Every year, around a million children in England are weighed and measured at school through the National Child Measurement Programme (NCMP), and this study will find out whether that process harms their mental health or changes their eating and activity habits. The programme has run since 2006 to track childhood obesity, but two problems have emerged: parents and campaigners worry that being weighed in front of classmates could trigger anxiety or disordered eating, and local authorities face budget cuts that force them to justify the programme’s cost. No large-scale, controlled study has yet measured these psychological effects or compared the expense of different ways to run the measurements and feed back results to families. If the research shows that the weighing process causes no harm, it will reassure schools and health officials that the programme can continue. If it finds negative effects, the results will help the Department of Health and Social Care redesign the process—for example, by changing how feedback is delivered—to minimise distress. The cost-effectiveness analysis will also tell local authorities which delivery models give the best value for money, allowing them to allocate limited resources more efficiently.
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Research question What is the impact of the surveillance (measurement) aspect of the National Child Measurement Programme (NCMP) on the mental health, wellbeing, and eating and activity behaviours of children? What is the value of NCMP data to local authorities, and which are the most cost-effective models for the measurement and feedback aspects of the NCMP? Background The NCMP was established in 2006 as a surveillance programme to monitor the weight status of children locally and nationally. It faces two challenges: concerns that it may adversely impact the mental wellbeing of children; financial pressures and a need to demonstrate its value and be cost-efficient. A new NCMP IT system will give new opportunities to use and share NCMP data. It is now important to understand the programme s impact and value and understand how to mitigate any harms and maximise benefits. Aims To provide new high-quality evidence on the impacts of measurement, value of the NCMP and cost-effective delivery of the NCMP to inform the future development of the programme. Methods To understand the impact on children: We will conduct two natural-experimental controlled studies to quantify the impact of measurement on children s mental health, wellbeing, and behaviours, by comparing the survey responses to a wellbeing questionnaire for children who are being measured and children who are yet-to-be measured. For Year 6 children (n=2,500), we will use an online questionnaire completed twice, ~6 weeks apart. The exposed group will complete one survey pre-measurement and one post (and prior to feedback); the control group will complete both surveys prior to NCMP measurement. Parents of Year 6 and Reception children (n=2,000) will complete an online or paper questionnaire. The exposed group completing the questionnaire within six weeks after their child s measurement (and prior to feedback) and the control group before measurement. We will use Generalised Linear Models to compare differences in outcomes between children who have been measured ( exposed) and those not ( controls ). We will conduct focus groups and interviews with parents, Year 6 children, school staff and NCMP staff around the time of measurement, and make ethnographic observations of the process, to understand the measurement process and perceptions of its impact. Data will be analysed using the Framework Method. To understand the value of the NCMP and cost-effectiveness of delivery models: We will conduct focus groups and interviews with people (n=30) responsible for the NCMP in local authorities to understand the delivery models and applications of the data. Based on this work, we will deliver a survey to all upper-tier local authorities (n=152) to understand the resources associated with each delivery model. Cost-consequence and cost-effectiveness analysis will be conducted for each delivery model. Timelines: 24 months (1/4/25 to 31/3/27) Impact and dissemination We will work collaboratively with DHSC, parents, children and other stakeholders to frame and disseminate findings. We will take a flexible approach to sharing findings with DHSC so early work may inform policy decisions. Outputs will include a final report, a seminar, a podcast, short animation, infographics and academic papers.
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