5. SUMMARY AND DISCUSSION
5.1 BACKGROUND INFORMATION
The national Free Fruit in Schools initiative aims to provide one portion of fruit three times a week during term time to all primary I 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. The Scottish Executive has provided £2m per year for financial years 2003-04 to 2005-06 to introduce the Free Fruit initiative across all publicly funded schools in Scotland.
The initiative had been implemented in most schools by December 2003 and the 2005 SEED School Meal census shows that almost 100% of primary schools were giving free fresh fruit to P1 and P2 pupils. Only four local authorities did not report full coverage of the initiative within all of their primary schools. The Scottish Centre for Social Research (ScotCen) was commissioned by the Schools Group Analytical Service Unit in the Education Department of the Scottish Executive in February 2005 to evaluate the implementation of the Free Fruit in Schools initiative in Scotland.
ScotCen used a mixed methods approach to evaluate the free fruit initiative. Firstly, a formative phase was carried out which encompassed in-depth interviews with key stakeholders and further qualitative work in pilot schools. This phase helped inform the development of the research instruments for the main survey phase. In the main study phase, semi-structured telephone interviews were conducted with 47 local authority professionals able to comment on both the policy context and the operational aspects of the free fruit initiative. Responses were gathered from all of the 32 local authorities in Scotland. Finally, a questionnaire survey of a representative sample of 510 primary schools was carried out, addressing all aspects of the implementation of the scheme at a school level. After telephone follow-up, 458 questionnaires were completed, a response rate of 90%.
5.2 VIEWS OF LOCAL AUTHORITY PROFESSIONALS
Respondents in a majority of local authorities (n=20) reported that there were fruit and vegetable schemes running in their areas before the implementation of the Scottish Executive free fruit initiative. However, these schemes varied widely, from large, well-established programmes in all primary and nursery schools city-wide to areas which introduced fruit into school tuck shops or offered free fruit on a limited basis. The introduction of the national Free Fruit Initiative affected most of these pre-existing schemes in a number of different ways. For example, in some cases fruit was now given to pupils in other primary years, or given on a more frequent basis.
It was reported that the Free Fruit Initiative had been implemented in 100% of primary schools in every local authority, although most recent Scottish Executive figures suggest that four areas have not achieved full coverage as yet. Most areas had also implemented the scheme in all of the special schools in their area, but three-quarters of authorities had not covered nursery schools, and secondary schools were not part of the scheme in any locality.
Respondents in two areas said that their primary schools gave free fruit to pupils in every primary year. The other respondents stated that P3 pupils in composite P2/P3 classes also received free fruit in 13 of the local authority areas. In six local authority areas all children in schools with a small pupil roll received free fruit. In the majority of local authorities the pupils were given one portion of fruit three times a week, in accordance with the aims of the Scottish Executive initiative. In three authorities pupils received one portion of fruit five days a week.
In terms of the supply of fruit to schools, professionals in 9 local authority areas said that the school meals service was the supplier of fruit for the initiative, although in four of these areas local suppliers of fruit were also involved. In the majority of areas fruit was supplied by a local fruit or fresh produce wholesaler. A community food initiative and a housing association were involved in supplying fruit in other areas, as were local shops. Some authorities used a combination of suppliers. In nearly all cases the supplier of the fruit also distributed the fruit to schools, although in two areas another organisation was responsible for distribution. In the majority of local authority areas the fruit supplier and distributor were chosen by the local authority alone. In four areas, schools also had some input into the choice of supplier. Three of these were in rural and remote areas, suggesting that these areas required a bit more flexibility in terms of implementing the scheme. In one area it was said that the primary schools alone chose who supplied their fruit.
Professionals in almost all of the authorities expressed that they were at least quite satisfied with the quality of fruit delivered to their schools. In some areas it was said that there had been problems with the quality of fruit initially, but when this was raised with the supplier the problems were quickly resolved. Only a few respondents still perceived that the fruit quality was, or could be, poor. However, respondents from nine areas reported that there could be problems related to the ripeness of the fruit delivered; this was mostly due to fruit being not ripe enough at the time of delivery. Although it was said that some areas were able to save the unripe fruit this was not an option for schools in all areas, presumably in the main because of inadequate storage facilities, and it had on occasion to be sent back to the supplier. Respondents from several authorities mentioned that although they were not unhappy with the quality of the fruit they were currently supplied with they were continually looking at other potential suppliers to see if they could improve on quality. Quality of fruit was gauged in a variety of ways, from formal surveys and evaluations as well as more anecdotal measures, such as informal feedback from school staff.
