School Health

Current research

The WISE Project (Wellbeing in Secondary Education)

WISE logo

The overall aim of this full-scale study is to evaluate the effectiveness and cost effectiveness of the WISE intervention that provides peer support for secondary school teachers, and teacher training in mental health first aid.

The study will address the following questions:

  1. Does the WISE intervention lead to lower levels of teacher depression, absence and presenteeism, improved student wellbeing, attendance and attainment, and reduce student mental health difficulties compared to usual practice?
  2. Do any effects of the intervention differ according to the proportion of children receiving free school meals (FSM – an indicator of the socioeconomic catchment area) and geographical area, or individual level baseline mental health, gender, ethnicity and FSM?
  3. What is the cost of the WISE intervention, and is it justified by improvements to teacher and student wellbeing and reductions to teacher depression and student difficulties?
  4. Does the WISE intervention work according to the mechanisms of change hypothesised in the logic model?
  5. Is the WISE intervention sustainable?


The study is funded by the National Institute for Health Research Public Health Research Programme, NIHR PHR (project number 13/153/39). The intervention is funded by Bristol City Council, Public Health England and Public Health Wales.


The study started in the summer of 2016 with the collection of baseline data.  The training and support intervention began in the Autumn term 2016. The study will end in June 2018 with the final data collection. Results will be available in 2019.

The findings of the WISE pilot study were positive. Further details are available here on the NIHR SPHR website.


A new school-based digital intervention to prevent harmful alcohol use among young people

This research uses qualitative research to develop a novel internet-based intervention to prevent alcohol use and related harms, which will be embedded within the Personal, Social, Health and Economic (PSHE) curriculum for Year 9 students - age 13-14 years - within secondary schools.

The project is known as REACH Online (Reducing Excessive Alcohol Consumption and Harm). Qualitative research is being conducted with young people, teachers and professional experts to explore views and perspectives around the content and design of the intervention; alongside mapping of existing evidence and literature regarding behaviour change.

Young people advisory groups will be consulted to inform the design and optimisation of the internet-based intervention.

The NIHR School for Public Health Research project began on 1st January 2018, and is headed by Dr Georgie MacArthur. Further details are available here on the NIHR SPHR website.

Engaging with academies and free schools to enable school-based health promotion

Professor Rona Campbell and Professor Russ Jago are heading a NIHR School for Public Health Research project to scope out how we could work with academy chains of schools to help them achieve their educational goals and at the same time achieve improvements in the health of their students and staff.

Health and wellbeing of students are important to schools, and schools are a key setting for promoting the health of children, young people and the staff that work there. Academy school chains and free school groups are unique in that the schools within them have comparable structures and often share timetables, resources, and training. Such organisational structures could facilitate wide-scale implementation and evaluation of health improvement programmes in schools. However, as public health experts we currently lack experience and knowledge of how to work effectively with academy chains and groups of free schools.

The study began in February 2018.  It aims to understand how we could best work with school academy chains to help them with assessing the health and wellbeing needs of their students and staff, and implementing and evaluating the impact of evidence-based interventions. Further details are available here on the NIHR SPHR website.

Further details are available here on the NIHR SPHR website.

The Bristol Standard for Health

Bristol City Council has created a new "Bristol Standard for Health" (BSH) to supplement an existing educational quality improvement programme, called the Bristol Standard. The BSH is a self-evaluation framework for Early Years Settings (e.g. nurseries, children's centres, childminders) to support them to make changes regarding their policies and practice across 10 health priorities. Researchers from the Centre for Public Health (PI: Ruth Kipping) are working with colleagues from Bristol City Council and UWE on a study which aims to explore the acceptability and feasibility of the BSH as it is tested in early years settings in Bristol.


Completed research

Implementation of health promotion in schools

Bristol researchers were involved in a year-long review of the evidence on successful implementation of health promotion in UK schools. The review took place from 2012 to 2013, and led to an NIHR Dissemination 'Signal'. Further details are available here on the NIHR SPHR website.

A Cluster Randomised Controlled Trial to Test the Effectiveness of an Educational Hand Washing Intervention (Hands up for Max!) in reducing absenteeism in primary schools


To help teach and promote hand washing in primary schools the Health Protection Agency, in collaboration with schools, developed 'Hands Up for Max!', a hand washing resource pack, designed to teach children how to wash their hands and encourage them to do so.

In 2009, the Health Protection Agency, Healthy Schools, and the University of Bristol set out to evaluate the effectiveness of the Hands Up for Max! resource in reducing absenteeism in primary schools due to common infectious illnesses. 178 schools in the area of Bristol, BANES, North Somerset, South Gloucestershire, Swindon, and Wiltshire agreed to take part in the study. Of the 178 schools, 23 schools took part in collecting additional data about pupil and staff absences and completed questionnaires about hand washing.

The trial was funded by the National Institute for Health Research (NIHR), Research for Patient Benefit (RfPB) programme, and was a collaboration between the Health Protection Agency and the University of Bristol.

It ran from September 2009 to August 2011. 

A process evaluation was also conducted on the factors influencing hand washing behaviour in primary schools, and another on the acceptability of the intervention.


Bristol Girls Dance Project: A cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11-12 year old girls

Many children do not do enough physical activity. Girls are less active than boys. Getting low-active girls to do more physical activity would improve their hearts, lungs, and mental well-being. There is a lack of studies that focus on ways to help girls to be physically active. Dance is an activity that appeals to many girls and could engage low-active girls in physical activity. A feasibility study led by Professor Russ Jago found that it is possible to recruit 11–12 year old girls to participate in an after-school dance study, and that an after-school dance intervention has potential to positively affect the PA levels of 11–12 year old girls.

The Bristol Girls Dance Project aimed to find out if dance is a good way to get Year 7 (11-12 year old) girls more physically active in the longer term. During the first half of 2014, Active7 provided free after-school dance sessions for Year 7 girls in nine schools in the greater Bristol area. Around 600 Year 7 girls in 18 secondary schools in the greater Bristol area volunteered to take part in the research.

This project was funded by the National Institute for Health Research Public Health Research programme (project number 11/3050/01).

Health and education in secondary schools: Teachers’ perspectives

Investigating issues highlighted during our Cochrane systematic review into the WHO’s Health Promoting Schools review, Beki Langford and Jonny Currie led a piece of qualitative research conducted with secondary school teachers in the South West of England. The study aimed to investigate teachers’ views on the following questions:

  1. What are the main health and well-being issues in secondary students?
  2. How do these health and well-being issues affect students’ ability to learn
  3. How are health and well-being are promoted in schools

The WHO Health Promoting School Framework for Improving the Health and Well-being of Students and Staff

Beki Langford is led a Cochrane systematic review to assess the effectiveness of the World Health Organization's Health Promoting Schools (HPS) framework in improving health, well-being and academic achievement. The review focused on cluster randomised controlled trials of the HPS framework that target children and young people aged between 4-18 years attending school/college. Primary outcomes included student health and well-being and academic achievement. Secondary outcomes focused on attendance, process outcomes and intervention costs.

This work is a collaboration between the University of BristolCardiff UniversityUniversity of OxfordUniversity of Melbourne and University of Florida.  The full review can be downloaded from the Cochrane library.

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