Poster Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Assessing the preliminary effectiveness of an m-health intervention to support parents to pack healthy school lunchboxes (#334)

Alison Brown 1 2 , Rachel Sutherland 1 2 3 , Nicole Nathan 1 2 3 , Christophe Lecathelinais 2 , Renee Reynolds 2 , Lisa Janssen 2 , Clare Desmet 2 , John Wiggers 1 2 3 , Sze Lin Yoong 1 2 3 , Meghan Finch 1 2 3 , Karen Gillham 2 , Vanessa Herrmann 2 , Luke Wolfenden 1 2 3
  1. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  2. Hunter New England Population Health, Wallsend, NSW, Australia
  3. Hunter Medical Research Institute, Newcastle, NSW, Australia

Background and significance: In countries such as Australia and New Zealand, most foods consumed by children at school are brought from home in lunchboxes.1 The inclusion of energy dense foods in children’s lunchboxes is common2 and a driver to increased risk of overweight and obesity.1 Scalable interventions that improve the nutritional quality of foods packed in lunchboxes are urgently required. This study assesses the effectiveness of an m-health intervention, ‘SWAP IT’, targeting parents to improve the nutritional quality of foods packed in children’s lunchboxes.

Methods/ Design: A pilot RCT was conducted with twelve primary schools (n=1769 students, mean age=8.0yrs) that utilised a school communication app in New South Wales, Australia. Six schools were allocated to receive a multi-component intervention comprising four strategies: 1) information to parents (sent via the app); 2) school nutrition guidelines; 3) curriculum lessons and 4) resources. Outcome measures were taken at baseline and immediately post intervention (6 months) and included mean total energy (KJ) packed in lunchboxes, mean energy from everyday foods and percentage of lunchbox energy from everyday foods assessed via observation.

Findings: A non-significant reduction favouring the intervention group in the mean total energy of foods packed within lunchboxes was observed between groups (-118.39 kJ, CI=-307.08, 70.30, p=0.22). A statistically significant increase was observed between groups for mean energy from everyday foods (79.21 kJ, CI=-1.99, 156.43, p=0.04) and percentage energy from everyday foods increased in the intervention group (4.57%, CI=-0.52, 9.66, p=0.08).

Conclusion: SWAP IT shows promise in reducing the energy content and improving the nutritional composition of school lunchboxes. A fully powered trial is warranted to determine the efficacy of the intervention on energy packed within the lunchbox and the impact on total daily dietary intake and child weight status.

  1. Bell, A.C. & Swinburn, B.A. 2004. What are the key food groups to target for preventing obesity and improving nutrition in schools? European Journal of Clinical Nutrition, 58, (2) 258-263.
  2. Sanigorski, A.M., Bell, A.C., Kremer, P.J., & Swinburn, B.A. 2005. Lunchbox contents of Australian school children: room for improvement. European Journal of Clinical Nutrition, 59, (11) 1310-1316.