Rising childhood obesity rates remain a pressing public health concern in Wales and across the United Kingdom. Recent evidence highlights the superior nutritional quality of school meals compared to packed lunches, underscoring the importance of promoting school meal participation to instil healthy dietary habits from an early age.

Despite the introduction of universal primary free school meals in Wales, a substantial portion of primary school children continue to opt for packed lunches, missing out on the benefits of a nutritious school meal. In response, Nesta collaborated with two pioneering councils, Caerphilly County Borough Council and Torfaen County Borough Council to pilot ‘School Meals, Count Me In Month’ (SMCMIM), a new intervention aimed at increasing uptake of universal primary free school meals in Wales, in six primary schools across Caerphilly and Torfaen. The intervention centred on setting the expectation that all pupils within a school would be eating a school meal unless their parents actively opted out by informing the council of their child’s preference for a packed lunch – shifting from the current assumption that pupils will bring a packed lunch unless their parent actively selects a school meal. This intervention set out to leverage concepts from behavioural science such as the ‘default bias’ – people's tendency to stick with a pre-set option – and the influence of ‘social norms’ in encouraging people to conform to behaviours that are common among others in their community. In four out of six schools, the switch to opt-out was accompanied by supporting activities, such as taster sessions for pupils and parents, which aimed to help build trust in the school food offer.

Key findings

• The SMCMIM intervention demonstrated potential for increasing school meal uptake. Five out of the six schools that took part in SMCMIM observed a higher increase in school meal uptake compared to non-participating schools. These schools observed between a five and 14 percentage-point larger rise in school meal uptake than non-participating schools during SMCMIM compared to a recent month.
• While SMCMIM had a moderate impact on school meal uptake, the effectiveness of the intervention was likely to have been limited by challenges in creating a default for school meals through the opt-out process. Specifically, many parents continued to send children to school with a packed lunch without formally opting out of school meals. In most cases, this did not result in their child being given a school meal instead of their packed lunch, nor in parents being engaged by the school to remind them of the opt-out process. The key barriers to more effective enforcement of the school meals default were a lack of capacity from school and catering team staff and the need for up-to-date information on allergies for all children.
• Parental, school & council catering team feedback indicated that the positive impact of SMCMIM on school meal uptake observed may have been driven by creating a strong social norm and expectation (or endorsement) for school meals from the school leadership, rather than the opt-out process making it easier to stick with a school meal instead of switching to a packed lunch.
• The impact of the taster sessions and other activities aimed at building trust in school meals to support the successful implementation of SMCMIM remains unclear despite strong support from parents for these activities – the two schools that implemented SMCMIM without taster sessions experienced both the smallest and largest increase in school meal uptake of participating schools.
• While around half of the surveyed parents said that SMCMIM would make them more likely to choose school meals in the future, a three-month post-intervention analysis of school meal uptake in Caerphilly schools revealed that in only one of the three schools that participated in SMCMIM did the increase in school meal uptake compared to non-participating schools persist considerably over this period. This suggests that SMCMIM may need to be repeated several times over the school year to obtain long-term increases in school meal uptake.

The success of this initiative was largely driven by the hard work and enthusiasm of the councils and schools we partnered with; this included school leaders vocally setting an expectation for pupils to eat a school meal. This, alongside the opportunity to increase the efficacy of the opt-out process through stricter enforcement of school meals as the default option suggests the importance of school leaders being enthusiastically brought into interventions like SMCMIM. Since addressing childhood obesity in Wales will likely require large-scale takeup of successful interventions like SMCMIM, an outstanding question remains around how to most effectively encourage and empower schools and councils across Wales to adopt interventions like this.

While leveraging behavioural change interventions like opt-out systems can nudge better dietary choices, this study suggested that these should be coupled with community engagement initiatives that give students, parents, and educators a voice to have the greatest effect.

As Wales renews its focus on curbing obesity rates, combining behavioural insights with grassroots collaboration can progressively reshape societal norms and reduce barriers to healthy eating.

