enhancing food security and physical activity for maori, pacific and ...

Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesKey components for effectivenessGreenhalgh et al 25 report the findings of a realist review of 18 school food programmestudies. The interventions included in these studies ranged from milksupplementation to full lunch meals, from the 1920s until early 2000s, and acrossdeveloped and developing nations. They draw conclusions of process factors thatseemed to increase the efficacy of the programmes, which include:• clear nutritional deficiencies being targeted• well organised school and food distribution chain• locally designed interventions• pilots of interventions are used to assess acceptability of the food to children• processes increase the likelihood that the food is consumed, such assupervision, and• inclusion of social aspects of the meal in the intervention.Literature scan: National ContextUse of school food programmes in New ZealandSince the end of the school milk programme in the 1960s, there was no governmentfundedschool food provision in New Zealand 9 , until the introduction of the Fruit inSchools scheme in 2005. There have, however, been a number of individual schoolsand non-government organisations providing locally organised breakfast or lunchfoods to schools. 9There is little evidence in New Zealand of the impacts of food provision in schools onchildren, and even less on children from food insecure households. A processevaluation of the Fruit in Schools scheme, completed after one year of operating,reported significant increases in the number of students reporting eating vegetablesand fruit every day, as well as the amount of vegetables and fruit being consumed. 26This result is from a relatively small sample of 591 students. Staff and students weresupportive of the scheme. Further evaluation results with more child outcomeinformation should be available in 2009.The positive results from the Fruit in Schools evaluation are supported by the findingsof Ashfield-Watt et al, 13 in a pilot study of a free fruit in primary school scheme.Across ten matched intervention and control schools in Auckland, schools where apiece of fruit was provided daily increased average fruit intakes by 0.39 pieces perschool day per student, compared with no increase in control schools. There was areduction of almost 50 percent in students who ate no fruit in intervention schools.The increased fruit intake was not sustained six weeks post intervention, and theauthors suggest the intervention period of one school term was not long enough toestablish new habits independently of the intervention. Other studies internationallyhave shown sustained effects following longer intervention periods. 17A study in the Waikato as part of project Energize, 27 trialled the provision of vitamin Dfortified low fat milk to all students in eleven low decile primary schools. The studyfound that compared with control schools, students receiving the milk had higherserum vitamin D levels, even though both groups’ vitamin D remained low. Thestudents who received the milk also had a significantly better cardio-protective lipidprofile compared with students from control schools.The Red Cross Breakfast in Schools programme was launched nationally in 2007, 28with 29 schools involved as at March 2008. An evaluation survey was conductedincluding eight months of operation. A majority of teachers considered that bothbehaviour and students’ learning capacity had been improved by the breakfast55