Global parent perspectives on school food service internationally: A mixed papers narrative review.

Aims: The views of parents/caregivers about food programs in schools internationally is not well understood. This review aimed to synthesise what parents/caregivers identify as the key features of school food programs and their perspectives of these programs globally.

Methods: A mixed papers review was undertaken with a systematic search (January 2024) and screening of three databases (Scopus, Web of Science, PubMed). Eligible studies captured parent/caregiver perspectives across all school food models. Study findings were extracted using Bayesian methods to translate quantitative findings into qualitative data. Data was deductively categorised to identify features of school food models, and separately themed to identify parent perspectives.

Results: Twenty-six eligible studies were identified from 11 countries. Fifteen features were identified, including cost, time, effort and convenience, child preferences, nutrition, policy and messaging, eating environment and food education. Parent perspective themes were: child is the priority, lunchbox procurement, preparation and provision is challenging, school-provided meals have strengths and limitations, and parents acknowledge they are central to feeding. An overarching theme was that compromises must be made to meet the needs of family members, when parents make decisions on school food.

Conclusions: This review found that globally parents perceive benefits and challenges to school food programs, regardless of provision model, with a range of features that influence parent acceptability. Considering parent/caregiver perspectives when developing or changing school food provision models is likely to increase caregiver acceptability, supporting children to engage with health promotion efforts.