Fruit in Schools Initiative

July 2008

Compiled by Vicky Ledgerwood, Health Improvement Practitioner, Health Improvement Team, West Dunbartonshire Community

Health Partnership

Snap Shot Evaluation Summary Acknowledgements

West Dunbartonshire Community Health Partnership’s Health Improvement

Team would like to thank the following for their cooperation and support

• Pupils, parents and staff at Saint Josephs Primary, Faifley

• Pupils, parents and staff at Saint Peters Primary, Bellsmyre

• West Dunbartonshire CHP Health Visiting staff.

• Maria Hubbert, Graphic Recorder.

• GG & C Research and Evaluation Team, Dalian House.

• West Dunbartonshire Council, Educational Services

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West Dunbartonshire Snap Shot Evaluation

Introduction

National Evaluation

“The national free fruit in schools initiative aims to provide one portion

of free fruit three times a week during term time to all primary 1 and

primary 2 pupils in local authority managed schools. The initiative is an

additional measure to the recommendations made by the Expert Panel

on School Meals in their report, Hungry for Success. Both initiatives

are part of the Scottish Executive’s Health Improvement Programme

which recommends eating more fruit and vegetables. Improving the

uptake of school meals and fresh fruit is also an essential part of

supporting those children in most need.”1

This summary document has been compiled to collate and present findings

from a snap shot evaluation of the West Dunbartonshire Fruit in Schools

initiative undertaken by West Dunbartonshire Community Health Partnership

(WDCHP).

As a result of government funding the Fruit in Schools Initiative has been

operational in West Dunbartonshire since 2003, fruit provision was to all

primary one, two and combined 2/3 classes. However the former Greater

Glasgow Health Board previously provided additional funds to extend the

provision in Clydebank areas to Primaries four to seven.

The initiative has been rolled out across all of West Dunbartonshire and for

session 2007/2008 West Dunbartonshire Community Health Partnership have

provided funding to incorporate the additional twice weekly provision to all

primary four to seven in the 35 primary schools in West Dunbartonshire.

1 Scottish Executive Education Department (2005) Evaluation of Free Fruit in Schools

Initiative, Scottish Centre for Social Research, Stationary Office, Edinburgh

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The Fruit in Schools Initiative operates in partnership with West

Dunbartonshire Community Health Partnership and West Dunbartonshire

Councils Educational Services. Knowes Housing Association is

commissioned to source and supply the fruit to all schools involved in the

initiative. The housing association are already involved in operating a local

community café which is based in Faifley, Clydebank.

Aim

The overall aim of the report is to explore the initiative’s fit with national/local

policy and research utilising a collaborative approach with relevant partner

organisations.

Objectives

1. To review current policy and research in relation to the Fruit in Schools

Initiative.

2. To gather views from parents, teachers and pupils on the Fruit in

Schools Initiative.

3. To contribute to appropriate planning processes in relation to the ‘way

forward’ for the initiative.

Fruit in Schools Snapshot Summary Page - 4 - of 19

Objective 1. To review current policy and research in relation to the Fruit

in Schools Initiative

National/Local Policy and Research

Since the Fruit in Schools Initiative commenced various national policies and

guidelines have been developed which may have an impact on the future

development of the initiative. The following summarises the main points from

key documents.

Schools (Health Promotion and Nutrition) (Act) Scotland (2007)2

The act has two main themes, health promotion in schools and the provision

of food & drink in schools.

The main points of the act are to ensure:

• Health Promotion is placed at heart of schools’ activities.

• That food and drink served in schools meet the nutritional

requirements specified by the Scottish Ministers regulations.

• That local authority promotes the uptake and benefits of school meals

and in particular, free school meals.

• That the stigma associated with free school meals is reduced.

• The act also requires local authority protects the identity of those

eligible for free school meals.

• The act gives local authorities the power to provide pupils with healthy

snacks and drinks, either at a cost or free of charge.

• That schools adopt a ‘whole-school’ approach to integrate health

promotion into every aspect of school life.

• That local authorities work with partners to identify and meet the health

needs of the whole school and its wider community.

2 http://www.scotland.gov.uk/Topics/Education/Schools/HLivi/foodnutrition

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“Encourages you to eat more at

home”

Pupil, St Peters

The Nutritional Requirements for Food and Drink in Schools (Scotland)

Regulations 20083

Food in Schools - a guide to implementing the nutritional requirements,

explains the nutritional requirements detailed in the regulations and provides

guidance on how to comply with them. The regulations stipulate that school

meals should provide no less that two types of fruit every day.

