Health Promotion to Increase the Uptake of School Lunches in Primary Education - Research Proposal Example

Health promotion to increase the uptake of school lunches in primary education (6-9 year olds) Abstract Health promotions based on theories are essential in designing and planning for intervention. The study population will involve ten primary schools within Nottingham for pupils between the ages of 6 and 9 years, which will be selected by stratified random sampling based on the social disadvantage. The program will take one year with two phases; phase I will be on the first month while the rest of the months will be phase II. The aim of this program is to provide lunch to ten primary school children within Nottingham. The objective is to encourage healthy diet and nutritious eating during school lunches among school going children by convincing them to take meals, which pose less healthy risks to their lives. Moreover, project tries to determine whether healthy eating may contribute towards making the children in these schools been health conscious and determining whether they will not be overweight. The objectives will be achieved through use of booklets, video, lectures, questionnaires and provision of lunch to the pupils. Social cognitive theory, change model and community organization models will be used in this study. The weights and performance of the children will be monitored during the study to analyse the effect of healthy eating on these two attributes. Questionnaires to teachers concerning the concentration of the children in class will also be administered to help in the evaluation of the program. Additionally, stakeholders from different sectors and disciplines will be brought together to contribute towards achieving the set objectives and aims ensuring ethical and moral obligations are championed. It is estimated that the entire project will cost £150,000- £300,000sourced from stakeholders, schools contributions and charities. Introduction Effective management programs of public health, chronic diseases and health promotion helps in maintaining and improving health, reduction of disease risks in addition to management of chronic illnesses such as obesity. Children are important people in the society and they require healthy and nutritious foods; they play different roles ensuring sustainability of the society. Moreover, healthy and nutritious lunches and appropriately taken helps in improving the well being and self sufficient of different groups are including individuals and organizations (Altman & Bland, 1995). The intervention plan could involve all education staff including teachers, subordinate staff and other important stakeholders. Other persons who will be involved in ensuring the project is successful are five therapists, parents and two lectures will be provided for the parents and other stakeholders to understand the importance of healthy eating. The project will pass through phase I and phase II; phase I will take the first one month while phase II will take between the second and twelfth month – generally, the project will take one year. To achieve the set aims, three important theories will be used which includes social cognitive theory, change model, and community organization model. The evaluation process will involve determining whether health eating has effect on the weight of the children. School meals Fruit and vegetable intake in UK is very low in comparison to other European countries. This has resulted in an increase in heart diseases and other conditions such as obesity, which are related to unhealthy diet consumption (Fruhbeck, 2000). Children are among the population, which is unwilling to take healthy diets and therefore at risk of this health related conditions. In line with government’s efforts to encourage healthy eating among children, we propose provision of lunches, which contain healthy diets to children. The program is aimed at encouraging children to eat healthy diets at both school and home (Story, 1999). It also aims at encourage the children to like eating healthy diets and at the same time make them proud of being healthy eaters. The program is also expected to encourage schools to support healthy eating among children. The short-term health of children, their growth and development is improved when they eat healthy diet (Fruhbeck, 2000). In addition, the children are able to avoid chronic illnesses in their older life. Furthermore, healthy diets improve the concentration, behaviour and achievement of children in school. Children are also able to play important roles in their later lives if they learn to eat communally. The intake of nutrients by children has been highlighted to have some influence on the cardiovascular diseases in the later lives of the children. Persons with low income have difficulties in obtaining varied and healthy diet. Thus, there is need to introduce school meals uptake for children hailing from low income homes (Fruhbeck, 2000). It is appropriate to provide lunch in primary schools in order for the pupils to obtain varied and healthy diet. The program will enable children who hail from low income families to get access to varied and healthy diet, which in most cases is unavailable in their homes. This will help also improve their concentration, behaviour and achievement in school (Story, 1999). It is also expected to help them to eat communally which is vital for them to play important roles in their adulthood. Furthermore, the program is expected to reduce incidences of heart related diseases and obesity, which is associated with poor eating, habits. The program will involve provision of lunch to the children and educating the pupils and their parents on the importance of healthy diets. This is in line with national curriculum which spells out that children ought to be taught about the importance of taking food for activity and growth in addition of the necessity of adequate and healthy diet. All food provided to school pupils are required by the law to be nutritious. School governing bodies are responsible for deciding the content and cost of meals and at the same time ensuring that the meals provide the minimum nutritional requirements. The nutritional standards that are based on food types are provided on the Department for Education and Skills (DfES) (DCSF, 2010). Daily minimum nutritional standards in primary schools should