Developing a theory of change, outcome measures and evaluation design for an evaluation of the impact of the Daily Mile on obesity and health

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Getting children to be more physically active is important. Many do not currently do enough exercise to protect their health. This contributes to the growing problem of obesity. To address these problems, the UK Obesity Strategy has many recommendations: one is that primary schools take part in The Daily Mile. This involves children running or walking/jogging for 15 minutes every day, in school, in which time most children will average at least one mile in distance. It is a popular scheme which started in Scotland and is now being rolled out widely, with over 750 schools in England already taking part. There are many potential health benefits from The Daily Mile. If it increases the physical activity children do, it improves their fitness and may help protect from obesity and other health problems in later life. The physical benefits may also improve children's concentration and behaviour in the classroom. However, there are also some potential negative effects. The scheme may take school time away from other, more beneficial, activities. It may put some children off doing sports or other activity in later years. We would like to understand more about all the possible health effects from the Daily Mile, and (if these are positive) how it works best. What is needed for it to work? What stops it working? Does it have different effects for different kinds of children or schools?These are difficult questions to answer because we cannot just compare children who have taken part with those who haven't. Schools that choose to take part are likely to be different from the ones that don't, and health differences we find may reflect this, not the effect of The Daily Mile. This is a common problem in public health research. An additional problem is that policy makers need to know whether a scheme will work in their area. Schools will want information on what the necessary conditions for success are, and how to implement the scheme to get the most benefit. We aim to look at all the possible ways that The Daily Mile might impact on children's health. We are particularly interested in obesity. All children are weighed and measured at age 5/6 and again at age 10/11, so we can compare differences in weights over time within schools which have and have not taken part. We also want to find out what other possible outcomes might be included in a study, and whether there is available information about these. Finally, we aim to develop new ways of using case studies of implementation. We will look in detail at Lewisham, talking to children, teachers, parents, heads, and public health specialists to look at what happens when a school decides to get involved in The Daily Mile. This is important because policies are taken up in complex, and varied, settings. We need to understand better how these settings affect whether something works, for whom, and why. Issues such as who decides the school will take part; what kind of school it is; what kinds of children are enrolled at the school might change what happens. We will use this information to help us understand whether The Daily Mile might have different effects for different children - such as for boys and girls, or those from different backgrounds. At the end of this study, we will have: 1) A detailed description of The Daily Mile, using a checklist used by public health researches to describe interventions; 2) A full map of all the possible health outcomes from The Daily Mile; 3) A plan for a study that can evaluate these across England. We are working in collaboration with partners who have an interest in what works to improve children's health.These include colleagues from The Daily Mile Foundation, public health specialists from Lewisham, teachers, governors and parents from schools in Lewisham and other areas, and other academic colleagues. This partnership will ensure that our findings are taken to the next stage, which will be a national evaluation of The Daily Mile.