Forest school research

ISRCTN	ISRCTN87263624
DOI	https://doi.org/10.1186/ISRCTN87263624
ClinicalTrials.gov (NCT)	Nil known
Clinical Trials Information System (CTIS)	Nil known
Integrated Research Application System (IRAS)	337007
Protocol serial number	205640, IRAS 337007, CPMS 59695
Sponsor	Humber Teaching NHS Foundation Trust
Funder	National Institute for Health and Care Research

Submission date: 05/09/2024
Registration date: 11/09/2024
Last edited: 21/10/2025

Recruitment status: Recruiting
Overall study status: Ongoing
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
A growing number of children and young people are experiencing poor mental health. Getting the right help can be difficult because waiting times for children’s and adolescent mental health services are long. Schools can offer opportunities for children and young people to receive well-being support tailored to their needs and learning levels. Being outdoors and connecting with nature can help people’s mental health. However, it is well documented that young people are not spending enough time outdoors, which can negatively impact both their physical and mental health. Forest Schools, a method of outdoor-based learning, are becoming increasingly popular in community settings and schools. While participation in Forest Schools may benefit children’s mental health, there is currently insufficient evidence to support this claim. There is a need to improve the quality of evidence regarding the effectiveness of Forest Schools for children’s mental health. This study aims to assess the feasibility of conducting a randomised controlled study of Forest Schools in primary schools across England, in which they are randomly put into different groups to compare the effects of the intervention against a control group to see if it works. The study seeks to determine whether Forest School is acceptable to both children and school professionals.

Who can participate?
Schools with existing capacity and training to deliver Forest School as defined in the study intervention and all Key Stage 2 children aged between 7 and 11 years old within the specified class

What does the study involve?
The study will first identify primary schools that can implement Forest Schools. Efforts will be made to ensure that the participating schools offer similar activities. Children will be randomly assigned to two groups, each engaging in different activities. In this study, the groups will consist of schools with selected Key Stage 2 classes. Two schools will participate in Forest School for 12 weeks during the Spring term, and two additional schools will participate for the same duration during the Summer term. The remaining schools will continue with their usual term-time activities and serve as the control group. The study will assess whether the necessary data can be collected and whether enough participants can be recruited within the available timeframe. Interviews will be conducted to gather feedback on what worked well and what did not. This information will inform future planning for Forest Schools. Additionally, data on the costs associated with running Forest Schools will be collected to determine whether a larger study can be conducted to evaluate the impact of Forest Schools on children’s mental health.

Patient and public involvement: The research team includes two PPI (Patient and Public Involvement) leads who work closely with children and young people. There is also the inclusion of a parent carer of children with additional needs and a Forest School teacher at a special educational needs school. Collaboration with Humber NHS Teaching Foundation Trusts has enabled the involvement of children and young people in the development of the research application. PPI events have been conducted in four schools, where children participated in both classroom and outdoor activities. This has helped in developing a version of Forest School specifically for this study.

Dissemination: Plain English summaries of the study’s findings will be produced, with support from the PPI group. The results will also be published in scientific journals and presented at public health and education conferences. Throughout the study, blogs and social media platforms such as Instagram and Twitter will be used to keep parents, schools, and Forest School professionals informed of the study’s progress.

What are the possible benefits and risks of participating?
The benefits to the school will include a training session from the study team and an ongoing community of practice which will support continuing professional development and upskilling in the use of Forest Schools for both individuals and the wider school. The school will be part of a National Institute for Health Research study, which will contribute to the development of new knowledge, policy and practice guidance.
The study involves asking participants to allocate time to answering questions using questionnaires and interviews. The impact of these activities on school schedules will be minimised, and where possible, opportunities identified to conduct these off-site and outside school hours. Schools involved in the delivery of forest school will be asked to allocate time to sessions within existing timetables, which could impact the means to offer other educational activities. Where possible, the research team will work with the school to ensure that forest school sessions are integrated within existing timetables.

