham.ac.uk/
"ROR"	https://ror.org/03angcq70

Funders

Funder type

Government

National Institute for Health and Care Research
Government organisation / National government

Alternative name(s): National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location: United Kingdom

Results and Publications

Intention to publish date	31/01/2026
Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Available on request
Publication and dissemination plan	A dissemination strategy will be co-developed with Public Advisory Groups. A key aim is to inform a future funding application for defining and improving dietary intakes and support for healthy eating for special/AP school attendees. The main output will be the delivery of a knowledge mobilisation workshop with key stakeholders (including representatives e.g. Departments for Education and Health and Social Care; school food campaign groups, catering providers, school staff, parent and pupil representatives) to share the findings and gather feedback on priority areas for action. Additional outputs, in consultation with our Public Advisory Groups, will be: 1. Academic publications/presentations on special/AP school settings including: Implementation of school food policy; Nutritional quality of menus; Facilitators/barriers to healthy food provision; and Approaches to qualitative research on school food with special/AP schools/pupils; 2. Infographics or audio/visual outputs for school stakeholders and the general public and; 3. A policy briefing for local/national government including recommendations from the workshop.
IPD sharing plan	The datasets generated during and/or analysed during the current study will be available upon request from the study Principal Investigator (Marie Murphy, m.murphy.3@bham.ac.uk) in alignment with FAIR (findable, accessible, interoperable and re-useable) principles wherever possible, following the cessation on the study. Only pseudonymised data will be made available in this way. These requests will be considered on a case-by-case basis and a data-sharing agreement will be required to ensure appropriate management and access. Where proposed usage extends beyond existing ethical approval, further approval and participant consent will be requested. The approach to data management will comply with Birmingham, Northumbria and Edinburgh’s institutional data management standards and will align with the Data Protection Act 2018 and the UK General Data Protection Regulation as outlined in our data management plan and participant information.

Editorial Notes

22/11/2024: The ethics approval was added.