Outcome of peer nomination

The peer nomination process was largely successful. A small number of students copied others or felt pressure to nominate those that their friends had, but the majority of students nominated confident or active peers as they thought they would make legitimate PSs. Consistent across all schools and stakeholder groups was the perception that the girls selected to be a PS were ‘sporty’, ‘confident’, ‘outgoing’ and ‘self-motivated’, and this was the main reason for their nomination:

I think it’s because we’re all like quite sporty people.

School 2, PS focus group

If you have a non-active person telling you to be active, you wouldn’t listen to them as much would you? Because you think, well why should I, you’re not.

School 3, NPS focus group

Views on whether or not nomination had identified the influential PSs who were representative of the Year 8 girls varied between and within schools. For example, in schools 2 and 4, PSs thought that they represented different friendship groups, whereas NPSs thought that girls from the same ‘popular-type groups’ were selected. In school 2, trainers felt that the girls who were nominated could have been influential for the wrong reasons, describing them as ‘bullies’ (trainer B, top-up training day):

I think there was [sic] quite a few [girls] from lots of different ones [friendship groups].

School 2, PS focus group

There was evidence that some NPSs in school 3 viewed the PSs as potentially influential despite not being close friends:

I’m not close friends with them, but I can talk to them, but I don’t count them as friends.

School 3, NPS focus group

In one school, some PSs felt that their potential network of influence was reduced, as some of their friends were also PSs:

A lot of my friends went on the PLAN-A thing . . . like literally everybody that’s in our like group of friends went, and you kind of ran out of friends [to support].

School 6, PS focus group

Views on being nominated

There was consensus across participant groups that PSs were proud and happy to have been nominated and that they felt their nomination reflected their peers’ trust, support or confidence in their ability to be a PS. Parents suggested that their daughters were ‘shocked’, ‘proud’ and ‘really pleased’ to be nominated:

I felt quite privileged ‘cause like not everyone gets chosen, it’s nice that everyone like us gets chosen over everyone else really.

School 6, PS focus group

She was really pleased I think that people thought she could do it and like I said it just boosted her confidence.

School 2, parent

Consenting to be a peer supporter

Peer supporters were interested in becoming a PS because they liked the PLAN-A concept and wanted to help others be active:

I like the idea of helping others become more active . . . it’s the idea of helping my friends to do more stuff like inside or outside physically active [sic].

School 3, PS focus group

Peer supporters’ parents thought that the role aligned with their daughter’s characteristics, such as ‘wanting to help other people’ (school 4, parent), being ‘caring’ (school 2, parent) and having an interest in sports:

She’s just always looking for something sports wise and activity wise . . . not just for herself. So . . . I think that’s its appeal for her.

School 3, Parent

Non-peer supporters on not being nominated

Most NPSs did not mind or were relieved at not being a PS, providing some evidence that the nomination process was effective in identifying students who were sufficiently confident to influence the PA of their peers:

I didn’t want to do it because I didn’t want to have to meet new people. I don’t like talking to people who I don’t know and that made me feel really awkward about doing it.

School 4, NPS focus group

In contrast, a small number of NPSs were disappointed at not being nominated:

I like, didn’t want to do it, but when everyone else got chosen, I was a bit like, ‘well, does that mean that all of my other year group don’t think I’m good enough to do it?’.

School 4, NPS focus group

Attendance at peer supporter training

Attendance at all 3 days of the PS training was high, ranging between 90.91% and 100% (Table 25). In the majority of cases, absences were because of participant illness. In one case (school 2), a student had already been absent from school in the same week and her parents requested that she not attend. Attendance at training was not different in the school where training was delivered within the school setting (school 4) compared with the other schools where training was delivered off site.

TABLE 25

Attendance of PSs at the PS training

Venue

Training for three schools was delivered at four non-school off-site venues (three of these gave sole access to a large hall with a break-out space, tables, chairs and kitchen/toilet facilities; one venue was a small room among office space, with no break-out space and shared access to facilities with office workers). Trainers rated two of the venues as suitable and valued having sufficient space and facilities:

That [school 2 venue] was good, that was a perfect space, there was plenty of room for us and then having the kitchen separate and the bathrooms we had to ourselves, that worked really well, that was a really big space.

