The provision of healthy food in a school tuck shop: does it influence primary-school students' perceptions, attitudes and behaviours towards healthy eating?

Objective: To investigate students' tuck shop buying behaviour, choices of lunchbox items and healthy eating perceptions and attitudes at a school with a nutritionally regulated tuck shop and a school with a conventional tuck shop. Design: Mixed-methods research comprising a cross-sectional survey and focus groups. Setting: Bloemfontein, South Africa. Subjects: Randomly selected grade 2 to 7 students from a school with a nutritionally regulated tuck shop (school A; n 116) and a school with a conventional tuck shop (school B; n 141) completed a self-administered questionnaire about perceptions, attitudes, buying behaviours and lunchbox content. Six students per grade (n 72) in each school took part in focus group discussions to further explore concepts pertaining to healthy eating. Results: In school A, older students had a negative attitude towards their `healthy' tuck shop, while younger students were more positive. School B students were positive towards their conventional tuck shop. In both schools students wanted their tuck shop to allow them to choose from healthy and unhealthy items. School A students mostly bought slushies, iced lollies and baked samoosas, while school B students mostly bought sweets and crisps. The lunchboxes of school A students contained significantly (P< 0(.)05) more healthy items but also significantly more unhealthy items. Conclusions: A single intervention such as having a nutritionally regulated tuck shop at a primary school cannot advance the healthy school food environment in its totality. A multi-pronged approach is recommended and awareness must be created among all role players, including parents who are responsible for preparing lunchboxes.