Why does asking questions change health behaviours? The mediating role of attitude accessibility

"The Health Related Behaviour Survey is an incredibly useful resource for (us) as it provides schools, with invaluable data which can inform curriculum content, methods of lesson delivery and empower schools to better meet the needs of their pupils."

"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

"We did this last year with Year 8 and 10 and was incredibly useful. It is WELL worth doing and so useful to inform PSHE planning. The safeguarding audit team were delighted that we had done it. The findings are so so interesting.
"The findings are really comprehensive and range from what percentage of year 8 have breakfast in the morning to how many have tried this particular drug, to identity, health and sleep patterns, mental health, citizenship issues....
"It's essential for the PSHE and pastoral curriculum."

"Many thanks to SHEU for your excellent professional support over the years."

"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

"You have made a fantastic contribution to children’s health education and promotion. I am personally grateful to you for helping to kickstart my research career." Prof. Neil Armstrong tribute 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

"I would like to take this opportunity to thank you for your work regarding writing and compiling the sex education survey. The survey was well executed and the schools have found their individual reports very helpful. The results of the survey have enabled the Local Campaign Group to justify the need for young men's campaigns and given us invaluable insight as to the thoughts and experiences of this target group."

"I really appreciate the professional service which SHEU offers.  We have had a great experience working with Angela on the school surveys." 

"You have made a truly significant contribution to health education and health promotion of young people in, not only England, but all over the United Kingdom and beyond." Colleague from NHS Scotland paying tribute to John Balding, presented at his retirement lunch, May 2005

"The system works and I find quite a lot of it useful in my work. I've also recommended it to others."

"The Schools Health Education Unit has gained a reputation as one of the most reliable sources of information about young people's health." BBC

“(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."        
 

"The Unit is to be congratulated in preparing ... material of the highest standard and worthy of wide dissemination." National Association for Environmental Education

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.

"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."

"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

"We have never consulted our young people like this before. The survey makes a great contribution to our 'best value' planning." Sports Development Officer

"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."

"It's good to talk with you again - we used so much of those data and did so much with it in schools - we really got the place buzzing!"

"The Schools Health Education Unit is the jewel in the crown of the Health Education Authority." Major General Sir John Acland 1928 - 2006

"I have never looked at myself in this way before." Pupil

"The survey reports have been used to inform commissioning at specific commissioning groups. They are also being used within our Extended Schools Clusters and to inform The Annual Public Health and the Joint Strategic Needs Assessment." Programme Manager - Young People

"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."

"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

"This is an excellent way of keeping up to date belt and braces style."

"Within the curriculum, we are part of the Healthy Schools programme - and the local, Director of Public Health Award. We cover many facets of health from emotional intelligence to safety education and our very strong, Anti-Bullying and Child Protection programmes. You can imagine our delight when the Local Authority and our school nurse made the following comments after we took part in the regional Schools Health Education Unit Survey: " Head Teacher.
“This was an amazing set of outcomes and really good evidence that (your school) is doing a wonderful job in prioritizing the health and well-being of its pupils … Well done to staff, governors and parents for all your work on this through the Director of Public Health award and other strategies. It is very clear that pupils feel happy, safe and involved at the school and your caring ethos shines through this data.”
Healthy Schools Coorduinator.

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.

"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."

"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 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

"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 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