Analysis of interview data

Seven out of 41 interviews were transcribed by the researcher, whilst the remaining interviews were transcribed by a professional who had signed a confidentiality agreement. Upon receiving the transcripts, the researcher listened to the audio tapes whilst correcting any mistakes made during transcription. Early notes on data analysis were also taken at this point. Coding was conducted using NVivo software. Interviews were analysed using thematic analysis (Braun & Clarke, 2006) with aspects of a Grounded Theory approach incorporated (Corbin & Strauss, 2014). Inductive open coding was used to develop an initial coding system before comparing and structuring the codes. This involved repeated reading of the transcripts in an active manner (Braun & Clarke, 2006). In line with grounded theory, a second scan of the interview transcripts was then undertaken, whilst actively suppressing any presuppositions about the data, in order to identify any other possible themes. All codes were then organised into overarching themes and sub-themes. Themes were then reviewed in terms of whether the data extracts fit into each coherent theme and whether the themes and sub-themes accurately represented the overall dataset. Alterations were made accordingly (Braun & Clarke, 2006), before naming and defining the themes. This was an iterative process, whereby pertinent codes were elaborated upon within future interviews. These data were also compared across case study schools, and across and within groups of stakeholders in each school, to develop a deeper understanding of how health and wellbeing contexts vary across different complex school systems.

102 4.5 Analysis Plan

The research methods described above each sought to answer specific research questions. Question ‘a’ was explored through the survey and social network analysis. Meanwhile, questions ‘b’ and ‘c’ were explored through the survey, and semi-

structured interviews with staff, students and parents. Question ‘c’ was also explored through social network analysis. This is represented within Figure 4 below.

103 Figure 4 Diagrammatic representation of the link between main research question one, sub questions and methodology

a. How do system starting points and characteristics give rise to variability in initial responses to efforts to engage schools in a discussion about health improvement?

1. How are efforts to engage schools in a discussion about health improvement impeded or facilitated by system characteristics?

b. To what extent, and in what ways, do school stakeholders perceive a collaborative research network to offer

potential for reorienting school systems towards health and wellbeing?

c. How does the position of schools within broader systems, and in relation to external systems, impact their functioning and responses to a collaborative research network? SURVEY: Representatives from 34 schools in SHRN SOCIAL NETWORK ANALYSIS: Wellbeing Leads within 4 case study schools SEMI- STRUCTURED INTERVIEWS WITH STAFF: Wellbeing Leads and 3-4 staff members within 4 case study schools

SEMI- STRUCTURED INTERVIEWS WITH STUDENTS: 3-4 paired interviews within 4 case study schools

SEMI- STRUCTURED INTERVIEWS WITH PARENTS: 1-4 parents within 4 case study schools

104 Further to this, research questions ‘d’, ‘e’ and ‘f’ were explored using social network analysis and semi-structured interviews with staff, students and parents. This is represented within Figure 5 below.

105 SOCIAL NETWORK ANALYSIS: Wellbeing Leads within 4 case study schools SEMI- STRUCTURED INTERVIEWS WITH STAFF: Wellbeing Leads and 3-4 staff members within 4 case study schools

SEMI- STRUCTURED INTERVIEWS WITH STUDENTS: 3-4 paired interviews within 4 case study schools SEMI- STRUCTURED INTERVIEWS WITH PARENTS: 1-4 parents within 4 case study schools d. To what extent is health and

wellbeing embedded into social networks of the school system and how do interactions, internal and external to the school, facilitate the implementation of health

improvement activity in schools and the development of schools as healthy systems?

f. How does the consistency of health improvement actions with the Health Promoting Schools Framework vary between schools with differing network structures and differing levels of

engagement with a collaborative research network?

e. How are the structure of school health-related social networks and the position of key actors within these networks associated with engagement with a collaborative research network and the orientation of school systems toward health? 2. How do school structures and informal social networks affect the embedding of health and wellbeing into complex school systems?

106 4.6 Ethical considerations

This research has been conducted in line with the Medical Research Council’s ‘Good research practice: Principles and guidelines’ document. Ethical approval was

obtained by Cardiff University’s School of Social Science Research Ethics Committee in May 2014 and a Disclosure and Barring Service (DBS) check was undertaken by the researcher in December 2013. Additional Research and Development approval was obtained from the National Health Service. This was required to conduct an interview with a Healthy School Coordinator who was

employed by their Local Health Board, encompassed by the National Health Service.

Information sheets were sent to all participants, both individuals and organisations, to inform them of the purpose of and the procedures to be employed within the study. Their right to withdraw at any point before, during or after the duration of the study was also stated. All participants were informed that their data may be included within this thesis, as well as future academic publications or presentations.

Moreover, all data was confidential and anonymised using pseudonyms for people and places. Data will be stored for five years in locked filing cabinets, whilst electronic data is password protected in line with the Data Protection Act (Great Britain, 1998). Participants were informed of these measures prior to participating.

Written informed consent was obtained for the interviews from all staff, the Healthy School Coordinator and the parents who were interviewed face to face. Those

parents who were interviewed by telephone provided verbal informed consent. In the case of student participants, to attenuate response bias, opt-out consent was obtained. Schools were asked to send information sheets and opt-out consent forms to the parents of participating students, in order to maintain confidentiality. Parents were then provided a two-week window to opt their child out of participating. If no correspondence was received after two weeks, consent was assumed. Assent was also obtained from each child prior to commencing their interview.

Opt out consent is often preferred by researchers due to its ability to yield high and representative response rates through attenuating the inevitable social patterning which prevails when parents are required to sign and return a form (Courser et al.,

107 2009; Lacy et al., 2012). This, combined with a decreased burden on schools, is arguably a more ethical way of conducting research due to the improved quality of research findings, as parents from a lower socioeconomic background may be less likely to opt their child into research (Courser et al., 2009; Lacy et al., 2012). Moreover, children of a lower socioeconomic status have been shown to have a higher prevalence of engaging in unhealthy behaviours (Hanson & Chen, 2007). Thus, their representation within research is vital to ensure that their needs and perceptions are responded to (Lacy et al., 2012).

Although the risk of harm was low, there was a potential for participants to feel a minimal amount of discomfort talking about health, particularly in relation to emotional wellbeing. Moreover, there was a minimal risk of pressure to participate from colleagues, peers and/or teachers. This potential risk for harm was minimised through the use of informed consent, as outlined above. Moreover, the researcher travelled to interviews alone and therefore adhered to the Cardiff University ‘Lone Working Policy’ to minimise risk. The researcher travelled by car with a fully charged mobile telephone and a range of emergency contact numbers and was primed to leave the setting immediately if made to feel uncomfortable. As a further precaution, a responsible person/research supervisor was nominated and their

consent gained prior to any face-to-face data collections. The responsible person was available during the data collections to act as a contact and was provided with all the information regarding the data collection (e.g. timeframe, setting, contact number, mode of travel). The responsible person was contacted both prior to and after each data collection.