Acceptability and feasibility of strategies to promote healthy dietary choices in UK secondary school canteens: a qualitative study.

OBJECTIVE To explore the acceptability and feasibility of choice architecture strategies for dietary change in UK secondary school canteens from the perspectives of pupils, school staff and catering providers through qualitative focus groups and interviews. RESULTS Three focus groups with adolescents (n = 15; mean age 13.7 years; standard deviation 1.9) and eight interviews with school staff and caterers recruited from one school and catering provider in Coventry UK were undertaken. The most acceptable choice architecture strategies for intervening to drive healthy dietary choices are those that make use of proximity and positioning, on the basis that convenience was one of the main drivers for food/drink selections. Acknowledging adolescents' desire for autonomy and for food to be familiar and predictable was considered important in enhancing acceptability. Challenges to the feasibility of nudge strategies included concerns about behavioural issues, increased food waste, and a decline in uptake of canteen purchases. The design of food choice architecture interventions for secondary school settings should consider the specific characteristics of this age group and setting to ensure successful implementation.