Physical Activity and Wellbeing in Schools

It is estimated that about one in ten school-aged children suffer from problems such as anxiety, depression and conduct disorders. National attempts to impact on this problem have not so far met with great success. One important factor in psychological wellbeing appears to be regular physical exercise and there is concern that inactive lifestyles are undermining their mental health. This problem is the focus of this proposal.

To be successful, interventions must change behaviour and the importance of utilising powerful peer relationships whilst drawing upon a broad range of social influences in young people's local communities is now widely recognised. Psychological research has shown that offering commitment in front of others is a particularly powerful mechanism for sustaining a course of action. The proposed interventions build on such ideas.

Proposed work

One of the most promising pathways to improving mental health is to increase levels of physical activity and there is an impressive body of work suggesting a positive impact on self-esteem, cognitive function, stress and anxiety. We propose two school-based interventions linked to the secondary school curriculum. The research will involve a multi-site clustered factorial randomised control trial with 60 schools allocated to one of the interventions or both or to a control group which receives a delayed intervention.

The first approach, the 'participative learning' strategy, will be situated in Geography lessons; the second the 'personal coach' strategy, will feature in Physical Education classes. Both employ collaborative work linked to ways of capturing data about children's physical activity. Physical activity monitors (accelerometers) will be used for both approaches and, for the participative learning strategy only, Geographical Positioning receivers will be used to track children's locations during and outside school time.

In the Geography lessons, students will be encouraged to work together to gain a greater self-understanding of their environment. This activity will be informed by the data about their movements during the day. This will allow individuals and groups to explore their own levels of physical activity and those of others. Technological equipment will be used to encourage discussion about the data; the students will come to understand their environment in more sophisticated ways. The Physical Education lessons will employ the powerful cross-age peer tutoring paradigm in which older children teach younger children. Research has shown that both tutors and tutees gain greater knowledge and understanding. Agreeing upon and regularly reviewing personal targets for increased physical activity are key to the intervention.

The primary research questions are:
* What impact do these school-based interventions have separately and together on students' levels of moderate to vigorous physical activity?
* What impact do the interventions have separately and together on students' mental health?
The secondary research questions are:
* Are the interventions effective in improving students' knowledge, motivation and sense of efficacy? (And why?)
* Do the interventions provide a useful adjunct to teaching resources from the teachers' point of view? (And how?)
* To what extent do the interventions improve social interactions amongst the participants?
* To what extent do the interventions increase the time spent in meaningful physical activity outdoors? (And how are these related to context?)

Benefits
If this ambitious project is successful, the pay-off is enormous in terms of improving the lives of many children and the wellbeing of families and communities. Identifying effective approaches will enable resources to be targeted cost-effectively. U.K. children have been identified as having some of Europe's greatest mental health problems and large-scale interventions that involve and engage young people would appear to be essential.

The proposal offers the potential to impact on the nation's health and wealth. The work is designed to lead to national school-based interventions which have a direct impact on the mental health of children. If successful this will have implications for many young people and their families. A sizable proportion of the population's lives is blighted by mental health problems and this is not only an individual source of great distress, but at a societal level, it has a significant negative impact on the economy. (One recent estimate to the national economy of depression alone, via lost working days, deaths and NHS resources, put the cost at £9 billion pounds per year, Thomas and Morris, 2003).

In recognition of the importance of the issues tackled by this proposal, the Government has spent millions of pounds on the Targeted Mental Health in Schools and the Social and Emotional Aspects of Learning (SEAL) projects. There is considerable national interest on mental health in schools and this research speaks directly to that interest, although our focus is very different from those initiatives.
The proposed research also has the potential to inform our understandings of how to effect large-scale changes in young people's behaviour and findings are likely to be of significant interest to policymakers. Insights obtained are likely to be particularly welcomed by such bodies as the Government's new Behavioural Insight Team (colloquially known as the "nudge" unit), which seeks to use insights from behavioural economics to assist individuals to make better choices for themselves. Many of the elements of our proposed project (e.g. the importance of social norms, and aligning long and short-term preferences through the use of self-commitment devices) draw upon similar principles and mechanisms to those outlined in the 'nudge' choice architecture literature. Thus, the study seeks to introduce an intervention that maps on closely to those approaches recently identified by Government as helping to fulfil its 'big society' agenda.
Staff working on the project will gain significant experience of working with leading international researchers across a variety of academic disciplines. They will gain opportunities to utilise and evaluate the potential contribution of different research methods. They will gain valuable experience of collaborating with students and staff in schools in developing fully participatory forms of action and evaluation. Such experience will be valuable for a variety of future professional roles in education. Exploration of the research potential of different forms of leading-edge electronic equipment will provide staff with valuable skills for similar future research projects.

Timescale: Following the dissemination of findings from a successful project, it is reasonable to expect other research and professional groups, as well as the original team, to build on that success in the following few years. An active national policy could incorporate the message from the research into policy within five years.

Reference
Thomas C, Morris S. (2003). Cost of depression among adults in England in 2000. British Journal of Psychiatry, 183: 514-519