Trainer B, top-up

Trainers (see Appendix 14) and PSs (see Table 30) in schools 3 and 4 rated the training venues as adequate (0.50 ± 0.71 and 1.50 ± 0.71, respectively). The venue for school 3 was considered unsuitable because it was among a number of offices and there was no safe outdoor space. This venue was changed for the top-up day and received higher scores (see Appendix 14). Trainers thought that the venue size, layout and location was an important influence on the energy and engagement levels of the PSs:

TABLE 30

Peer supporters’ evaluation of training content and logistics (2-day and top-up training)

If the girls are tired, if they’re just not feeling it, if the, if the [sic] venue’s not suitable, then I think that all brings them down.

Trainer C

Holding the peer supporter training within a school

In school 4, PS training was held on the school grounds. This provided trainers some more time to deliver each training day (because they did not have to travel to the training venue after registration at school). However, other students and PS commitments (e.g. music lessons) caused distractions. The trainers suggested that if a location that is separate from other students was available, then this would support delivery of the training within the school:

When you’re at school you have more time and I liked that . . . it was nice to have longer to do the reflection and relaxation thing, I almost prefer at the school, if there was a room where nobody was going to come into.

Trainer B

The school contact recognised that although PSs felt privileged ‘they would probably [have] felt more special if they were going out for the day’. PSs liked that the training was held within the school because it was familiar; however, PSs also recognised that they needed a bigger space and felt the usual school day structure (including the bell) was distracting:

Participant 1:

that was better because you’re in the place where you knew.

Participant 2:

and if you needed to go anywhere you knew where it was.

School 4, PS focus group

View on the content of the peer supporter training

Table 26 shows that the PSs enjoyed all 3 days of the training. Enjoyment increased from day 1 to day 2 (mean ± SD = 3.60 ± 0.77 and 4.24 ± 0.58, respectively). Enjoyment levels were similar on the top-up day to day 1. Trainers’ perception of PS enjoyment was similar to the PS ratings of enjoyment (Table 27).

TABLE 26

Peer supporter enjoyment of the training on days 1 and 2 and on the top-up day

TABLE 27

Trainers’ evaluation of peer supporters’ response to training

Qualitative evidence from all stakeholders suggested that PSs liked the novelty, participatory inclusiveness and autonomy of the training:

I think they enjoyed it. There was laughter, which is always a good sign.

Trainer C

I think it was about it being different; we hadn’t done anything like it before so it was just nice to try something new . . . It was a lot more we were involved, in classes we just get a teacher telling us things.

School 4, PS focus group

PSs found the training activities enjoyable and interesting (see Table 30). In particular, active games, competitions, working together and interactive activities (e.g. role-plays, discussions about videos) were enjoyable (see Appendix 17) and engaging because they differed from usual school-based learning:

I liked the alphabet game. It got us all together and it was like a competition and it made us think more as a group.

School 3, PS focus group

I think the things that are less like school are even better because they think then this is fun day, and then it’s less like they don’t even realising how much they’re learning at the moment, they’re just having fun.

Trainer B

. . . the discussions that come out of that ‘Like a Girl’ video exercise afterwards I think are brilliant in terms of what is going on in their groups . . .

Trainer A

They loved that video [Like a Girl] and they talked about that for ages.

School 2, school contact

Trainers and school contacts felt that the large majority of training activities were well conceived, flowed well, provided a clear message and were pitched at the right level. However, PSs from one school found some wording difficult to understand and struggled to give their opinion:

It probably meant something simple but it was a bigger word that no one really understood and that one didn’t have as many answers.

School 3, PS focus group

A lot of us struggled when we had to give our opinion on why picked stuff [sic] because you feel like you’re either going to be wrong [sic].

School 3, PS focus group

In contrast to the interactive tasks, PSs lost focus and struggled with behaviour when activities covered information that they already knew, and they did not enjoy activities that involved lots of writing, sitting and listening or repetition (see Appendix 17):

. . . the odd little bit that may have been a little bit wishy-washy in the sense that it is something that the kids were already aware of. And maybe that could have been why they lost concentration at times – or was less engaging.

School 2, school contact

It took ages and I think we remembered it more than they thought we would of [sic], so we didn’t really need to go through all of it again.

