The Saxton Fellowship 2017-2020

The Institute of Health Research at the University of Exeter Medical School has a long and established record of work on evidence analysis and development of complex behavioural change interventions to support healthy lifestyles. Their work has shown no link between the primary school built environment and childhood overweight and obesity, nor a link between primary school diet and physical activity policies and childhood overweight and obesity, and attention has now been directed at older age groups.

This Saxton fellowship was awarded to Camilla McHugh at the University of Exeter Medical School to explore the enablers and barriers of embedding a healthy school culture in order to co-create and evaluate a series of processes and activities to positively impact the diet and physical activity choices of adolescents in secondary school. Previous work completed by Camilla and funded by ASET explored what adolescents felt were the main enablers and barriers for them to make a healthy choice; adolescents identified that there was more schools could do to educate and support them in making healthy diet and physical activity choices; see the results here:

The fellowship took place over three years and was organised into four phases.

The ASET fellowship team

The ASET fellowship team: Katrina Wyatt, Camilla McHugh, Anthony Leeds (ASET Trustee) and Jenny Lloyd.

The fellowship phases of work:

Phase one: aimed to understand the evidence for taking a whole school approach to health promotion and systematically reviewed the effectiveness of the World Health Organisation Health Promoting Schools framework on the diet and physical activity behaviours of pupils (11-18 years) attending secondary schools. This review found limited use of this approach in secondary schools with some evidence for restricting unhealthy choices rather than encouraging healthy options in supporting health dietary behaviours. Results of this work can be found here:

Phase two: aimed to understand and explore the main barriers schools faced in implementing a whole school approach to address lifestyle behaviours to adolescents. The work involved interviews of secondary school heads and staff; observing food provision and surveying parent's views of their child's school health promotion culture. The results demonstrated a lack of policy support in this area with schools identifying barriers to developing such a culture whilst recognising that it was an important role for schools. The results of this work has been submitted for publication.

Phase three: aimed to develop with schools a programme of processes and activities to support a health promoting school culture. This set of processes aimed to be flexible to fit each individual school context. See below:

Health Promoting School Process

Phase four: aimed to assess proof of concept of the programme and the feasibility and acceptability of the processes and activities in changing diet and/or physical activity behaviours and school ethos. Taking into account the barriers in school identified in phase 2, Camilla is working closely with two schools in low socio-economic areas to support and evaluate implementation of the process. This work is ongoing and once completed the results will be written up for publication. See more information here:

Young Person's Advisory Group

In addition to the publications reporting the study results a lasting legacy of the Fellowship is the establishment of a Young Person's Advisory Group that has been set up by Camilla and colleagues to give young people a voice in the child health research conducted by the Medical school. Learn more here:

Young Person's Advisory Group Young Person's Advisory Group

Characterised by innovation in research, successful publication of research findings and evidence for community engagement on a topic of great public health importance, this fifth Saxton Fellowship has met the All Saints Educational Trust expectations that grant-support should help make a lasting improvement to the welfare and future prospects of individuals and communities.