Evaluating the efficacy of a multi-component dissemination strategy on the adoption of a school-based lunchbox nutrition program on the NSW Mid North Coast Local Health District of New South Wales

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 Mid North Coast 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 four 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. A program invitation will be disseminated to schools via an eNewsletter targeting school principals and teachers, which will provide an overview of SWAP IT and encourage schools to adopt the program via an online portal. Schools will be provided with access to the online portal, which will 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. Following the initial program invitation, a comprehensive communication strategy, consisting of emails (up to two) with embedded videos, will be disseminated to schools to increase school principal motivation to adopt the SWAP IT program. The emails will be delivered in a staggered approach (i.e. sent approximately 4-5 weeks apart) throughout the intervention period and will consist of educational and motivational videos addressing theoretically identified barriers to nutrition program adoption. The emails will take approximately two minutes to read and target school principals or key contacts. Each video is less than one minute duration and focusses on a key barrier to the adoption of SWAP IT. If a school registers for the program, they will not receive further communication encouraging adoption. The number of emails sent and received, and video views will be used to monitor the implementation of the intervention.