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Master's Thesis Master’s Thesis Public Health Nutrition May 2021 School children’s participation in a free school meal scheme: Experiences from a pilot project in the Oslo school. Name: Sandra Mauer Course code: MAME 5910 Word count: 29210 Faculty of Health Sciences Preface and acknowledgements When I started my master’s study in Public Health Nutrition in the autumn of 2019, I did an externship at the Agency for Health in Oslo, which means to get a glimpse into the real-life workplace through shadowing an employee from the same field and observing the jobsite. In connection to that externship I got the opportunity to write my master’s thesis on the pilot project for free school meals, that was launched in that year. Free school meals are politically strongly debated and I found the topic very exciting. When I decided to write my master’s thesis on that topic, I also applied for a place in the Health Science Research Programme at OsloMet. The application process led to the early planning of the project already in the autumn of 2019. It was inspiring and instructive to be involved from the beginning of the planning phase of the research project. The Covid-19 pandemic required several changes and adjustments. Undoubtedly, the past year has been intense and demanding with many challenges, especially related to Covid-19 and the data collection. After all, this year was the most exciting and instructive year in my life, and I am grateful for everything I have experienced and learned. I have planned and carried out my own research project with the best professional support one could get. I would therefore like to extend a special thanks to my two supervisors, Associate Professor Laura Terragni and Professor Liv Elin Torheim, who have given me excellent professional guidance and good support and motivation throughout the whole research process. I would also like to thank the project staff from the Agency for Health in Oslo and the Education Agency for their good cooperation. I would also like to thank all the informants who participated in this study. A special thanks to the school management for good collaboration. They were patient and facilitated and helped me with the recruitment, even when they have been in a very demanding situation through the pandemic. Finally, I also want to thank my boyfriend, who has motivated and supported me throughout the whole process. Oslo, Mai 2021 Sandra Mauer I Summary Introduction: The City Council of Oslo has decided to introduce a free school meal for pupils in the Oslo School. In preparation for this, three schools in the Municipality of Oslo conducted a pilot of three different school meal schemes in 2019-2021. The purpose of this qualitative study was to explore factors influencing pupils’ participation in free school meal schemes by investigating pupils’, school staff’s and parents’ experiences with and views on the school meals at two of the pilot schools. Method: The study was inspired by a Grounded Theory research design. A total of 20 focus group interviews were conducted with 39 pupils (5th -10th grade), 15 parents, and 12 school employees in October-December 2020. Participant observations during breakfast and lunch and food production were also conducted at both schools. Line-by-line coding, memo writing and a constant comparative technique were used to analyse the data and identify emerging factors related to pupils’ participation in school meals. Findings: The most relevant factors found in this study were the popularity of the food served, the attraction to the nearby store or fast-food restaurants, and social factors like eating together with friends. Continuity in the offer, predictability of the menus, involvement of the pupils and parents, and time were highlighted as other important factors affecting whether the pupils took part in the school meals. The restrictions caused by Covid-19 had of course an impact as well. Conclusion: To ensure pupils’ participation in free school meal schemes, schools have to meet the challenges to finding a balance between healthy but often unpopular options and popular food, often more unhealthy. In addition, it is important to create a social friendly eating environment. Further research is needed to investigate what it takes for those who do not attend free meals to participate in free school meal schemes. Keywords: School Meal Programs, Schools, Nutrition, Pupils, Children, Adolescents, Social inequality, Oslo, Qualitative study II Sammendrag Introduksjon: Byrådet i Oslo har besluttet å innføre et gratis skolemåltid for elever i Osloskolen. Som forberedelse til dette gjennomførte tre skoler i Oslo kommune en pilot av tre forskjellige skolematordninger i perioden 2019-2021. Hensikten med denne kvalitative studien var å utforske faktorer som påvirker elevers deltakelse i gratis skolemåltidsordninger ved å undersøke elevenes, skolepersonellets og foreldrenes erfaringer med og synspunkter på skolemat på de to pilotskolene i Oslo kommune. Metode: Studien har en «Grounded Theory» inspirert forskningsdesign. Det ble gjennomført 20 fokusgruppeintervjuer med 39 elever (5.-10. klasse), 15 foreldre og 12 skoleansatte i perioden oktober-desember 2020. Deltakende observasjoner under frokost og lunsj samt matproduksjon ble også gjennomført på begge skolene. En sosialkonstruktivistisk Grounded Theory-tilnærming ble brukt. Line-by-line koding, memo-skriving og en konstant komparativ metode ble brukt for å analysere dataene og identifisere relevante faktorer som kunne forklare elevers deltakelse i skolematordningen. Resultater: De mest relevante faktorene som ble funnet i denne studien var popularitet av maten som ble servert og tiltrekningen til nærliggende butikker eller fast-food restauranter, og sosiale faktorer som å spise sammen med venner. Kontinuitet i tilbudet, menyenes forutsigbarhet, involvering av elevene og foreldrene, og tid ble fremhevet som andre viktige faktorer som påvirket om elevene deltok i skolematordningen. Covid-19 hadde selvsagt også en påvirkning. Konklusjon: For å sikre elevenes deltakelse i gratis skolemåltid, må skolene klare å løse utfordringene med å finne en balanse mellom sunne, men ofte upopulære alternativer og populær mat som ofte er mer usunn, i tillegg til å skape sosiale og vennlige spiseomgivelser. Det er behov for videre forskning for å undersøke hva som skal til for at elever som ikke pleier å spise de gratis måltidene, skal delta i skolematordningene. Nøkkelord: Skolemåltidsprogrammer, Skoler, Ernæring, Elever, Barn, Ungdom, Sosial ulikhet, Oslo, Kvalitativ studie III Table of contents PREFACE AND ACKNOWLEDGEMENTS ...................................................................................................... I SUMMARY ........................................................................................................................................................... II SAMMENDRAG .................................................................................................................................................. III TABLE OF CONTENTS ..................................................................................................................................... IV LIST OF APPANDICES .................................................................................................................................. VIII LIST OF TABLES ............................................................................................................................................... IX LIST OF FIGURES ............................................................................................................................................. IX LIST OF ABBREVIATIONS AND ACRONYMS ........................................................................................... IX DEFINITIONS ...................................................................................................................................................... X 1 INTRODUCTION ........................................................................................................................................ 1 1.1 CONTEXT FOR THE MASTER’S THESIS ..................................................................................................... 2 1.2 OBJECTIVES AND RESEARCH QUESTIONS ............................................................................................... 3 2 EXISTING KNOWLEDGE AND PREVIOUS RESEARCH .................................................................. 4 2.1 CHILDREN AND ADOLESCENTS AS A GROUP WITH A PARTICULAR NEED FOR GOOD NUTRITION ............. 4 2.2 NORWEGIAN CHILDREN AND ADOLESCENTS’ DIETARY HABITS .............................................................. 4 2.3 WHAT INFLUENCES CHILDREN AND ADOLESCENT’S DIETARY INTAKE? ................................................. 6 2.4 SOCIAL INEQUALITY IN HEALTH AND DIETS IN NORWAY ....................................................................... 7 2.5 SCHOOLS AS AN ARENA FOR PROMOTING HEALTHY DIETARY HABITS .................................................... 9 2.6 SCHOOL MEAL SCHEMES IN THE NORDIC COUNTRIES .......................................................................... 11 2.6.1 School meals in the Nordic countries ............................................................................................. 12 2.6.2 School meals in Norway ................................................................................................................. 13 3 METHODS .................................................................................................................................................
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