This study was a collaborative effort involving Nesta, Cardiff Council, Caerphilly County Borough Council, Torfaen County Borough Council and the enthusiastic participation of headteachers, staff, pupils and parents from several primary schools across the region. We are hugely grateful to the headteachers, staff, pupils and parents of Ysgol Gymraeg Cwmbran, St David’s R.C Primary School, Garnteg Primary School, Rhiw Syr Dafydd Primary School, Blackwood Primary School and Deri Primary School who took part in these pilots. We are also indebted to Karen Spiller and Marcia Lewis (Caerphilly County Borough Council) and Tracy James (Torfaen County Borough Council). We would also like to thank the headteachers, staff, pupils and parents of Trelai and Glyncoed Primary Schools in Cardiff and Judith Gregory (Cardiff City Council) for their involvement in the design process that led to these pilots.

Recent studies consistently highlight the superior nutritional quality of school meals compared to packed lunches across the UK. Despite the introduction of universal primary free school meals in Wales last year, approximately 30% of primary school children still opt for packed lunches. This means that more than 70,000 children are missing out on free and nutritious school meals in the middle of the school day.

Research on packed lunches suggests they typically pack between an estimated average of 61 and 94 extra calories compared to school meals which meet the Welsh government’s nutrition standards. The cumulative effect of this extra intake over the school year and across the population could be contributing to the escalating rates of overweight and obesity among Welsh children.

In response, last year we teamed up with Cardiff Council, Caerphilly County Borough Council, and Torfaen County Borough Council to pilot various initiatives targeting parents and pupils. The goal? Boosting the uptake of free school meals and steering more Welsh children towards a nutritionally balanced midday meal containing less fat, salt and sugar than typical packed lunches.

Our intervention design process was firmly rooted in the communities we aimed to serve. We ran workshops with Welsh head teachers and council catering leaders to better understand the constraints they face, how circumstances vary between different schools and councils, and where leverage points for intervention might be. We visited primary schools in Torfaen, Cardiff and Caerphilly to observe on-the-ground school meal delivery and talk to chefs, teachers, lunchtime supervisors, pupils of various ages and their parents.

We also researched how school meal uptake has been improved in the UK and internationally. This included examining academic literature, interviewing school food professionals and talking to headteachers in schools with almost 100% school meal uptake. We also considered the behavioural science around how parents and children make choices relevant to school food.

We used a design-led approach to inform this research, iterating and testing several intervention prototypes with pupils and parents in multiple primary schools.

Leveraging the default bias to smooth the path to ordering school meals

In response to parental and pupil feedback on prototype ideas we developed, SMCMIM emerged as the most likely to be cost-effective, feasible and scalable. This intervention operates on a straightforward premise: setting a whole school expectation that pupils will partake in school meals for a designated month unless their parents actively choose to opt out through direct contact with the council catering team.

SMCMIM tapped into the well-known default bias – our tendency to stick with the default or pre-set option (think of that unchanged ringtone on a new mobile phone). We theorised that by flipping the default option – shifting from an assumption that pupils will bring a packed lunch unless their parent actively selects a school meal, to pupils receiving a school meal unless parents specify otherwise – we could nudge more students to try out school meals.

Fostering a shift in social norms

Social norms are the implicit rules that define what behaviour is acceptable or expected within a group or community. They explain why people form orderly queues in the UK, but adopt what can appear to some as a more haphazard approach elsewhere. SMCMIM aimed to capitalise on the influence of social norms by advocating for default participation in school meals. The goal was to foster a critical mass of children joining in and catalyse a shift in whole school behaviour. Ultimately, the aim was to make eating school meals the norm and bringing packed lunches the exception rather than the rule.

The long-term aim was to prompt lasting improvements in school meal uptake by allowing pupils who typically opt for packed lunches to get better acquainted with, and hopefully develop a sustained liking for the food on offer at school. While we piloted making school meals the default option for one month only, we were also interested in exploring the feasibility and desirability of its permanent implementation as part of this trial.

