Jan 16, 2013


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


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).

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.

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:


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.