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This action research study explores how co-developing school meals can be taken as a case for education for sustainable development, as integrated to home economics education. We analyse a seven-month-process of collaborative participation in a Finnish secondary school conducted with two home economics teachers, a school food manager, and students during a voluntary home economics course. Data include interviews, multi-professional meetings, and professional reflections of the named school staff members (N = 3), as well as students’ (N = 8; 7th grade; aged 13–14 years) learning diaries, interviews and feedback questionnaire. We develop the term shared food sense (joint understanding, collective application, re-definition of co-action) as a conceptual tool for analysing food-related learning outcomes of the collaborative process. Analyses focused on 1) tensions emerging during the participatory work and 2) outcomes achieved through negotiation and collaboration, including roles that became possible for students to enact. Results show that collaboration succeeded in offering young people opportunities to influence and voice their opinions of school meals, as well as novel modes of interaction across the school’s social. However, students’ experiences of the participatory work varied, and power hierarchies among the different participating groups remained rather unchanged, demonstrating tensions between ideals and realities of participation.

Busy and unstructured school environments can present challenges for pupils diagnosed with autism spectrum disorder (ASD)and attention deficit hyperactivity disorder (ADHD). Although school restaurants may be demanding, limited research hasfocused on these pupils. This study explores how pupils diagnosed with ASD or ADHD navigate the physical, social, and pedagogical environments of school meals. Based on ethnographic fieldwork in four Swedish schools, involving observations, conversations, and interviews with five 12-year-old boys and their mothers, findings show how pupils valued having a teacher orclassmate nearby during lunchtime. Crowded and narrow spaces posed motor challenges, leading to spills and comments ontable manners. Socially, pupils alternated between engaging with others and seeking solitude to escape noise and interactions.The study calls for reflection on how societal norms and environmental structures of school meals impact pupils diagnosedwith ASD or ADHD, emphasizing the role of school nurses in identifying potential issues.

This school meals case study forms part of a collection led by the Research Consortium for School Health and Nutrition’s "Good Examples" Community of Practice. The School Meals Case Study of Sweden serves to document how the national school meals programme is organized, funded, and monitored throughout the country. The objectives of this case study include presenting an introduction to the country profile, outlining the design and implementation of school feeding programmes, describing their monitoring and evaluation processes, and highlighting lessons learned, best practices, and challenges. This case study is written as a working paper, and can be updated to reflect evolving circumstances. The ‘Good Examples’ Community of Practice supports the evidence generation of the Research Consortium for School Health and Nutrition, the evidence-generating arm of the School Meals Coalition. The Research Consortium’s objective is to carry out independent research across diverse sectors and generate solid, compelling, and actionable evidence regarding the benefits of school food programs to inform evidence-based decision-making on school health and nutrition policies and practices.

In line with equal opportunities for all, free school meals are served to all pupils in Swedish compulsory schools, prepared and served by assigned school meal staff. This paper explores how school meal staff describe and approach their roles and responsibilities in relation to the school meal, and what influences their conditions to contribute to an inclusive school meal community. Based on approximately 100 hours of participant observations over five months in four schools, and interviews with five school meal staff, the analysis illustrates how school meal staff enacted inclusive practices, which included creating a safe and home-like environment in the school restaurant, aiming to provide a nutritious meal for all pupils, thereby reducing inequalities. However, participants reported a lack of collaboration with headteachers, upon whom they were highly dependent on to implement improvements. Moreover, feedback from pupils was often negative. Accordingly, the school meal staff balanced their mission by employing different approaches: some focusing on tasks related to food service, while others prioritized interactions with pupils. The findings suggest a need to acknowledge the contributions of school meal staff as important actors in building a school meal community, into which they themselves are not inherently integrated at present.

Introduction: The implementation of telehealth began globally before the onset of COVID-19 but the use of telehealth, particularly video consultations (VCs), is expected to have increased with pandemic restrictions on face-to-face consultations (FTFCs). However, little is known about its actual usage. In Sweden, VCs have the potential to bridge long distances between Registered Dietitians (RDs) and their patients. This study investigates the use and perceptions of VCs among Swedish RDs before and after the onset of COVID-19.

Methods: Swedish RDs were invited to participate in web-based surveys in 2016 (n = 61) and 2021 (n = 112). Data are analysed and later discussed through the lens of Levesque et al.'s framework for patient-centred access to healthcare.

Results: More RDs reported having VC-experience in 2021 compared to the 2016 survey, 67% and 16% respectively. A majority of the RDs (85%-88%) believed that access to dietetic care would increase with the use of VCs compared to FTFCs. In 2021, about half of RDs (55% and 46%) perceived treatment quality and relational quality to be unaffected by VCs, while approximately one-third (31% and 43%) saw it as being reduced. With their additional experience, there was the caution by 69% of RDs in 2021 that consultations requiring language interpretation services were less suitable for VCs.

