Impact case study database

Providing a Resource for Staff in Secondary Schools to Help Support the Wellbeing of Students Preparing for their GCSEs (2018 onwards)

Approximately 580,000 students take GCSE examinations each year. Putwain’s research shows approximately 1 in 10 male, and 1 in 5 female, students report a level of exam anxiety that presents significant risk to achievement and mental health. Although schools support students in a variety of ad-hoc ways there is a high perceived need for additional evidence-based resources targeted specifically for exam anxiety. In response to these concerns a resource pack, drawing on key research findings from Putwain’s research (e.g., how students can learn effective emotion regulation strategies to manage anxiety) was developed for schools that comprised of a poster outlining key issues, an assembly presentation with accompanying notes, a student guide on effective coping with exam pressure, and a staff guide for effective student support [A].

The resource pack was distributed in 2018 to 200 LJMU partnership secondary schools based in the Liverpool City Region and the wider North West with a reach of approximately 30,000 students per a single year, 10 Educational Psychology services, who support secondary schools, based in the North West and South West regions of England. A follow-up survey [B] showed materials used in a variety of intended ways (e.g., school assembly, personal social and health education lessons, distributing student guides in form time, and so on). Responders indicated that the materials had proved helpful in supporting students, for instance, "[the materials] Helped to instigate conversations and allowed pupils to understand that stress is a normal response", "Pupils took more care over emotions", and "...students found the resources useful".

The (English) Department of Education has endorsed the student guide and made it available through the Office of Qualifications and Examinations Regulation website from March 2019 onwards [C] and referenced in a House of Commons debate on 7th May 2019 [D]. The student guide was viewed 135,824‬ times on the Ofqual Twitter feed, and was downloaded 51,322‬ times from the Ofqual Facebook page and 9,770 times directly from the Ofqual webpage, over the summer 2019 examination season [E]. Total downloads were 196,916. A second round of distribution planned for the 2020 GCSE and A Level examinations was cancelled due to the disruption resulting from the Covid virus.

Contributing to BBC Mindset Bitesize Campaign to Support Secondary School Students Preparing for their GCSEs 2017-2018

The BBC Mindset Campaign comprised of twelve short films using peer-to-peer coaching. Each film focused on a key aspect of effective coping with exam pressures and was accompanied with links to online resources. Putwain developed the themes for each of the films based on findings arising from his research, advised on the editing on the films to ensure that key messages were clearly delivered, and provided the on-screen text to accompany the films [F].

The BBC surveyed 992 students across 2017 and 2018 on the GCSE results day to gauge their experiences of using the Mindset resources [G]. 68% of students reported that Mindset resources helped them to feel more mentally prepared for their GCSEs, 63% reported it helped them to feel calmer about taking their exams, 68% helped them to revise better, 67% reported it helped them to feel supported, and 70% reported helped them to perform their best. Students commented that "It’s really reassuring for students who find it [doing GCSEs] stressful", "It made me feel as if I was not alone", "It’s useful to know how others felt in the situation you were in", and "It was reassuring having the Mindset and it did set my mind at rest during an awful time".

Using Cognitive-Behavioural Intervention with Secondary School Students Preparing for their GCSE Examinations to Reduce Exam-Related Anxiety

The intervention (STEPS) comprises of six sessions, each lasting approximately 45 minutes, delivered to a group of 6-8 students, by a trained facilitator. Each session had a specific focus that utilised findings from Putwain’s research (see outputs 2, 3, and 4, listed in section 3) to help students to effectively manage their anxiety. Session 1, for example, focused on understanding the signs of high exam anxiety and their triggers. Session 2 focused on effective emotion regulation, and so on. It has been delivered to nine LJMU partnership secondary schools from 2017 – 2020. Anonymous feedback was collected from 142 students and compiled into short reports for schools [H]. 63% of students reported feeling in a better position to control their anxiety before and during their GCSE examinations, 61% reported feeling better able to cope with the pressures of taking GCSE examinations, and that 86% students reported they had learnt useful methods of controlling anxiety that can be implemented during GCSE examinations. Comments from students included "the techniques helped me to achieve calmness", "it helped me to understand the reasons why I panic and how to overcome it", "it helped me to overcome my anxiety", and "I learnt lots of relaxation techniques and that its okay to panic as long as I can deal with it".