School 4, PS focus group

I think just sometimes sitting down for a bit longer than other times. . . . I think it is probably listening for a long time.

School 6, PS focus group

Many PSs believed that the 3-day training would be more active/sporty than it was:

I thought it was going to be more active. We talked a lot about being confident and stuff and I thought we were going to play some activities like, I don’t know, run round a field or something like that but we didn’t.

School 3, PS focus group

Although script writing and role-play was relatively unpopular at the 2-day training, it was the most enjoyed activity during the top-up day (see Appendix 17). This may reflect the PSs seeing the relevance of role-play at the top-up training, having had experienced being a PS for 5 weeks or their growing confidence:

I think some of the girls are kind of quite outgoing, confident, so the whole role-playing thing was great for them, they loved it. Whereas other girls, that’s their idea of hell and so for them that isn’t their thing so basically they’re a little bit out of their comfort zone.

School 3, school contact

Trainers reported that PSs also found it hard to understand the goal-setting task:

They found it [SMART (specific, measurable, achievable, realistic and timely) goals] quite hard to do it or they maybe misunderstood that it was in relation to . . . It’s more of a workplace, an adult thing . . . they did struggle a bit to get to grips with that one.

Trainer D

Most PSs would recommend the training to potential PSs, citing that it was fun and educational and motivated them to increase their PA:

You learn so much more and it really does change your mind about things.

School 2, PS focus group

I think it’s [sic] made me more confident.

School 3, PS focus group

The extent to which each training activity objective was achieved was assessed by the observer (see Appendix 18). For the majority of activities, objectives were achieved to at least some extent or lots on all training days and there was little variation between trainer pairs. When learning objectives were not achieved well [e.g. day 2 ‘communication skills’ (mean 1.75, SD 0.71)], the observations showed that delivery of the activity was suboptimal through either poor explanation, poor use of space or a lack of linking the activity to the role of a PS.

Peer supporter engagement with the training

On the whole, trainers and school contacts thought that the PSs had a positive attitude towards the training and their role as a PS. Trainers agreed that the PSs were excited and felt that they were ‘in a privileged position’ (trainer A) to attend the training:

I think the girls were really positive, they were positive about the whole event.

School 2, school contact

They seemed enthusiastic to be there. And they still seemed like something that was important to them.

Trainer E

In some cases, trainers thought PSs viewed the training as ‘a day out of school’ (trainer B, top-up), and in school 2 the trainers felt the PSs ‘were not really that fussed about it [being a PS]’ (trainer C, top-up). These findings are supported by the trainer survey findings (see Table 27).

Peer supporters engaged well in the activities on all 3 days. Engagement decreased throughout the afternoon of day 1, which corresponds with the lower enjoyment levels on day 1 (see Table 26). However, engagement was maintained throughout day 2 and the top-up day. Engagement levels did not differ between trainer pair/school and no particular activities elicited poor engagement. Notes from the observer’s and trainers’ evaluations support this; trainers rated the PSs as being engaged in the 2-day training (mean 2.50, SD 0.54) and top-up day (mean 2.13, SD 0.84) and were involved and interested in the activities:

You could tell they were really listening and not just pretending to listen, it was like they wanted to be there . . . when they were giving answers it was like they had the read the book! The way that they were genuinely understanding what we were talking about . . . what we were saying to them was getting through to them and they understood it.

Trainer B

However, the scores indicate some room for improvement and the qualitative evidence suggested that PSs were less engaged and/or lost concentration during longer and less varied or (inter)active tasks. At these times, the trainers found delivery difficult, particularly when PSs could not report any PS actions:

I would try and ask them . . . ‘Well, can you see yourself in a conversation?’ I wouldn’t get anything. Nobody would even shake their head yes or no. It was flat, nothing. . . . So then I felt like, ‘well now I’m putting things in their head and I’m assuming’ but they weren’t talking.

Trainer B

Peer supporter engagement was also influenced by the characteristics and behaviour of the group. School 6 in particular was challenging to engage and work with, with both trainers describing it as ‘like pulling teeth’ (trainer B). Behaviour problems in school 2 affected the level of engagement and interest. This is supported by the data in Table 27 that show lower interest and involvement for schools 2 and 6. In school 2, such behaviour made the trainers question how these PSs would carry out their role and how they would talk to others:

We were kind of thinking ‘oh my gosh, if they go and talk to their friends like this, it’s not going to be encouraging them, that’s really going to put them off’.

