Impact case study – Our school-based research

Background 

Schools are a key setting for children’s public health as most children and adolescents regularly attend school. Health and educational outcomes are inextricably linked. Improving children’s health increases their capacity to learn and educational attainment is associated with people living longer and happier lives. Schools provide a setting in which it is possible to deliver and implement health improvement strategies that have the potential to be delivered at scale.

Our research and why it is useful

The SPHR has conducted a whole series of studies in schools that have:

1. Built the evidence base for the value of school-based public health research;
2. Provided evidence of the key public health issues for children and young people; and
3. Evaluated a next generation of school-based public health interventions and polices.

In terms of advancing knowledge about the value of school-based research, SPHR has conducted studies on the key challenges and opportunities that are presented by the emergence of academy chains and forest schools across England and improved our understanding of school culture and mental health. These changes in school structures have dramatically changed the ways in which researchers interact with schools to conduct research.

We have used this new knowledge to guide the development of a School Health Research Network in the Southwest of England which provides a platform for understanding behaviours, sharing best practice in adolescent health and creating a coalition of schools and researchers that can work together to improve health and wellbeing. We have also created a network to characterise and improve adolescent mental health and wellbeing and created LGBT+ affirming school environments via the Creating LGBT+ Affirming School Environments, or CLASS research project, and developed a core outcome set for physical activity interventions in primary schools.

In terms of understanding the key issues that children and young people face, we have conducted a wide range of projects. These have included:

• work to understand the link between social media use and adolescent mental health;
• understanding adolescent mental health during the COVID-19 pandemic;
• identifying friendship as having a potential role to play in increasing physical activity; and
• assessed tools for measuring movement behaviour in pre-school children

For health improvement interventions in schools, we have:

• evaluated nutrition policies for low income children;
• assessed the feasibility of delivering a resilience building programme for parents of secondary school aged children;
• provided evidence-based sex and relationship guidance for secondary school pupils;
• developed a digital alcohol intervention to prevent harmful alcohol use;
• evaluated a screening tool for identifying secondary school pupils with immediate health needs who are referred to the School Nurse;
• examined the factors involved in successfully implementing a peer-led programme for improving adolescent mental health in schools;
• assessed the impact of the Universal Free School Meals policy on lunchtime and overall nutritional intakes in infant schoolchildren;
• evaluated the impact of the Daily Mile on physical activity in primary schools and;
• investigated the effect on health body weight of children switching to walking or cycling to school

Collectively, this body of research has provided key information on the importance of schools as a health promotion setting and provided new data to improve the health and well-being of children and young people.

Real world impact

A policy briefing and webinar on engaging with academy trusts to promote health in schools have been produced. We produced a policy briefing summarising our evidence-based guidance on sex and relationships education which was widely circulated to MPs and health officials. This was timely because in March 2017 the requirement for all primary schools to provide relationships education and all secondary schools to provide relationships and sex education became statutory. The Minister of State for School Standards wrote to thank us for sharing our evidence and as a result this work was cited in a Parliamentary POSTNOTE. The lead researchers were also invited to contribute to the subsequent call for evidence “Changes to the teaching of Sex & Relationship Education and PSHE” and to attend a Relationship Education, RSE and PSHE Roundtable at the Department of Education (DoE) on 25 January 2018. Following this, DoE guidance was published in 2019 and became statutory in September 2020, although its implementation was delayed because of the impact of the COVID19 pandemic. Our work was also incorporated into UNESCOs International Technical Guidance on Sexuality Education – An evidence informed approach, published in 2018, and described as ‘some of the most reliable and contemporary evidence on SRE available’. To accompany our guidance, we made a short film to illustrate what successful sex and relationships education looks like.

Walking and cycling became more popular and better supported during the COVID-19 pandemic and our research has highlighted that children who switched to active transport between the ages of 7 and 14 had healthier body weights than those who continued to travel by car. A greater number of children from lower-income households in the study walked or cycled to school which is important because interventions to encourage change like this can have the effect of conferring more benefit on those from affluent backgrounds.

Our research on mental health during COVID-19 drew substantial media attention when published as an SPHR report. It was reported in six UK national newspapers and on 14 other news (including the BBC) and specialist organisation platforms. Details of the work have also been included in a Department of Education research report and cited in a parliamentary POSTNOTE on children’s mental health and the COVID-19 pandemic. School-based research on young people’s social media use has also been timely and an animation made with young people provides guidance on healthy social media use based on the research findings.

Our project to enable young people to be involved in action to reduce inequalities in the social determinants of health (SDH) produced journal articles (International Journal of Environmental Research and Public Health; Emerald Publishing Limited) but the researchers and young people involved also worked with third sector organisations and designers and artists to produce an animation summarising the findings, a toolkit to enable young people to understand the SDH and how to become involved in action to reduce these, teaching resources about SDH for use in lessons at key stages 3, 4 and 5 and a strategy for working with young people.