School Breakfast Clubs


This study is a clustered-randomized controlled trial of breakfast clubs across England, U.K, designed to measure the health, educational, and social impacts of these clubs in low-income schools. Breakfast clubs are school-based and provide students who arrive early the opportunity to eat a healthful breakfast at school. An intent-to-treat analysis found evidence of improved concentration in the intervention group, compared with the control group at a 3 month follow-up). There were no statistically significant differences across measures of eating behavior, conduct, relationships, child school attendance and activity involvement, or medical service uptake as compared with the control group.


Target population: Primary and secondary school children attending low-income schools in England.

School breakfast clubs are a Department of Health initiative across England to serve children living in low income communities. Research indicates that almost half a million children in the UK skip breakfast, and this is most common among socio-economically disadvantaged children. Breakfast clubs attempt to remedy this by making a healthful breakfast available to students. The intervention consists of breakfast provision at school, prior to the start of school each morning.


Evaluated population: Two-hundred students were recruited from each of 43 schools with no pre-existing breakfast club that were willing to conform to the Department of Health requirements for a breakfast club. Of the 43 schools, 24 were assigned to the intervention and 19 to the control. Due to exclusion or withdrawal, 18 schools ultimately participated and provided data in the intervention group, and 12 schools participated and provided data in the control group. This yielded a sample of N=3565 students in the intervention group at baseline and first follow up, and N=2372 students in the control group at baseline and N=2019 at the 1st follow up. A second follow up was completed; but, due to contamination and attrition, results are not included here.

At the baseline, the population was skewed toward primary participants (64 percent in the control; 70 percent in the intervention); the majority of the participants were white (93 percent in both intervention and control); and the majority were eligible for free and reduced school lunch (69 percent in the control and 64 percent in the intervention).

Approach: Students completed (or, in the case of primary students had completed on their behalf) two survey instruments--a life, health, and school questionnaire; and a strengths and difficulties questionnaire measuring behaviors, emotions and relationships. In addition, students completed the Trail Making Test to measure concentration, and parents completed a family questionnaire measuring children's school-based activity involvement, family access to child care, parental employment and recent uptake of medical services. In addition, researchers collected data on students' school attendance, punctuality, and attainment.

Results: At the first follow up (3 months), intent-to-treat analysis showed improved concentration among the intervention group. This was demonstrated by a shorter average time to complete the Trail Making test in the intervention as compared to the control. At the first follow-up there was no statistically significant difference across measures of eating behavior, conduct, relationships, child school attendance and activity involvement, or medical service uptake as compared with the control group.


Abstract Website:


Shemilt, I. Harvey, I., Shepstone, L., Swift, L., Reading, R., Mugford, M., Belderson, P., Norris, N. Thoburn, J. & Robinson, J. (2004). An Evaluation of School Breakfast Clubs: Evidence from a cluster randomised controlled trial and an observational analysis. Child: Care, Health & Development,30,413-427.

KEYWORDS: Nutrition; Elementary School; Middle School, Co-educational; White/Caucasian; School-based, Other Education

Program information last updated on 6/3/11.

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