This study aims to determine whether an online marketing campaign increases children's school meal participation. Parents whose children do not currently eat school meals frequently will be exposed to messages designed to encourage their children's increased participation in school meals.
In this 6-week-long online randomized controlled trial, participants will be randomized to one of two arms: 1) Control (neutral) messages or 2) Messages designed to increase school meal participation. In each arm, participants will join private Facebook groups corresponding to their study arm. The study team will post campaign messages to these groups. Participants will answer online survey questions before and after the study on their attitudes about school meals and their child's participation in school meals.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
832
Messages focused on the benefits of children consuming school lunch and breakfast, using text and images developed based on parent interviews. Participants will view a total of 10 messages.
Control messages approximately matched to the intervention messages on length and design, but discussing a neutral topic unrelated to school meals (reading). Participants will view a total of 10 messages.
Stanford School of Medicine
Palo Alto, California, United States
Children's consumption of school lunches
Parental report of the usual number of days per week their child ate school lunch during the past month. Assessed with 1 item: "Thinking about the last month, how many days a week did your child usually eat school lunch?" This item will be scored on a 6-point scale from "0 days per week" (0) to "5 days per week" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Children's consumption of school breakfasts
Parental report of the usual number of days per week their child ate school breakfast during the past month. Assessed with 1 item: Thinking about the last month, how many days a week did your child usually eat school breakfast?" This item will be scored on a 6-point scale from "0 days per week" (0) to "5 days per week" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Noticing the school meal campaign
Parental report of whether they noticed the school meal campaign. Assessed with 1 item: "In the last 6 weeks, have you seen any messages or advertising on Facebook encouraging children to eat school lunch or school breakfast?" Response options are "yes" (1) and "no" (0).
Time frame: Collected in a ~10 minute survey at 6 weeks.
Number of school meals campaign topics recognized
Parental report of the number of topics they recognize having seen in messages about school meals. Assessed with 1 item: "Which of these topics did the messages discuss, if any? Check all that apply." Response options list 8 topics plus options for "none of these" and "not sure." Number of topics recognized will be calculated as the sum of all topics that parents indicate they have seen. Those who answer, "none of these" and "not sure" will be coded as recognizing 0 topics. Those who report not noticing the school meal marketing campaign will be coded as recognizing 0 topics.
Time frame: Collected in a ~10 minute survey at 6 weeks.
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Frequency of reading campaign messages
Parental report of the frequency with which they read their assigned campaign messages. Assessed with 1 item: "In the past month, how often did you read these messages?" This item will be scored on a 5 point scale ranging from "Never or less than 1 time per week" (1) to "Every day or more often" (5).
Time frame: Collected in a ~10 minute survey at 6 weeks.
Social interactions about campaign
Parental report of the frequency with which they talked to others about their assigned campaign messages. Assessed with 1 item: "In the last month, how often did you talk to others about these messages?" This item will be scored on a 5 point scale ranging from "Never or less than 1 time per week" (1) to "Every day or more often" (5).
Time frame: Collected in a ~10 minute survey at 6 weeks.
Social interactions about school meals
Parental report of the frequency with which they talked to others about school meals. Assessed with 3 items (e.g., "In the last month, how often did you talk to others about school meals?"). Response options are on a 5-point scale ranging from "Never or less than 1 time per week" (1) to "Every day or more often" (5). Responses to the 3 items will be averaged to create a mean score.
Time frame: Collected in a ~10 minute survey at 6 weeks.