In 2019-20 short anonymous first hand narratives were collected from 17 students after they had completed STEPS [I]. In these narratives students described the benefits they had taken from the STEPS programme including feeling more confident about exams and being able to manage anxiety more effectively. A selection of comments to illustrate these benefits included the following: “I liked learning about the visualisation techniques as they can help me when I’m in an exam and I’m panicking. I can imagine myself after the exams and being relieved which would help calm me down”, “The STEPS programme has helped me to deal with my stress and has given me tips to encourage me to revise. I’m feeling really confident in myself”, “The STEPS course was helpful in stressful situations such as the breathing techniques when I get worked up and have NATS [negative automatic thoughts]. It helped me to calm down and relax thinking more realistically/ positively about everything in the situation, allowing me to take a break and then finish the work”, “Before STEPS I was nervous about my exams and didn’t know many revision techniques. After STEPS I feel like I know how to revise. I feel like I know relaxation techniques so when I’m stressed I can pause and sort it out” and “Before I was not confident in myself and let my struggles around mocks get the better of me. Now I feel like I can go into an exam stress free as I understand that I can only do the best I possibly can”.

STEPS is used by Hounslow Child and Adolescent Mental Health who conducted an independent evaluation in 2017-18. Feedback collected from 35 students from four secondary schools showed that 82% of students found the intervention either ‘helpful’ or ‘very helpful’ and exam anxiety reduced on average by 17.5% [J]. When asked what the best thing about the intervention was, students replied with comments like “It helped me in preparation for GCSEs; how to relax and feel less stressed going in [to an exam]”, “helped me to understand the reasons why I panic and how to overcome it”, and “being able to talk about anxiety, especially when you can’t tell anyone”.

There have also been two randomised-control trials of STEPS published in peer-reviewed journals (outputs 5 and 6 listed in section 3). The first, conducted with 56 students from two secondary schools, one from London and one from Liverpool, over 2016-17, showed moderate to large statistically significant reductions in examination anxiety (ds = .76 – 1.14) following intervention. The second, conducted with 146 students from eight secondary schools located in London and Liverpool, over 2018-19, showed a large reduction in test anxiety (d = .86) following intervention.

The research led to three core impacts.

1. Enhancing Sport England’s organisational learning, and national strategy and policy development

The research and the associated knowledge of behaviour change, which included the TTM [R1], was a key foundational contribution to building Sport England’s capability of applying theoretical models into their applied activities and practices. For example ‘This Girl Can’. This is corroborated by Sport England’s Head of Research:

“I don’t think we were working with any kind of behavioural models at all before that. …in those early years it wasn’t a regular part of conversation, internally and that has definitely changed, over these last 10 years and I think, I Will If You Will was an early example of us … introducing that into the work and … it is now much more widespread and common, as a discussion across all of the work that we do … I Will If You Will was … a relatively early attempt to do that, to put that type of thinking, very much in the heart of the development of the project and certainly ‘This Girl Can’ … informing every decision we made about the design and implementation of the campaign” [E1].

This is further demonstrated through the inclusion of the TTM as a framework for the Sport England strategy: Towards an Active Nation (2016-2021) [E1]. Evidence of how the research findings demonstrate our role in educating Sport England on the TTM, are also corroborated with other contributions made during different implementation phases of IWIYW [E2]. This collectively shows how our work has informed Sport England in adopting a systematic approach in the application of the TTM of behaviour change in their strategic activities [E3]. This result is further corroborated by Sport England’s Head of Research [E1].

“One of the things that struck me, when I was looking back, that was reflected in your work … was an attempt to more systematically apply behavioural understanding into the design and delivery of opportunities…so I suppose by that I mean the stages of change, the processes of change … but certainly that attempt to work in that systematic way and some of the learning about what was and wasn’t effective, I think did inform, This Girl Can, which similarly attempted to apply that type of behavioural understanding, into the design of the campaign and some of the associated activities.”

More recently, Sport England have indicated in their strategy (2021-2031) ‘Uniting the Movement’ that they will ‘continue to develop and deliver behavioural campaigns, building on the success of This Girl Can’ and other targeted campaigns.