Trainer E

Interestingly, PSs recognised when their behaviour was poor and challenging for the trainers:

‘Cause we are still like kids, if we do something [wrong] and they like tell us off, but it won’t go into our heads straight away. If they tell us to stop talking then us being like kids we always try to finish the conversation . . .

School 2, PS focus group

Impact of training on peer supporters

Peer supporters felt that their confidence to promote PA among their peers increased as a result of completing the 2-day training (mean 3.33, SD 0.68) and top-up day (mean 3.38, SD 0.69) (see Table 30). Despite this, PSs commonly wanted further support to develop confidence to talk to people and start a conversation and with what to say (Table 28).

TABLE 28

Peer supporter reports of additional help needed following the 2-day training

Trainers expressed some reservations (Table 29) about whether or not the training increased PS confidence to instigate conversations with their peers (mean 2.63, SD 0.74) and, in a minority of cases, questioned how realistic some of the PS-generated practice conversations were:

TABLE 29

Trainers’ evaluations of the level of achievement of the training objectives (2-day training)

Sometimes when they were writing conversations I was thinking ‘is this really a conversation you know you would have?’.

Trainer A

The qualitative evidence supported the scores in Table 30 that show that the PSs understood their role. The girls demonstrated that their role was not to talk to students they did not know, that they knew when it was appropriate to offer support and that they understood that there are different forms of PA to suggest:

Knowing that a lot of things are exercise was really reassuring, you are doing exercise, it’s just not in some other ways [sic].

School 4, PS focus group

Peer supporters reported gaining new knowledge about PA among girls, PA guidelines and benefits and the distinction between PA and sport (see Table 30; see Appendix 19). In addition, PSs reported building their communication skills and self-confidence. This corresponds with the trainer-rated achievement of objectives (see Table 29; Table 31), including enhancing PS knowledge of PA and their interpersonal and communication skills. Focus group evidence supported the quantitative findings and demonstrated how improvements in having the confidence to talk to others, problem-solving and PA knowledge worked together:

TABLE 31

Trainers’ evaluations of the level of achievement of the training objectives (top-up day training)

When you have the right information, [it] sort of gives you confidence and they [the trainers] said to go round obstacles that might occur.

School 4, PS focus group

Trainers’ perceptions of achieving the training objectives were generally lower on the top-up day than on the 2-day training. This may be because there is a ceiling effect following the high achievement rates at the 2-day training and it suggests that different objectives should be assessed after the top-up day. This finding may also be because of the poor achievement of objectives in school 2. The qualitative work indicated that this was a result of the behaviour of the children in school 2; trainers felt that the time they spent trying to manage this may have had an impact on what they managed to achieve throughout the training. This was not experienced in any other schools.

As a result of improving PS knowledge and their confidence to talk to people, the PSs felt prepared to support their friends, and their parents agreed:

Like slipping it into a conversation was pretty easy after we learnt how to do it [agreement]. Like before you’d be like ‘urrrr’ . . . But, yeah, learning it I think it actually helped.

School 4, PS focus group

However, some PSs were apprehensive to peer support because they were unsure of how to start and have a conversation promoting PA:

They didn’t tell you so much about going up to people and like how to start off the conversation.

School 6, PS focus group

Peer supporters reported an increased personal awareness of their activity levels and those of girls in England, which motivated them to increase their PA:

It like changed how like active you were, because like I wasn’t very active but then I’ve heard like only 8% of girls are active, so I started being more active.

School 6, PS focus group

Furthermore, in the schools where the year group was structured in two halves, PLAN-A helped integrate the two sides of the year and build friendships:

I think it’s also good that we interact with the other side of the year and sort of made friends with them as well.

School 4, PS focus group

The trainers, PSs and school contacts believed that the top-up day was an important and beneficial element of the training. Key content involved revisiting important PA information, supporting confidence and exploring how to communicate, providing a reminder of the PS objective/role and encouragement to continue peer supporting:

I think the top-up day kind of enforced [reinforced] the fact that you are actually trying to do something important.

Trainer C, top-up

Just to remind us . . . because after you have been to a top-up day we always think ‘we need to do this’ and then I’ll forget about it.