Although there had been initial problems in ascertaining how much fruit to distribute to schools in each area, at the time of the telephone interviews almost every respondent perceived that the quantity of fruit delivered to the schools as part of the initiative was at least quite sufficient.
A wide range of fruits and vegetables was reported as being distributed in each area. Not unexpectedly, apples, bananas, grapes, melon and oranges were supplied to most schools. However, vegetables including carrots, peppers and celery, and more exotic fruits such as mango and star fruit, were mentioned as being supplied in a minority of areas.
The perception of the local authority staff was that grapes, melon, bananas, apples and strawberries were most popular among pupils. However, it is likely that the relative popularity of apples and bananas was related in some way to the fact that they were supplied more frequently to schools. The respondents thought that the popularity of fruit such as grapes, melon and strawberries was because they were sweet and easy to eat. In addition, the size was also thought to be important and larger fruit such as melons and apples were said to be more appealing when cut up into a more manageable size, or packaged in a particular way. Fruits considered to be relatively unpopular with pupils included tomatoes, oranges, apples and carrots. Other unpopular fruits ranged from red peppers to dried fruit. Factors related to unpopularity included the size of the fruit, the need for preparation (eg. peeling), the mess created in preparation and the presence of stones and pips. Also, in the case of tomatoes it was argued that the children simply did not like the taste.
The respondents were mostly satisfied with the variety of the fruit delivered to schools in their areas. In three authorities some of the respondents felt that the variety of fruit on offer needed to be widened. It was also stated in a few cases that the lack of variety in fruit available was as a result of budget restrictions.
Given the generally positive views expressed above, as would be expected professionals in the majority of local authorities said that they were at least quite satisfied with the performance of their fruit suppliers, with staff in only two areas stating that they were not satisfied, for example, because of irregular deliveries. Also, some respondents, although they were largely satisfied with their supplier, did want to make changes to the arrangements and planned to do this in the near future. As has been said, in many cases the suppliers of fruit also distributed it to schools and therefore, not surprisingly, the level of satisfaction with the distribution of fruit was similarly high. Respondents from only one area reported that they were not very satisfied with their fruit distributor. Remote schools did pose challenges in some authorities, and arguably island authorities experienced particular problems, but the consensus was that initial distribution difficulties had been resolved.
It was stated that an evaluation of the free fruit initiative was being carried out in some form in 25 local authority areas. Respondents in only four areas said that they were sure that no evaluation was being conducted. Most of those who were conducting local evaluations said that were doing so through questionnaire surveys; these were being sent to a mixture of school staff, parents and pupils. Several respondents also stated that the initiative was being evaluated as part of Hungry for Success. In a few instances, catering and education services, health promotion departments and independent consultants were carrying out evaluations. Other measures being utilised included ongoing consultation and feedback from school staff and pupils, as well as monitoring data on deliveries of fruit to schools and fruit returned from kitchens. However, it is very difficult to ascertain from the interviews with local authority staff the nature of the evaluations conducted, and the quality of research evidence being gathered locally. It is likely that both formal and anecdotal evidence was being used to justify the view expressed by the respondents that most areas were evaluating the initiative.
The Scottish Executive issued guidance to local authorities in order that issues such as local sources of fruit, supply of seasonal fruit, reducing levels of wastage, organic fruit and links with school meals were considered. It was reported that most of the areas were being supplied with fruit by the school meals contractors. Although most suppliers were locally-based, some areas used suppliers from outwith the area, for example, in order to guarantee the volume of fruit necessitated by the initiative.
Almost all of the authorities reported that where possible they supplied seasonal fruit and vegetables. The seasonal fruits were mainly limited to strawberries in summer and satsumas in winter, but other berry fruits were also mentioned. Several respondents mentioned that their supplier alerted them to offers on seasonal fruit which helped them to reduce costs. However, respondents from five areas cited cost as a problem in providing seasonal fruit. Island respondents reported that providing fruit was not just a seasonal problem in their areas. The majority of authorities did not supply organic fruit and vegetables at the time of the research, with most citing the higher cost and/or the lack of availability of sufficient amounts of organic produce as obstacles to its provision. It was reported that three authorities did supply a low percentage of organic fruit, but in two of these authorities this was limited to very few schools. It was said in two areas that they were considering introducing organic fruit.