2. Informing the development of national educational resource guidance for increasing women’s participation in sport and physical activity

Our research findings have contributed to a number of national educational guidance resources which are utilised by Sport England’s key partners and all organisations in the sector who want to engage women and girls such as National Governing Bodies of Sport and County Sport Partnerships across England. To increase women and girls (14+) participation in sport and physical activity nationally, the creation of a ‘toolkit’ of learning that could be replicated elsewhere to create, promote and support sports opportunities and activities, was developed based on key learnings from the ‘IWIYW’ evaluation (The ‘IWIYW’ evaluation is listed as a contribution source in this toolkit (page 49) [E4]. This toolkit supported the roll out of ‘This Girl Can’ across England. This was corroborated below:

“So I think …all of … our experiences with I Will If You Will informed the subsequent decisions we made around This Girl Can.  One of the kind of specific ways that happened was … I don’t know if you ever saw this, … but we produced … a compilation of some of I Will If You Will, this advice pack called ‘Go Where Women Are’ [a learning tool kit]” (Head of Research, Sport England) [E1].

The learning toolkit resource, which 13,000 national partners have signed up to use [E3], explores current understanding of women, their relevant motivations, barriers and triggers to getting more active, and what this means for sports and exercise activities and initiatives. The toolkit has also been cited in Public Health England’s evidenced-based guidance for commissioners understanding and addressing inequalities in physical activity (2021). [E5]

Following the development of Sport England’s ‘Go Where Women are’ insight pack, Sport England subsequently developed ‘Helping Women and Girls to Get Active: A Practical Guide’ to support organisations in practical implementation strategies. Our research findings were part of the learning that contributed to the development of this document. This is evidenced in the document with the following statement:

“Sport England has funded programmes aiming to increase the attraction of sport and physical activity to women and girls – including more than £2m for a large-scale practical investigation in Bury, Greater Manchester called I Will If You Will (IWIYW). We have spent time pulling together all of this valuable learning, and we hope that you find this resource useful” [E6]

This was further corroborated by the then Sport Minister Helen Grant:

“All the lessons learnt from phase one of I Will If You Will are currently being collated into a guide that will be available for other councils and organisations to use when setting up a programme to help get more women and girls take part in sport and physical activity.” [E6]

3. Increasing women’s participation and engagement in sport and physical activity

Our research findings were used to inform both the development and delivery of the local pilot IWIYW and Sport England’s National Campaign, ‘This Girl Can’ through sharing research insight in relation to factors that influence sport and physical behaviour change for women. This is corroborated by Sport England below:

“Targeting delivery strategies to different types of women ... thinking about how different groups of women, what motivates them, what’s appealing to them, what’s available and then those kind of social and emotional influences alongside … practical influences and what people do were all things I think that our own understanding, changed through the experience of being involved with I Will If You Will and those experiences informed what we did subsequently [This Girl Can].” (Sport England Head of Research) [E1].

Added to this, the Department for Culture, Media and Sport, Final Report of the Governments Women and Sport Advisory Board, stated that IWIYW in Bury is yielding some valuable insight (2015) [E7].

Our findings were further utilised in the development of the Bury Council Physical Activity and Sport Strategy (2015-2020). In the section titled ‘Summary of what evidence tells us works’ it identifies that significant learning has been developed through phase one of the programme [IWIYW] which informed the strategy. The strategy acknowledges that “bringing innovative behaviour change thinking to traditional sports development is challenging but necessary and productive” [E8].

IWIYW has delivered over 25,000 activity sessions and has engaged 6,500 women and girls. The impact of this engagement in activity is evidenced by Councillor Jane Lewis, Cabinet Member for Communities and Culture (Bury Council):

“We’ve gathered some great stories from some really inspirational ladies, who’ve managed to take that first step, break down the barriers and realise a more active lifestyle.  We’ve been blown away by the journey some of our local ladies have embarked on and what they’ve managed to achieve” [E6].

This is further evidenced by Phil Smith, The Sport England Director of Sport highlighting the impact of IWIYW both locally and nationally:

“I Will if You Will has already had a major impact locally and the lessons learned so far have allowed us to better understand how women and girls take part in sport. It’s also helped shape our new national ‘This Girl Can’ campaign. With two million more men than women playing regular sport, I Will If You Will can help us close the gender gap.” [E6]

Given the success of the first phase of ‘IWIYW’ further funding (£2M) was provided by Sport England to continue to build upon this and continue to increase women and girls (14+) sport and physical activity participation. This is corroborated as follows by both Sport England and Bury Council:

“We are really pleased to be working with Bury Council to extend and expand ‘I Will If You Will’. Great results have been achieved so far and there are strong plans for the next two years.” (Phil Smith Director of Sport, Sport England) [E6].

“Continuing the programme for another two years is massively important. It gives us a fantastic opportunity to build on what has already been achieved and carry on working towards a borough where being regularly active is the norm and second nature for Bury women and girls.  A fitter, happier, healthier population is what we want to achieve.” (Councillor Jane Lewis, Cabinet Member of Communities and Culture, Bury Council) [E6].

