Adapt-Ed Nourish: Feasibility and Acceptability Study

Why is the research needed?

Children and young people with special educational needs and disabilities (SEND) in special schools often find eating difficult and may need extra help at mealtimes. They are also more likely to be entitled to free school meals, but less likely to have them, than in mainstream schools. Schools play a big part in children’s health. But we do not have enough evidence about what helps special schools provide nutritious food and good eating experiences for children with SEND.

In an earlier project, we worked with School Food Matters charity, children and young people with SEND, parents/carers, school staff and policy professionals. Together, we adapted an existing school food programme, so it better fits special schools, called Adapt-Ed Nourish. Before running a bigger project, we need to check the programme and research methods are practical and acceptable in real schools and with CYP and parents/carers and make improvements if needed.

What are we doing?

We will work with three special schools in Hertfordshire. Two will try Adapt-Ed Nourish, one after another. We will support the third school to try Adapt-Ed Nourish after our research ends. A School Food Matters Project Officer will help each school involve pupils, families and staff to:

• Understand what school food, education and eating experiences are like now
• Agree what good food and eating experiences should look like
• Choose priorities for change and try new activities
• Help changes last using practical resources and a peer support network

We will do this for three and a half school terms (just over a year). Schools will be able to adapt activities to suit their pupils.

All pupils in the schools will receive the school-wide programme but taking part in the research is optional. We will invite pupils aged 3–19 and parents/carers to volunteer to take part in study measures. We aim for about 25% of pupils to join the research (around 105 in total), plus their parents/carers.

To understand if the programme is making a difference, we will look at if it:

• Helps children eat a wider variety of food
• Improves take up of school meals
• May affect health, education and wellbeing using existing records where possible

To check if the programme and research methods are workable, we will measure:

• If enough pupils and families join the research and stay involved
• If the programme can be delivered as planned
• What practical problems come up, and how to fix them
• What pupils, families and school staff think about the programme

We will use a mix of methods, working with children and young people with SEND in flexible ways.

Working with families and young people

Children and young people with SEND and parents/carers helped shape this study and will be involved at all stages. They will help us make sure the research is accessible and engaging, make sense of what we learn and share results. Two public co-applicants (with experience of SEND) helped produce this summary (checked by one young person) and will co-lead this involvement.

How are we working with communities, services and organisations?

Public contributors (children and young people with special educational needs and disabilities (SEND) and parents/carers) and professional stakeholders (people working in and with special schools and in policy) were involved throughout the previous application development award. We aim to meet our Knowledge Mobilisation objectives via three key mechanisms: a Steering Group, a Community of Practice, and public engagement programme in collaboration with CYP.

Our detailed approach to public involvement is summarised below.

Public Involvement
Children and young people (CYP) with special educational needs and disabilities (SEND) and parents/carers were involved throughout the application development award (ADA), co-producing the logic model for the Adapt-Ed Nourish intervention, and advising on engagement and data collection methods, outcome measures and ways to involve CYP as contributors and participants.

Approach
In the feasibility study, public involvement will be embedded through all stages of the study including design, development of recruitment and data collection materials, analysis, reporting, and dissemination. The approach will be flexible, inclusive, and rights-based, drawing on the team’s expertise, learning from the ADA and evidence that involvement works best when co-developed with young people rather than imposed by adults.

Learning from the ADA
Engaging existing SEND Youth Forums was more effective and inclusive than creating a bespoke advisory group. Relationships were built through repeated visits, online meetings, and collaborative activities (e.g., podcasts) with CYP aged 11–25 in three East of England SEND youth forums. To reach those with complex needs, the team consulted CYP on inclusive engagement strategies and successfully ran an interactive stand at SENDFest, an event attended by more than 300 families of CYP with SEND, using creative activities to gather views on school food, outcome measures, and project branding.

Our approach to CYP’s involvement
Involvement of CYP in the study will be flexible and inclusive. We will use a hub-and-spoke model: the hub being SEND Youth Forums, and spokes including other groups, networks and individual CYP, leveraging our contacts and networks to reach less-heard voices.

Parent/Carer Involvement
Parent/carer involvement will start with up to six members of the ADA advisory group, including parents of children with autism, learning disabilities, and who are tube-fed. We will expand this to include parents of children with SEND and eating needs not currently represented. Diversity in gender, ethnicity, and socioeconomic status will be prioritised. Contributors will be compensated per NIHR guidance, with additional recognition considered.

Public Co-Applicants
Two public co-applicants (AF and JT) have co-facilitated meetings, reviewed plans, and co-authored the Plain English Summary.

Evaluation
As a feasibility study, the project will capture reflections, impacts, and outcomes of public involvement from all stakeholders. It will develop inclusive approaches for CYP with complex needs, evaluate these methods, and inform a PPIE model for a full study. Findings will contribute to the evidence base on inclusive public involvement through co-authored outputs with public contributors.

What will the impact and benefits of this research be?

Two-way engagement with policy and practitioner stakeholders from the outset is central to maximising impact. Although this is a feasibility study, it is timely and policy-relevant, addressing a clear gap and opportunity linked to current concern with SEND inequalities and education reform, as our policy brief highlights. 

Rising investment in school food provision also reflects growing support for systems- level approaches to reducing public health inequalities. Building on our ADA, we will strengthen relationships with local and national knowledge users across SEND education and school food, engaging them in interim findings as well as final results.

This is the first programme of work of its kind in the UK. It addresses a major gap in what is known by focusing on how to make school food more inclusive. If successful, we will seek funding for a larger project to show how schools can help reduce health inequalities.

What do we have planned for knowledge mobilisation and implementation?

Our Knowledge Mobilisation (KM) objectives are to reduce health inequalities through impacts on: 

• Implementation of whole school approaches  in special schools, generating evidence and partnerships to support future rollout of Adapt-Ed Nourish
• National school food policy, ensuring accessibility is monitored and embedded within standards and guidance (e.g. School Food Standards, breakfast club guidance, mandatory data collection) and considering transferability to mainstream settings
• Public awareness of and debates about enhancing access to school food for CYP with SEND

We will share and mobilise knowledge through three mechanisms:

• Steering Group: Academic and policy/practice members will advise on interpretation, dissemination and planning a definitive trial and support opportunities for policy engagement
• SEND School Food Community of Practice (CoP): Building on networks developed through our previous work, we will establish a CoP to share evidence, experience and “what works” across the UK, reducing siloed learning. Led with the School Food Matters Policy and Communications team, subject to members' preferences, it will include a quarterly newsletter update and two online meetings per year, promoted via stakeholder, School Food Matters and NIHR Applied Research Collaboration (ARC) networks.
• Public engagement: With School Food Matters, ARC EoE and public contributors, we plan to launch the project with an event at or linked to Suffolk Food Museum (School Dinners Exhibition) and share learning throughout via the School Food Matters Adapt-Ed webpage, news/blog content and media/social channels. We will co-produce accessible outputs with CYP with SEND and parents/carers, tailoring formats to preferences (e.g. festivals, podcasts), and explore opportunities for children and young people's leadership (e.g. School Food Ambassador), and an inclusive end-of-study event.