Prior to being awarded an Economic and Social Research Council (ESRC) Wales Doctoral Training Centre (DTC) Studentship, I worked as a Research Administrator at the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University. DECIPHer brings together leading experts from a range of disciplines to tackle public health issues such as diet and nutrition; physical activity; and tobacco, alcohol and drugs, with a particular focus on developing and evaluating multi-level interventions that will have an impact on the health and wellbeing of children and young people.
Young people spend a considerable amount of their childhood and adolescence at school, meaning schools can be an excellent source of participants. The school site is considered an important setting for health promotion, with teachers playing an integral role in the development and support of positive health behaviours[i]. Schools are an optimal site for intervention, with the school environment providing considerable opportunities for health improvement and behaviour change. Healthy school environments can improve child health and emotional wellbeing which can contribute towards the development of positive health behaviours into adulthood as well as increased educational attainment [ii].
At DECIPHer, I worked on the Wellbeing in Secondary Education (WISE) Study, a cluster randomised control trial which aimed to improve the mental health and wellbeing of teachers, in addition to the mental health and wellbeing of students. The evaluation was undertaken in 25 schools across the South West of England and South Wales, with the Cardiff research team being responsible for the collection of data in Wales (n=12). The school-based intervention provided mental health support and training to secondary school teachers through delivery of the training package Mental Health First Aid, and the development of a staff peer support service[iii]. The 25 schools were randomly assigned as either an intervention school (n=12) or a control school (n=13). For the purposes of the evaluation, the research team collected data related to teacher and student wellbeing and emotional health, school health and wellbeing policies, teacher attendance, teacher absence data and school-level educational attainment data.
From my experiences working as a research administrator, I have compiled a list of some of the general challenges faced when conducting school based research.
- Accessing the field
There are many practical issues to consider when conducting research in schools, but accessing the field and developing positive relationships with designated school study contacts can be arguably the most challenging[iv]. Gaining access into schools can be difficult for all researchers but particularly for early researchers. Research has explored some difficulties faced by early researchers and found that early researchers’ assumption of a lack of social capital within the field and a lack of confidence in comparisons with experienced researchers can be problematic when recruiting and accessing schools[v]. As a research administrator, one of my main responsibilities was maintaining contact with the schools study contact and organising data collection dates. However, this could often be challenging. I often found it difficult to gain access to the school contact with the reception offering to pass on my messages but never connecting me with the relevant person (huge difficulties bypassing gatekeepers). In some instances, I would have to pass on certain schools to senior members of the research team who would use their experience to gain access to the study contact.
- Informed Consent
When conducting research it is crucial to gain informed consent from all relevant parties. All research will require ethical approval from a relevant board, whether this is a university ethics committee, a funder’s ethics committee or both. In the case of schools and in particular children, consent is often required from the head teacher or senior management in the school where the research is being conducted, from the child themselves, and from the children’s parent/guardian. The WISE study collected data from many different stakeholders including, teachers, students, mental health trainers and head teachers. An opt-out procedure was adopted with children, meaning parents were given the opportunity to withdraw their children from the research prior to the start of the research. Opt-out consent models arguably have scientific advantages as opt-out consent is likely to lead to higher coverage across a population and avoid social patterning in respondents which is often a criticism of opt-in procedures.
If a child was withdrawn from the research, the research team would provide the child with an alternative activity such as a cross word to avoid the child feeling left out or other children questioning why the child was unable to participate. In relation to the child consent procedure, children were asked to complete consent forms prior to the completion of the research and informed of their right to withdraw at any point.
- Tackling Sensitive Topics (Duty of Care)
As mentioned the WISE study aimed to improve mental health and wellbeing and therefore the research was collecting data around a highly sensitive topic. As researchers we have a duty of care to our research participants, meaning we have a legal and moral obligation to ensure individuals do not suffer any unreasonable harm or loss. When researching sensitive topics or issues such mental health and wellbeing, there is an increased risk of sensitive or potentially harmful information being disclosed to the research team. To overcome the challenges associated with conducting research around a sensitive topic, the WISE research team employed a rigorous consent procedure and emphasised individuals’ ability to not complete or withdraw from any data collection at any time. If participants’ divulged information which was a cause of concern, the research team would follow the relevant protocol and inform the suitable party or organisation.