The learnings of the IWIYW evaluation have been applied on a national scale to reduce the gender gap in sport, by getting more women and girls physically active. The Lancet Public Health Editorial (August, 2019: E360) highlighted ‘This Girl Can’ as a promising intervention in tackling the physical activity gender gap in sport. The national collective impact accumulated is evident below [E9 & E3]:

• 2.8 million women being more active

• 1.6 of the 2.8 million started or restarted exercise (e.g. got back into exercise after a break)

• ¼ million increase of sustained participation in physical activity weekly (reduction in the gender gap based on the national yearly Sport England Active People survey data)

• 95 million views of the initial media campaign

• 1.2 million visits to its website

• 6.8 million women aged 14-40 recognised the campaign advert

• £66 million total gross value to economy

• £320 million total economic value of health benefits

• £387million total estimated value.

Alongside this national impact, ‘This Girl Can’ has been adopted by Australia state government to reduce the gender gap in sport. This is evidenced in the statement, “Australia is the first country in the world to license this powerful campaign” [E10], and further corroborated below:

“Following the success of ‘This Girl Can’ England, VicHealth, an Australian state government health promotion agency, entered into a licence agreement with Sport England to launch ‘This Girl Can’ in the state of Victoria” (Rowe and Sherry, 2020: 168).

Improving coach education CPD

Through initial exposure to this research (R2), two major Sporting National Governing Bodies (UK Coaching, Football Association) in the UK, commission Dr Amy Whitehead to implement and deliver a series of educational workshops, which include an introduction to Think Aloud and how the previous research can be used to inform coaches of the benefits of Think Aloud and the practicalities of using it. As a result, these organisations have now adopted TA as a reflection tool within their practice. Specifically, within Coach Developer education and practice, TA is now a key part of the coach developer’s practice within UK Coaching (SC9 & SC10), specially during the Covid pandemic from April 2020 onwards Dr Amy Whitehead ran two online workshops for the four (100%) UK Coaching Coach Developers and 17 (70%) high performance coaches on the UK Coaching Performance Foundation Programme. The Coach Developers have then used TA as a tool to support their coaches remotely. Lead Coach Developer, Jenny Coady commented, “during the Covid pandemic, we have used TA as a vehicle to support our coaches. Coaches have used TA within their practice and then shared their audio file with us (Coach Developers), this has allowed us to have remote reflective conversations and it’s also really help us build rapport with our coaches. Specifically, during a time when we are unable to see our coaches face to face. I can definitely see improvement in our coach’s confidence in a variety of different areas.” In November 2020, UK Coaching, in collaboration with Dr Amy Whitehead released three online modules, of an ‘Introduction to Think Aloud’, ‘Reflecting on your Think Aloud’ and ‘Think Aloud Case Studies’. These online modules are available to the 8,000 subscribed members of the UK Coaching website resource (SC6).

Improving coach and mentor reflection and practice

As a result of the multiple education workshops which were developed from the previous research, over 375 coaches, teachers and mentors in the UK have adopted TA as a reflection tool within their education and practice. For example, as a results of R2, in June 2017 Graham Williams (SC5), who is the athletic development coach for Millfield School (one of the leading independent schools in the UK) adopted the use of TA following the exposure to previous research (R2), within the whole athletic development department, which include 4 Strength and Conditioning Coaches, 4 physiotherapists and 6 tennis coaches. Graham and his colleagues have continued to use TA, “We are still active in our use of TA. Since 2017 we have continued to use TA within our strength and conditioning team”, “It has challenged our interpretation of effective reflective practice and it has created a common language around in action reflections. It has empowered practitioners to engage in and throughout coaching sessions on reflections and the necessary changes required to enhance coaching outcomes, such as improved communication with our athletes.”

In January 2018, Dr Amy Whitehead delivered a TA programme (as evidenced in R2) with 10 FA Coach mentors from Liverpool County FA (SC3). This 3-month programme involved educating mentors on the use of TA within their mentoring practice to improve their ability to communicate with their coaches (mentee’s) and become more effective coach mentors. Steve Smithies (SC7), who is the FA Regional Mentor Manager stated, “The TA programme has helped the mentors realise the benefit of reflection, it has given them another tool in the tool box for reflection and perhaps more importantly, it has actually improved their understanding of reflection because it’s about the why. Why do I reflect? So they can actually make some adjustments or challenge their thinking or actions and it helps the mentor go on and help the coach or the person they’re working with. The impact of this research is that it has improved the mentor-coach relationship, the mentors communicate more effectively with their mentee coaches which in turn has improved the coach’s we work with.”

