Tackling Obesity: A Qualitative Exploration of a Whole School Food Policy Guideline

Introduction Childhood obesity is an ever-increasing public health concern in England. Schools offer a unique opportunity to influence childhood obesity. Children spend a significant proportion of their time at school, and there is an opportunity to equip them with lifelong knowledge and skills whilst they are highly influenced by their environment. This Whole School Food Policy Guideline was designed to help schools make whole system changes to their culture and ethos, promoting healthier eating and life choices for their pupils. This project disseminated the guidelines to all schools in the London Borough of Haringey through the local authority's Public Health team, and its impact was explored. The aim of this project was to develop a cost-effective resource, the Whole School Food Policy Guideline, to assist schools in creating environments that promote healthy life choices. Methods Development involved collaboration with local dietitians, teachers and chefs to combine ideas and resources surrounding healthy school food policies. Draft guidelines were reviewed by all contributors. Once finalised, guidelines were printed into booklets and sent to all Haringey schools in February 2020. Semi-structured telephone interviews were conducted in April 2020 with "Healthy School Leads (HSL)" from three local schools: one primary, one secondary and one special educational needs (SEN) school. The aim was to assess initial impressions of the guideline and its perceived usefulness. The data were thematically analysed, and the resulting themes were validated by both researchers. Results Five main themes emerged during analysis, labelled: "utility", "facilitators", "barriers", "special schools" and "guideline improvements and other resources". The guideline was reported as a useful resource with appropriate suggestions for change. This included being adaptable to the needs of the children with SEN. It was particularly valued as a council-produced document, adding a layer of support when implementing change. Resistance to change from parents, children and staff was reported as a previously encountered barrier to healthy change, and the guidelines' informative tone and authority from professionals were useful to address this. The packed lunch guide was well-received by all interviewees, directly addressing their concerns about the quality of food brought from home. The only implemented change at the point of data collection was that this guide had been sent by one school to parents via email. A common view was the feasibility of the recommended water-only policy. All schools mentioned this initiative; one interviewee felt their existing water-only policy needed to be "tightened up", and both other schools considered introducing this idea. It was found that water-only policies are an easily accepted change in comparison to the emotive and controversial nature of food-based policies, suggesting this change would be easily established. Conclusion The guideline fills a gap in supporting schools implementing changes as a Whole School Approach to improve students' health. Its potential impact depends on integration within current practice. The findings from this study suggest that future efforts should focus on water-only policies, working collaboratively with parents and continuing to engage passionate staff who drive positive, meaningful change within their school.