- The Context of Schools
When implementing an intervention such as the WISE Study it is crucial to consider the context of the school within the highly complex social and politic contexts [vi]. Standardised interventions which do not consider the local context of the school, area or community are often regarded as inappropriate to deliver due to the complex nature of school systems[vii]. Research has indicated that a schools individual ownership of an intervention may enable the school to identify school-level solutions to problems and enhance the chances of sustainability. In relation to the WISE study, the intervention schools nominated staff they would talk to if facing a problem, and these teachers were chosen to receive mental health training and subsequently became the schools peer supporters. Typically in peer support interventions, peer supporters are those who have had similar experiences to those who are currently seeking help[viii]. However, in this instance peer supporters were chosen by teaching staff in each intervention school enabling the school to identify the peer supporters whom they believed to be the most appropriate and supportive, contributing towards the interventions chances of success and sustainability.
5. The Zero Sum Game
Researchers not only face the challenges of conducting research within schools, but face the challenges presented by the research itself. The focus of the research and its aims may not align with the priorities of schools which can lead to further practical issues. Literature indicates that schools often show resistance to engagement with health improvement practices or policies as schools’ believe they should narrowly focus their attention on the core mission of increasing academic attainment[ix]. This concept of the ‘zero sum game’ relates to the perception that health improvement strategies compete with education attainment strategies in schools, therefore diverting attention away from the ‘core business’ of schools[x][xi]. Schools and teachers face huge educational pressures and teachers often feel school-health based interventions are forced upon them, meaning teachers do not meaningfully participate and implementation is often not successful[xii].
It could be argued that the inclusion of health improvement strategies within schools is actually a ‘non-zero sum game’, as it is well document that education and health are levers for improving one another. However, to overcome the perception of the zero sum game, it has been found that schools are more likely to be engaged in interventions which fit within schools priorities, are supported by a school champion and support the improvement of education attainment[xiii][xiv]. For example, the WISE study considered the complexities of the school context. Though the intervention schools received the same intervention, the schools often tweaked intervention components to fit within their individual schools context and culture, which research has shown increases the chances of intervention sustainability.
[i] Dewhirst, Byrne, and Speller, ‘Raising the Profile of Health and Well-Being Education in Teacher Training’.
[ii] Langford et al., ‘Obesity Prevention and the Health Promoting Schools Framework’.
[iii] Evans, Borriello, and Field, ‘A Review of the Academic and Psychological Impact of the Transition to Secondary Education’.
[iv] Plummer et al., ‘A Behind-the-Scenes Guide to School-Based Research’.
[v] Oates and Riaz, ‘Accessing the Field: Methodological Difficulties of Research in Schools’.
[vi] Joyce et al., ‘Evaluating for Impact’.
[vii] Waters et al., ‘Cluster Randomised Trial of a School-Community Child Health Promotion and Obesity Prevention Intervention’.
[viii] Byrom, ‘An Evaluation of a Peer Support Intervention for Student Mental Health’.
[ix] Langford et al., ‘Obesity Prevention and the Health Promoting Schools Framework’.
[x] Bonell et al., ‘Why Schools Should Promote Students’ Health and Wellbeing’; Littlecott et al., ‘Health Improvement and Educational Attainment in Secondary Schools’.
[xi] Littlecott et al., ‘Health Improvement and Educational Attainment in Secondary Schools’.
[xii] Nordin, ‘Implementing the Health Promoting School in Denmark’.
[xiii] Langford et al., ‘Obesity Prevention and the Health Promoting Schools Framework’.
[xiv] McIsaac et al., ‘Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review’.