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Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial

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Sarah F. Brennan, Fiona Lavelle, Sarah E. Moore, Moira Dean, Michelle C. McKinley, Patrick McCole, Ruth F. Hunter, Laura Dunne, Niamh E. O’Connell, Chris R. Cardwell, Chris T. Elliott, Danielle McCarthy, Jayne V. Woodside

Original languageEnglish
Article number23
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: Agri-Food Quest Competence Centre, funded by Invest Northern Ireland. The study funder had no role in the study design, collection, analysis or interpretation of the data and had no role in writing the manuscript. Funding Information: The authors wish to thank the pupils, principals, teachers and caterers from all the schools that participated in the project or were involved in the development of the resources. The authors are grateful for the support received from the local food industry partners, visiting experts from Queen?s University Belfast and personnel from Higher Education Colleges during the implementation of the trial. The authors would also like to thank Mrs. Clare Jess for her assistance with the administration of the trial. Publisher Copyright: © 2021, The Author(s).

King's Authors


Background: Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children’s health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions. Methods: Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) ‘Nourish’, ii) ‘Engage’, iii) ‘Nourish’ and ‘Engage’ and iv) Control (Delayed). ‘Nourish’ was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. ‘Engage’ was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured. Results: Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6–7 years and n = 458 aged 10–11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6–7 and 10–11 year old pupils) who received the ‘Nourish’ intervention compared with those that did not (adjusted difference in mean = − 0.82; 95% CI -1.46, − 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The ‘Nourish’ intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10–11 year old pupils. The ‘Nourish’ intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed. Conclusions: Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the ‘Nourish’ whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted. Trial registration: National Institute of Health (NIH) U.S. National Library of Medicine Clinical (ID: NCT04277312).

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