In almost all local authority areas at least some of the fruit was prepared in some way. This included fruit being washed, chopped or sliced, grapes being de-stalked, etc. Fruit was then often portioned in small pots or dishes and, in some cases, bagged. Preparing the fruit in this way was thought to increase its appeal to the pupils and make it easier to eat. In two authorities the respondents said that they did not prepare fruit, yet in one of these areas the fruit was supplied pre-washed; in the other area the fruit was washed in school. In both these areas children were given whole fruit. In a majority of authorities it was said that fruit and vegetables were prepared in school by school catering staff. The respondents added that in schools without kitchens fruit was prepared by other school kitchens in the authority area and then delivered to the schools. In one local authority area it was pointed out that all fruit preparation was carried out by the fruit supplier.
Respondents seemed to be unaware of the guidance from the Scottish Executive to ensure that the food miles of the fruit provided to schools were minimised. Only a few respondents were aware of this guidance, or local guidance related to the same issue. Apart from the use of local suppliers, as noted above, there did not appear to have been a great deal of consideration of this element of the Scottish Executive guidance.
About three-quarters of local authority areas were said to have levels of fruit wastage of less than 20%. One respondent thought that 60% of vegetables in some schools were being wasted. However, respondents found it difficult to give an overall estimate for their area in that it varied from school to school. As with Scottish Executive guidance related to food miles, very few respondents were aware of specific guidance on reducing levels of wastage of fruit. However, many measures had been introduced locally, including limiting fruit supplied to schools, encouraging children to eat fruit in the classroom setting, distributing leftover fruit to other pupils or school staff and composting any fruit waste. As a result, the majority of authorities did not think that wastage of fruit was a problem for most schools.
The majority of authorities did report some link with their school meals service. For some authorities the provider of the school meals service also provided the fruit for the initiative. In addition, the catering service was reported to be involved in a number of ways, from simply ordering the fruit for the initiative, through preparing fruit and in some cases distributing the fruit. Respondents from only four authorities reported that the initiative did not link with the school meals service at all. One other link mentioned was that the initiative had had a positive impact on the choices made by pupils for their school lunches. In addition, respondents from three-quarters of the authorities spoke of Hungry for Success, and that the whole school approach to healthy eating had been assisted by more than the Free Fruit initiative operating in isolation. Similarly, links with the health promoting schools concept and the provision of drinking water in schools, as well as links with curricular teaching, were also viewed as beneficial.
Despite the lack of awareness of certain issues outlined above, informants in the majority of authorities reported that the guidance provided by the Scottish Executive was at least quite useful. Many respondents found the guidance clear, concise and helpful, particularly when they were setting up the initiative. There was occasional criticism, particularly from those in rural areas, who thought that the guidance did not meet the needs in their locality. However, others said that they were able to adapt the guidance to suit their needs locally. In addition, it was said that some authorities provided schools with guidance, mostly focusing on fruit handling and food hygiene, and in a few instances storage of fruit.
In relation to difficulties encountered by the initiative, not one respondent thought that there had been any major problems with the running of the schemes in their areas. Inevitably, some said that there had been initial teething problems in the early phases of setting up the scheme, but these had been largely overcome. The main hurdle that had to be overcome was the time teachers had to spend on administering the initiative and the consequent loss of class time with the children. In some areas there was initial resistance from teaching staff to the scheme, the problem scarcely ameliorated by the recommendation that the fruit should be eaten in the classroom rather than in the playground. However, local authority respondents stressed that they had liaised with school staff - with head teachers and teachers - to convince them of the value of the initiative. Other difficulties experienced in the different areas included the costs of the scheme, delivery of fruit across a wide geographical area, occasional problems with the quality of fruit and implementing the initiative in areas with many composite classes containing P2 and P3 pupils. These problems had been dealt with in a number of ways.
