School staff and university instructors perceptions of barriers and facilitators of whole-grain consumption among children in Thailand: qualitative findings.

Thailand is experiencing a rapid rise in childhood obesity, increasing the risk of early-onset non-communicable diseases. Although whole grains support weight management and reduce non-communicable diseases risk, consumption remains low in Thailand and is insufficiently addressed in the Thai Food-Based Dietary Guidelines. Whole grains are also rarely included in the National School Lunch Program. Given its high participation rate, the school lunch program represents a strategic platform for increasing whole-grain intake and fostering lifelong healthy eating habits. This study aimed to identify facilitators and barriers to increasing whole-grain provision in Thai elementary schools from the perspectives of adult stakeholders We conducted in-depth interviews guided by the Integrated Behavioral Model with 19 teachers and contracted school cooks from two Thai elementary schools, and with 10 faculty and staff members at Mahidol University. Interviews explored perceived norms regarding student whole grain consumption, attitudes toward whole grain, and perceived facilitators and barriers to whole grain provision in schools. Data were analyzed using framework analysis, combining the Integrated Behavioral Model-informed thematic categorization with inductive coding. Transcripts were independently coded by two researchers to develop an Integrated Behavioral Model-grounded conceptual framework describing factors influencing intentions to increase whole grain provision in Thai elementary schools. Participants were predominantly female (93.1%) and highly educated (89.7% with a bachelors degree or higher). Most supported incorporating whole grains into school meals, citing their health benefits for schoolchildren. However, participants reported low WG intake among schoolchildren, attributable to limited availability at both schools and homes. Two primary barriers to whole grain provision were identified. The first was student-level resistance, including unfamiliarity and sensory aversions, particularly toward brown rice. The second involved systemic challenges, including the absence of regulatory guidance promoting whole grain inclusion and operational constraints related to contracted food services and inflexible menu systems. Multi-level engagement among schools, households, and government agencies was identified as a key facilitator of increased whole grain provision in school meals.? These findings indicate that although teachers and cooks are receptive to whole-grain provision in school meals, translating this support into practice will require coordinated, multisectoral action to address persistent structural barriers at the student, school, and policy levels. Future research should incorporate childrens perspectives and examine a broader range of school settings to inform the design of effective, sustainable strategies for whole grain integration.