The Nutritional Requirements for Food and Drink in Schools (Scotland)

Regulations came into force 4th August 2008. Regulations 3 and 4 will not

have effect in secondary schools until 3rd August 2009.

The Curriculum for Excellence (2008) Building the Curriculum 3-18

The Curriculum for Excellence has evolved following major restructuring of the

National Education system, with the aim that all children and young people

should be “successful learners, confident individuals, responsible citizens and

effective contributors”4

Health and wellbeing has been firmly placed within this curriculum,

recognising that children will become confident individuals “If children and

young people are healthy and emotionally secure they will become more able

to develop the capacity to live a full life. With a sense of wellbeing they will be

better able to deal with the unexpected and cope with adversity…They should

3 http://www.scotland.gov.uk/Topics/Education/Schools/HLivi/foodnutrition 4 A Curriculum for Excellence, Building the Curriculum 3-18 (1) The Contribution of curriculum Areas Scottish Executive 2008, Page 1

Fruit in Schools Snapshot Summary Page - 6 - of 19

learn to find appropriate sources of information that help make informed

choices”5

The curriculum for excellence experiences and outcomes for Health & Well

being is inextricably linked to the health promotion guidance accompanying

the Schools (Health Promotion and Nutrition) (Scotland) Act 2007. The

guidance will support the planning of experiences and outcomes which relate

to the whole school approach to health promotion in relation to physical

activity & nutrition, physical education, personal & social development, health

education & aspects of home economics including practical food preparation

and nutrition.

Being Well – Doing Well (2004) A framework for health promoting schools in

Scotland

Being Well – Doing well is a national framework for Health promoting schools

that was developed to:

• Establish a working definition of health promoting schools.

• Ensure a holistic view of education and health promotion is utilised,

specifically one that can be adopted by all stakeholders and used as a

foundation for planning purposes.

• Target all those who have a responsibility for policy and practice in

relation to education, health improvement and community development

within local authorities, education departments, NHS boards, health

promotion departments, schools and the voluntary sector.6

Being Well – Doing Well adopts the broad definition of health promoting

schools set out by the World Health Organisation which states

“A health promoting school is one in which all members of the school

community works together to provide pupils with integrated and positive

experiences and structures, which promote and protect their health. This 5 A Curriculum for Excellence, Building the Curriculum 3-18 (1) The Contribution of curriculum Areas Scottish Executive 2008, Page 9 6 Being Well – Doing Well. A framework for health promoting schools in Scotland Feb 2004

Fruit in Schools Snapshot Summary Page - 7 - of 19

includes both the formal and informal curriculum in health, the creation of a

safe and healthy school environment, the provision of appropriate health

services and the involvement of the family and wider community in efforts

to promote health.”

Lets us try new fruits.

Pupil, St Josephs

The Health of the People of West Dunbartonshire, Needs Assessment Report

(2007).

The recent comprehensive health needs assessment report undertaken in

West Dunbartonshire highlighted the poor diet that exists among West

Dunbartonshire residents, specifically around the increased intake of junk food

and reduced consumption of fruit and vegetables. Consequently the report

raised concerns regarding the potential for a greater risk of health problems

including obesity, diabetes, heart disease, gastro-intestinal disease,

hypertension (due to salt intake) and stroke. In order to address the existing

unhealthy diet within West Dunbartonshire the report suggests the need to

utilise health improvement strategies which are based on both education and

empowerment as well as health protection, where healthier choices are made

easier for the consumer. As a result one of the recommendations within the

report states that the Council and

schools should “Lead on providing free,

nutritionally balanced school meals,

with free fruit schemes resourced in

across all schools as a minimum.”7

Try fruit at school, then at home. Pupil, St Josephs

7 The Health of the People of West Dunbartonshire, Needs Assessment Report August 2007

Fruit in Schools Snapshot Summary Page - 8 - of 19

Objective 2. To gather views from parents, teachers and pupils on the Fruit in Schools Initiative Summary of Key Findings from Snapshot Evaluation

Many ideas were investigated to identify an effective approach to the

evaluation process one that would capture a snapshot of how the Fruit in

Schools Initiative is progressing. It was acknowledged that Parents, Teachers

and Pupils are key to the success of the initiative and it was deemed crucial to

develop an inclusive method, therefore, participatory appraisal was utilised to

ensure optimal involvement.