School 2, PS focus group

Need-supportiveness of trainers and peer supporters’ perceptions of need support

Peer supporters rated the trainer autonomy support as high during the 2-day training (mean 3.31, SD 0.63; possible range 0–4) and slightly lower at the top-up day (mean 2.92, SD 0.80). These scores are reflected in the qualitative findings; however, there was no clear explanation for the lower scores at the top-up day.

Evidence of peer supporter diffusion

There was evidence from all stakeholders to suggest that the PSs made numerous attempts to peer support using different strategies:

I have overheard conversations because some of the mentors [PS] have been in my tutor group and even the girls saying to the boys ‘wow, you’re just always on the computer’.

School 2, school contact

What I quite often hear at the moment after that [PS training] is the girls will say to each other ‘for goodness sake woman up’.

School 2, school contact

A good few of them definitely had conversations.

Trainer B, top-up

Efforts to support peers included sharing knowledge with friends and offering to co-participate in clubs, sports, daily PA and active play. The PSs reported being empathetic to their friends and trying to encourage them to try new activities and persist with those in which they were already engaged:

There is a couple [of girls] [sic] actually, who I know got their friends joining [sic] a club doing a sport . . . and said that now a friend was doing a sports club or doing a different after-school club.

Trainer B, top-up

Whereas before they go [sic] to a youth club and I used to drop them off, now she’s walking. She gets her friends to call, they call for each other and they walk.

School 3, Parent

Participant 1:

You know [NPS girl] because she is really good at athletics? She like . . .

Participant 2:

Puts herself down a lot, doesn’t she?

Participant 1:

Yeah, and then I have like let her join the athletics club with me. Because she is very good at high jumping.

Interviewer:

So, you’ve tried to convince her to join the club with you? Have you succeeded yet?

Participant 1:

Nearly there.

School 2, PS focus group

I do rounders, so me and [PS12] went up and spoke to her and said do you want to come and do rounders with us, you can come it’s all OK . . . she actually really enjoys it.

School 3, PS focus group

There was evidence that PSs carefully considered their diffusion attempts:

I tried to incorporate something that they liked. Erm, ‘cause some of my friends like to dance so it’s finding something that they like and encouraging them to do that more.

School 6, PS focus group

. . . at the top-up day we had a talk about when you’re in the car and talking about it and me and my friend were having a lift to go to someone’s house and we were talking about it and we ended up getting out the car early and then actually walking a bit because I was talking to her about all the benefits and we hadn’t done anything that day and we need to do stuff . . .

School 3, PS focus group

Generally, PSs felt that support given to close friends was more likely to be accepted and met with a positive attitude, and this was supported by NPSs who reported listening to PSs and accepting the support given if it was provided in an encouraging and polite way:

I feel [that] if I talk to my friend about it they won’t sort of be stubborn about it and when it’s coming from a friend or someone that they’re close with then they’re more sort of open about being active and what they would like to do, maybe rather than . . . So I feel that it’s sort of better coming from a friend.

School 4, PS focus group

If they say it [encouraging to be active] politely then yeah [they would try to be active], but if they get rude then probably not.

School 6, NPS focus group

The PSs in school 2 reported that it took time for some girls to accept support and that they persisted with their efforts. However, in school 6, NPSs were initially receptive ‘but they just sort of gave up after a while’ (school 6, PS focus group):

At first, yeah [NPS] was very negative about it, but over time she changed a lot – her mind . . . so we don’t want to give up on her because she does have potential, I think.

School 2, PS focus group

Trainers and PSs also reported that they had initially practised their role with family members as opposed to their peers; many found this easier:

She wasn’t actually talking to peers so she was trying to do it but she was doing it with her mum and her dad and her grandmother and her sister.

Trainer B, top-up

Despite the evidence of these PS activities, the trainers reported that many PSs seemed to have done little to peer support at the top-up training:

Some were like clearly covering up that they hadn’t done it and saying they had.

Trainer B, top-up

I just got the impression, particularly with the first school [school 6], that I’m not sure how much they were doing.

Trainer D, top-up

This was supported by many NPS:

NPS 2:

No, no-one said anything to me.

School 4, NPS focus group

However, in line with their role, some PSs suggested that with effective peer support:

People might not know that you’re doing it.

