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Table 1 Identified barriers to packing a healthy lunchbox

From: Protocol for an effectiveness- implementation hybrid trial to assess the effectiveness and cost-effectiveness of an m-health intervention to decrease the consumption of discretionary foods packed in school lunchboxes: the ‘SWAP IT’ trial

 

Setting (school)

Family (parental)

Individual (child)

Barriers

• Food safety regarding lack of refrigeration and reheating facilities at school [34, 35]

• School allergy policy [35]

• Accessibility of fresh produce [35]

• Availability of discretionary food and drink products [36]

• Advertising and packaging [34, 36]

• Time to prepare lunchbox [34]

• Cost and affordability and perception that healthy food is more expensive [34]

• Poor nutritional knowledge on healthy food products [34]

• Negative parental modelling [37]

• Conflicting food purchases [37]

• Parental food preferences [37]

• Lack of skills in cooking and preparing food [37]

• Convenience [34, 37]

• Discretionary food provision as a reward for good behaviour [37]

• Lack of social support [36]

• Social norms and cultural challenges [36]

• Child preference and fussy eating [34]

• Attitude [36]

• Food and beverage likes and dislikes [36]

• Parental pressure to offer what the child prefers [36]