Participatory appraisal (PA) is a qualitative method which can be tailored to be

accessible to everyone; this was considered to be of particular importance

when involving primary aged children, ensuring they are involved to their

fullest potential.

“Many of the methods are visual, and create opportunities for people to

participate in discussions at the level that they feel comfortable with. The

approach can be used in meetings, with groups or individuals. Sometimes

people participate for a few minutes, at other times for an hour or more. The

methods can be used wherever people are at home, in the pub, at bus stops,

in schools, clubs, at the shopping centre. They are accessible across age,

gender and cultural differences.”

Have you been PA’d.

Using Participatory Appraisal to shape local services.

June 20038

8Have You Been PA’d, Using Participatory Appraisal to Shape Local Services? Greater Glasgow NHS Board East End Health Action, Greater Easterhouse Community Health Project, Oxfam GB (2003).

Fruit in Schools Snapshot Summary Page - 9 - of 19

In order to achieve an insight into the workings of the initiative the evaluation

collated views from pupils, teachers and parents.

The two participating schools were selected from separate geographic areas

in West Dunbartonshire, (Clydebank and Dumbarton). This included a school

that has received the additional provision of fruit to primary four to seven since

2003 (St Josephs, Clydebank) as well as a school that has recently

commenced the additional provision to primary four to seven (St Peters,

Dumbarton).

For list of questions / prompts relating to key findings, please refer to Appendix 1

Listed below are common themes highlighted from both schools during

Parents discussions.

Parents

• In both schools parents are buying the same

amount, if not more fruit in weekly shop.

• Parents acknowledged that children had

different attitudes to fruit when at home as

opposed to when in school.

• In both schools parent’s recognised the

children had an increased awareness of

healthy eating.

• Parents were still including fruit in packed

lunches even though fruit was supplied in

school.

• In both schools parents recognised that the

availability of fruit in school is of great benefit

to those children who maybe don’t get fruit at

home.

Fruit in Schools Snapshot Summary Page - 10 - of 19

Teachers

Listed below are the common themes which were highlighted from both

schools during Teachers discussions.

• Delivering fruit as part of a whole school approach

would be an idea teachers would be keen to

explore.

• Resources specific to healthy eating would be a

welcome additional support.

• In both schools the dispensing of fruit to the

pupils is the responsibility of teaching staff.

• According to the teachers there appeared to be

no issues regarding wastage of fruit

• Awareness of fruit in school being of benefit to

pupils who may not receive fruit at home.

• Teachers and peers positive attitude toward fruit

eating is inspiring to pupils.

• Keen to have fruit available everyday.

• Teachers in Both Schools are happy with

variety, standard and quality.

• Aware how much the children AND Teachers

would miss fruit in schools if it was not longer

available.

Fruit in Schools Snapshot Summary Page - 11 - of 19

Pupils

Listed below are the common themes which were highlighted from both

schools during pupil session.

• Majority of pupils like the fruit they get in school.

• Pupils from both schools commented fruit in schools is a good idea,

that it encourages eating fruit at home and would be unhappy if it was

unavailable.

• Pupils from both schools commented they like the variety.

• Pupils from both schools demonstrated good awareness of the benefits

of healthy eating

• Pupils from both schools demonstrated awareness and knowledge of

the “5 a Day” message.

Objective 3. To contribute to appropriate planning processes in

relation to the ‘way forward’ for the initiative

The next steps are to present findings via appropriate planning structures.

It is proposed each partner’s roles and responsibilities in terms of

implementing the following recommendations are reviewed along with a

commitment to explore potential areas for collaborative work. This is in

order to progress the initiative utilising a more ‘joined up’ approach in line

with national policy direction and more locally the establishment of the

West Dunbartonshire Single Outcome Agreement.

Recommendations

1. To implement a ‘whole-school’ approach to the Fruit in Schools Initiative.

2. The provision of teaching pack resources to support the implementation of a ‘whole school approach’ to the fruit in schools initiative.

3. To ensure WD CHP is a key partner and engaged in the planning & delivery of a ‘whole –school approach’.

Fruit in Schools Snapshot Summary Page - 12 - of 19

4. To ensure the fruit in school initiative enhances the school meal regulations.

5. To ensure the Fruit in Schools Initiative links to curriculum for excellence health & wellbeing outcomes.

6. To ensure active involvement of parents in fruit in schools initiative.

7. To support the implementation of the WD Health Needs Assessment recommendation in line with locally identified need and review findings from the local pilot for free school meals.