School 2, PS focus group

They didn’t really know I was peer supporting because with some friends we did it quite subtly.

School 2, PS focus group

. . . you have just got to like every now and then just say something like ‘do you want to walk to school with me?’ or something or ‘why don’t you do PE today? Like have a go at it’.

School 2, PS focus group

The perceived effect of the Peer-Led physical Activity iNtervention for Adolescent girls on Year 8 girls (non-peer supporters)

The various stakeholders believed that PLAN-A had potential positive effects including increased participation in PA (e.g. extracurricular activities, daily PA or planned exercise), improved intrayear relations and knowledge of the importance of PA. One student reflected that a PS had helped her ‘realise that some sports are actually more fun than others’ (school 6, NPS focus group). In one school, students who were not nominated to be PSs appeared to take on the role of a PS by talking to others, this was perceived to be because these students did not want to ‘miss out’ and wanted to ‘be seen in the same way that PSs are’ (school 2, school contact):

It is good and it helps confidence and it makes people feel like people do trust them [PS], people do look up to them [PS] and people do actually think I would want them [PS] to do stuff with her; I want to be active with her [a PS].

School 3, PS focus group

They’ve grown in confidence again, I’m not sure whether I could say wholeheartedly that’s because of PLAN-A . . . Because it’s, they’ve matured because they feel more settled in the tutor group. But they are very happy to be themselves and not be a follower.

School 2, school contact

Some of them, like in my group a lot of them did actually start going to the gym now but I don’t know if it was ‘you’re allowed to go to the gym now let’s go for it’ or if it was ‘we should do this because of PLAN-A’.

School 2, NPS focus group

Non-peer supporters demonstrated some understanding of PLAN-A, but could not explain it fully. In their view, any impact that PLAN-A had on other girls within Year 8 was minimal and, if any, was short-lived. Reasons given for this were a lack of interfriendship group communication, ignoring advice or not being spoken to by a PS:

I’m that kind of person that will take it on for a day and then forget about it the next day . . .

School 2, NPS focus group

I don’t think that people should like encourage us because if we wanted to do it then we would do it but like them telling us, isn’t going to really change our opinion of if we want to do it or not.

School 3, NPS focus group

The impact of the Peer-Led physical Activity iNtervention for Adolescent girls on peer supporters

The perceived impact of the PS training on PS knowledge, motivation and PA is reported in Chapter 6, Peer supporter training, Impact of training on peer supporters. The most commonly reported effect of PLAN-A and actually being a PS was its positive effect on PSs’ self-confidence and self-perceptions. In addition to the pride and privilege associated with being nominated by one’s peers (see Chapter 6, Peer nomination), parents felt their daughters had ‘definitely become more confident’ (school 4, parent) and used terms such as ‘feel valued’, ‘empowered’ and ‘more assertive’:

I think it’s done their confidence a world of good and, like I say, they’ve taken quite a lot of pride in what they’re doing because they’ve been chosen to do it.

School 2, school contact

Although the NPSs identified an increased sense of confidence in the PSs, in school 3 they interpreted this negatively, describing PSs as ‘a bit more boastful’, with one girl suggesting that ‘it’s not good for the rest of us, because they are cocky’. Girls in school 4 suggested that the PSs were ‘confident anyway’ and that ‘they get a bit big headed, just ‘cause they did get chosen’.

There was also a perception that PSs were more empathetic in general with their peer group:

It’s just the everyday getting along. The supporting in a classroom and not if somebody gets something wrong – not laughing. You know, they are much more aware of people’s feelings themselves.

School 2, school contact

There was a clear understanding that being active was more than just participation in ‘sport’. Some girls claimed that their participation in PLAN-A had changed the way in which they think, and for many it led to an increase in their own PA levels:

It’s definitely helped me be a better person. It’s realised [sic] that I am active, I don’t have to just have to do loads of sports, I can just walk around the house, go up and down the stairs and I end up doing a lot of active things. It has helped me become a better person in how I talk to people as well, like making me think before I say to some people like I know that before I probably, if we didn’t have the PLAN-A thing, I probably would have just gone to someone, ‘oh you need to be active, come on a run’ and I think that would have then ended up not working.

