We put the premise of opt-out to the test through the School Meals, Count Me In Month (SMCMIM) initiative in six Welsh primary schools. SMCMIM operated on a straightforward expectation: pupils would partake in school meals for a designated period unless parents actively chose to opt them out.

The findings? Five of the six schools that participated in SMCMIM experienced a larger month-to-month increase in school meal uptake than non-participating schools in their council area. This suggests that the SMCMIM intervention has the potential to increase the uptake of school meals. However, the impact of this pilot may have been limited by a failure to adequately create a default for school meals through the opt-out process. Rather, findings from workshops with parents, schools and councils, alongside conversations with parents at the school gates and the parental survey suggested that the impact observed may have been driven by SMCMIM creating a social norm and expectation for school meals from the school leadership.

Despite limited evidence on the effectiveness of taster sessions, parent support indicated a role in boosting engagement. The impact of taster sessions on school meal uptake is likely to have been limited by a lack of awareness by parents. Schools running such sessions in the future should give parents plenty of advance notice of upcoming tasting sessions and multiple reminders, if possible.

The key challenge identified with the implementation of opt-out school meals was in how to effectively engage parents with the change and to uphold the default of school meals by enforcing non-compliance, ie, parents sending children to school with a packed lunch without formally opting out. Future implementations of opt-out school meals should seek to put clear protocols in place to deal with this situation. This could involve encouraging pupils to try a school meal anyway and sending letters home to remind these parents of the new process. The latter will require allergy information to be comprehensively collected from parents before implementation.

The potential impact of school leaders vocally setting an expectation for pupils to eat a school meal, alongside the opportunity to increase the impact of opt-out processes on school meal uptake through greater enforcement of non-compliance, suggests the importance of school leaders feeling empowered and enthusiastically bought into interventions like SMCMIM. Since addressing childhood obesity in Wales will likely require the takeup of successful interventions, an outstanding question remains around how to most effectively encourage and empower schools and councils across Wales to adopt effective interventions like SMCMIM.

While this evaluation of SMCMIM demonstrated positive short-term gains, only one of the three schools that participated in SMCMIM experienced a considerable increase in school meal uptake compared to non-participating schools that persisted three months after the intervention. This suggests that SMCMIM may need to be repeated several times over the school year in order to obtain long-term increases in school meal uptake.

This pilot demonstrated that interventions like SMCMIM may hold the potential for increasing school meal uptake; however, there is more work that could be done to understand whether such an intervention should be scaled nationally. This may include a thorough evaluation of resource requirements, cost-effectiveness, and potential adaptations for diverse school environments, alongside a statistically powered trial to gain more robust and generalisable insights into potential impact.

Maintaining the active involvement of parents, pupils, school staff, and public health officials in the co-design and implementation of future initiatives will be crucial for developing tailored, culturally relevant, and sustainable solutions. To boost uptake, ongoing efforts must prioritise enhancing the quality, variety and appeal of school meals to ensure long-term satisfaction and sustained participation.

The insights from this SMCMIM pilot lay a promising foundation for future healthy lifestyle initiatives in line with the Welsh government's focus on combating childhood obesity. By leveraging principles of behavioural science, fostering community engagement, and prioritising co-design with key stakeholders, this or similar interventions could play a vital role in shifting dietary norms and improving the well-being of children across Wales.