In:
Public Health Nutrition, Cambridge University Press (CUP), Vol. 17, No. 6 ( 2014-06), p. 1280-1289
Abstract:
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.
Type of Medium:
Online Resource
ISSN:
1368-9800
,
1475-2727
DOI:
10.1017/S1368980013003133
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2014
detail.hit.zdb_id:
2016337-X
SSG:
21
Permalink
