Details and acceptability of a nutrition intervention programme designed to improve the contents of children's packed lunches.

OBJECTIVE: To describe the 'Smart Lunch Box' intervention and provide details on feedback from the participants on the acceptability and usability of the intervention materials. DESIGN: A cluster randomised controlled trial, randomised by school. English schools were stratified on percentage free-school-meals eligibility and attainment at Key Stage 2. A 'Smart Lunch Box' with supporting materials and activities on healthy eating was delivered to parents and children via schools in the intervention group. Feedback forms containing information on a total of fifteen intervention items were filled out by the parents and/or children participating in the intervention and were collected after each of the three phases of the intervention. SETTING: Eighty-nine primary schools in England, Scotland, Wales and Northern Ireland, randomly selected; forty-four schools in the intervention arm. SUBJECTS: A total of 1294 children, aged 9-10 years, took part in the trial. Of the 604 children in the intervention arm, 343 provided feedback after at least one of the three phases. RESULTS: A median of twelve items out of a total of fifteen were used by responders. The two intervention items most likely to be used were the individual food boxes and the cooler bags. Whether a participant liked an item significantly affected whether they used it for all items except the cooler bag, fruity face and individual food boxes. CONCLUSIONS: Practical intervention items aimed at parents are likely to be used in the longer term and therefore may be appropriate for use in an intervention strategy to improve packed lunches.

Study protocol: a cluster randomised controlled trial of a school based fruit and vegetable intervention - Project Tomato.

BACKGROUND: The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. METHOD: This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. DISCUSSION: A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. TRIAL REGISTRATION: Medical Research Council Registry code G0501297.