Could a parent funded, primary school based, child growth programme be sustainable in England?

Vince-Cain, Sarah (2023) Could a parent funded, primary school based, child growth programme be sustainable in England? Masters by Research thesis (MSc), Manchester Metropolitan University.

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Abstract

Introduction: A child’s growth pattern is a fundamental indicator of physical health and emotional wellbeing and yet, despite professional recommendations, there is currently no system in England that routinely monitors children’s growth from birth through to adolescence. Parents are unable to recognise growth concerns in their own children and the increasing rate of childhood obesity in England has shifted the norm so that visual comparison between children is ever less valid. The societal stigma that surrounds overweight in childhood has created a reluctance to raise visible growth concerns with parents. Aim: To measure the acceptability and feasibility of a parent funded, primary school based, child growth programme in England and to assess whether such a programme could have long term sustainability. Method: A mixed methods approach was adopted incorporating an electronic questionnaire completed by parents (study 1. n=110) whose children were linked with primary schools (n=62) with both higher free school meal (FSM) eligibility (n=22) and lower FSM eligibility (n=40). Furthermore, semi-structured interviews were conducted with primary school leadership of varying degrees of seniority (study 2. n=6). Both studies took place in Greater Manchester. Results: The findings from study 1. showed that that child growth monitoring in Early Years is perceived positively by parents. However, this positivity diminishes as children progress beyond primary school age, and as parents have experience of the National Child Measurement Programme (NCMP). Study 1. also showed that parents consider primary schools to be an appropriate setting for child measurement and that they appreciate the benefits of annual growth monitoring. The findings show the need for clear communication surrounding the relevance of growth information and the importance of acceptable feedback methods. Study 1. also found that parents value child measurement and growth feedback and are open to the idea of paying an affordable fee, with the preferred amount being £5.00 per year, irrespective of relative deprivation level. The findings from study 2. showed that school leadership also consider primary schools to be appropriate settings in which to measure children. The study found that school leaders place importance on communicating the benefits of child growth information effectively and on ensuring that feedback is presented in such a way as not to cause a negative response. Whilst school leaders are amenable to facilitating a parent funded programme, they expressed reservations regarding levels of parent engagement and regarding fee collection. Conclusion: This research offers a new perspective on monitoring child growth trajectories. It shows that parents place a personal financial value on receiving growth information and that a sustainable parent funded, primary school-based child growth programme is feasible. The research also highlights the crucial role political support plays in programme sustainability, alongside parent and school leadership support and engagement. Recommendations for practice include exploring and testing models to further ascertain concept feasibility. Recommendations for research include using the existing primary school based NCMP to test and evaluate novel parent feedback methods, including the integration of explanatory visual diagrams that offer a reduced reliance on language and that foster positive parental response.