Ambivalence and fluidity in the teenage smoking and quitting experience: Lessons from a qualitative study at an English secondary school

"As a Deputy Head in a large secondary school I was involved in taking part in a city wide health and wellbeing survey over a period of six years. Completing the survey every two years grew in importance year on year, with the final cycle having a major impact on our SDP, PHSE curriculum, Ofsted outcomes and governor understanding.
Over the six year period we moved from a small sample in two tutor groups filling in a paper survey to two year groups completing an online survey. The reports produced give graphical analysis of a wide range of issues. As a result of the survey we increased the number of PSHE workshop days for students to address issues such as smoking, drug and alcohol awareness, anti-bullying workshops. The surveys helped Governors make a positive informed decision to allow Brook Advisory Clinic nurses on site to support students.
As a result of taking part and using the evidence provided we were able to offer more support for students which had a direct impact on improved attendance and outcomes."

"The system works and I find quite a lot of it useful in my work. I've also recommended it to others."

"On behalf of all the health promoters in Scotland I would like to say a big thank to you and your colleagues for your excellent work over the years. This includes not only your survey work but your role as a visiting examiner in Scotland and adviser on course development."
Tribute from a Health Commissioner to John Balding, presented at his retirement lunch, May 2005

"You and the team have the evidence to show how young people's behaviour has or hasn't changed over time." 
Tribute from a Health Education Co-ordinator to John Balding, presented at his retirement lunch, May 2005

"I have never looked at myself in this way before." Pupil

"The data from last time were spot-on and we have done lots of work with it. We are very keen to repeat the survey." Headteacher

"I really appreciate the professional service which SHEU offers.  We have had a great experience working with Angela on the school surveys." 

"I would like to say that this survey was very useful and made me realise things about PE and health that I had never realised before......Food at school is groovy, especially if your school does Jamie Olivers School Dinners. Viva apples and thanks for the survey." Female pupil, 13 yrs old

"The data for (us) are very useful ... This is especially important when evaluating the impact of interventions regarding alcohol or other areas, as the survey data are likely to provide an earlier indication than routine data sources."

"I have valued greatly the work I have done with the team in Exeter, it has been a highlight of my years here." Health Promotion Specialist

"The children found the survey very interesting and enjoyed doing it." Class Teacher

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        
 

"The (named) Children and Young People's Partnership has benefitted from the results of the SHEU survey locally for many years now, and we should like to continue to do so in future."

 “The (SHEU survey) helped us to prioritise where we needed to be in terms of PSHE education. We delivered assemblies based on the evidence as well as curriculum development, and dealt with whole school issues – particularly in regard to pastoral care. The answers received to the question on the survey “Who are you most likely to approach if you needed help” worried staff as “teacher” was not a popular answer. Subsequently the staff asked themselves why this had happened and what needed to be done to address the issue. There was more emphasis on wider aspects of PSHE education delivery, which needed more attention.

To summarise, the (SHEU survey) allows the PSHE department to assess the impact of teaching and learning and modify future lessons accordingly. It allows our school to look at whole school issues such as the extent to which the pastoral care system is meeting the needs of our pupils. It helps us to do need analysis of our pupils. It helps to provide important evidence for SEF / the extent to which we are meeting wellbeing indicators / National Healthy School standards.”  

Any comments on specific survey questions that may have caused difficulty? No problems. My children were fully briefed before the survey and they understood that they could miss questions if they did not want to answer them. We did not have any children with any concerns regarding the survey at all.

Any comments on the use of the web site? No it was easy to use.

Any general comments on the exercise? The children really enjoyed completing the survey, It has lead to many positive discussions about our health and how we all have slightly different experiences and home lives.

"We use the data to inform whole school practice: Pastoral programmes for target groups of pupils; Items for discussion with School Council; Information to help us achieve the Healthy School gold standard; To develop and dicuss with pupils our Anti-Bullying Policy; Targeted whole class sessions with the Police Community Support Officers; To share pupil perceptions of all aspects of their school life with parents, staff and governers." 

Thank you for doing this project. We really have been wondering how best to collect pupil voice and this gives such a good overview for us and what we need to do going forwards. This data will really support us with our planning for mental health and wellbeing and what actions are needed for our school.

"The Unit is to be congratulated in preparing ... material of the highest standard and worthy of wide dissemination." National Association for Environmental Education

(Our) Senior team were very enthused with the rich source of data provided within the reports (and thought that the analyses including within the appendices section of the main reports were really interesting).

"We would like to take part in the next ECM survey. We have found the data produced invaluable for supporting evidence in our SEF etc."

"We have never consulted our young people like this before. The survey makes a great contribution to our 'best value' planning." Sports Development Officer

"Thank you from my staff to you and all your staff. The speed of 'turn-around' of the questionnaires is outstanding in anyone's terms." Headteacher

"Your work in developing the Health Related Behaviour Survey was ground breaking and has continued to evolve." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"Many thanks for all of the fantastic information that you have sent to me over the years, it has really helped me to plan relevant courses for my students to follow and to help me to focus on the needs of the students I teach."

"Thanks for presenting the survey to local schools this morning, I just wanted to thank you for such interesting and thought-provoking information.  
I’m really glad we were able to take part - the information (particularly headline data and differences) will support us to have some really interesting questions with the Year group as a whole about the sense they’re making of this; what they think it might mean in terms of changes they might make, and what they need to support them in this."

"You have made a fantastic contribution to children’s health education and promotion. I am personally grateful to you for helping to kickstart my research career." Prof. Neil Armstrong tribute to John Balding, presented at his retirement lunch, May 2005

Thank you for following up with schools the comments that caused concern. It is very sad to hear that some of our children have these thoughts and feelings and I am so grateful that you were able to make the schools aware of this so that they can attempt to offer some support.

This is another reason why I am so pleased that we have been able to work with you to offer this survey.

"Many thanks for a major contribution to the health of children in the UK and elsewhere over many years and putting in place the continuation of the Unit." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Any comments on specific survey questions that may have caused difficulty?
All questions are clearly worded and easy to answer

"The Schools Health Education Unit has been a unique inspiration to all of us. For me, as I have worked in the many different areas of the NHS, the SHEU, its principles and your determination have always been a cornerstone in what a health promoting service should be about."
PCT Performance Manager paying tribute to John Balding, presented at his retirement lunch, May 2005

"We never make a move without looking at these excellent reports." Public Health Consultant