The effects of a school breakfast programme on school attendance and nutrition

INTERVENTION: The intervention will be the provision of a free breakfast at primary schools in deprived areas in the North Island, New Zealand. This will be delivered as either the Red Cross Breakfast in Schools Programme or a non‐branded five day a week breakfast food provision programme. At a minimum, the breakfast provides weetbix and milk. There is no minimum or maximum amount of food allowed to be taken. The breakfast is provided in a suitable communal area prior to school starting, and is available for any child to attend of their own volition. It will be available every school day from the randomised start time over one school year. Participants will be followed up four times over the school year. CONDITION: Effect of school breakfast intervention on attendance, learning, behaviour, nutrition, and food security PRIMARY OUTCOME: proportion of students with a school attendance rate of 95% or higher, measured using attendance data routinely collected by schools SECONDARY OUTCOME: Academic achievement in literacy and numeracy will be assessed using an existing measure collected by schools. As there are a variety of tests in use, this will be determined once schools are recruited. Detailed nutrition assessment will be conducted in a sub‐group of children using a self‐completed four‐day food and drink record, with the main outcome being change in absolute daily energy intake Dietary habits will be briefly assessed using a measure developed for the study. The questions are based on questions from the New Zealand Health Survey, New Zealand Children's Nutrition Survey, and Mission On Survey Food security assessed using the Community Childhood Hunger Identification Project (CCHIP) scale Number of sick days will be obtained from data routinely recorded by schools Psychosocial function measured using Strengths and Difficulties Questionnaire Sense of belonging using the OECD Programme for International Student Assessment (PISA) 2000 Student Engagement Questionniare Student self‐reported grades in reading will be assessed using one question self‐ranking students on a 5‐point Likert scale against other students in their Year in New Zealand Temporary hunger will be assessed using an analog scaling device for measuring fullness in children ("Freddy") INCLUSION CRITERIA: Schools: Primary schools in low‐decile areas in the North Island of New Zealand, who have agreed to particpate in a free school breakfast programme, but have not yet commenced it. Schools must be of sufficient size that they estimate at least 25 students would participate in the programme. Students: students who report being likely to participate in the breakfast programme will be recruited