Parental Reports of Lunch-Packing Behaviours Lack Accuracy: Reported Barriers and Facilitators to Packing School Lunches

Publication: Canadian Journal of Dietetic Practice and Research
12 June 2018

Abstract

Purpose: Parents influence the foods their children consume and often provide proxy reports of this intake. One way parents exert this influence is by providing home-packed lunches. This study compared parental reports of foods packed in children’s lunches with what was actually packed and identified parental barriers and facilitators to packing lunches.
Methods: Grade 3 and 4 student–parent dyads (n = 321) in 19 elementary schools in Ontario participated. Parental reports and actual packed lunch contents were collected via self-administered surveys and direct observation, respectively. Parental barriers and facilitators were obtained through open and closed survey questions.
Results: Median portions packed were significantly higher for sugar-sweetened beverages and snacks and significantly lower for fruits, fruit juice, vegetables, milk/alternatives, and meat/alternatives than parents reported. Packing a healthy lunch was “important/very important/of the utmost importance” for 95.9% of respondents, and 97.5% perceived their nutrition knowledge as “adequate/good/very good”. Barriers to packing a lunch included: child’s food preferences, time, finances, allergy policies, and food safety. Nutrition resources, observing other children’s lunches, child’s input, and planning ahead were identified as facilitators.
Conclusions: Strategies to improve packed lunches should move beyond parental nutrition knowledge and importance of lunch packing to address parental barriers and facilitators.

Résumé

Objectif. Les parents ont une influence sur les aliments que consomment leurs enfants et fournissent souvent des déclarations par personne interposée à cet égard. Ils exercent entre autres cette influence en préparant des boîtes à lunch. Cette étude a comparé les aliments déclarés par les parents au contenu réel des boîtes à lunch et a ciblé les obstacles et les facteurs qui facilitent la préparation des boîtes à lunch chez les parents.
Méthodes. Des dyades parent-élève de 3e ou de 4e année (n = 321) de 19 écoles primaires de l’Ontario ont participé à l’étude. Des renseignements sur le contenu des boîtes à lunch, réel et déclaré, ont été recueillis à l’aide d’observations directes et de sondages auto-administrés, respectivement. Enfin, l’information sur les obstacles et les facteurs facilitants a été obtenue au moyen de questions de sondage ouvertes et fermées.
Résultats. La taille médiane des portions servies était considérablement plus élevée pour les boissons et les collations sucrées, et nettement moins élevée pour les fruits, le jus de fruits, les légumes, le lait et ses substituts, et les viandes et leurs substituts, que ce que les parents avaient déclaré. Préparer des dîners santé était « important/très important/extrêmement important » pour 95,9 % des répondants. Par ailleurs, 97,5 % d’entre eux considéraient leurs connaissances en nutrition comme « adéquates/bonnes/très bonnes ». Les obstacles à la préparation des boîtes à lunch comprenaient : les préférences alimentaires de l’enfant, le temps, le budget, les politiques relatives aux allergies et la salubrité des aliments. Les ressources sur la nutrition, l’observation du contenu de la boîte à lunch d’autres enfants, la rétroaction de l’enfant et la planification ont été reconnues comme des facteurs facilitants.
Conclusions. Les stratégies visant à améliorer la préparation des boîtes à lunch devraient tenir compte des connaissances parentales en nutrition et de l’importance des dîners santé, mais également des obstacles et des facteurs facilitants vécus par les parents.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: This work was supported by the Canadian Institutes of Health Research [POH-123776].
Conflict of interest: The authors declare that they have no conflicts of interest.

