A qualitative process evaluation of universal free school meal provision in two London secondary schools

P E Jessiman*, Vicky Carlisle, Katie Breheny, Rona M Campbell, Russell Jago, Marcus Robinson, Steve Strong, Judi L Kidger

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

3 Citations (Scopus)

Abstract

Background
In the UK, one in five households with children experienced food insecurity in 2022, defined as a household-level economic and social condition of limited or uncertain access to adequate food. Free school meals are a public health intervention aimed at reducing food insecurity amongst children. The provision of universal free school meals (UFSM) to secondary school-aged children is a novel and untested intervention in the UK. This study is a process evaluation of a pilot of UFSM in two secondary schools in England. The aim was to understand the feasibility, acceptability, cost implications and lessons for the implementation of UFSM.

Methods
20 parents, 28 students and 8 school staff from two intervention schools participated in online qualitative interviews, as well as 4 staff from non-intervention schools. The Framework Method of thematic analysis was applied. These data were supplemented with student-led observations of school meal times, and school lunch uptake-data and cost information provided by the local authority delivering the pilot.

Results
UFSM in secondary schools is a feasible and acceptable intervention, with coherent goals of increased access to a healthy meal, reduced food insecurity and better nutrition. All participants perceived these goals were met. Acceptability was further enhanced by the perception that UFSM were supporting a greater proportion of low-income families than the national, targeted Free School Meal scheme, as well as being easier to implement. Potential barriers to implementation include limited school kitchen and dining infrastructure, meal quality and choice, and increased queuing times. Participants’ concerns that UFSM may benefit middle- and high- income families not in need were not as prevalent as the perception that UFSM was an effective way to support all families with secondary-aged children experiencing food insecurity.

Conclusion
This small-scale pilot study suggests that UFSM in secondary schools is feasible and acceptable, but more evidence is required from larger studies on the impact on long-term health, psychosocial and educational outcomes. Future, larger studies should also include detailed economic evaluations so this approach can be compared with other possible interventions.
Original languageEnglish
Article number300
Number of pages1
JournalBMC Public Health
Volume23
Issue number1
Early online date9 Feb 2023
DOIs
Publication statusPublished - 9 Feb 2023

Bibliographical note

Funding Information:
This study/project is funded by the National Institute for Health Research (NIHR) Public Health Intervention Responsive Studies Team (PHIRST/NIHR131567). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Funding Information:
RJ is partly funded by the by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West).

Publisher Copyright:
© 2023, The Author(s).

Structured keywords

  • HEHP@Bristol

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