Children’s Food and Drink Purchasing Behaviour “Beyond the School Gate”: The Development of a Survey Module

Many children eat a diet which supplies a higher than recommended amount of nonmilk extrinsic sugars and saturated fatty acids. The school setting is often targeted for nutrition intervention as many children consume food at school. In Scotland, attempts have been made to improve the nutritional content of food in schools and attention has now turned to food and drink available “beyond the school gate.” This paper describes the development of a module on food and drink purchasing behaviour. The Food Purchasing Module was designed to collect data, for the first time, from a representative sample of children aged 8–16 years about food and drinks purchased on the way to/from school, during break time/free periods, and at lunchtime, from outlets around schools. Cognitive testing of the module highlighted that younger children find self-completion questionnaires problematic. Older children have fewer problems with self-completion questionnaires but many do not follow question routing, which has implications for the delivery of future surveys. Development of this survey module adds much needed evidence about effectively involving children in surveys. Further research exploring food and drinks purchased beyond the school gate is needed to continue to improve the nutritional quality of children’s diets. 1. Introduction Many children’s intakes of nonmilk extrinsic sugars (NMESs) and saturated fatty acids (SFA) fail to meet dietary targets for these nutrients [1]. Diets high in NMES and SFA are likely to contribute to the continued high prevalence of obesity and overweight amongst children. The Scottish Government has taken several steps to try to improve children’s diets, including interventions in the school setting. The Schools (Health Promotion and Nutrition) Scotland Act [2], passed in 2007, sets out nutritional standards for school meals and prohibits the sale of foods high in sugar in primary and secondary schools (e.g., confectionery and sweetened soft drinks) and limits the sale of foods high in fat (e.g., fried foods and most snacks). Once the act was implemented across all schools in Scotland, attention turned to some of the other factors which could be influencing school-aged children’s diets. One suggestion was to address children’s purchasing of food and drinks high in fat and/or sugar in outlets found in the vicinity of schools. Such outlets are referred to in Scotland’s Obesity Route Map Action Plan as being “beyond the school gate” [3]. Evidence suggests that the presence and geographical density of food outlets (this includes restaurants and