N09006: Are fruit tuck shops in primary schools effective in increasing pupils' fruit consumption? A randomised controlled trial

Study Duration: October 1998 to February 2001

Contractor: University of Bristol

This project aimed to identify the feasibility of setting up fruit tuck shops in primary schools, and to identify the impact of such tuck shops on pupils' consumption of fruit and other snacks.

The scientific objectives of this study were to:

• Recruit fruit retailers and schools and randomly allocate schools into intervention and control groups.
• Develop and pilot 3-day non-weighed dietary records; collect baseline fruit intake data in all schools; develop brief questionnaire to assess enjoyment of fruits; record weekly sales from pre-existing tuck shops, if present.
• Set-up fruit tuck shops in intervention schools; liaison with schools and continued contact to ensure effective running of fruit tuck shops.
• Measure fruit intake 12 months after baseline data collected; monitor fruit tuck shop sales over a 12 month period; analyse change by comparison with baseline data.
• Qualitatively assess fruit tuck shops: interviews and focus groups to ascertain teachers’ and pupils’ views and experiences with the fruit tuck shops, supported by information collected by project officers from their visits to intervention schools.
• Identify the policy implications resulting from the project: completion of final report with main findings and recommendations.

Forty-three primary schools in South Wales and South-West England participated in this study, which aimed to identify the feasibility of setting up fruit tuck shops in primary schools, and to identify the impact of such tuck shops on pupils’ consumption of fruit and other snacks. Twenty-three schools were randomly allocated to the intervention group, and each of them set up a fruit tuck shop in the autumn term, 1999. Tuck shops sold fruit at 15p per item, and were operated by the schools with no additional funding, and with limited support from the research team. Fruit was supplied to schools by wholesale greengrocers, fruit retailers, or by teachers buying fruit from supermarkets. The other twenty schools agreed not to set up a fruit tuck shop in the academic year 1999/2000.

Before the intervention period, in the summer term 1999, 1902 pupils in Years 5 and 6 (aged 9-11) in all 43 schools completed a computerised questionnaire that aimed to measure the pupils' intake of fruit and snacks using a 24-hour recall questionnaire. The computerised questionnaire was developed specially for this study since no validated measurement method was available that could feasibly be used within such a large study to identify the fruit and snack consumption of this age group. The computerised questionnaire was tested for validity and reliability, and while there was clearly substantial measurement error, the instrument did provide measures that correlated positively with measures obtained from a record prompted 24-hour recall interview, and appeared to be reliable in test-retest measures obtained after seven days. The baseline measures also demonstrated content validity, since differences were detected in fruit and snack consumption between schools, which were statistically significantly associated with schools’ policy on snacks brought into school.

Researchers working in Bristol and parts of Wales helped set up fruit tuck shops in primary schools and tested their effect on the intake of fruit compared to the intake in control schools without tuck shops. Children's fruit intake before and after the intervention was assessed by a validated computerised questionnaire administered to the children.

All twenty three intervention schools successfully set up fruit tuck shops, and many schools were very positive about them. In particular, schools identified numerous positive spin-offs from the tuck shops, including benefits for the curriculum, social benefits, community links and litter reduction. In all schools, fruit sales were high in the first few weeks of operation, but then declined at varying rates over the intervention year. It is estimated that 70,000 fruits were sold in the 23 intervention schools over the year, but this equates to only 0.046 fruits per pupil per day. Four schools had ceased to operate their tuckshops by the end of the intervention year.

Researchers concluded that fruit tuck shops on their own would not have a substantial impact on the fruit intake of pupils. However, they are likely to be a valuable component of any comprehensive plan to increase children's fruit consumption. Within schools, a comprehensive school policy on snacks brought to school supplemented by a school fruit tuck shop (and, in England, by National School Fruit Scheme fruit provided to younger infants) may achieve a more substantial impact.

Final report is available from the FSA Library and Information centre. To obtain a copy, please contact the Enquiry Desk, Dr. Elsie Widdowson Library and Information Services, Food Standards Agency (020 7276 8181/8182 or at library&info@foodstandards.gsi.gov.uk).

Publications
Moe J, Roberts J, Moore L (2001) Planning and running fruit tuck shops in primary schools. Health Education 101 61-68.

Moore L, Paisley C, Dennehy A (2000) Are fruit tuck shops in primary schools effective in increasing pupils' fruit consumption? A randomised controlled trial, Nutrition and Food Science 30 (1) 35-38.

Published booklet:
Food Standards Agency in Wales (2000) Fruit tuck shops in primary schools. A practical guide to planning and running a school fruit tuck shop. Cardiff: Food Standards Agency Wales, in collaboration with the National Assembly for Wales. This can also be accessed on the Wired for Health web site at : wiredforhealth.gov.uk

A Welsh version is available on the Food Standards Agency's Website at: http://www.food.gov.uk/multimedia/pdfs/fruitwalesw.pdf