Our pilot intervention was trialled in Torfaen and Caerphilly in October 2023 and January 2024 respectively. A total of six schools trialled SMCMIM. Given the complexity of intervention design, we expected initial challenges. We tested SMCMIM in Torfaen first, intending to incorporate early insights into the subsequent pilot in Caerphilly.

Can the opt-out measure drive uptake alone?

Our prototyping workshops with parents and children highlighted that clear communication and advocacy for school food were crucial for building trust in school meals. Parents wanted to taste and see for themselves that school meals were both tasty, nutritious and satisfying. Children themselves were also eager for a taste-and-see approach.

We, therefore, tested whether simply requiring parents to opt-out if their child would not be eating a school meal was enough or if additional activities, in the form of tasting events and extra communications, would also be necessary. With this in mind, we varied the materials and activities across schools. Some changed to opt-out of school meals solely (accompanied only by rudimentary communication to announce SMCMIM to parents and children), while others were given supporting activities: these activities included tasting events for parents and children during and outside school and a letter to parents from the catering team’s dietician.

In the Caerphilly trial, we included one additional school which held a taster session for parents and children but did not take part in SMCMIM in order to understand if the taster sessions in and of themselves had an impact on increasing school meal uptake.

By comparing school meal uptake between these and non-participating schools in the same council area, we sought to understand the driving factors behind any uptake change.

Outcome measurement and process evaluation

We evaluated the intervention using quantitative and qualitative methods. Our goal was to understand how effective the intervention had been in increasing school meal uptake and to gather feedback on its execution and perceived value. We also wanted to learn how the intervention could be improved. Through a combination of data analysis and stakeholder input, we aimed to uncover the strengths and weaknesses of the intervention, ensuring a multiplicity of voices within the local school system was considered.

School meal uptake data analysis

We analysed school meal uptake data to understand if SMCMIM leads to an increase in uptake compared with non-participating schools in the area, both during and three months after SMCMIM. As this was a pilot and not statistically powered, the analysis of this data was descriptive with no inferential statistical tests being performed.

Observations and interviews during the intervention

We observed school lunchtimes during the intervention and conducted semi-structured interviews with the school and catering staff as well as pupils to assess implementation and identify challenges and strategies to overcome them. We also engaged parents in informal discussions at the school gates.

Parent survey and focus groups

A post-intervention survey and workshop invitation was sent to the parents of the approximate 1,600 pupils that attend the six schools that participated in SMCMIM. The survey and workshops aimed to help us understand why parents chose to opt out, what they liked about SMCMIM and what could be improved. Nearly 350 parents/carers responded to the survey and over 40 parents/carers took part in the workshops.

Post-intervention workshop with schools and councils

After the intervention, we organised structured workshops involving council catering leaders and the headteachers who spearheaded SMCMIM within their respective organisations. These sessions aimed to gather insights into their perspectives on the pilot's execution, identify areas for improvement, and explore possibilities for scaling the intervention.

We used data obtained from Torfaen and Caerphilly County Borough Councils to compare the uptake of school meals during the intervention to uptake in a previous month.

School Meals, Count Me In Month has the potential to increase school meal uptake

Overall, SMCMIM was associated with an increase in school meal uptake in both Torfaen and Caerphilly.

The two schools in Torfaen that implemented supporting activities, such as taster sessions, experienced a greater increase in school meal uptake compared to the other schools in the area. Specifically, these schools saw an 8 and 9 percentage point (pp) increase in school meal uptake compared to the previous month (September). This represents a 5 and 6 pp higher rise in uptake compared to the 3 pp increase observed in the 25 non-participating schools in Torfaen. However, the school implementing the opt-out part of the intervention only without supporting activities did not differ from non-participating schools.

