Search

ObjectivesUniversal 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.DesignCluster-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.SettingFifty-five intervention and fifty-six wait-list control primary schools.SubjectsApproximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up.ResultsSchool-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.ConclusionsUniversal 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. [ABSTRACT FROM AUTHOR]

Abstract: Aims: This study aims to explore associations of attitudes towards breakfast, self-efficacy and normative perceptions (in relation to parents, peers and teachers) with breakfast skipping in 9–11-year-old schoolchildren in Wales. Methods: A cross-sectional design was employed. Data were collected using self-report measures of attitudes towards breakfast, parental and peer descriptive norms, parental, peer and teacher related injunctive norms, self-efficacy for eating breakfast and self-reported habitual breakfast skipping. Participants were 1672 year 5 and 6 pupils within 52 schools in 9 local education authorities across North, South and West Wales. Results: Bivariate analyses indicated that all variables, with the exception of peer-related injunctive norms, were associated with breakfast skipping. In multivariate ordinal logistic regression analyses, adjusted for clustering at the school-level, only attitudes towards breakfast, parental descriptive norms and self-efficacy for eating breakfast were significantly associated with breakfast skipping. Conclusions: The associations reported in this paper highlight the need to consider attitudinal and normative factors when attempting to facilitate change in children''s breakfast eating behaviours, as well as investigating means of enhancing self-efficacy. Impacts of school breakfast provision on these factors, as well as the impact of these factors on uptake of school breakfast provision merit investigation. [Copyright &y& Elsevier]

Objective: Breakfast consumption has been consistently associated with health outcomes and cognitive functioning in schoolchildren. Evidence of direct links with educational outcomes remains equivocal. We aimed to examine the link between breakfast consumption in 9-11-year-old children and educational outcomes obtained 6-18 months later. Design: Data on individual-level free school meal entitlement and educational outcomes (Statutory Assessment Tests (SATs) at Key Stage 2) were obtained via the SAIL databank and linked to earlier data collected on breakfast consumption. Multilevel modelling assessed associations between breakfast consumption and SATs. Setting: Trial of the Primary School Free Breakfast Initiative in Wales. Subjects: Year 5 and 6 students, n 3093 (baseline) and n 3055 (follow-up). Results: Significant associations were found between all dietary behaviours and better performance in SATs, adjusted for gender and individual- and school-level free school meal entitlement (OR=1·95; CI 1·58, 2·40 for breakfast, OR=1·08; CI 1·04, 1·13 for healthy breakfast items). No association was observed between number of unhealthy breakfast items consumed and educational performance. Association of breakfast consumption with educational performance was stronger where the measure of breakfast consumption was more proximal to SATs tests (OR=2·02 measured 6 months prior to SATs, OR=1·61 measured 18 months prior). Conclusions: Significant positive associations between self-reported breakfast consumption and educational outcomes were observed. Future research should aim to explore the mechanisms by which breakfast consumption and educational outcomes are linked, and understand how to promote breakfast consumption among schoolchildren. Communicating findings of educational benefits to schools may help to enhance buy-in to efforts to improve health behaviours of pupils. [ABSTRACT FROM AUTHOR]