The Daily Mile: Whole-school recommendations for implementation and sustainability. A mixed-methods study

Abstract

Regular physical activity (PA) during childhood is associated with a range of positive health outcomes and higher educational attainment. However, only 2.0% to 14.7% of girls and 9.5% to 34.1% of boys are meeting the current PA guidelines of 60 minutes of moderate to vigorous PA daily. Schools are targeted as a key setting to improve children's PA levels. The Daily Mile (TDM), a teacher-led 15 minute PA intervention was established in 2012 and has been widely adopted globally. However, the dynamic school environment generates challenges for school-based interventions to follow a uniform implementation method resulting in sustainability issues and limited evaluation. The aims of this mixed-methods study were to (1) explore whether whole-school experiences of TDM were related to implementation and (2) examine the association between TDM and CRF in children from high and low socioeconomic groups. Focus groups with pupils (n = 6) and interviews with teachers (n = 9) and headteachers (n = 2) were conducted to explore factors associated with successful implementation. Pupils (n = 258 imputed) aged 9-11 from six primary schools in south Wales, United Kingdom participated in CRF assessments (20m shuttle run test) at two timepoints (baseline, 6 month follow-up). Thematic analyses of qualitative measures and linear regression analyses of quantitative measures were used to assess the research questions. Qualitative findings identified implementation factors associated with a positive experience of TDM; flexible and adaptable, not replacing current play provision but delivered as an additional playtime, incorporate personal goal setting, teacher participation, whole-school delivery with community support. Both groups demonstrated equal increases in shuttles between baseline and follow-up (deprived: 4.7 ± 13.4, non-deprived: 4.8 ± 16.0). There was no significant difference in this increase for deprived compared to non-deprived children adjusted for age and gender. Findings from this study provide a set of recommendations for the future implementation and sustainability of TDM.

Sociodemographic profiles, educational attainment and physical activity associated with The Daily Mile™ registration in primary schools in England: a national cross-sectional linkage study

“…It appears to be a wide-reaching intervention reaching high-performing and low-performing primary schools alike and local authority areas with better and poorer health. If it can be assumed that the physical fitness benefits of TDM seen in small trials to date are sustainable, 14 15 17 then our findings that it is taken up by urban schools serving disadvantaged school populations suggest added value from TDM over other interventions, that when scaled have failed to reach populations of children most in need. 39…”

“…Further, a recent study of TDM in Wales showed similar benefits in fitness among children from both low and high socioeconomic groups. 15 …”

“…A recent study found that TDM increases cardiorespiratory fitness in children from both deprived and affluent backgrounds. 15 If TDM can improve cardiorespiratory fitness equally and be an accessible solution to reduce the growing inactivity in children, it is important to understand whether TDM is an equitable intervention reaching varied high-risk populations. We recommend further research to explain variation among local authority areas in registration to TDM.…”

“…11 These features could be a key to its success in implementation and explain why more complex school-based interventions have failed. 12 13 A growing evidence base suggests that TDM increases physical activity and fitness over the first 12 months of its adoption, 14 15 but evidence of its impact on educational performance, well-being or maintaining healthy weight is limited. 16 17…”

The Daily Mile Is Able to Improve Cardiorespiratory Fitness When Practiced Three Times a Week

“…Given the simple intervention characteristics (e.g., the short execution time and relatively low cost) and the flexible organization that supports the teacher's autonomy, The Daily Mile appears to be acceptable and feasible [18]. Teachers recognize the potential of such an intervention to improve cardiorespiratory fitness [19] and to reduce negative health consequences (such as childhood overweight) [17,20]. Moreover, The Daily Mile offers social time to facilitate/promote the relationships between peers and teachers [17,20] and supportive school climate [21].…”