Caerphilly saw a similar increase in uptake during SMCMIM. The schools with supporting activities saw a 6 and 7 pp larger increase in uptake, compared to that observed from the combined average of the 70 other primary schools in Caerphilly between November 2023 and January 2024 (we excluded December due to the winter holidays). Comparison schools showed a 1 pp decrease in uptake over this period. However, most notably, the school where only the opt-out part of the intervention was run (Deri Primary School) experienced the largest increase (14 pp greater than non-participating schools) in school meal uptake. Compared to other schools that participated in SMCMIM, the smaller size of Deri Primary School may also have contributed to the larger percentage increase in school meal uptake observed, as small numerical changes can manifest as more substantial percentages in smaller populations, while additionally making it easier for school leadership to engage and share information about the month with parents.

SMCMIM has the potential to have a longer-term impact on school meal uptake

The results from our survey of parents suggested SMCMIM may have a lasting impact on School Meal uptake. Almost half (49%) of surveyed parents in Torfaen and nearly 58% of parents in Caerphilly said that SMCMIM would make them more likely to choose school meals in the future.

However, an analysis comparing school meal uptake in Caerphilly schools before SMCMIM (November 23) with 3-months after SMCMIM (April 2024) revealed that only 1 of the 3 schools that participated in SMCMIM (Rhiw Syr Dafydd Primary School) did the increased school meal uptake compared to non-participating schools persist considerably over this period (this data was not available for Torfaen schools).

The impact of taster sessions on school meal uptake is unclear

While feedback from the parents’ survey and workshops suggested that taster sessions may have helped drive an increase in school meal uptake; results from the analysis of school meal uptake data were not conclusive.

In Torfaen, the schools with taster sessions reported a higher percentage increase in school meal uptake as compared to the school which did not run taster sessions. However, in Caerphilly, the school which did not run taster sessions outperformed the schools which did. This coupled with the 1 pp decrease in school meal uptake in Waunfawr Primary (where only taster sessions took place) means it is not possible to draw any firm conclusions about the impact of taster sessions – in the format they were run as part of this pilot – either when delivered in combination with the opt-out part of SMCMIM or on their own.

Feedback from the survey and parent workshops revealed that parental awareness of the taster sessions varied between the two councils, suggestive of limitations in efficiency and timeliness of communication. This may have reduced their impact on school meal uptake. However, of those who were aware of them, more than a third said they influenced their decision to take part in SMCMIM. During workshops, parents said that taster sessions allowed them to understand what their children were eating and therefore they could persuade them to give school meals a try. Workshops with the councils and schools also echoed the support for the taster sessions.

The positive impact of SMCMIM on school meal uptake was likely driven not by a default, but by changing social norms for school meals and an expectation of participation from school leadership

We designed SMCMIM as a default. Research suggests three reasons why people tend to choose default options: firstly, a default may reflect an endorsement (in this case for school meals) from those presenting the options to choose from (the school and catering team); secondly, sticking with the default choice requires no active effort, so is simply easier than switching away from it (ie, to packed lunches); and thirdly because faced with making a decision, people tend to focus more on what we lose than on what we gain (in this case opting-out could be seen as losing a free school meal).

During workshops and informal conversations with parents at the school gate, parents typically described SMCMIM in terms of the school wanting all their pupils to try school meals that month, rather than referring to the requirement to opt-out of school meals. This was echoed by the school and council leadership, highlighting the importance of an increased push from schools and councils in driving uptake. Parents also often expressed that they liked that it was something the ‘whole school was doing together’.

These findings reflect a key challenge that we encountered with regard to creating a strong default for school meals through the opt-out process. Specifically, many parents continued to send children to school with a packed lunch without formally opting out of school meals. In the majority of cases, this did not result in their child being given a school meal to eat instead of their packed lunch, nor in parents being engaged with by the school to remind them of the opt-out process.

The survey results below corroborate this by suggesting that for most parents we did not make school meals the easier choice, nor create a sense that by shifting to a packed lunch by opting out parents would be losing something (i.e. the benefit of a school meal). Therefore the intervention did not ultimately act as a default intervention.

