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

让孩子多锻炼身体是很重要的。许多人目前没有做足够的运动来保护他们的健康。这导致肥胖问题日益严重。为了解决这些问题，英国肥胖战略提出了许多建议：一是小学参加每日一英里。这涉及到孩子们每天跑步或步行/慢跑15分钟，在学校，在这段时间里，大多数孩子的平均距离至少为一英里。这是一个受欢迎的计划，始于苏格兰，现在正在广泛推广，英格兰已经有750多所学校参加。每日一英里有许多潜在的健康益处。如果它增加了孩子们的体育活动，它可以改善他们的健康状况，并可能有助于保护他们在以后的生活中免受肥胖和其他健康问题的影响。身体上的好处也可以改善儿童在课堂上的注意力和行为。但也有一些潜在的负面影响。该计划可能会占用学校时间，使学生无法参加其他更有益的活动。它可能会让一些孩子在以后的几年里不做运动或其他活动。我们想了解更多关于每日一英里的所有可能的健康影响，以及（如果这些是积极的）它如何发挥最佳作用。它需要什么才能发挥作用？是什么阻止了它的工作？它对不同类型的孩子或学校有不同的影响吗？这些都是很难回答的问题，因为我们不能只比较参加过的孩子和没有参加过的孩子。选择参加的学校可能与不参加的学校不同，我们发现的健康差异可能反映了这一点，而不是每日一英里的影响。这是公共卫生研究中的一个常见问题。另一个问题是，政策制定者需要知道一个计划是否会在他们的领域发挥作用。学校希望了解成功的必要条件是什么，以及如何实施该计划以获得最大利益。我们的目标是研究《每日一英里》可能对儿童健康产生影响的所有可能方式。我们对肥胖特别感兴趣。所有儿童在5/6岁和10/11岁时都要称重和测量，因此我们可以比较参加和没有参加的学校随着时间的推移体重的差异。我们还想知道研究中可能包括哪些其他可能的结果，以及是否有关于这些结果的可用信息。最后，我们的目标是开发新的方法来使用实施案例研究。我们将详细介绍刘易舍姆，与儿童，教师，家长，负责人和公共卫生专家交谈，看看当学校决定参与每日一英里时会发生什么。这一点很重要，因为政策是在复杂多样的环境中制定的。我们需要更好地理解这些设置如何影响某件事是否有效，对谁有效，以及为什么有效。诸如谁决定学校将参加;它是什么样的学校;什么样的孩子在学校注册等问题可能会改变发生的事情。我们将使用这些信息来帮助我们了解每日一英里是否会对不同的孩子产生不同的影响-例如男孩和女孩，或者来自不同背景的孩子。在这项研究的最后，我们将有：1）每日英里的详细描述，使用公共卫生研究所使用的清单来描述干预措施; 2）每日英里所有可能的健康结果的完整地图; 3）可以在英格兰评估这些研究的计划。我们正在与那些对改善儿童健康感兴趣的合作伙伴合作，其中包括每日一英里基金会的同事，刘易舍姆的公共卫生专家，刘易舍姆和其他地区学校的教师，州长和家长，以及其他学术同事。这一伙伴关系将确保我们的调查结果进入下一阶段，这将是对每日一英里的国家评估。

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.