Since this programme Dr Amy Whitehead has disseminated the findings from this work at the FA Grassroots Development Conference in December 2018, where 80 national FA coaches and coach mentors were present (SC8). Mark Haining (SC8) is a coach mentor who attended the Coach mentor Conference, following his exposure to the use of TA, Mark explained “I’ve used TA to develop and reflect on my feedback as a mentor, and through using it I’ve been able to change and improve this. So my feedback is more of a dialogue now than a report.” Furthermore, a TA workshop was delivered in March 2019 at the FA mentor conference at Saint Georges Park, where over 200 FA mentors attended and 100 attended the TA seminar.

Further impact within rugby league has been evidenced through the development of a second TA Programme, which was run with 8 (75%) of the Saint Helen’s RFL development/academy coaches from October- December 2018 (SC1). Craig Richards the Coach Education Manager stated “The TA process first increased knowledge of reflective practice. Over a number of weeks following the TA program, it became possible to have short informal interventions during practice were coaches would be more comfortable reflecting in action. Previous to the TA program the challenges that were evident were linked to getting coaches to reflect on the positives of their delivery. I found coaches more open to talk about what they did wrong and became fearful of other coaches doubting their ability”, “As a result of the TA programme we have observed these coaches interacting more effectively with the players, which is key to player development”.

Following the delivery of this TA programme with Saint Helen’s, Dr Whitehead was invited to share this programme with the Rugby Football League’s England Talent Pathway Coaches, and in January 2019, presented this work at the England Talent Pathway Conference, where 25 (100%). national coaches were present (SC2). Adam Prentis, RFL Coach Developer stated the impact of this work “This (think aloud) helped me in a number of situations, namely to stay focused on the present and not let my attention wonder, to articulate what exactly I was; feeling, observing, and aiming to achieve. Combine those factors with being able to consolidate what it was I wanted to express and help me think how may I communicate this with others whether it be other members of the coaching staff, coach education or directly to the performer.”

Since 2018, a number of TA workshops have been delivered by Dr Amy Whitehead across different UK Coaching events. UK Coaching represents over 30,000 coaches across the UK, from elite to grass root sports across a wide range of sports. Chris Chapman (SC9) from UK Coaching (Learning experience Manager and Previous Head Coach for Great Britain Women’s Rugby League) said “The work of Amy Whitehead, specifically TA has had a significant impact in a number of areas; at a personal, coach development and support and the wider coaching system. TA has been applied and used considerably within our coach development, support, programmes and applied practice. Amy has influenced through the approach in my own practice as a coach and coach developer; creating an approach and reflection tool that I have been able to adapt and use within my own mental models. Whilst the National Head Coach, I used TA and adapted versions of this with players within a team sport. Very often key decision makers and those new to and/or changing playing position. The approach you shared challenged mine and the coaching teams thinking on how players make decisions, communicate these to their team mates and even influenced team meetings. As you know we adjusted the approach to be peer on peer with injured and ‘senior’ players sharing with other peers. Your work within UK Coaching has featured constantly whether as an approach within the Coach Developers tool kit, providing in situ support for coaches and the sharing and cascading of the principles and approaches of TA at regional and national events. The impact on individuals, their participants and they coach support network has been significant.”

Adoption of the TA programme by coaches in the Blackburn Rovers FC academy led to development of self-awareness, effective communication skills, identifying personal biases, and informed the development of a reflective practice programme for all the club coaches (N=16). The TA programme was introduced to the club in March 2020 by Dr Amy Whitehead, through the clubs Sport Psychologist (Laura Swettenham). The positive changes and influence on the coaching staff are reflected in the testimonial statement by the club’s Sport Psychologist, Laura Swettenham (see SC4) that highlights the positive feedback received and the benefits after introducing the TA programme, “Great feedback from the coaching staff after the TA workshop. All coaches see the benefits of using TA and moving past other forms of reflection to create a more in-depth and sustainable way of reflecting. Main impacts include the development of self-awareness, effective communication skills, and identifying personal biases. Some of the coaches also mentioned its potential impact with their coach mentor, allowing their mentor to get a better understanding of their decision making processes in-action rather than just having video data to go off. I'm working with our head coach at the moment to develop a reflective practice programme across the academy with TA being an integral component!”.