On the other hand, the willingness, enthusiasm and commitment of both teaching and catering staff involved with the initiative were mentioned most frequently as the factors which facilitated the operation of the initiative. The experience of catering staff and the existing school meal providers, particularly in terms of the preparation and distribution of fruit, was perceived as being invaluable. Funding was mentioned by a few respondents as being vital to the implementation of the initiative. The existence of Hungry for Success and the publicity surrounding it, and healthy eating in general, was considered by some to have assisted the introduction and acceptance of the free fruit initiative within schools.
Almost every local authority area was able to provide cost data for the operationalisation of the free fruit initiative, even if the costs were approximate only. Given the very different areas and school rolls covered by the local authorities, costs ranged from about £12K to £1000K per annum. Respondents in the majority of local authorities thought that the funding provided by the Scottish Executive was at least quite sufficient to run the initiatives in their schools. However, at least 12 local authorities perceived that this was not the case, although it is difficult to give precise local authority figures as in eight areas different views were expressed. In areas in which funding was thought to be sufficient already, it was often said that there had been additional costs at the outset of the initiative, but once the initial outlay had been met costs had reduced or stabilised in the following years. In a number of cases local authority respondents argued that Healthy for Success monies had been used to help subsidise the free fruit initiative. Other examples were given of shortfalls, or what could be achieved with even more funding, for example, by extending the types of fruit supplied to schools.
Almost all (n=45) of the respondents said that fruit consumption had increased among pupils as a result of the initiative, with only two professionals stating that there was no evidence for such an increase. It should be noted that both of these respondents represented authorities in which another individual indicated that fruit consumption had increased among pupils. However, the fact that the Free Fruit initiative was part of Hungry for Success, and not operating in isolation, was a point raised during every phase of the research, and it is important to note that many of the perceived impacts identified in this evaluation are likely to be due to a Hungry for Success component, and not solely a free fruit initiative effect. Reasons given to support the claim that fruit consumption had increased included the results of formal evaluations in the local schools, feedback received from school staff, parents and pupils, direct observation during school visits and an increased demand for fruit and vegetables from school tuck shops and for school lunches.
Only one local authority professional thought that the initiative had no place in promoting healthy eating more generally in school pupils. Every other respondent thought that the initiative did have this wider role, the general consensus being that the awareness of fruit and its relationship to healthy eating had increased, pupils who had never tried fruit or were only aware of a limited range of types were enjoying new tastes, links with the curriculum and health promoting schools had been forged, and the combined impact with other related initiatives, such as Hungry for Success as a whole, was changing the eating habits of children for the better.
As might be expected, given the positive views expressed above, two-thirds of the local authorities rated the free fruit initiative as being very successful, with professionals in seven areas stating that the scheme had been quite successful. In the remaining areas the two respondents gave different opinions, although only one of the 47 respondents said that the initiative had not been successful at all. All of the 47 local authority respondents, including the individual who had expressed more negative views, thought that the free fruit initiative should continue to run in their areas in the future. The fact that the initiative was thought to impact favourably on the diets of young primary school-aged children, and would then have the capacity to produce health benefits for future generations, in combination with other initiatives, was cited. It was stressed that the initiative had been very successful, and it should be allowed to continue and not have its funding cut. It was also argued that the initiative was one of the best to be introduced by the Scottish Executive.
The most frequently mentioned change to the running of the free fruit initiative, given its very positive reception among local authority informants, was to expand the initiative so that children received fruit on 5 days per week and/or pupils in more or all primary years were covered by the scheme. Several respondents also mentioned extending the scheme to include nursery schools and one respondent wanted to see the initiative expanded into secondary schools. A few respondents were content with the initiative as it was and did not want any changes to the way the scheme operated. Other suggestions for changes to the initiative, suggested by a minority of respondents, included increasing the variety of fruit offered, increasing the portion size and encouraging children to be involved in fruit preparation. Again, the fact that most of the requested modifications to the initiative would actually increase its scope emphasises the very positive reaction to the initiative among the local authority professionals.
5.3 VIEWS OF SCHOOL STAFF RESPONDENTS
After 510 questionnaires were distributed to schools, a total of 458 questionnaires were either returned by post or completed by telephone interview. This represents a response rate of almost 90%. Responses were received from schools in every local authority in Scotland, with the response ranging from four schools in an Island authority to 44 forms in an urban area. As a result of this very encouraging response rate, it was possible to analyse responses by the urban-rurality scale, the size of the school roll and the pupils' entitlement to free school meals. Not unexpectedly, the vast majority of the schools which responded belonged to one of the urban or rural categories - few schools were based in towns. Also, schools based in urban areas were more likely to have high school rolls and high levels of pupil entitlement to free school meals when compared with their rural counterparts.
