期刊
PUBLIC HEALTH NUTRITION
卷 17, 期 6, 页码 1280-1289出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1368980013003133
关键词
Socio economic status; Children; Breakfast; School
资金
- National Prevention Research Initiative [87122]
- British Heart Foundation
- Cancer Research UK
- Department of Health
- Economic and Social Research Council
- Medical Research Council,
- Research and Development Office for the Northern Ireland Health and Social Services
- Chief Scientist Office
- Scottish Executive Health Department
- Welsh Assembly Government
- World Cancer Research Fund
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
- Diabetes UK
- MRC [MR/K023233/1, G0701875, MR/K006525/1, MC_UU_12017/4] Funding Source: UKRI
- Chief Scientist Office [SPHSU1] Funding Source: researchfish
- Medical Research Council [MR/K023233/1, MR/K006525/1, MC_UU_12017/4, G0701875] Funding Source: researchfish
Objectives: 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 3 whole-school percentage FSM entitlement and intervention 3 aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention 3 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.
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