School-based food and nutrition initiatives are widely implemented to improve dietary behaviours, nutritional status, health, wellbeing, and educational outcomes among children and adolescents. However, substantial variation exists in the outcomes measured and reported across studies, limiting comparability, evidence synthesis, and the translation of research into policy and practice. This study aims to develop a Core Outcome Set (COS) for school-based food and nutrition initiatives, following guidance from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Candidate outcomes identified through an umbrella review will be reviewed and refined by the working and advisory groups, with relevant existing COS considered where appropriate to minimise duplication. Outcomes will then be prioritised through a multi-round electronic Delphi survey involving relevant interest-holders, followed by a consensus meeting to agree the final COS. A later phase will identify and evaluate appropriate measurement instruments for the agreed core outcomes.
Relationship to existing COS and rationale for a new COS:
An existing COS has been developed for school-based interventions aimed at preventing childhood overweight and obesity (COMET Study 971). Although there is overlap in the school setting, target population and some health-related outcomes, our proposed COS has a broader intervention and outcome scope. It will encompass school-based food and nutrition initiatives, including nutrition education, school meal or feeding programmes, and modifications to the school food environment, rather than focusing specifically on overweight and obesity prevention. It will also consider outcomes across dietary, health, social and emotional wellbeing, and educational domains. Our COS is therefore intended to complement the existing COS by addressing outcomes relevant to the wider range of objectives of school-based food and nutrition initiatives. Relevant outcomes from existing COS will be considered during development to minimise unnecessary duplication and this COS referred to as appropriate.
Jayne V. Woodside, Queen’s University Belfast, Principal investigator
Dilara Olgacher, Final International University
Brittany Johnson, Flinders University
Disease Category: Public health
Disease Name: Nutrition
Age Range: 5 - 18
Sex: Either
Nature of Intervention: Diet and nutrition, Educational/self-management
- Clinical experts
- Consumers (caregivers)
- Families
- Food industry
- Governmental agencies
- Methodologists
- Other
- Policy makers
- Researchers
- COS for clinical trials or clinical research
- COS for practice
- Recommendations for outcome measures (measurement/how)
- Consensus meeting
- Delphi process
- Literature review
- Nominal group technique (NGT)
- Systematic review
The candidate outcome list was generated through a completed umbrella review of systematic reviews and organised into preliminary outcome domains. Relevant existing COS and related COS development activities will also be considered, where appropriate, to minimise unnecessary duplication and inform refinement of the candidate outcomes. The working and advisory groups will review and refine the list before the Delphi process. In Round 1 of a multi-round electronic Delphi survey, interest-holders will rate the importance of each candidate outcome and may suggest additional outcomes through free-text responses. Suggested outcomes will be analysed, reviewed by the working and advisory groups and, where appropriate, included in subsequent rounds. In later rounds, participants will receive anonymised group feedback before re-rating the outcomes. Predefined consensus criteria will be applied, followed by a purposively sampled consensus meeting to agree the final, feasible COS. A subsequent phase will identify and evaluate appropriate measurement instruments for the agreed core outcomes.