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Using Social Media to Increase Participation in Universal Free School Meal Programs: An RCT With Parents of
Anna H Grummon1, Amanda B Zeitlin2, Cristina J Y Lee3
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California; Department of Health Policy, Stanford University School of Medicine, Stanford, California.
Introduction:
As of 2025, 9 states have adopted Universal Free School Meal programs. The success of these programs depends in part on high participation. This study tested whether a social media campaign promoting school meal participation increases school lunch and breakfast participation in states with Universal Free School Meal programs.
Study Design:
This was an RCT.
Setting/Participants:
A total of 832 parents of elementary-aged children living in states with Universal Free School Meal programs were included.
Intervention:
Parents were randomized to a school meal promotion campaign or a control campaign about reading. Campaigns were delivered through private Facebook groups for 6 weeks between October and December 2024.
Main Outcome Measures:
The coprimary outcomes were children's school lunch and school breakfast participation as reported by parents in baseline and follow-up surveys. Secondary outcomes included engagement with the campaigns (e.g., noticing, reading, and talking about campaign messages) and perceived barriers to participation in school meals. Data were collected in September-December 2024 and analyzed in 2025.
Results:
The school meal promotion campaign elicited more noticing of the campaign messages (difference versus control, 37 percentage points); reading the campaign messages (difference=0.16 on a 1-5 scale); and talking with others about the campaign messages, school meals, and the benefits of school meals (differences=0.14-0.21 on 1-5 scales) (all ps<0.05). The campaign did not increase participation either in school lunch (difference-in-differences=0.08 meals/week, 95% CI= -0.08, 0.25, p=0.30) or breakfast (difference-in-differences=0.02 meals/week, 95% CI= -0.16, 0.20, p=0.81). Parents reported several barriers to their child's participating in school lunch and breakfast, including that the child does not like the meals (38%-63% of parents reported), the meals appear to be low quality (17%-27%), and there is not enough time to eat (25%-30%).
Conclusions:
Delivering school meal promotion campaigns to parents through Facebook is feasible and acceptable but may not be sufficient to increase children's school meal participation.
Trial Registration:
This study is registered at ClinicalTrials.gov (NCT#06419218).
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