The majority of questionnaires were returned by head teachers. This was particularly true for smaller, often rural, schools. Primary school teachers were more likely to complete the forms in smaller schools, although in a number of cases one individual combined a senior school post with the teaching of a composite primary class. About one-quarter of questionnaires returned had been completed by more than one respondent.
Only four schools (1%), three of which were special schools, were not running the free fruit initiative, and three of these schools had no pupils in the appropriate primary years. Also, 13% of schools reported that a similar fruit initiative was in operation before the Scottish Executive scheme was implemented. Schools in about one-third of local authority areas reported no previous fruit-related schemes, which supports the views expressed by the local authority respondents. In addition, school staff stated that the Scottish Executive inspired initiative had resulted in the pre-existing scheme being extended in some way, such as covering more pupils or fruit being distributed more frequently. This again is in accordance with the views of the local authority respondents.
Primary 1 and 2 pupils were indeed the main beneficiaries of the free fruit initiative, as intended. However, 46% of schools gave fruit to primary 3 pupils, with 65% of schools in the low school roll category doing this, presumably because of the influence of composite classes (75% of schools with primary 2 and 3 pupils within the same class offered fruit to both year groups). Over one-quarter of primary 7 pupils received free fruit, with a majority of schools in five local authority areas giving free fruit to this year group. About 75% of school respondents reported that the pupils in the relevant years received one free fruit portion on three days of the week - the programme announced by the Scottish Executive. However, 29% per cent of schools in the large urban category compared with only 11% of schools in the remote rural category reported giving fruit to pupils on a daily basis (P<0.01), again reflecting the different approaches adopted by individual local authorities.
There was a major difference noted between fruit and vegetable deliveries to urban and rural schools, with 34% of large urban schools compared with 3% of remote rural schools receiving fruit deliveries on at least four days per week (P<0.001). The size of the school roll also seemed to have some impact on school deliveries, with those with low school rolls more likely to receive weekly deliveries. Those most frequently involved in fruit and vegetable distribution within the school were members of catering staff, classroom assistants and primary 1 and 2 teachers.
Those in remote rural schools were much more likely to report storing fruit in refrigerated units compared with respondents in large urban schools (49% vs 25% P<0.01) - large urban schools were more likely to use boxes and baskets. This might reflect the different deliveries to schools outlined above, with rural schools needing to keep fruit for a longer time period before distributing it to the pupils. However, schools in the "other urban" category followed a similar storage pattern to the rural schools. Eighty percent of schools were reported to have storage facilities that were at least quite adequate, but 25% of schools based in large urban areas said that storage facilities were inadequate. Those who thought that the storage facilities were inadequate tended to say that refrigeration of the fruit was necessary to limit wastage, and certain fruit types were distributed as soon as practicable as they had a greater propensity to decompose. However, many of these schools also said that they managed quite well despite the lack of storage facilities.
Almost 75% of the sample of schools prepared (as in washed and cut up) the fruit and vegetables in the school kitchen. This was especially the case in remote rural schools, with large urban based schools more likely to have fruit prepared within the classrooms, general purpose rooms or "other" places. In two-thirds of schools catering staff were involved in preparing the fruit for pupils. However, only 44% of schools in large urban areas had catering staff preparing the fruit and vegetables. Others involved in fruit preparation included classroom assistants, primary 1 and 2 teachers and the fact that fruit came prepared either from the supplier or from other school kitchens. In addition, in almost 40% of schools the fruit was cut or packaged in a particular way by suppliers, and in about 59% of schools the school staff also prepared the fruit in such a way ( e.g. smaller portions, pick 'n' mix bar) to increase its appeal to pupils.
Only 63 (14%) schools reported health and safety concerns related to the free fruit initiative, reflecting the fact that fruit and vegetables are relatively low risk foods. This figure was higher in large urban schools (23%), which might be because a higher percentage of respondents from these schools perceived that their storage facilities were inadequate, as identified above. The major concern voiced by the 63 schools was that the hygiene, in terms of handling and cleaning fruit and its overall preparation, might be inadequate. The safe storage of fruit was also a concern. Respondents from only 15 schools said that fruit stones or fruit allergies were of concern to school staff members.