While the opt-out process may have contributed to the sense that school meals were the endorsed option, the findings from conversations with parents suggested this was likely to be just driven by school leadership being vocal about their expectation for children to eat a school meal when communicating about SMCMIM.

Together these findings support the conclusion that the impact of SMCMIM was likely driven by the creation of a social norm for school meals and school leadership vocally setting an expectation that they would like their pupils to participate in eating them, rather than as a result of the opt-out process. This suggests that a similar increase in school meal uptake could potentially be achieved through simpler interventions, such as running a SMCMIM that emphasises that it is a ‘whole school’ event and school leadership’s expectations for participation, without altering the ordering process. Nevertheless, if future initiatives can overcome the challenges associated with creating a strong default for school meals, it may be possible for out-of-school meal interventions to drive larger increases in school meal uptake than were observed in this pilot.

The benefits of SMCMIM extend beyond saving time and money

An overwhelming majority in Torfaen (94%) and a majority in Caerphilly (59%) agreed they were assured that their child ate a healthy meal during SMCMIM. Significant cost and time savings were a key benefit, with 82% in Torfaen and 61% in Caerphilly confirming it saved their family money and approximately 75% of parents reporting saving time in the morning. Similarly, reduced morning-time stress was appreciated by 75% of parents in Torfaen, though slightly less at 48% in Caerphilly.

Trying new foods was a positive outcome, with 79% in Torfaen and 74% in Caerphilly stating their child did so. Relatedly, many parents (79% in Torfaen and 74% in Caerphilly) felt their child became less picky about food at home. 88% of parents in Torfaen and 93% of parents in Caerphilly also agreed that their child enjoyed school meals.

An additional benefit reported by schools during workshops was fewer storage problems as the number of packed lunches decreased, leading to smoother operations during lunchtime.

Concerns from parents often came back to choice and variability of the school meal menu

Despite the numerous benefits cited by parents, menu variety was a key concern highlighted through the survey and the parents' workshops. 40% of parents in Torfaen and 53% of parents in Caerphilly shared this concern. However, there was an appreciation of the sandwiches and salad bars available as alternative options by both councils. Following this finding Caerphilly Council has already increased the number of food choices available on school meal menus.

Some parents raised perceived concerns about portion size with 60% in Torfaen and 56% in Caerphilly reporting that they worried their child was not eating enough. However, workshops revealed that this concern was often alleviated when parents were able to see school meals for themselves during taster sessions. The size of portions served to pupils is influenced by their requirement to meet the Welsh government’s nutrition standards.

School Meal Count Me in Month was not solely about serving up more lunches; it was also about designing scalable solutions with the potential for nationwide replication. A crucial goal was learning how schools and councils could best run similar interventions in the future. We explored the nuances of our delivery methods and scalability through school visits, surveys and workshops with multiple stakeholders aiming to uncover successes, challenges, and potential solutions for future initiatives.

Communication is key

During the initial School Meals, Count Me In Month pilot in Torfaen in October 2023, communication relied primarily on parent emails and school posters. Two-thirds of surveyed parents reported being aware of SMCMIM beforehand; however, most parents we spoke to at school gates couldn't explain what it involved or its purpose. Parental understanding was crucial as they were required to opt out if they wanted their child to eat a packed lunch. So during Caerphilly's January 2024 pilot, we employed additional reminder emails and banners outside schools. While surveyed Caerphilly parents only showed a modest increase in awareness – 67% reported being aware of SMCMIM beforehand – one week into the intervention they exhibited improved understanding during informal school gate conversations, with the majority of parents we spoke to clearly articulating what was being asked of them during SMCMIM. This may have contributed to the slightly greater impact on school meal uptake observed in Caerphilly schools.

