A Multicomponent mHealth-Based Intervention (SWAP IT) to Decrease the Consumption of Discretionary Foods Packed in...

Area of Science:

• Public Health
• Nutrition Science
• Health Behavior Interventions

Background:

• Childhood nutrition is a public health concern, with school lunchboxes offering opportunities for improvement.
• Effective, scalable interventions are needed to enhance the nutritional quality of foods children consume at school.

Purpose of the Study:

• To evaluate the effectiveness of the SWAP IT (Smart খাদ্য Packing) mobile health intervention.
• To reduce the energy contribution of discretionary (less healthy) foods and drinks in children's school lunchboxes.

Main Methods:

• A cluster randomized controlled trial involving 32 primary schools in New South Wales, Australia.
• The SWAP IT intervention utilized the Behaviour Change Wheel, incorporating school guidelines, lessons, and parent-focused digital communication.
• Outcomes measured included energy content of discretionary and core foods packed/consumed, using validated school food checklists.

Main Results:

• The SWAP IT intervention significantly reduced the mean energy content of discretionary foods packed in lunchboxes by 117.26 kJ (P=.003).
• Significant reductions were also observed in mean total lunchbox energy packed and consumed.
• No significant differences were found in student engagement, out-of-school consumption, or lunchbox costs.

Conclusions:

• The SWAP IT intervention successfully reduced energy from unhealthy foods in primary school children's lunchboxes.
• Widespread adoption of the SWAP IT program could positively impact childhood weight status and reduce related healthcare expenditures.