Almost one-half of the schools usually gave fruit to the pupils before the morning break. Schools with a large number of pupils were more likely to distribute fruit at this time (61% 'high roll' versus 38% 'low roll'; P<0.001). This might be partly explained by the time of day fruit is supplied to large urban schools which tend to have more pupils, as well as the lack of storage facilities in these schools. The next most common time for fruit to be distributed was after lunch, with 35% of respondents reporting that fruit distribution to pupils took place at this time. About one-quarter of schools often gave fruit to pupils during the morning or lunch breaks.
According to the respondents, over 75% of schools usually had pupils consuming the fruit within the classroom. About 30% of school respondents also thought that the playground was the usual place of fruit consumption. (Some schools gave fruit out at different times and places for the various primary years covered by the initiative.) Schools with a high level of school roll were more likely to allow pupils to eat the fruit in the classroom, and less likely to have pupils eating the free fruit in the dining hall, compared to schools with a low pupil roll. This probably relates to the different distribution pattern within school described above.
About 68% of the school respondents reported that over 80% of pupils eligible for free fruit were eating it. In remote rural schools 83% of schools reported this consumption level, as opposed to only 62% of large urban schools (P<0.01). Respondents from only 7 schools perceived that between 21-40% of eligible pupils in their schools consumed the free fruit on offer. Over 90% of school respondents reported that between 0-20% of fruit ended up being discarded as waste. Only two schools reported levels of fruit wastage of over 60%. Again, remote rural and schools with small pupil rolls reported relatively low levels of wastage. A majority of the schools gave any leftover fruit to other pupils within the same school. It was stressed that fruit only ended up as waste occasionally, with fruit being given to those without snacks, for consumption at home, made into fruit "smoothies" and used for compost, again supporting the views expressed by local authority respondents.
A similar list of fruit and vegetables supplied to schools was given in the questionnaire survey when compared with the local authority survey. The questionnaire asked what types of fruit and vegetables were supplied to the schools. Apples, bananas, grapes, oranges, satsumas, pears, kiwi fruit and melon appeared to be supplied most commonly to primary schools. However, a wide range of fruit and vegetables were reported as being supplied to schools. Indeed, 89% of respondents reported that they were at least quite satisfied with the variety of fruit provided to schools. However, school respondents in large urban areas were much less likely to be very satisfied with the variety of fruit and vegetables on offer when compared to the remote rural schools (25% versus 58%: P<0.001).
Green grapes, and to a lesser extent red grapes, as well as apples, bananas and melon were perceived as being most popular with the pupils. However, apples and bananas also had relatively high percentages of respondents stating that these were least popular with their pupils, and the fruits supplied more frequently to schools arguably have a better chance of inclusion in both the best and least popular lists. Strawberries and fruit juices, obviously only available in some localities, were popular and not thought to be disliked by the pupils. On the other hand, cherry tomatoes, oranges, pears and kiwi fruit appeared to be more disliked than liked, according to the informants. On the whole, these perceptions of the school respondents were shared by the local authority professionals.
Almost one-third of schools were very satisfied with the quality of fruit delivered to them, with only 12% of school respondents expressing some form of dissatisfaction. Those responding from remote rural schools were almost twice as likely to be very satisfied with the fruit on offer compared with large urban schools (39% versus 21%, P<0.01). Respondents from urban schools did seem to be more dissatisfied on the whole, which might reflect individual variation within local authority practice or the difficulty of catering for a larger school roll. The minority of school staff members who expressed dissatisfaction added that the fruit was often of variable quality, was often under- or overripe, could arrive at school in a damaged condition and was sometimes of such poor quality that it had to be returned to the suppliers. In relation to the quantity of fruit delivered to schools, informants from only 13 schools thought that they were not being supplied with enough fruit as part of the initiative.
