'It Does Help but There is a Limit': Young People's Perspectives on Policies That Restrict Hot Food Takeaways Opening Near Schools

Background: Local authorities (LAs) in England are increasingly using the planning system to control the proliferation of hot food takeaway outlets (takeaways) near schools as part of a range of policies to promote healthy weight in children. These takeaway management zones (TMZs) include restrictions on planning permission to open new takeaways within a certain distance of a school. In this qualitative study we explore young peoples perspectives of TMZs. Methods: We purposively recruited 46 young people (aged 11-18 years old) attending secondary school across two contrasting London LAs with operating TMZs. We conducted semi-structured, walking group interviews (go-alongs) in January-February 2023 in the local food environment close to participant schools. We analysed data using framework analysis. Results: Participants generally viewed TMZs as reasonable and uncontroversial but were not always aware that TMZs were in operation. Although participants understood that TMZs prevented new outlets from opening, they observed they did not seem to reduce existing provision. This was viewed positively as it did not result in the closure of local takeaways perceived as important components of the social fabric of school life. Participants believed that the potential health impact of TMZs is limited by their exclusive focus on takeaways as other food retail commonly patronised by young people, such as convenience stores, are important sources of unhealthy food. Participants also identified inadequacies in the wider food environment, including the school dining environment and access to food delivery apps. Conclusions: Our findings suggest that although young people find TMZs acceptable and believe they have some positive impact on diet, they did not perceive TMZs as effective as they could be. Participants articulated that the management of takeaways on their own is unlikely to reduce exposure to unhealthy foods. Widening the remit of planning policy to include outlets selling convenience foods may be important for policy optimisation. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the National Institute for Health Research (NIHR) Public Health Research Programme (Project number: NIHR130597). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. MK, MW, JA and TB were supported by the Medical Research Council (grant number MC\_UU\_00006/7). OM was supported by a UKRI Future Leaders Fellowship (MR/T041226/1). CT was supported by the NIHR Applied Research Collaboration (ARC) East of England. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Full ethical approval was obtained from the London School of Hygiene and Tropical Medicine Research Ethics Committee (Ref/ 26337). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors and in line with LSHTM ethics procedures.