Conclusions: The findings suggest broader VC usage among Swedish RDs participating in the study. Implications for clinical practice include maintained access to healthcare and further practice development to meet quality needs and increased equity.

Objective: Previous research indicates that head teachers in Sweden frequently fail to see school lunch as part of the educational activities of a school. This study contributes to an understanding of how head teachers in Sweden perceive and experience current national policy intentions related to school lunch.

Design: Qualitative inquiry.

Setting: Ten municipal state schools in Sweden.

Method: Individual semi-structured interviews were conducted with 10 head teachers responsible for the compulsory education of 6- to 15-year-olds in state schools. Data from digitally recorded and transcribed interviews were thematically analysed.

Results: Head teachers primarily saw school lunch as a means to ensure pupils were fed and energised. Their focus tended to be on what followed after school lunch in the form of academic performance and mood, rather than the stated intentions of national school meal policy. Head teachers stressed the value of a free and nutritious school lunch for social equality, and the importance of good collaboration with food service managers and school meal personnel, despite the difficulty of achieving this.

Conclusion: This paper highlights a gap between head teachers' perspectives with respect to school lunch and official intentions stated in Swedish national school meals policy. The meanings head teachers saw as connected to school lunch were those of social equality and ensuring pupils were fed, rather than the wider potential envisioned by the authorities. This paper identifies factors that affect the possibility of realising national policy intentions for school lunch in Sweden.

This chapter highlights conditions for a pleasant school lunch based on experiences and perceptions from pupils, teachers, and head teachers. The empirical part of the study is based on a qualitative design using empathy-based stories, individual interviews, and a qualitative analysis of open comments from a questionnaire. Henri Lefebvre's theory of social production of space constitutes the theoretical framework, placing emphasis on how school lunch is experienced, perceived and conceived. The results show that these pupils, teachers and head teachers share the perception of school lunch as a space for socializing. Additionally, they show that conditions for a pleasant school lunch experience, chief among them the environment and time available, are not always favorable. The results presented in this chapter indicate that physical and organizational dimensions of school lunch need to be given more attention.

Background: An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases.

Objective: The purpose of this study was to investigate what types of VF 4th grade pupils (10–11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender.

Design: A cross-sectional study design was used where pupils’ VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated.

Results: The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123).

Discussion: This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden.

Conclusions: The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.

In Sweden, pupils eat tax-funded school lunches, often in the company of teachers. This article focuses on Swedish compulsory school grade (ages 7-15) teachers' (n = 823) perceptions of the school lunch in terms of intentions and daily practice. Analysis was based on written answers for an open-ended question that was part of a questionnaire focusing on teachers' attitudes towards school lunch as a pedagogical activity. It was found that participating teachers saw the potential of the school lunch, placing emphasis on the social interaction that takes place in the school restaurant and the possibility of meeting pupils in a more informal setting. However, a key outcome was teachers' depictions of the struggle between ideals and reality with the effect that teachers were not always provided with favourable conditions for school lunch interactions. It is important to address this in order to improve meal-time practices and the experience of school lunch.

The Swedish National Agency for Education states that educational provision should involve pupil opportunities for interdisciplinary work and the experience of learning in different ways. In this context, the current study aimed to explore the actual operation of interdisciplinary teaching (IDT) in Swedish compulsory schools, i.e. from preschool (6 years) to grade 9 (16 years) regarding nutrition and health. To investigate this, two web-based nationwide questionnaires were sent out in 2014 to compulsory schools in Sweden. One questionnaire was aimed at teachers in five subjects: Home and Consumer Studies (HCS), Natural Science Subjects (NSS) (Biology, Chemistry, Physics), and Physical Education and Health (PEH). The second questionnaire was for school principals. A total of 388 teachers and 216 principals answered the respective questionnaire. The study showed that 40% of the teachers and 59% of the principals reported that their school worked in an interdisciplinary way regarding nutrition and health education. Practical scheduling problems and a lack of time for planning were seen as the main barriers by both teachers and principals, but to a much larger extent by teachers. A prerequisite for successful IDT is that teachers have a chance to meet and plan, and this study indicates that frame factors have a critical impact on what is possible regarding IDT in Swedish schools. It is crucial that principals appreciate their part in facilitating IDT. Increased interdisciplinary teaching for nutrition and health (IDT-NH) might increase school potential for the better integration of knowledge and understanding about the importance of lifestyle for health, the environment and society.