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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]