Achieving equity in Crunch&Sip^®: a pilot intervention of supplementary free fruit and vegetables in NSW classrooms

Abstract

Issue addressed Anecdotal evidence from teachers in Western Sydney Local Health District (WSLHD) indicated that many primary school children are regularly unable to participate in the Crunch&Sip (C&S) program (breaks during class time to eat fruit and/or vegetables and drink water) as they do not bring produce from home. Actual reach of the program may therefore be currently overestimated, and inequitable. This study examined the feasibility, acceptability and efficacy of providing school children supplementary, fresh free produce in supporting equitable participation in C&S. Methods Free fruit and vegetables were provided for 10 weeks to four schools in a socioeconomically-disadvantaged area in Western Sydney. WSLHD sourced the produce at a discounted rate and storage and distribution was arranged in partnership with industry. Schools determined methods of allocation to children who did not have fruit or vegetables for the C&S break. Pre- and late-intervention (Week 9) classroom surveys provided quantitative data of intervention efficacy. Qualitative methods were used with key school persons to explore barriers and enablers to implementation. Results Participation of children in C&S increased significantly from 46.7% pre-intervention to 92.0% in Week 9. The proportion of children bringing fruit or vegetables from home also increased significantly, from 46.7% to 54.0%. Schools perceived the supplementary strategy to be highly feasible and acceptable. Conclusion Expansion of this equity strategy warrants consideration, although issues of sustainability would need to be addressed. The criteria for 'full implementation' should include high proportional participation by students in participating classes. So what? Establishing a system by which schools in disadvantaged areas can supplement their C&S program would effectively increase access to fruit and vegetables among those children most at need.

Potential influence of school-based lifestyle strategies among Australian Aboriginal and non-Aboriginal children: a cross-sectional comparison of adiposity and weight related behaviours between 2010 and 2015

“…This is consistent with other studies that suggest additional and/or different dissemination strategies are required to facilitate a greater adoption of policies and practice within schools. [9,33] While we found there were positive changes in many weight-related behaviours which were generally in the same direction and of the same magnitude for Aboriginal and non-Aboriginal children, adiposity prevalences were higher in 2015 than 2010 for all children and were consistently higher among Aboriginal children. This may indicate there are issues with the fidelity and quality of the delivery of these programs in some schools.…”

Evaluation of the Cancer Council NSW Eat It To Beat It Healthy Lunch Box Sessions: A short intervention to promote the intake of fruit and vegetables among families of primary school children in NSW Australia

“…Similar findings have been shown elsewhere and data from the NSW Schools Physical Activity and Nutrition Survey (2015) and national data confirm that children are much more likely to meet guidelines for fruit intake than vegetable intake . This suggests that a focus on vegetables as a separate entity rather than as a combined entity with “fruits and vegetables” is needed to increase children's vegetable intake to meet Australian dietary guidelines for vegetables …”

“…4 This suggests that a focus on vegetables as a separate entity rather than as a combined entity with "fruits and vegetables" is needed to increase children's vegetable intake to meet Australian dietary guidelines for vegetables. 17,18 Systematic reviews examining school-based programs to improve fruit and vegetable intake and dietary intake in general have shown that multi-component interventions are most effective but that intensity of the intervention did not result in further improved intake in the longer term. 7,19,20 This is reinforced in our evaluation in which the positive effects of this low-intensity intervention were largely sustained for 6 months.…”

Engaging a disadvantaged community with a fruit and vegetable box scheme

“…8 Subsidisation may be one way to ameliorate this barrier whereby the provision of free fruit and vegetables in disadvantaged schools was recently found to be an effective way to significantly increase their consumption. 9 However, sourcing sustainable funding for community-based subsidy programmes is likely to be challenging. 9 Evidence ultimately suggests that behavioural change interventions will continue to be met with limited success in the absence of policies which act upon these structural barriers to healthy eating, particularly in disadvantaged groups.…”

“…9 However, sourcing sustainable funding for community-based subsidy programmes is likely to be challenging. 9 Evidence ultimately suggests that behavioural change interventions will continue to be met with limited success in the absence of policies which act upon these structural barriers to healthy eating, particularly in disadvantaged groups. 10 Policies which support access to affordable, healthy foods should be the focus of future research.…”