Evaluating the provision of Glasgow’s outdoor nature-based early learning and childcare for children’s health and wellbeing

Traynor, Oliver Campbell Lloyd (2024) Evaluating the provision of Glasgow’s outdoor nature-based early learning and childcare for children’s health and wellbeing. PhD thesis, University of Glasgow.

Abstract

Background: Outdoor play and learning (OPL) in the early learning and childcare (ELC) setting has the potential to encourage children to be physically active and develop their social and cognitive skills, while helping them maintain a healthy weight later in life and support more equitable access to local green spaces. In Scotland, this is a policy-driven programme that has seen increased popularity in the last decade with numerous guidance documents available for practitioners along with several ELC models of outdoor provision: fully outdoors, satellite, indoor/outdoor, and traditional settings. However, the quality of the scientific evidence is low with recent systematic reviews demonstrating an absence of well-designed evaluations meaning that the current evidence base is insufficient to continue to inform the rollout of this complex programme. This thesis argues that this is partly the result of research advancing to effectiveness studies without first conducting rigorous pre-evaluation activities to fully understand the programme under investigation, identifying active ingredients, mechanistic pathways, appropriate and feasible outcomes, and testing well considered evaluation design features to then inform an effectiveness evaluation. This thesis addresses this gap in the literature, adopting a systematic pre-evaluation process using a novel co-production approach to understand outdoor ELC provision, the contextual factors that influence programme implementation and evaluation design, providing evaluation recommendations and new knowledge regarding the programme theory of outdoor ELC provision. The aim of this thesis was to determine how best to design and conduct an evaluation of outdoor ELC provision in the Glasgow early years sector for child wellbeing.
Methods: The design and implementation of the four studies in this thesis was informed by the recently updated MRC guidance for developing and evaluating complex interventions. A co-production approach was taken, with key stakeholders in the LA and third sector organisations who were part of a research advisory group that supported the decision-making process and study design.
Study one was an Evaluability Assessment (EA) with practitioners involved in ELC provision in Glasgow. In June 2021, three workshops took place online using MS Teams with two groups of participants: (1) 10 ELC practitioners from across the Glasgow City Council area and (2) 10 ELC managers and 2 Scottish Childminding Association managers (n=22). Using a Theory of Change (ToC) approach, the workshops developed a shared understanding around how outdoor ELC is implemented and expected to influence children’s outcomes. A series of evaluation options were developed and critiqued. The findings of Study one directly informed the design of Study two.
Study two was a mixed-methods feasibility study designed to address the uncertainties identified in Study one, as recommended by the MRC guidance. A series of predefined study progression criteria using a traffic light approach (green, amber, and red) were developed and published prior to Study two implementation. Six ELC settings were recruited across Glasgow: two traditional, two outdoors, and two satellite ELC settings. During July and September 2022, three- and four-year old children (n=46) completed outcome measures at baseline (anthropometric measures, balance assessment, accelerometery measured physical activity, emotional wellbeing) and at follow-up, five to seven weeks later. Quantitative and qualitative methods were used to analyse the data using descriptive statistics, propensity score matching and thematic analysis. Findings from Study two produced recommendations for the study design of a future effectiveness evaluation.
Study three explored how the affordances of the outdoor environment influenced children’s play behaviours across different ELC settings (outdoor, satellite, and traditional). Systematic play observations were carried out using the expanded version of the Tool for Observing Play Outdoors (TOPO) across three days at each participating ELC setting recruited in Study two. Factors associated with children’s play were also recorded including adult interaction, play communication, risky play, peer interaction, and environmental interaction. Play behaviours were analysed using descriptive statistics in MS Excel.
Study four was a qualitative study using semi-structured interviews with ELC practitioners (n=10) and headteachers/managers (n=5) to understand how OPL is implemented across different ELC settings using normalisation process theory (NPT). The NPT constructs informed the thematic analysis of transcripts on NVivo (version 14). Findings from Study three and four contributed novel understanding around the contextual factors that influence programme effectiveness and should be considered in the design of an effectiveness evaluation alongside the recommendations of Study two.
Results: Study one co-produced a ToC, initially developed as part of my MSc dissertation, creating a shared understanding of how the programme functions and the mechanisms that might lead to change in child outcomes. Routinely collected data in ELC settings was identified to support outcome measures. Participants discussed evaluation questions they would like answered and contextual factors that influence daily operations. Analysis of EA outputs identified several uncertainties associated with evaluation design: (1) recruitment and retention of participants, (2) suitability of a randomisation study design, (3) appropriate outcome measures, (4) suitability of current monitoring and evaluation (M&E) practice to support an effectiveness evaluation, and (5) the acceptability of the study design methods among practitioners. The findings were presented to the research advisory group with five evaluation options. It was agreed that a feasibility and pilot study of Glasgow’s outdoor ELC programme should be conducted to address these uncertainties.
In Study two, recruitment and retention rates met the amber progression criteria. Propensity score matching met the red progression criteria. Anthropometric measures and balance assessment met the green progression criteria while parent-reported strengths and difficulties questionnaire and accelerometer wear-time met the red progression criteria. It is recommended that these approaches are reviewed before an effectiveness evaluation. The M&E tools, ‘learning journals’, provided a cross-sectional descriptive assessment of how children progress against curriculum outcomes. These could be used in a case study for monitoring children’s development within curriculum areas over time within different ELC settings - if curriculum outcomes are considered important for a future effectiveness evaluation. Practitioners found the pilot study design acceptable in terms of the limited intrusiveness to their daily operations and the level of participation required, however, suggested that the wrist-band mounted accelerometers should be revised.
Study three found the most prominent play behaviour across ELC settings was physical play. The outdoor ELC model afforded more opportunities for imaginative play and expressive play reinforcing the benefits of rich natural features for diverse play behaviours.
Study four identified four broad factors that supported outdoor play and OPL implementation: i) practitioners have the knowledge and skills, through training, to implement OPL; ii) there is supportive leadership and a motivational environment that advocates for OPL provision; iii) there are sufficient resources available for implementation; and iv) there is endorsement by governing bodies and guidance documents supporting integration of OPL into daily routine.
Conclusion: This thesis contributes novel findings to the fields of evaluation and early years literature by demonstrating a systematic, co-produced, and replicable approach for determining the evaluability and feasibility of outdoor ELC provision (Studies one and two), a complex public health programme, addressing the methodological limitations of the current literature base and providing recommendations for a future effectiveness evaluation. Additionally, this thesis provides new insights regarding our understanding of the contextual factors that affect the effectiveness of OPL provision (Studies three and four). These findings contributed to the development of a context-specific programme theory, which can help design and interpret a future effectiveness evaluation.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Additional Information: Supported by funding from the Medical Research Council (MRC) and Glasgow City Council (GCC).
• Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO Unit
• Funder's Name: Medical Research Council (MRC), Glasgow City Council (GCC)
• Supervisor's Name: McCrorie, Dr. Paul, Martin, Dr. Anne and Chng, Dr. Nai Rui
• Date of Award: 2024
• Depositing User: Theses Team
• Unique ID: glathesis:2024-84825
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 21 Jan 2025 15:24
• Last Modified: 27 Jul 2026 14:19
• Thesis DOI: 10.5525/gla.thesis.84825
• URI: https://theses.gla.ac.uk/id/eprint/84825

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