Volunteering for the Commonwealth Games: what can realist synthesis contribute to health policy making?

The aim of this thesis was to investigate, using the real-time test case of the 2014 Commonwealth Games, whether the realist synthesis methodology could contribute to the making of health policy in a meaningful way. This was done by looking at two distinct research questions: first, whether realist synthesis could contribute new insights to the health policymaking process, and second, whether the 2014 Commonwealth Games volunteer programme was likely to have any significant, measurable, impact on health inequalities experienced by large sections of the host population. The 2014 Commonwealth Games legacy laid out ambitious plans for the event, in which it was anticipated that it would provide explicit opportunities to impact positively on health inequalities. By using realist synthesis to unpick the theories underpinning the volunteer programme, the review identifies the population subgroups for whom the programme was likely to be successful, how this could be achieved and in what contexts. In answer to the first research question, the review found that while realist methods were able to provide a more nuanced exposition of the impacts of the Games volunteer programme on health inequalities than previous traditional reviews had been able to provide, there were several drawbacks to using the method. It was found to be resource-intensive and complex, encouraging the exploration of a much wider set of literatures at the expense of an in-depth grasp of the complexities of those literatures. In answer to the second research question, the review found that the Games were, if anything, likely to exacerbate health inequalities because the programme was designed in such a way that individuals recruited to it were most likely to be those in least need of the additional mental and physical health benefits that Games volunteering was designed to provide. The following thesis details the approach taken to investigate both the realist approach to evidence synthesis and the likelihood that the 2014 Games volunteer programme would yield the expected results.

Farm visits: interdisciplinary outdoor learning for primary school pupils and Scotland’s Curriculum for Excellence

There is concern around children’s lack of knowledge and understanding of food sources and production, and more broadly around their apparent disconnection from nature. Spending time in the outdoors has been shown to yield a range of benefits, although the mechanisms underpinning these are not well understood. Studies have suggested, however, that there has been a decline in time spent outdoors by children. The introduction of the ‘Curriculum for Excellence’ guidelines in Scotland was heralded as an opportunity to address this decline. Although the guidelines advocate the use of outdoor environments, little research has been conducted, and little guidance is available, on how teachers can and do use outdoor learning in relation to the guidelines, particularly beyond ‘adventure’ activities. Farms are utilised as an educational resource around the world. This research explored the use of educational farm visits, as an example of outdoor learning, in the context of Curriculum for Excellence. A qualitatively driven, mixed methods study, comprising survey and case study methodologies, was undertaken. A questionnaire for teachers informed subsequent interviews with teachers and farmers, and ‘group discussions’ with primary school pupils. The study found that teachers can link farm visits and associated topics with the Curriculum for Excellence guidelines in a range of ways, covering all curriculum areas. There was a tendency however for farm visits to be associated with food and farming topics at Primary 2-3 (age 6-7), rather than used more widely. Issues to consider in the planning and conduct of farm visits were identified, and barriers and motivations for teachers, and for farmers volunteering to host visits, were explored. As well as practical examples of the use of farm visiting, this research offers a perspective on some of the theoretical literature which seeks to explain the benefits of spending time outdoors. Furthermore, five main recommendations for farm visiting in the context of Curriculum for Excellence are given. These relate to the type of visit appropriate to different age groups, opportunities for teachers to become more familiar with what farms visits can offer, and raising awareness of the organisations and networks which can support volunteer farmers to host visits.