In terms of the impact of the initiative, of those respondents able to give a view, almost 60% thought that the pupils were now eating more fruit and vegetables as part of their school lunch. The consumption of fruit and vegetables for school lunches was said to have decreased in only six schools. However, a slight majority of respondents perceived that the free fruit initiative had made no difference to the food brought into school by pupils for their snack or lunch. Despite this, over 40% of respondents thought that pupils were now more likely to bring fruit in to school for lunch or a snack. Respondents in only 12 schools stated that pupils were less likely to bring fruit for a snack, possibly because they were already having fruit and vegetables provided as part of the free fruit scheme. In addition, in 11% of schools it was reported that sales of fruit from the school tuck shop had increased as a result of the initiative, with only 12 schools reporting a decrease in sales. However, over two-thirds of schools either had no tuck shops or did not sell fruit from tuck shops.
The vast majority of school staff members reported that the free fruit scheme had resulted in both increased fruit consumption in pupils eligible for the initiative (95% of respondents) and a general improvement in their healthy eating habits (90% of respondents). Although the first of these points might seem obvious, it was pointed out in the formative research phase that some children were eating the same amount of fruit as they no longer brought in fruit as a snack. Also, 65 respondents were unable to give an opinion on whether the general eating habits of pupils had improved, mostly because they did not know what the pupils were eating at home. Others stressed that many children who did not eat fruit were now requesting it, peer pressure resulted in most children eating fruit, there was evidence of healthier snacks being brought into school and an increased awareness of healthy eating as a whole. Not unexpectedly, the vast majority of respondents reported that there had been no change in the behaviour of pupils within the school as a result of the free fruit initiative. However, of those able to give an opinion, 13% of respondents argued that pupil behaviour had actually improved.
The perceptions of respondents to the overall impact of the free fruit initiative are therefore very positive. However, it must be stressed that the views of parents and pupils were not sought as part of this evaluation. In addition, these findings are based on the perceptions of school staff, and not on more formal evaluations or measures of impact on the pupils and their eating behaviour. As has already been pointed out, at least some of these reported changes are unlikely to be due to the free fruit scheme on its own, and Hungry for Success and other initiatives have probably been a factor in some of the perceived effects. Nevertheless, these positive perceptions support the views expressed by the local authority respondents, with both surveys suggesting that the impact of the free fruit initiative has been favourable in terms of the healthy eating practices of pupils more generally.
About 88% of schools said that links had been made between the taught curriculum and the free fruit initiative. The links identified included the initiative being mentioned as part of health education topics, environmental studies or personal and social development teaching, as well as being referred to when health projects were being addressed. It was also argued that the initiative was part of the health promoting school ethos and thus the whole school was promoting healthy eating and choices. The scheme, and healthy eating in general, was addressed in subjects as diverse as maths, science or geography.
About one-tenth of schools reported incurring additional financial costs, supposedly not met by the local education departments, as a result of implementing the scheme. These costs tended to separate into two main components: staff time in terms of administering the scheme (in some cases this was an indirect cost and also appeared to be met by local authorities), and the purchase of items to assist the operation of the scheme, including chopping boards, knives, and anti-bacterial sprays. The other main source of costs to schools cited was the purchase of additional fruit so that other pupils could benefit from the scheme.
Almost 90% of schools had not experienced major disruption as a result of implementing and running the free fruit scheme. However, 16% of schools with a high school roll compared with 7% of schools with low pupil numbers did report that the initiative had been quite disruptive (P<0.05). The vast majority of respondents supported the view put forward by the local authority professionals that the initiative might have caused problems in its early phases, but had become bedded in as part of the school routine, and tended to run very smoothly. Some respondents did stress that this was due to the good will of school staff, but that it was a worthwhile initiative and worth the extra effort. Those who had said that the scheme had been disruptive spoke of the time lost in an already overloaded curriculum, the problems in getting staff to prepare or distribute the fruit, as well as the issue of clearing up afterwards.
As would be expected, given the very positive views described above, a majority of the respondents (55%) stated that the free fruit initiative had been very successful, with only 3% of school respondents perceiving that the initiative had not been very successful. Those respondents in schools with a high pupil roll were less likely to say that the initiative had been very successful than those in schools with lower pupil rolls (44% versus 59%; P<0.05), possibly reflecting the greater difficulty and disruption in implementing the scheme in such schools. The 15 schools that perceived the scheme to have been unsuccessful were spread across 11 local authority areas. There is some evidence to suggest that those schools who distributed fruit to pupils on five days per week held the most positive views, although the sample size was relatively low and other factors might also have been responsible.