Perceived benefits of school lunch
Parental report of the benefits of their child consuming school lunch. Assessed with 8 items (e.g., "My child eating school lunch helps my child do well in school"). Response options are on a 5-point scale ranging from "Strongly disagree" (1) to "Strongly agree" (5). Responses to the 8 items will be averaged to create a mean score.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Perceived benefits of school breakfast
Parental report of the benefits of their child consuming school breakfast. Assessed with 8 items (e.g., "My child eating school breakfast helps my child do well in school"). Response options are on a 5-point scale ranging from "Strongly disagree" (1) to "Strongly agree" (5). Responses to the 8 items will be averaged to create a mean score.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Knowledge that school lunch is free
Parental knowledge that lunches served at their child's school are free to all students. Assessed with 1 item: "Are school lunches free for all students at your child's school?" Response options "yes" (coded as 1) and "no" or "not sure" (both coded as 0).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Knowledge that school breakfast is free
Parental knowledge that breakfasts served at their child's school are free to all students. Assessed with 1 item: "Are school breakfasts free for all students at your child's school?" Response options "yes" (coded as 1) and "no" or "not sure" (both coded as 0).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Perceived healthfulness of school lunch
Parental perception of the healthfulness of the lunches served at their child's school. Assessed with 1 item: "How healthy or unhealthy are the school lunches at your child's school?" Response options are on a 5-point scale ranging from "Very unhealthy" (1) to "Very healthy" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Perceived healthfulness of school breakfast
Parental perception of the healthfulness of the breakfasts served at their child's school. Assessed with 1 item: "How healthy or unhealthy are the school breakfasts at your child's school?" Response options are on a 5-point scale ranging from "Very unhealthy" (1) to "Very healthy" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Intentions to encourage their children's consumption of school lunch
Parental report of the likelihood of encouraging their child to eat school lunch in the next month. Assessed with 1 item: "In the next month, how likely are you to encourage your child to eat school lunch?" Response options are on a 5-point scale ranging from "Not at all likely" (1) to "Extremely likely" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Intentions to encourage their children's consumption of school breakfast
Parental report of the likelihood of encouraging their child to eat school breakfast in the next month. Assessed with 1 item: "In the next month, how likely are you to encourage your child to eat school breakfast?" Response options are on a 5-point scale ranging from "Not at all likely" (1) to "Extremely likely" (5).
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Barriers to children's school lunch consumption
Parental report of the barriers preventing their child from eating school lunch. Assessed with 1 item: "What are some reasons that your child doesn't eat school lunch more often? Check all of the reasons that apply." Response options list 15 reasons plus "NA - my child eats school lunch every day or almost every day" and a free response option for "other." Total number of barriers selected will be summed. Those who report "NA - my child eats school lunch every day or almost every day" will be coded as having 0 barriers.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Barriers to children's school breakfast consumption
Parental report of the barriers preventing their child from eating school breakfast. Assessed with 1 item: "What are some reasons that your child doesn't eat school breakfast more often? Check all of the reasons that apply." Response options list 16 reasons plus "NA - my child eats school breakfast every day or almost every day" and a free response option for "other." Total number of barriers selected will be summed. Those who report "NA - my child eats school breakfast every day or almost every day" will be coded as having 0 barriers.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Household food insecurity
Parental report of household food insecurity. Assessed with 6 items (e.g., "In the last month, were you ever hungry but didn't eat because there wasn't enough money for food?") Response options include "no" or "yes"; "never true", "sometimes true", or "often true"; "only 1 or 2 days," "some days but not every day," or "almost every day." Responses of "often" or "sometimes" and "yes" are coded as affirmative (yes). Likewise, responses of "almost every day" and "some days but not every day" are coded as affirmative (yes). The sum of affirmative responses to the six questions in the module is the household's raw score on the scale. Household food security status is assigned as follows: Raw score 0-1-High or marginal food security Raw score 2-4-Low food security Raw score 5-6-Very low food security Analyses will dichotomize households into those with high or marginal food security and those with low or very low food security.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.
Child food insecurity
Parental report of child food insecurity. Assessed with 8 items (e.g., "In the last month, did you ever cut the size of your child's meals because there wasn't enough money for food?") Response options include "no" or "yes"; "never true", "sometimes true", or "often true"; "only 1 or 2 days," "some days but not every day," or "almost every day." Responses of "often" or "sometimes" and "yes" are coded as affirmative (yes). Responses of "almost every day" and "some days but not every day" are coded as affirmative (yes). The sum of affirmative responses to the 8 questions in the module is the child's raw score on the scale. Child food security status is assigned as follows: Raw score 0-1-High or marginal food security among children; Raw score 2-4-Low food security among children; Raw score 5-8-Very low food security among children Analyses will dichotomize households into those with children with high or marginal food security or children with low or very low food security.
Time frame: Collected in a ~10 minute survey at baseline and again at 6 weeks.