Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework

Abstract

Background UK and global policies recommend whole-school approaches to improve childrens’ inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective and sustainable interventions which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure ‘systems’ change, a framework is required that identifies the many components of a whole-school PA approach. The aim of this paper was to co-develop a whole-school PA framework using the double diamond design approach (DDDA); a four-stage reflective process to discover, define, develop, and deliver an innovative solution to a problem. Framework development process Fifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n=9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n=6) stakeholder groupings. Six draft frameworks were created before stakeholders selected one ‘initial’ framework through an individual voting process. Next, stakeholders reviewed the ‘initial’ framework, proposing modifications. Following the workshop, the original stakeholders voted on eight proposed modifications using an online questionnaire. Following voting, the final Creating Active Schools (CAS) Framework was designed. Summary To the authors knowledge, this is the first time practitioners, policy makers and researchers who understand the powerful driving agents of school systems and teacher and pupil PA behaviour, have co-designed a whole-school PA framework from initial conception. The novelty of the CAS framework resides in formally identifying the multitude of interconnecting elements of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The CAS framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, the CAS framework presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives ‘with’ schools, while abandoning outdated traditional approaches of implementing interventions ‘on’ schools.

Sustainable school‐improvement in complex adaptive systems: A scoping review

“…Two of the reviewed papers were longitudinally designed experimental studies (Bartelink et al ., 2019a; Bartelink et al ., 2019b) with both originating from the Healthy Primary School of the Future (HPSF) project in the Netherlands. One reviewed paper used an iterative experience‐based co‐production study design to develop a framework for sustaining physical activity initiatives in UK schools (Daly‐Smith et al ., 2020). Nine of the reviewed papers from the UK, Netherlands, Canada, Australia, South Africa and the US reported on health and wellbeing initiatives (Table 1); two from the US on special education initiatives (Bal et al ., 2014; Bal et al ., 2016); two from the US and Brazil on teaching methods initiatives (Magalhães de Barros et al ., 2017; Minnema et al ., 2006); one on an international professional development initiative involving schools in Canada, Hong Kong and Spain (Laferrière et al ., 2012); one from the US on an educational change initiative (Mason, 2008) and one from South Africa on a technology integration initiative (Thomas & Cronje, 2007).…”

“…As evident from Table 3, the most frequent terms were ‘ dynamic ’ (15/16) and ‘ inter‐dependent ’ (15/16). Alternate terms were ‘ non‐static ’ (Thomas & Cronje, 2007); ‘ changing ’ (Bartelink et al ., 2019b; Bisset & Potvin, 2007; Daly‐Smith et al ., 2020; Keshavarz et al ., 2010; Laferrière et al ., 2012; Rosas, 2017); ‘ evolving ’ (Bisset & Potvin, 2007; Daly‐Smith et al ., 2020; Preiser et al ., 2014); and ‘ transformational ’ (Bal et al ., 2014; Bal et al ., 2016; Magalhães de Barros et al ., 2017; Mason, 2008). These terms describe the changing nature of schools.…”

“…Authors who used these terms described sustainability as a continuous systemic improvement and capacity building process that triggers a continuous cycle of change and adaptations (Bal et al ., 2014; Keshavarz et al ., 2010). This then becomes a part of the dynamics of the school system where desired emergent products such as healthy behaviours (Bartelink et al ., 2019a; Bartelink et al ., 2019b; Daly‐Smith et al ., 2020) and knowledge building (Laferrière et al ., 2012) are embedded into the school system. Describing sustainability in this manner sees a shift from a centralised‐controlled school system to an emergent‐controlled school system which is responsive to feedback from agents in the school system (Magalhães de Barros et al ., 2017).…”

“…From a CAS perspective, there is a strong emphasis in viewing schools as dynamic and evolving social systems that consist of inter‐dependent interactions between agents in schools (Bal et al ., 2014; Bartelink et al ., 2019b; Bisset & Potvin, 2007; Butler et al ., 2010; Murphy et al ., 2018; Preiser et al ., 2014). The foci of most of the articles in our scoping review were on the changing nature of relationships between agents in schools which led to co‐learning (Magalhães de Barros et al ., 2017), co‐production (Daly‐Smith et al ., 2020), adaptability (Bartelink et al ., 2019a), complexity (Preiser et al ., 2014) and sustainability (Laferrière et al ., 2012). Because each school acts in a unique way and reacts differently to changes, context is important when implementing and sustaining initiatives in schools (Bartelink et al ., 2019a; Keshavarz et al ., 2010; Mason, 2008; Rosas, 2017).…”

“…This concept does not give preference to players in social power hierarchies nor the direction from which change comes. This was evident in the literature we reviewed where authors noted that sustaining improvement initiatives in schools required the combined bottom‐up, top‐down and lateral involvement and support of all agents in schools and their related sub and supra systems (Bartelink et al ., 2019a; Daly‐Smith et al ., 2020; Laferrière et al ., 2012). In other words, change from all directions and at all levels is needed to sustain improvement initiatives in schools.…”