Almost all of the schools surveyed (99%) wanted the free fruit initiative to continue in the future. Respondents in only five schools, based in different local authorities, reported that the initiative should be stopped, and six other schools were unable to give an opinion. However, it is important to note that almost all schools of different sizes, serving catchment areas from the relatively affluent to the relatively deprived, and from urban to rural settings, wanted the initiative to continue. This reflects the views of the local authority professionals, and is arguably also supported by the fact that the response rate to the questionnaire survey was so encouraging.
In that the initiative had been received so warmly by the majority of respondents, the most commonly proposed change was for the scheme to be extended to cover more primary school children. The next most popular proposed change was for the variety of fruit and vegetables on offer to children to be increased. About one-quarter of respondents wanted the storage facilities to be improved, for free fruit be given to pupils on a more frequent basis and that school staff should be paid for washing and preparing fruit. About 19% of the sample said that the quality of fruit delivered to schools could be improved. Again, these views were similar to the ones elicited from the local authority professionals, and it is important to note that both surveys gave quite similar results, albeit from different perspectives.
5.4 SCHOOL SURVEY RESPONSES BY ENTITLEMENT TO FREE SCHOOL MEALS
Responses to the school survey were analysed by the urban-rurality scale, size of the pupils roll and the level of entitlement to free school meals. As has been pointed out, there is a relationship between these factors, with urban schools more likely to have a high pupil roll and high pupil entitlement level to free school meals. Also, the fact that local authorities have implemented the initiative in different ways is likely to mean that some of the statistically significant differences identified above are actually due in part to a local authority effect. However, in that the initiative is a component of the Scottish Executive's Health Improvement Programme which recommends eating more fruit and vegetables, and poor diet and poor oral health is more common in communities with lower socioeconomic status, it is important to look at some of the school survey results by entitlement to free school meals. Schools with 0-10% of pupils entitled to free meals were said to have low entitlement, those with 11-30% of pupils entitled to free meals were said to have mid entitlement, whereas those with entitlement levels of over 30% had high levels of entitlement to free school meals.
As might be expected, a higher percentage of pre-existing fruit schemes, before the Scottish Executive launched the national initiative, were in operation in schools with a high level of free school meals entitlement (22% in high versus 10% in low, P<0.01). It is possible, though, that this reflects the approaches taken by individual local authorities.
When consumption and wastage of fruit were considered, there was little difference reported between schools with low entitlement to free school meals compared to schools with high entitlement, suggesting that children from different backgrounds were benefiting from the initiative. Also, schools with a high level of entitlement to free school meals were more likely to give leftover fruit to pupils without snacks (31% high versus 11% low, P<0.001) and also for pupils to take home.
67% of respondents from high entitlement schools, compared with 54% of those in low entitlement schools, perceived that the pupils were eating more fruit and vegetables at lunchtime (P=0.05). A higher percentage of staff from low entitlement schools thought that pupils were now more likely to bring fruit in as part of their snack or lunch, although 35% of those from high entitlement schools also felt that this was the case. As has already been reported, 95% and 90% of respondents thought that pupils were consuming more fruit and had improved their healthy eating behaviour respectively. These results were very similar across the different entitlement levels to free school meals.
Respondents from schools with a high entitlement to free school meals were twice as likely as those in schools with low entitlement to report that pupil behaviour had improved as a result of the initiative (19% versus 9%, P<0.05). However, this should be treated with some caution as a relatively high percentage of respondents were unable to give an opinion.
Schools with a high entitlement to free school meals appeared to be less likely to have made links between the initiative and the taught curriculum. Even so, 81% of those in high entitlement schools said that such links had been forged.
When responses to questions related to disruption within schools, perceptions of success and the advisability of the initiative continuing were analysed, there was little variation in the results elicited from schools with different levels of entitlement to free school meals. (However, all five of the schools calling for the initiative to be stopped were low entitlement schools.) There were differences noted in relation to suggested modifications with, for example, high free entitlement schools more likely to want the variety of fruit and vegetables to be increased, but again this probably reflects variation within local authority practice.
In conclusion, those representing schools with a high pupil entitlement to free school meals were at least as positive in their views of the free fruit initiative as their counterparts from other schools. In some cases, they perceived that the impact of the initiative had been even more positive than those individuals responding from schools with lower levels of entitlement to free school meals.