School 3, PS focus group

Peer supporter 2:

I think it’s all the facts and it does make you realise how important it actually is having exercise.

Peer supporter 1:

I want to prove people wrong who say that girls aren’t as active as boys. Want to prove them wrong and say we are.

Peer supporter 3:

Like boys will still say, ‘ah, you run like a girl’ or something that’s like . . . you just want to prove them wrong. ‘Shut up’.

School 2, PS focus group

School policy and attitude towards physical activity

The control (mean 6.00, SD 1.41) and PLAN-A (mean 5.75, SD 1.71) schools scored similarly with regard to policies to encourage PA and PE (Table 32). One control school reported its annual PE budget and this was approximately £700 higher, on average, than PLAN-A schools. School 3 scored lowest (4.00) overall on policy and attitudes, reflecting few written PA policies and provisions, such as cycle training. School 4 was the highest scoring, reflecting a broad range of support for both staff and student PA and PE. All schools reported facilities to support staff PA (e.g. showers/changing); however, no schools required staff to receive training on PA promotion. The qualitative interviews revealed that schools 2 and 5 were involved in a variety of schemes and programmes (This Girl Can, Healthy Schools) to encourage student PA.

TABLE 32

School policies on PE provision and PA

Physical activity within the curriculum was scored similarly in both PLAN-A and control schools (Table 33); however, both scores are relatively low, providing limited evidence for the promotion of PA across the curriculum, outside PE. Half of schools used PA in other subjects aside from PE, primarily in personal, social, health, economic (PSHE) education. Two PLAN-A schools encouraged staff members to promote PA to students. Mostly, the delivery of PE is not often compromised for other needs. However, in four out of the six schools, children are sometimes withheld from PE for other academic subjects, which is supported by the interview findings:

TABLE 33

Physical activity throughout the wider curriculum

I think the schools at the moment are under so much pressure to get like the academic side, sometimes they forget the other [PA] side.

School 6, school contact

School physical activity provision

The audit of school-level PA provision (i.e. quality of cycling, walking and sports/play provisions) ranged from 13 to 25 out of 46 (Table 34), with higher scores indicating greater provision. The two lowest total scores (13 and 16) were from the PLAN-A schools; this is supported by the number of active after-school clubs offered in the same schools (20% and 37.5% of all clubs offered are physically active, respectively). School 4 scored highest (25 out of 46), commensurate with its high score for policies on PE and attitude towards PA. Although parents and students from this school thought that the sports facilities were excellent, space and equipment were not always accessible:

TABLE 34

School PA provision

I heard that [the school has their own ‘sports facility’] the other day. I thought that was brilliant.

School 4, parent

One school contact recognised the need for appropriate equipment and space to encourage girls to be active, but the school may not have the capacity to do this:

[At the training] when they had the breaks and they had all the skipping ropes out and they were really happy just to do that. There was no boys around so they were not inhibited and I would love them to be able to do that somewhere but I’m not sure we’ve got the facility to do it but . . . they’re too embarrassed to do these activities so they don’t.

School 6, school contact

Five schools provided after-school activity club data. Out of the clubs provided for, and available to, Year 8s, approximately 50% were categorised as active in three schools; 37.50% of active clubs in school 4 were for girls only.

Physical activity facilities were rated as good at five out of six schools and adequate in school 2 (see Table 34). Of the three schools that had a written policy to encourage active travel (see Table 32), school 2 had relatively low scores for cycling and walking provision. When referring to PA in school, students commonly referred to formal sports or PE opportunities rather than broader opportunities such as cycling or walking:

Participant 1:

And there’s clubs as well [sic].

Participant 2:

Yeah, there are quite a few clubs [netball, rounders, badminton . . .

Participant 1:

There’s a girls’ fitness club as well.

School 3, NPS focus group

School-level built environment

Table 35 provides a description of school grounds and the area within an 800-m buffer around each school. School field areas at PLAN-A schools were approximately 9000 m² larger than school field areas at control schools. The area of school playground and field do not appear to align with the data on level of sports and play precision within each school. The length (9952.67 m vs. 6381.04 m) and density (3.56 km/km² vs. 2.39 km/km²) of footpaths within the buffer was greater in control schools than in the PLAN-A schools. The data align with the scores in Table 34 in which school 2 scored lowest on walking provision; Table 35 shows that there are no footpaths within its buffer area. The majority of schools have no cycle paths within their buffer area; however, it is important to note that data are not available for cycle lanes that are part of roads or pavements, which are more common in England than separate cycle lanes. Therefore, these data do not agree with the cycling provision data in Table 34. The size of grassland areas is greater at control schools than at PLAN-A schools, and urban and suburban areas are larger at PLAN-A schools than at control schools.

