VegUP: The effect of a vegetable-focused menu in primary school canteens

INTERVENTION: The intervention consists of increased vegetable provision and online ordering changes in NSW primary school canteen menu's for an 8‐week period. The menu changes consists of the following elements: 1. Novel vegetable‐containing product A new vegetable‐containing product ‘Rainbow Dippers’ will be introduced. This product concept was developed based on sensory science and knowledge on children’s food acceptance. The product contains a range of vegetable dippers which include a dipper (raw vegetable sticks) and a vegetable dip, and it will contain one serve of vegetables. The product was developed using insights from a consumer sensory acceptance test with children. The product will adhere to school guidelines concerning allergies and will be produced by a commercial producer and delivered for free to schools during the intervention period. 2. Changes to online menu structure/choice architecture Two changes will be made to the online menu structure: ‐ Positioning changes will be made to fit with the “primacy effect” – the tendency to pay more attention to the first items in a list. Vegetable‐containing items will be positioned higher than non‐vegetable‐containing items in their categories in the (online) menus. ‐ Sandwiches with a protein component (e.g. cheese/ham/turkey/chicken) will contain one vegetable filling by default, to which parents can opt‐out. Currently, parents/children need to opt‐in for a vegetable filling. This strategy is based on the finding that decision makers have a tendency to choose the default among several possible actions, as a result of ‘loss aversion’. 3. Changes to hot foods The vegetable content in popular hot foods will be increased through recipe development, undertaken in collaboration with the cantee CONDITION: Diet and Nutrition ‐ Other diet and nutrition disorders low vegetable intake;poor diet; ; low vegetable intake ; poor diet Public Health ‐ Health promotion/education PRIMARY OUTCOME: Overall vegetable sales (g/week), derived from canteen sales data; ; ‐ Menus of participating schools will be assessed by a trained dietitian experienced in reviewing school canteen menus. Vegetable content (in g) will be determined for each vegetable‐containing item on the online menu. Where needed, specific information from the canteen manager will be sought; ‐ Daily individual sales data from canteens from online ordering will be used; ‐ Any over‐the counter‐sales of vegetable‐containing items will be manually recorded on a check‐list by canteen managers; ‐ Vegetables sold will be calculated by multiplying the number of vegetable‐containing items sold each day by the vegetable content (in g) of the items. Daily vegetable sales will be converted to weekly sales by adding daily totals.[Baseline data collection will take place over 3 weeks in the first term of the school winter menu. Follow‐up data collection will take place over 8 weeks of the intervention in the following school term.] SECONDARY OUTCOME: Canteen revenue sales (in AUS$/week) ; ; To determine that the intervention does not adversely affect canteen sales, total revenue data will be collected from online ordering data and over‐the‐counter cash register data [Baseline data collection will take place over 3 weeks in the first term of the school winter menu. Follow‐up data collection will take place over 8 weeks of the intervention in the following school term.] Process evaluation amongst parents in intervention schools ; ; [Within three weeks after completion of the intervention period] Process evaluation data from canteen managers of intervention schools. ; ; ; ; INCLUSION CRITERIA: Schools (through principals) and canteen managers in metropolitan Sydney (NSW) will be recruited that meet the following INCLUSION CRITERIA: ; An online quantitative survey will be undertaken with parents of students to seek information on menu perception and behavioural changes using a combination of multiple choice questions and 7‐point Likert scales. All eligible parents from the participating intervention schools will be invited to take part. The survey was designed specifically for this study. ; After the online survey, a follow up phone call will be undertaken with canteen managers when needed to be able to get deeper insights and clarify answers.[Within 1‐2 weeks after completion of the online survey] Process evaluation data from canteen managers of intervention schools. ; An online survey (closed and open questions) will be undertaken with canteen managers to evaluate the perception of student interest on specific elements of the intervention, implementation difficulties, long‐term viability and potential improvements. The survey was designed specifically for this study.[Within three weeks after completion of the intervention period] Vegetable sales (g/wk) in specific categories (e.g. sandwiches, snacks) ; Menu items will be grouped into subcategories. Vegetable sales data in relevant subcategories will be captured and analysed in the same way as for the overall vegetable sales.[Baseline data collection will take place over 3 weeks in the first term of the school winter menu. Follow‐up data collection will take place over 8 weeks of the intervention in the following school term.] Vegetable waste (g/week) ; To verify if vegetable sales is a good approximation of vegetable intake, student vegetable waste will be collected from school grounds from a random sample of 4 participating intervention (n=2) and control (n=2) schools. Dedicated bins will be provided during test days. Waste will be collected by research staff, sorted for vegetable items and weighed on the same day.[Vegetable waste will be measured over 2 representative days mid‐baseline and mid‐intervention period.] ‐ Government, independent and catholic primary schools (Kindergarten ‐ Year 6) with a school canteen ‐ School canteen is operating with an online ordering system (Cashless) with more than 70% of sales done online ‐ School canteen is operating at least 3 days a week ‐ Principals are willing to let their school participate and are willing to share de‐identified sales data (provided by online ordering system provider) ‐ Canteen managers are willing to implement changes to their vegetable provision and participate in a follow up survey For the process evaluation, parents will be eligible for participation when: ‐ Child is enrolled in intervention school ‐ Parent regularly (at least once a week) orders food for their child from the school canteen via online ordering ‐ Parent does not exclusi