Although interventions delivered in school settings have the potential to improve children’s health and well-being, the implementation of effective interventions in schools presents challenges.
Schools and teachers are already under a lot of pressure to meet the demands of the curriculum and the greater responsibilities for improving health and well-being further add to these pressures. Previous research suggests that a partnership with head teachers giving greater ownership and choice to select interventions that align with existing school needs could improve the implementation and maintenance of these projects.
The aim of this study was to explore whether providing head teachers choice in the type of intervention components they could deliver influenced the projects uptake, effectiveness, how well it was delivered and whether it was sustained.
A sample of primary schools were provided with a choice of five evidence-based physical activity interventions: Playground scrap-store, daily classroom refreshers, alternative after-school clubs, parent and child after-school activities and an ‘In the Zone’ playground intervention. Fitness and physical activity measurements were taken before and after the three-month interventions and head teachers, coaches and pupils were interviewed to discuss their thoughts.
- All schools adopted different intervention components; alternative after-school clubs, parent and child after-school activities and daily classroom refreshers (a short activity done together, building class unity)
- Head teachers welcomed greater autonomy and choice in developing school-based interventions and appreciated the more collaborative approach.
- Mixed results were reported for the effectiveness and maintenance of the interventions adopted according to the fitness and physical activity results.
- The main facilitators for improving implementation included coach consistency and enthusiasm, alignment with existing curriculum, a positive school lead to champion the project, inclusivity, and autonomy.
- Allowing pupils choice and promoting a positive school environment were key factors for enhancing engagement.
Dr Danielle Christian, who led the research, stated that: “When designing complex interventions, such as school-based health interventions, it is important to look at the whole picture including the adoption, implementation and maintenance in order to assess the full effectiveness of the project. If head teachers do not want to implement the intervention, or pupils do not engage, the intervention ceases to be as effective as it could have been, and this study demonstrated the importance of understanding these barriers to improve school-based projects in the future.”
Professor Sinead Brophy added: “This study clearly shows the importance of including both pupils and head teachers in the design of future interventions to improve the adoption, engagement and delivery of school-based heath interventions.”
This research aligns closely with our primary school network (Health and Attainment of Pupils in a Primary Education Network: HAPPEN www.happen-wales.co.uk). HAPPEN was built in response to the need for a more collaborative approach to improving health and well-being of children in Wales. Collaboration between researchers, teachers, head teachers and pupils has ensured the network’s success to date. It is clear from this research and our wider research that one size does not fit all in school settings and involving head teachers, teachers and pupils in both the design and delivery of interventions is crucial to their success.