Woolley, Kay
(2022)
Primary school factors associated with children’s physical activity in the outdoor environment: a mixed-methods study to inform the development of a quality of outdoor environment survey.
PhD thesis, University of Nottingham.
Abstract
Recent data from the National Child Measurement Programme in England (2019-2020) shows that over a third of children aged 10-11 and more than a fifth of children aged 4-5 are overweight or obese. There is a need to implement strategies to reduce this prevalence in children in order to limit associated health problems now and in the future. Physical activity is thought to play a crucial role in the management of childhood obesity. However, despite the considerable benefits to children’s health, proportions of young people meeting WHO guidelines for PA levels are low across the world. Schools are thought to be ideally placed to promote children’s PA and may be able to utilise the outdoor environment for encouraging children to be active.
The purpose of the thesis was to gain a deeper understanding of primary school factors involved with promoting children’s physical activity in the outdoor environment and to use this knowledge to inform the development of a school survey for evaluating primary school provision for children’s physical activity in the outdoor environment. As there is no fully comprehensive picture to date of the school factors thought to be important for encouraging young people to be active when they are outside, a literature review was conducted, including qualitative, interventional and observational studies so as to gain a wide perspective on the subject. The literature review highlighted a need for further qualitative work to explore the ways in which school factors might either deter children from being active or facilitate their active behaviours.
Children’s perceptions of their own PA behaviours were considered to be crucial for forming a deeper understanding of how schools might best intervene to facilitate these behaviours. Whilst focus groups and individual interviews have increasingly been used to explore health-related issues with children, the rationale for choosing any one method is not often explained and despite considerable debate about their benefits and drawbacks these methods have rarely been compared directly. To address these issues, the relative merits of focus groups and individual interviews when collecting information from children about their perceptions of PA were compared. Although both methods were found to be suitable, content analysis showed that children who were interviewed spoke on more occasions and offered more information about facilitators for physical activity. They also spoke more frequently about potentially important aspects of the school outdoor environment with regard to PA promotion.
Subsequently, individual interviews were implemented with children and adults at 4 Nottinghamshire primary schools to gain more understanding about their perceptions and observations of aspects of school provision which might influence pupils to be active in the outdoor environment. Content analysis identified equipment, games/activities and active transport strategies thought to be important by the school community. Through a thematic analysis, nine themes were identified in the remaining data which encompassed ideas involving space, safety, peer influence, adult presence, equipment provision and variety, outdoor learning, football and school actions.
Findings from this qualitative study were used to inform the content and development of a survey of primary schools, the Quality of School Outdoor Environment Survey (QSOE). In a small pilot study, 68 English primary schools completed the QSOE on-line and data were analysed descriptively to provide a detailed description of provision that these schools were making for children to be active in the outdoor environment. Physical environmental features were found to be numerous and varied across the sample and considerable involvement of adults and children as facilitators of physical activity was reported. Policies to do with equipment availability, safety, weather or accessibility that could play a part in limiting children’s scope for physical activity in the school grounds were detailed. The survey format encouraged complete and full responses. However, as there was a low on-line response, it was thought that future versions might be better delivered in alternative formats.
Associations between children’s self-rated physical activity and school environmental variables, derived from the earlier stages of the project were then identified through multi-level linear regressions. Where schools trained pupils to be sports’ ambassadors and delivered health messages in the curriculum that supported active travel to school, children were more active. Children were less active at schools that provided outdoor clothing and training for outdoor learning.
The findings of these investigations were used to inform a summary checklist for schools comprising potentially important physical, social and policy items relating to school outdoor provision.
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