TABLE 35

Geographical and environmental description of each study school

Year group structure

All schools taking part in PLAN-A had a tutor system by which the year group was split in half. As such, girls in different halves of the year often were in different classes and did not interact. This influenced friendship groups, with girls often more likely to be friends with others in their half of the year:

Because we don’t see each other much, we’re never in any of the same lessons . . .

School 4, PS focus group

It also influenced peer nomination in some cases:

I’m on one side of the year so I chose the people who were on my side of the year that I knew were good at it but obviously I wouldn’t know the people on the other side of the year so I didn’t put [nominate] any of them.

School 3, NPS focus group

Awareness of and school-based support for the project

Awareness of PLAN-A was generally restricted to either the Year 8 students or the PE staff. In some schools, by focusing on PA promotion, PLAN-A was only considered important in the PE department. Among intervention schools, the level of priority depended on whether or not it fitted with the schools’ objectives and if it had the potential to be successful:

I don’t know about the school priorities, within the PE department it fits in very well with trying to promote PA . . .

School 4, school contact

The degree of support given by both school contacts and school leadership to the project was governed by contextual factors, such as changes in school senior management, work patterns of school contacts and teacher workload (data collection, accommodating the PS training and encouraging the PSs). In general, however, school contacts were helpful and facilitation of the study within schools was simple. In the school in which PS training was delivered in-school rather than off-site, there was a change in head teacher between initial school enrolment and intervention delivery:

The original head was really supportive towards it and I suppose the others have been – it’s not their thing – so it wasn’t a priority as such whereas [former head teacher] was very much keen to get involved.

School 4, school contact

School context summary

There were minimal variations between schools, as seen throughout the process evaluation. The majority of those that did exist (i.e. the behaviour issues in school 2 and poor PS engagement in school 6) could not be clearly linked to any school context factors. However, the year group structure can explain the barriers that some PSs experienced while trying to carry out their role as a PS. The split year group in most schools made it difficult for PSs to support girls outside the PS group and approach those in the other half of the year. Aside from this, evidence suggests that PLAN-A appears to be robust to a variety of contexts.

Parent understanding of and support for data linkage

The majority of parents understood the description of data linkage given; only a minority wanted additional information. All parents stated that they would be likely to consent to their daughter’s health and education data being used for data linkage, with some wanting to discuss it with their partner and/or seeking their daughter’s consent:

Yes [I would consent] if she wanted to do it.

School 4, parent

Parents supported data linkage as a contemporary and valuable scientific resource: ‘in this day and age it is something that needs to be done’ (school 4, parent), and commonly described their expectation that the process was secure and undertaken with appropriate governance so that data were ‘safe’ and ‘used positively’.

Most parents suggested that they would consent to data linkage studies until their daughter completed secondary or further education. Some parents would provide consent indefinitely, whereas others wanted to be able to review their consent in the future:

In principle, I would probably say until the end of school but it would be nice to be given the option on a yearly basis or whatever to change your mind, not that I probably would . . .

School 2, parent

Some parents suggested that the consent for data linkage should pass to their daughter either upon leaving school or at the age of 16 or 18 years:

I kind of think that then she’d be of an age, 18 [years], that, you know if you wanted to carry on it would be in her hands then. She’d be adult enough to say, ‘do you know what, now remove me’.

School 3, parent

Parents’ concerns

The majority of parents raised a range of concerns regarding anonymity, data security, potential negative effects of data linkage and who would have access to the data:

You know, where does that information go? Would it have her name, date of birth, etc.? So yes, I would want to know a lot more about it before I could be comfortable.

School 4, parent

I mean, because obviously of her age . . . it’s all secure isn’t it?

School 3, parent

I wouldn’t want to agree to something when she’s 12 years old that when she’s 30 years old might have a detrimental effect on her.

School 4, parent