As part of this pilot, there were also some great examples of schools taking it upon themselves to engage pupils in the SMCMIM, which may have contributed to its success. For instance, Garnteg Primary School in Torfaen initiated a competitive element between classes — the winner having the highest number of school meal eaters and Deri Primary School in Caerphilly invited their head boy to talk about the initiative in a school assembly.

Many parents did not engage with the opt-out process

Many parents did not engage with the initiative at all; not opting their child out of school meals, yet still sending packed lunches. In these pilots, there were no repercussions to this; where possible children were encouraged to try a school meal but they were not required to do so. A particular challenge to encouraging more children to eat a school meal – having bought a packed lunch but not opt-ed out – was the need for up-to-date information on allergies for all children. Future similar initiatives should aim to ensure this information has been comprehensively collected beforehand.

It is possible this lack of compliance from many parents would be short-lived if schools made a permanent switch to opt-out (rather than just for a month). Parents would have more time to adjust and schools more opportunity to follow up with non-complying parents – the majority of parents we surveyed supported a permanent shift to an opt-out process for ordering school meals (73% in Torfaen and 80% in Caerphilly). Nevertheless, those considering opt-out school meals should think carefully about how to ensure parent compliance.

Food waste was only a short-term issue

Initial concerns about potential food waste in kitchens overestimating meal needs only materialised in the short term. Catering teams swiftly adjusted their daily SMCMIM expectations, minimising waste after week one.

The optimal design of the opt-out process remains unclear

As part of SMCMIM, parents were required to actively opt out if they did not want their child to eat a school meal. Avoiding additional burden on school staff, opt-out requests went directly to council catering teams. In Torfaen, opting out required parents to call or email the council office. Caerphilly streamlined this through an online form. Reactions to the opt-out mechanism from parents were mixed, with approximately a third of parents either not aware or not using the opt-out mechanism. However, those that did use it, were generally satisfied with the process.

A key question was whether to allow parents to opt out of school meals for specific days or commit families to packed lunches or school meals for the duration of SMCMIM. Committing pupils to school meals for the whole month could nudge them towards more frequent school meals, increasing uptake. However, it risked parents opting out entirely if their child disliked a day's menu.

We settled on allowing daily opt-outs without explicit advertisement that this was an option. Parents appreciated this flexibility for days their children disliked the menu. However, some were confused about whether it was possible due to a lack of clear communication. Allowing opting out on specific days also complicated the councils' meal planning and meant that parents often opted out last minute, forcing councils to frequently recheck numbers and straining resources.

A joined-up approach to school meals is critical

Key to the success of SMCMIM was the strong collaboration between schools, councils and Nesta. While school leaders led the day-to-day engagement with parents, they valued communicating the council's support and Nesta's independent voice explaining why increasing school meal uptake was important.

Regular video calls between schools, Nesta and the council enabled streamlined coordination and rapid issue resolution. Schools valued resources like email templates and posters being provided by Nesta and the councils, suggesting a shared resource toolkit for schools could help scale such initiatives in the future.

The most resource-intensive element of SMCMIM was the taster sessions for parents and children. Taster sessions were run after school or during after-school events that parents and pupils would already be attending. Councils visited dinner halls too, offering samples to packed lunch eaters. These were only possible through the councils' dedicated work.

Listening to parents and pupils could drive improvements to the school food offer

Understanding the needs and preferences of customers – in this case, pupils and their parents – is crucial when designing any service; school meals included. Beyond evaluating SMCMIM's effectiveness and potential improvements, our regular interactions with parents and children offered invaluable insights into their desires and concerns regarding school meals. Though generally satisfied with the offer, they appreciated having a platform to share their thoughts and often expressed a desire for more opportunities to provide input and feedback on the food.

Furthermore, a secondary benefit of opt-out school meals was in opening up a direct communication channel between parents and the council, allowing them to voice any concerns or questions about school meals; a welcomed benefit for both parties. Future endeavours to enhance the school meal experience should actively involve parents and children in the design and feedback processes.

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.