UK secondary school pupils’ perspectives of interventions to encourage healthier food and drink choices in the school environment

The school food and drink environment offers opportunities to improve pupils’ food and drink choices, with school food accounting for up to 30% of pupils’ dietary intake (1) . School canteens are often overcrowded and chaotic, which may lead to pupils choosing less healthy but quicker options. Interventions aiming to improve adolescents’ dietary behaviours have been conducted but usually lack adolescent involvement and can have limited impact on pupils’ dietary choices (2) . Pupil involvement in design and development may lead to more acceptable interventions (3) . The aim was to explore potential interventions with secondary school-aged pupils focused on key areas of the school food and drink environment. A total of three North East England secondary schools were recruited based on pupil eligibility for free school meals and index of multiple deprivation. Approximately eight pupils (aged 12 – 13) were recruited per school to participate in three focus groups. Consent was collected from parents and pupils. In focus group one, pupils prioritised areas within the school food and drink environment for potential interventions. In focus group two, pupils explored what these interventions might comprise. Finally, pupils reviewed the acceptability, sustainability, and feasibility of their interventions. Thematic analysis using a coding framework was used to analyse data. Ethical approval was granted by Newcastle University Ethics Committee, reference number: 2402/24272/2021. Across the three schools, twenty-two (m = 9; f = 13) pupils participated in the focus groups. Preliminary analysis revealed the inability for pupils to eat their school lunch outside was a key area for improvement. Pupils felt that with dedicated areas to eat outside, they would have more time to eat and not rely on convenient options. Incorrect menus in the canteen also meant pupils did not know what they could select and instead chose the same, often less healthy options. Pupils wanted posters in the canteen to promote the available healthier options previously used in nudge-based interventions. School food and drink were usually considered poor value for money due to high prices and perceived poor quality of school food compared to what is available outside of school. Pupils felt that introducing meal deals or food-based rewards for healthier options would encourage higher consumption due to them being perceived as better value for money. Prioritised areas and interventions within the school food and drink environment were schoolspecific. Before interventions are conducted in schools, further understanding of the school context and whether interventions are appropriate are needed. Further work exploring continued project development, including further pupil and school staff input to explore intervention feasibility is required.