Influences on parents’ food choices for what children eat at school: a UK qualitative study

Childhood obesity is a growing public health concern, leading to school absenteeism, poor academic performance, poor health outcomes and increased morbidity. Given that children consume a significant proportion of their daily calories in school, creating a healthy food environment is a key determinant to battling this obesity crisis. In the UK, 50% of primary school pupils eat packed lunches at school, however only 1% of lunchboxes are thought to meet government nutrition regulations. These regulations are imposed on school-provided lunches; however, no such thing exists for packed lunches. To overcome this, schools have generated their own policies, however, they have been largely unsuccessful due to a lack of consideration for socio-economic, behavioural and cultural factors influencing parental perceptions around food. To create successful school lunch policies, the influences on parental food choices and decision-making must be understood in terms of why they decide to give their child a packed lunch or school lunch, and if a packed lunch what goes in it. Semi-structured interviews were conducted with nine parents of children at two Nottingham primary schools. Using constructionist thematic analysis, three themes operating across three levels (child, parent and school) were constructed: social influences, structural influences and societal expectations. Parental decision-making was shown to be influenced by various factors, including peer influences and parental reputation, perceived and observed societal norms around discretionary food, family circumstances, the quality of school-provided meals, the need for control over children's diets and expectations of the schools' responsibilities.