have foods in the categories of fruit and vegetables; starchy foods; meat, fish and other non-dairy protein and milk and non-dairy foods. The provision of food in schools should be in line with the four-food safety catering laws. These laws include The Food Safety Act (1990), Food Premises (Registration) Regulations (1991), Food Safety (General Food Hygiene) Regulations (1995) and the Food Safety (Temperature Control) Regulations (1995). To ensure the success of school lunch program, everyone involved should feel that the program is meeting and responding to his or her needs. Thus, children and parents should understand what is being offered and how it is changed. Pupils may be involved voicing their wishes, providing suggestion for menu options and naming catering services. The parents should be consulted on what is being offered and any changes that are being implemented (Story, 1999). Teachers need to be informed of the changes and should be encouraged to link the teaching on healthy eating with what is available in school. The wider community should be involved in the program for example by inviting the elderly to join the pupils once a week. Aims and objectives Target population to be stated clearly More pragmatic objectives The aim of this program is to provide lunch to primary school children within Nottingham. The objective is to encourage healthy diet eating among school going children by convincing them to take meals, which pose less healthy risks to their lives (Inga, Neale & Tilston, 1994). The meals provided at lunch hour will be expected to be healthy diet and children and their parents will be educated on how to do the same at home. The provision of lunch to children will be on all school days for a period of one year. It is expected that provision of lunch will improve the short-term health of children, their growth and development. In addition, the healthy diet provision is expected to alleviate chronic illnesses such as obesity in their older life. Furthermore, healthy diets are expected to improve the concentration, behaviour and achievement of children in school. Budgeting Catering services in schools receive income from subsidies provided by county council, allowances for free school meals and from sold meals. Part of the school’s delegated budget goes towards provision of meals (Story, 1999). This varies in accordance to the size of school and the number of free and paid for school meals provided. Schools facing particular difficulties usually get some extra funding from the county councils. Paid for meals’ prices are set by the schools which however should be minimum to encourage take up. Generally, the budget is estimated to be £150,000-£300,000 sourced from different sectors including private, government and Non-Governmental Organisations (NGOs) Method In order to increase uptake of school lunches by primary school (6-9) age children, ten primary schools within Nottingham will be chosen using stratified random sampling in accordance to social disadvantage to participate in the program. Primary schools within Nottingham are chosen because it is known that children attending schools from this region hail from homes with low income and therefore they cannot afford healthy diets (Story, 1999). Provision of lunch is expected to bring some benefits mentioned above to the children. The program will be funded by the county council of Nottingham. The staff to deliver the intervention will include head teacher, schoolteachers, catering manager, other catering staff, school office, school caretaker, consortium finance manager, county council and governors. The head teacher will be involved in management of the school, termly approval of menus, occasional checks on the operation of the kitchen, ensuring that risk and hazard assessment and analysis are undertaken and drawing up an annual catering budget. Schoolteachers will be mandated with the task of teaching the pupils healthy eating in relation to available foods in the school. The catering manager will be responsible for food budget, stock rotation, ordering and purchasing food, menu design and daily management of other catering staff. Other catering staff will be involved in the preparation of food and serving. School office will be responsible for staff contracts and salaries, organizing maintenance of equipment, food order processing and collection of lunch money (Story, 1999). School caretaker will be involved in pest control and cleaning. Consortium finance manager will be involved in the catering budget preparation. The county council will be involved in provision of payroll and personnel services. Finally, governors will be responsible for meeting statutory requirements in addition to overseeing school catering and wider issues of food in the school. Five hygiene therapists will be involved in training the staff on healthy diets and their benefits. The trained teachers will then be involved in training the children. A nutritionist will be involved on designing healthy diets to be provided in the schools during lunch hour (Parcel et al 1988). The parents will also be involved in the program to ensure that the foods they provide to their children are healthy diets. Leaflets containing the scheme and goals of this program will be provided to the parents (Thompson et al 1997). Children will be provided with lunch containing daily minimum nutritional standards, which includes foods in the categories of fruit and vegetables; starchy foods; meat, fish and other non-dairy protein and milk and non-dairy foods. Two lectures on the benefits of healthy diets will be provided weekly. Children will also be involved in watching a video prior to taking lunch. They will also be involved in physical exercise. This expected educate the children on dangers of eating unhealthy diets and at the same time highlight the benefits of healthy eating. Phase I (first month) The first phase will involve the training of the staff on the need of healthy eating. The children participating in the program will have their weights and previous class performance recorded. A talk will be delivered to the children on the benefits of healthy eating twice a week, which will also be attended by their parents. The children will be put on healthy diets during lunch hour. They will also be involved in physical exercise. Booklets on healthy eating will be provided both parents and children (Hill, Drape & Stack, 1994). The children will be watching a five-minute video from Food Dudes on healthy eating prior to taking lunch. This is expected to provide children with role models on healthy eating. It is also expected to educate the children on dangers of eating unhealthy diets and at the same time highlight the benefits of healthy eating. At the end of this phase, the children’s weights will again be taken. Phase II (month 2 to month 12) – Educational Year The children will continue receiving talks on healthy eating twice a week (Hill & Pallin, 1998). They will also continue watching a five-minute video on healthy eating prior to eating lunch. They will also continue undertaking physical activities organized by the school. The weights of the children will be recorded at the end of each month. In addition, their performance will be recorded at the end of each term (National Cancer Institute, 2005). Children who improve their performance and those who maintain their weights within healthy limits will be rewarded at the end of the term and month respectively. Ethical No harm will be inflicted on the children. The performance of the children will be kept confidential. The food to be provided to the children will be approved by nutritionist to contain healthy diets. The program will be supervised by teachers and parents in addition to nutritionist; the main concern is about the children with protein and nut allergy as they will proved for them special type of food by nutritionist. Ethics of Intervention Theories are used by researchers to seek answers to questions such as “why”, “what” and “how” in public health. Theories also help researchers to identify indicators that need to be measured and monitored during the evaluation of the program. Two approaches will used to encourage healthy eating among the selected population. The first approach will involve changing the behaviour of the children while the second will involve changing the environment. The stages of change model, social cognitive theory and community organization models will be used (East Anglia Food Link, 2004). The stages of change model will help us to learn from the parents their readiness to adopt the introduction of lunch provision to their children. It will also help identify the readiness of the children to take lunch from schools. This model will also help in approaching the county councils in the region on their willingness to provide funding and subsidies to these programs in school (Luepker et al 1994). The information gained using this model will help us to plan for effective and appropriate ways of providing lunch to primary school children. Social cognitive theory will aid in examining how social environment influence the uptake of healthy meals in schoolchildren. It will also help identify the expectation of children in terms of healthy diet provision (Sheena et al 1996). It will also help identify people who might be involved in provision of healthy diets to the children during lunch hour. Community organization model will help in devising ways of involving all stakeholders in the provision of healthy lunch diets. This will include parents, children, teachers, school administration and county council officials. Theories are associated with different principles and ideologies with each having its limitations and strengths. These three theories will be interconnected to ensure appropriate framework is developed and utilised into achieving the goals of the project. Juxtaposition of theories and ideas ensures optimum framework bringing into consideration ethics are brought into consideration (Sheena et al 1996) Evaluation The evaluation of the program will involve analysis of the effect of healthy eating on weights of the children (Burgess & Bunker, 2002). This is aimed at establishing whether healthy eating can reduce cases of overweight associated with unhealthy diet consumption and which exposes one to conditions like obesity. The effect of healthy eating on performance of children will also be evaluated since it is known that healthy eating improves concentration of the children in class in addition to their performance. Questionnaires will also be given to teachers of the children to assess their view on the concentration of the children in class. Conclusion Healthy eating is vital to the development and well-being of children. This is in terms of both their concentration in schoolwork and their health in general. It can alleviate the occurrence of some cardiovascular diseases in their adulthood and help them develop behaviours, which are useful in their roles in the community in their later lives. Nottingham has a population, which is mainly low income. Thus, not all parents are able to provide their children with healthy diets. This program will help such children get access to healthy diets in form of lunch. The program is also expected to improve the performance and maintain the weights of the children within the healthy limits. References Altman D. & Bland JM. 1995. Absence of evidence is not evidence of absence. BMJ, vol. 311, pp. 485 Burgess, A. & Bunker, V. 2002. An Investigation of School Meals Eaten by Primary School Children. British Food Journal, vol. 104, no. 9, pp. 705-712. Department for Children, Schools and Families. 2010. Schemes of Work. Available at http://www.standards.dfes.gov.uk/schemes3/ East Anglia Food Link. 2004. Providing Meals in Primary Schools. Defra Food Procurement Unit. Fruhbeck G. 2000. Childhood obesity: time for action, not complacency. BMJ, vol. 320, pp. 328-329 Hill AJ, Pallin V. 1998. Dieting awareness and low self worth: related issues in 8 year old girls. Int J Eating Disorders Vol. 24, pp. 405-413 Hill AJ, Draper E, Stack J. 1994. A weight on children's minds: body shape dissatisfaction at 9 years old. Int J Eating Disorders, vol. 18, pp. 383-389. Inga K., Neale, R., & Tilston, C. 1994. Children's Snack Food Consumption Patterns in Germany and England. British Food Journal, Vol. 96 Iss: 9, pp.10 – 15 Luepker RV, Murray DM, Jacobs Jr DR, Mittelmark MB, Bracht N, Carlaw R. 1994. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota heart health programme. Am J Public Health, vol. 84, pp. 1383-1393 National Cancer Institute. 2005. Theory at a Glance: A Guide for Health Promotion Practice. US Department of Health and Human Services. 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