Design and evaluation of a cognitive health education pilot program according to the RE-AIM framework

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        
 

Any comments on specific survey questions that may have caused difficulty?
Pupils at our primary school found the questionnaire very easy to understand and most of them completed the questions in less than 45min.

"Many thanks for all of the fantastic information that you have sent to me over the years, it has really helped me to plan relevant courses for my students to follow and to help me to focus on the needs of the students I teach."

"Thank you very much, David, for another excellent survey.  We look forward to receiving our reports."

"As a Deputy Head in a large secondary school I was involved in taking part in a city wide health and wellbeing survey over a period of six years. Completing the survey every two years grew in importance year on year, with the final cycle having a major impact on our SDP, PHSE curriculum, Ofsted outcomes and governor understanding.
Over the six year period we moved from a small sample in two tutor groups filling in a paper survey to two year groups completing an online survey. The reports produced give graphical analysis of a wide range of issues. As a result of the survey we increased the number of PSHE workshop days for students to address issues such as smoking, drug and alcohol awareness, anti-bullying workshops. The surveys helped Governors make a positive informed decision to allow Brook Advisory Clinic nurses on site to support students.
As a result of taking part and using the evidence provided we were able to offer more support for students which had a direct impact on improved attendance and outcomes."

"I have valued greatly the work I have done with the team in Exeter, it has been a highlight of my years here." Health Promotion Specialist

"...the most comprehensive health education survey."

"SHEU data proved the best source of the kind of information we were looking for (...) to provide research support to the National Healthy Schools Programme." 

"You have often stood alone against the media who were often looking for the sensational headline. I have noticed an important change: the media now look out for and report very fairly and fully on the reports from the team." 
Tributes from a Health Education Advisor to John Balding, presented at his retirement lunch, May 2005

"Many thanks for a major contribution to the health of children in the UK and elsewhere over many years and putting in place the continuation of the Unit." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"The data from last time were spot-on and we have done lots of work with it. We are very keen to repeat the survey." Headteacher

"Just to say a huge thank you for all your efforts in helping us with the Health survey amongst pupils. It has provided us with significant data which will be used across the school to help us improve. It helped us to obtain a healthy schools standard as well. I hope we can make this an annual feature as we can track the changing health of our pupils." Headteacher

"The children found the survey very interesting and enjoyed doing it." Class Teacher

"I very much value the contribution the Health Related Behaviour Survey has made to the public health agenda and feel confident it will continue to do so." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"We never make a move without looking at these excellent reports." Public Health Consultant

"The Schools Health Education Unit has been a unique inspiration to all of us. For me, as I have worked in the many different areas of the NHS, the SHEU, its principles and your determination have always been a cornerstone in what a health promoting service should be about."
PCT Performance Manager paying tribute to John Balding, presented at his retirement lunch, May 2005

"The data for (us) are very useful ... This is especially important when evaluating the impact of interventions regarding alcohol or other areas, as the survey data are likely to provide an earlier indication than routine data sources."

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." OFSTED 1998

"We are planning next year's programmes around this information." Health Education Adviser

"I really think that the HRBQ is a wonderful piece of work in terms of getting useful information for so many different organisations in one go." Healthy Children's Research and Statistics Officer

Any comments on specific survey questions that may have caused difficulty?
All questions are clearly worded and easy to answer

"We're very happy to commission another survey from you. Our colleagues in School Improvement are dead keen to work with us on this. During our last LA Inspection, we were flagged from our Tellus data as having a bullying problem. We could demonstrate with our SHEU data - which had a much better sample size and coverage of the authority - that we did not have the problem they suggested. The Inspectors went away happy and we are definitely surveying again with SHEU."

"As a result of the survey we reviewed and amended PSHE schemes of work, we are currently working on a "Green Travel Plan", a morning breakfast club was established and we further developed 6th Form mentoring."

Thank you for following up with schools the comments that caused concern. It is very sad to hear that some of our children have these thoughts and feelings and I am so grateful that you were able to make the schools aware of this so that they can attempt to offer some support.

This is another reason why I am so pleased that we have been able to work with you to offer this survey.

"This week I have been working on a major strategy for service design -- it is easy to get solely focussed on hospitals, performance targets, and work force planning -- all very important; but at the same the needs of young people and how we need to work across agencies to address the health needs of today and tomorrow must be recognised. SHEU is founded to do just this."

 “The (SHEU survey) helped us to prioritise where we needed to be in terms of PSHE education. We delivered assemblies based on the evidence as well as curriculum development, and dealt with whole school issues – particularly in regard to pastoral care. The answers received to the question on the survey “Who are you most likely to approach if you needed help” worried staff as “teacher” was not a popular answer. Subsequently the staff asked themselves why this had happened and what needed to be done to address the issue. There was more emphasis on wider aspects of PSHE education delivery, which needed more attention.

To summarise, the (SHEU survey) allows the PSHE department to assess the impact of teaching and learning and modify future lessons accordingly. It allows our school to look at whole school issues such as the extent to which the pastoral care system is meeting the needs of our pupils. It helps us to do need analysis of our pupils. It helps to provide important evidence for SEF / the extent to which we are meeting wellbeing indicators / National Healthy School standards.”  

"On behalf of all the health promoters in Scotland I would like to say a big thank to you and your colleagues for your excellent work over the years. This includes not only your survey work but your role as a visiting examiner in Scotland and adviser on course development."
Tribute from a Health Commissioner to John Balding, presented at his retirement lunch, May 2005

"The Unit produces an invaluable body of knowledge... providing exceptional information across time and throughout the country." Kelloggs

Any comments on specific survey questions that may have caused difficulty? No problems. My children were fully briefed before the survey and they understood that they could miss questions if they did not want to answer them. We did not have any children with any concerns regarding the survey at all.

Any comments on the use of the web site? No it was easy to use.

Any general comments on the exercise? The children really enjoyed completing the survey, It has lead to many positive discussions about our health and how we all have slightly different experiences and home lives.

"We use the data to inform whole school practice: Pastoral programmes for target groups of pupils; Items for discussion with School Council; Information to help us achieve the Healthy School gold standard; To develop and dicuss with pupils our Anti-Bullying Policy; Targeted whole class sessions with the Police Community Support Officers; To share pupil perceptions of all aspects of their school life with parents, staff and governers." 

"Brilliant - thank you Angela. As always you and your team are so proficient at getting our requests dealt with so promptly - it is a real pleasure to work with such a great organisation."

"Your work in developing the Health Related Behaviour Survey was ground breaking and has continued to evolve." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Thank you for doing this project. We really have been wondering how best to collect pupil voice and this gives such a good overview for us and what we need to do going forwards. This data will really support us with our planning for mental health and wellbeing and what actions are needed for our school.

"One year (following the SHEU survey) responses from our Year 4 cohort caused us concern, so we put in place a number of team building, motivational projects. We then assessed their effectiveness by requesting the SHEU questionnaires for these pupils as Year 5's."