Assessing the effectiveness of methods of inviting schools to implement a lunchbox nutrition program

A randomised controlled trial design will be used to test the effectiveness of a theory-based multi-component dissemination strategy to invite primary schools to implement a lunchbox nutrition program (‘SWAP IT’) among schools located in the Hunter New England Local Health District of New South Wales (NSW), Australia, that have not previously implemented the program. SWAP IT consists of electronic messages sent to parents via usual parent communication channels (parent communication app, newsletter or Facebook), together with classroom resources, and parent booklets. The SWAP IT program aims to improve the contents of children’s lunchboxes by supporting parents/carers to swap what is packed from discretionary (“sometimes”) foods and drinks to core (“everyday”) foods and drinks. SWAP IT has previously been found to be effective at improving the packing of healthy lunchboxes and improving child dietary intake. Primary schools that have not previously implemented the lunchbox nutrition program will be randomly allocated to one of two study groups: a multi-component intervention group or a minimal intervention control group. The intervention will be delivered over a period of 3-4 months. Schools allocated to the intervention group will receive a theoretically-based multi-component dissemination intervention to support schools to register for and adopt the lunchbox nutrition program. Schools will be provided with access to an online portal, which is act as a central registration system for schools to register for SWAP IT directly, and access all program resources. The portal will also contain a technical assistance function where principals, school staff and parents can enquire about the SWAP IT program. A program invitation will be disseminated to schools via email addressed to school principals or key contacts, which will embed educational and motivational videos addressing theoretically identified barriers to nutrition program adoption. A comprehensive communication strategy will consist of emails with embedded videos, telephone, and online portal content designed to increase school principal motivation to adopt the SWAP IT program. The emails (up to three) and telephone support (one telephone call) will be delivered in a staggered approach throughout the intervention period. The emails will take approximately 2 minutes to read. Each video is less than 1 minute in duration and focusses on a key barrier to the adoption of SWAP IT. One email and video will be sent to intervention schools approximately every 2 to 3 weeks (up to 3 in total) and will target the school principal or key contact. If a school registers for the program, they will not receive further communication encouraging adoption. Targeted telephone calls to encourage program adoption will also be conducted by health promotion practitioners. The telephone calls will be undertaken approximately 2-3 weeks following the emails with school principals, school wellbeing coordinators or key contacts and will aim to overcome any barriers to adoption. The duration of the telephone call is anticipated to be 10-15 minutes. Schools that have not registered to implement SWAP IT will receive feedback regarding program adoption through the emails and telephone call delivered to schools as part of the communication and marketing strategy. The feedback will specify the number of schools that have adopted the SWAP IT program. The number of emails sent and received, and video views will be used to monitor the implementation of the intervention. Telephone call date of completion and call duration will be recorded in a study monitoring spreadsheet.