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About the iMprOVE Study
About the iMprOVE Study
School based physical interventions are much needed to encourage children to be active throughout the school day in addition to curricular Physical Education (PE) lessons. Many schools have led active mile initiatives such as The Daily Mile™ or encourage active travel such as ‘Walking School Bus’. However, it has been hard to know which interventions are the most beneficial to children’s health, partly because different studies have assessed different aspects of health.
In summer 2021, a study team from the Child Population Health theme invited over 60 health professionals and researchers, educators, parents, and children themselves to help decide which health outcomes were the most important to measure. After extensive consultation to rank the most important measures in Delphi surveys there was agreement on fourteen core outcomes that should be measured that included childrens’ physical, social and emotional health, and educational performance.
Next steps were to find out how many schools were taking part in The Daily Mile™. The researchers surveyed 369 Greater London primary schools spanning every borough found that more than half reported that they were doing the Daily Mile™ and, although none of them followed the programme perfectly, a third reported sticking to 6 or more of its core principles while keeping the focus on what was practical and sustainable such as keeping it simple and fun to do. This was much higher than expected. The study team have previously reported that one in five state-funded primary schools in England have registered to do The Daily Mile™, and schools in urban areas with a higher proportion of disadvantaged pupils are more likely to register.
Using these co-produced core outcomes the research team was able to launch the iMprOVE cohort study in 2021 to investigate physical activity, mental health and wellbeing, and educational attainment of children in primary schools that take part in active mile initiatives, such as The Daily Mile™, compared with children in schools that do not.
Design and methods
Design and methods
The study is a quasi-experimental cohort study in Greater London. Physical activity is being measured using wrist-worn accelerometers to measure mean minutes of daily physical activity, and validated questionnaires are assessing mental health and educational attainment of the child.
Just over 1000 children were recruited and assessed in schools across Greater London between 2021 and 2023. The data is now being analysed. The study team hope to follow-up the children (now in Year 3) to assess changes in the outcomes.
Why is it important?
Why is it important?
Active mile initiatives, such as The Daily Mile™, are promoted in the UK’s Obesity Prevention Plan. They are designed to allow primary school children to achieve 30 minutes of physical activity during the school day, helping to meet the physical activity recommendations of at least 60 minutes of activity. However, less than half of children in England are meeting these targets, and particularly those in disadvantaged primary school populations in urban settings like London where physical activity is low, and has fallen off during the recent pandemic.
The Daily Mile™, targeted at the whole school, involves every child running or jogging for 15 minutes at least three times a week. A growing evidence base suggests short-term benefits of The Daily Mile (of up to a year) on children’s fitness. However, there is limited evidence of the impact on children’s mental health and educational attainment and its sustainability throughout primary school.
What does this mean for public health professionals?
What does this mean for public health professionals?
Findings from the iMprOVE cohort study will add to the evidence for public health policy makers about the long-term health benefits and sustainability of The Daily Mile™, which alongside other active mile initiatives is widely promoted in the UK’s Childhood Obesity Plan and Sport England’s guidance. The study will inform national strategies to address child health inequalities and may have direct effects if the findings can identify schools in areas needing more investment for implementation of this intervention.
The core outcome set jointly produced with London school communities was published in the BMJ Open and will help future research. Standardising the outcomes will allow the results of different studies to be combined to make it easier to compare school-based physical activity interventions.
What does this mean for the public?
What does this mean for the public?
Learning together
Learning together
Involving schools, children and their families allowed everyone to have a say in measuring what matters to them. The children enjoyed being our citizen scientists and learnt about the beneficial effects of being physically active outside of their PE lessons. The study team is especially grateful to parents who have been supportive of their child taking part.
Teachers and sports coordinators have come together with researchers across the UK and Europe in a joint working group that regularly supports schools seeking information about evidence and how to adopt The Daily Mile™. The study team has designed and jointly produced study materials for iMprOVE by consulting with teachers, parents and children and will continue to disseminate and exchange knowledge and provide opportunities for them to engage with the research.
If the cohort study shows health and educational benefits by doing The Daily Mile™, teachers may be encouraged to support this initiative or other similar active mile initiatives in schools where it is already being done and may also encourage otherschools to take it up. iMprOVE will result in raised awareness of potential benefits of physical activity and may encourage parents and children to be more physically active.
How did we involve people?
How did we involve people?
The iMprOVE study team have worked with professional and public stakeholders throughout the design stages of the study and will continue to consult with them for the duration of the study. The Daily Mile™ Research Advisory Group is a forum for knowledge exchange that meets termly and includes representatives from The Daily Mile Foundation, Sport England, London Marathon and London Sport and schools.
How can you stay updated?
How can you stay updated?
Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. The team will work with policy makers for direct application and impact of the findings.
Learn More
Learn More
Learn more about The Daily Mile™, our real-world application of a scalable school-based physical activity intervention, in our recently published cross-sectional survey of the implementation of The Daily Mile™ in Greater London primary schools.
Publications
Publications
Ram B, Foley KA, van Sluijs E, et al. Developing a core outcome set for physical activity interventions in primary schools: a modified-Delphi study. BMJ Open 2022;12:e061335. doi: 10.1136/bmjopen-2022-061335
Foley KA, Venkatraman T, Ram B, et al. Protocol for developing a core outcome set for evaluating school-based physical activity interventions in primary schools. 2019. BMJ Open. 9 (12).
Ram B, Venkatraman T, and Saxena S (2019). A systematic review of primary school-based physical activity interventions to determine a core outcome set of child health outcomes and measurement tools. PROSPERO: International prospective register of systematic reviews CRD42019146621.
Venkatraman T, Honeyford K, Costelloe C, et al. Sociodemographic profiles, educational attainment and physical activity associated with The Daily Mile registration in primary schools in England: a national cross-sectional linkage study. 2020. Journal of Epidemiology and Community Health.
Resources
Resources
Research Briefing: Adherence to The Daily Mile’s ten core principles
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