8. To hold an event to present findings to key stakeholders and facilitate discussions around planning a ‘way forward’ in relation to the Fruit in Schools initiative.

Fruit in Schools Snapshot Summary Page - 13 - of 19

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Appendix 1 Methodology

Two different types of Participatory Appraisal were developed, one for both

parents and teachers, and one for pupils.

Parents and Teachers Participatory Appraisal

The same format was used for both parents and teachers. Two separate

discussion groups were conducted, one for parents and one for teachers. The

discussions lasted approximately 20 minutes each and were facilitated by a

member of the Health Improvement Team with the assistance of a Graphic

Recorder.

A series of questions were devised to assist with the flow of the discussion

and ensure the conversations kept within the subject matter. However to

keep the discussions informal, the questions were not rigorously adhered to,

and in some cases were used more as prompts than direct questions.

The following prompts were formulated to assist with the parents discussions.

1. Do you get any feedback or have any discussions at home about

the fruit they receive in school?

2. Have you noticed any impact on the home environment? (Food

choices, packed lunches and fruit consumption)

3. Do you find you are buying more, less or the same amount of fruit in

your weekly shop?

4. Are you finding fruit replacing other, more unhealthy snacks?

5. Do you think your child’s attitude to fruit has changed since they

have been receiving free fruit in school?

6. Do you have any thoughts or ideas on how the initiative could be

improved?

7. One of the questions we are asking the children taking part today is

if they would miss the fruit if it was no longer available in

school….Would it have any impact on you as a parent if it wasn’t

available?

Teachers Questions

1. When are children getting their fruit?

2. Is fruit provision integrated in to the whole school approach?

3. If not…why not? What support do they need?(Resources, teaching

packs etc)

4. Do you receive any feedback from pupils about the fruit they get in

school?

5. Do you have any opinions on the quality and standard of fruit provided?

6. As you are on the front line when the children are receiving the fruit

have you ever been aware of any complaints? (E.g. Ripeness)

7. Have you noticed fruit replacing other more unhealthy snacks? (Ones

brought from home?)

8. Do you have any thoughts or ideas on how the initiative could be

improved?

9. One of the questions we are asking the children taking part today is if

they would miss the fruit if it was no longer available in school….What

sort of impact do you think it would have if it wasn’t available?

Pupils Participatory Appraisal It was decided to format the pupils Participatory Appraisal into a game. This

was to keep pupils attention, enable involvement of all pupils in the PA, and

add an element of fun to the piece of work. Various posters were displayed

around the area we were using. The posters had the following pictures on:

• Numbers 1 – 5

• Yes

• No

• Happy Face

• Sad Face

• Undecided Face

Pictures of the following fruit were also displayed:

• Pear

• Watermelon

• Grapes

• Pineapple

• Banana

• Apple

Fruit in Schools Snapshot Summary Page - 4 - of 19

• Kiwi

• Strawberry

• Orange

Due to the involvement of pupils from several classes, it was important to take

into account varying degrees of reading ability; therefore posters were used in

this exercise as prompts.

Pupils were asked a question; they then had to make their way over to the

corresponding poster. Once all pupils were stood at their chosen poster they

were counted and asked to elaborate why they had chosen to stand at the

specified poster.

To make the game more enjoyable children were asked if they wanted to run,

hop, skip, jump, etc. to the appropriate poster.

Pupil Discussions

The following details the findings from the discussions held with Pupils.

Listed below are the questions which were devised to assist with the PA

Game which was devised….

Do you like the fruit you get in school?

Yes: No:

Why?

Do you think that getting fruit in school is a good idea?

Yes: No:

Why?

Does getting fruit in school make you want to eat more fruit when you at

home?

Yes: No:

Why?

Fruit in Schools Snapshot Summary Page - 6 - of 19

What is your favourite fruit?

Kiwi: Strawberry: Apple:

Banana: Pineapple: Grapes:

Watermelon: Pear Orange:

Why?

How would you feel if you didn’t get free fruit in your school?

Happy: Sad: Not bothered:

Why?

How many pieces of fruit or veg do you eat in 1 day?

0 1 2 3 4 5

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Graphic Recordings St Josephs Parents comments shown on left hand side, Teachers on the right

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Fruit in Schools Snapshot Summary Page 12 of 19

St Peters Parents comments shown on left hand side, Teachers on the right