References

1
Wansink B. Nutritional gatekeepers and the 72% solution. J Am Diet Assoc. 2006;106(9):1324–7.
2
McPherson RS, Hoelscher DM, Alexander M, Scanlon KS, and Serdula MK. Dietary assessment methods among school-aged children: validity and reliability. Prev Med. 2000;31:S11–33.
3
Healthy Kids Panel. No time to wait: the healthy kids strategy; 2013 [cited 2018 Feb 1]. Available from: http://www.health.gov.on.ca/en/common/ministry/publications/reports/healthy_kids/healthy_kids.pdf.
4
Dorman SC, Gauthier AP, Laurence M, Thirkil L, and Kabaroff JL. Photographic examination of student lunches in schools using the balanced school day versus traditional school day schedules. Infant Child Adolesc Nutr. 2013;5(2):78–84.
5
Taylor JP, Hernandez KJ, Caiger JM, Giberson D, MacLellan D, Sweeney-Nixon M, et al. Nutritional quality of children’s school lunches: differences according to food source. Public Health Nutr. 2012;15(12):2259–64.
6
Conway TL, Sallis JF, Pelletier RL, Powers HS, Marshall SJ, Zive MM, et al. What do middle school children bring in their bag lunches? Prev Med. 2002;34:422–7.
7
Evans CEL, Greenwood DC, Thomas JD, and Cade JE. A cross-sectional survey of children’s packed lunches in the UK: food- and nutrient-based results. J Epidemiol Community Health. 2010;64:977–83.
8
Evans CEL, Cleghorn CL, Greenwood DC, and Cade JE. A comparison of British school meals and packed lunches from 1990 to 2007: meta-analysis by lunch type. Br J Nutr. 2010;104:474–87.
9
Hur I, Burgess-Champoux T, and Reicks M. Higher quality intake from school lunch meals compared with bagged lunches. Infant Child Adolesc Nutr. 2011;3(2):70–5.
10
Sanigorski A, Bell A, Kremer P, and Swinburn BA. Lunchbox contents of Australian school children: room for improvement. Eur J Clin Nutr. 2005;59:1310–6.
11
Farris AR, Misyak S, Duffey KJ, Mann GR, Davis GC, Hosig K, et al. A comparison of fruits, vegetables, sugar-sweetened beverages, and desserts in the packed lunches of elementary school children. Child Obes. 2015;11:275–80.
12
Bathgate K and Begley A. ‘It’s very hard to find what to put in the kid’s lunch’: what Perth parents think about food for school lunch boxes. Nutr Diet. 2011;68:21–6.
13
Clarke J, Fletcher B, Lancashire E, Pallan M, and Adab P. The views of stakeholders on the role of the primary school in preventing childhood obesity: a qualitative systematic review. Obes Rev. 2013;14:975–88.
14
Cleghorn CL, Evans CE, Kitchen MS, and Cade JE. Details and acceptability of a nutrition intervention programme designed to improve the contents of children’s packed lunches. Public Health Nutr. 2010;13(8):1254–61.
15
Sweizter SJ, Briley ME, Roberts-Gray C, Hoelscher DM, Staskel DM, and Almansour FD. How to help parents pack better preschool sack lunches: advice from parents for educators. J Nutr Edu Behav. 2011;43:194–8.
16
Neilson LJ, Macaskill LA, Luk JM, Sharma N, Killip SM, Salvadori MI, et al. Students’ food intake from home-packed lunches in the traditional versus balanced school day. Can J Diet Pract Res. 2017;78(1):3–10.
17
Baglio ML, Baxter SD, Guinn CH, Thompson WO, Shaffer NM, and Frye FH. Assessment of interobserver reliability in nutrition studies that use direct observation of school meals. J Am Diet Assoc. 2004;104(9):1385–92.
18
Richter SL, Vandervet LM, Macaskill LA, Salvadori MI, Seabrook JA, and Dworatzek PD. Accuracy and reliability of direct observations of home-packed lunches in elementary schools by trained nutrition students. J Acad Nutr Diet. 2012;112(10):1603–7.
19
Health Canada. Eating well with Canada’s Food Guide; 2011 [cited 2018 Feb 1]. Available from: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/order-commander/eating_well_bien_manger-eng.php#a2.
20
Canadian Food Inspection Agency. Information within the nutrition facts table: reference amounts; 2016 [cited 2018 Feb 1]. Available from: http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/nutrition-labelling/information-within-the-nutrition-facts-table/eng/1389198568400/1389198597278?chap=5.
21
Colton T. Statistics in medicine. 1st ed. New York, NY: Little Brown; 1974.
22
Burrows TL, Martin RJ, and Collins CE. A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water. J Am Diet Assoc. 2010;110(10):1501–10.
23
Masson LF, McNeil G, Tomany JO, Simpson JA, Peace HS, Wei L, et al. Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic. Public Health Nutr. 2002;6(3):313–21.
24
Cade JE, Burley VJ, Warm DL, Thompson RL, and Margetts BM. Food-frequency questionnaires: a review of their design, validation and utilisation. Nutr Res Rev. 2004;17(1):5–22.
25
Sweitzer SJ, Briley ME, Roberts-Gray C, Hoelscher DM, Harrist RB, Staskel DM, et al. Lunch is in the bag: increasing fruits, vegetables, and whole grains in sack lunches of preschool-aged children. J Am Diet Assoc. 2010;110(7):1058–64.
26
Yeh MG, Ickes SB, and Lowenstein LM. Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008;23(1):42–51.
27
Government of Ontario. Sabrina’s Law, 2005, S.O. 2005, c.7. 2005; 2005 [cited 2018 Feb 1]. Available from: https://www.ontario.ca/laws/statute/05s07.
28
Hesketh K, Waters E, Green J, Salmon L, and Williams J. Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health Promot Int. 2005;20(1):19–26.
29
Vahabi M. The impact of health communication on health-related decision making: a review of evidence. Health Edu. 2007;107(1):27–41.

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 79Number 3September 2018
Pages: 99 - 105

History

Version of record online: 12 June 2018

Authors

Affiliations

Dana L. Hawthorne MScFN, RD
Leeds, Grenville and Lanark District Health Unit, Brockville, ON
Lisa J. Neilson MScFN, RD
Rexdale Community Health Centre, Etobicoke, ON
Lesley A. Macaskill MHSc, RD
School of Food and Nutritional Sciences, Brescia University College, London, ON
Jonathan M.H. Luk MScFN, RD
South Riverdale Community Health Centre, Toronto, ON
Erica J. Horner RD
Guelph General Hospital, Guelph, ON
Colleen A. Parks MSc, RD
Sunnybrook Health Sciences Centre, Toronto, ON
Marina I. Salvadori MD
Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON
Jamie A. Seabrook PhD
School of Food and Nutritional Sciences, Brescia University College, London, ON
Departments of Paediatrics, and Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON
Children’s Health Research Institute, London, ON
Lawson Health Research Institute, London, ON
Human Environments Analysis Laboratory, London, ON
Paula D.N. Dworatzek PhD, RD
School of Food and Nutritional Sciences, Brescia University College, London, ON
Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University, London, ON

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Acceptability, Helpfulness, and Utility of the Healthy Lunch Box Booklet (HLBB) for Parents and School-Age Children

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media