Where is the study run from?
The University of York (UK)

When is the study starting and how long is it expected to run for?
June 2024 to June 2026

Who is funding the study?
National Institute for Health and Care Research (NIHR) (UK)

Who is the main contact?
Dr Hannah Armitt, hannah.armitt@nhs.net

Contact information

Dr Hannah Armitt
Public, Principal investigator

Humber Teaching NHS Foundation Trust, Research Team, Post Room, Mary Seacole Building, Trust HQ, Willerby Hill, Beverley Road, Willerby
Hull
HU10 6ED
United Kingdom

Phone	+44 (0)7736501176
Email	hannah.armitt@nhs.net

Prof Peter Coventry
Scientific, Principal investigator

Department of Health Sciences, University of York, ARRC Building, Heslington
York
YO10 5DD
United Kingdom

Phone	+44 (0)1904 321528
Email	Peter.coventry@york.ac.uk

Study information

Primary study design	Interventional
Study design	Feasibility cluster-randomized controlled trial
Secondary study design	Cluster randomised trial
Participant information sheet	ISRCTN87263624 FINCH_Interview_PIS_Parent & Child Interviews.docx
Scientific title	Forest school INterventions for Children’s Health (FINCH): a feasibility cluster randomised control trial
Study acronym	FINCH
Study objectives	Is Forest School an acceptable and feasible intervention to improve the mental health of Key Stage 2 primary school children? Is it feasible to run a cluster Randomised Controlled Trial (RCT) of Forest School for children in key stage 2? Forest School is a complex intervention and there is no agreed model of transformational process or theory of change. Studies have highlighted some potential pathways to improvements in mental health and well-being including self-regulation, resilience, autonomy, agency, providing nurture, time, and space away from school as well as connection to the rest of nature. This proposed programme allows for iterative cycles of testing and refinement of Forest School as an emotional health and wellbeing intervention in schools. In partnership with our PPI group/members/co-applicants and using current literature, an initial logic model has been developed underpinning programme theory to better understand likely mechanisms of action and pathways to impact emotional health and mental well-being. This work will seek to refine this model at the end of the study to provide a more cohesive framework for the mechanisms of action of Forest School as an emotional and mental health well-being intervention. This study will generate new knowledge about the feasibility of running a definitive Forest School trial with Key Stage 2 (KS2) children aged between 7-11 with and without SEND. It will test the acceptability and feasibility of delivery, assess the feasibility of trial processes, and establish key parameters for effectiveness and cost-effectiveness. The study team will seek to produce a manualised toolkit informed by our process evaluation and qualitative work to support further research and implementation.
Ethics approval(s)	Approved 19/07/2024, University of York, Environment and Geography Ethics Comittee (290 Wentworth Way, York, YO105NG, United Kingdom; +44 (0)1904 322999; environment-ethics@york.ac.uk), ref: DEGERC/Res/12072024/1
Health condition(s) or problem(s) studied	Children's wellbeing at primary school Key Stage 2. No specific condition identified.
Intervention	Study Design The research will consist of four interconnected work packages, using a mixed-method design. In Work Package 1 (WP1), a feasibility randomised controlled trial (RCT) of a Forest School intervention will be conducted with 250 children across 8 schools in Hull, East Yorkshire, and North Yorkshire. Work Package 2 (WP2) will involve an evaluation of the quality and fidelity of the intervention delivery through a process analysis. Work Package 3 (WP3) will focus on the preliminary collection of health economic data, while Work Package 4 (WP4) will use focus groups to refine the logic model and optimise the intervention. A web-based randomisation system will be provided by the York Health Trials Unit (YTU). Randomisation will be conducted at the school level. Forest School The Forest School intervention is defined as a non-classroom-based, timetabled session of child-led exploration and play in an outdoor space, designed to encourage connection with and exploration of nature. This intervention model is based on best practices and current definitions, including input from the Forest School Association (FSA), Nature-Friendly Schools, the Creative Outdoor Learning Award (COLA), and patient and public involvement (PPI) through PPI leads, workshops, and schools. In the context of this feasibility study, minimum standards have been established that all schools must follow during Forest School sessions. These include: An outdoor space featuring natural elements, room for gathering in a circle, and materials such as rope, tools, and natural objects like leaves and twigs. Activities that encourage a connection with and exploration of nature, including sensory interaction with the natural environment, fostering emotional bonds with nature, appreciating its beauty, contemplating its meaning, and demonstrating care and compassion for nature.
Intervention type	Behavioural
Primary outcome measure(s)	The study will collect feasibility data to inform a future randomised controlled trial of Forest School. 1. Recruitment rate recorded as the number of eligible participants who consent to participate in the study by 8 months 2. Retention rate recorded as the number of schools and participants to withdraw from the study from baseline to 6 month follow up 3. Representativeness of participants recorded by collection of demographic information at baseline to determine if the intervention is accessible for a diverse population. Age; gender (male/female/third gender); ethnicity (based on ONS categories); special educational needs and disabilities (children with EHC; diagnosis); Index of Multiple Deprivation based on participant home postcode. 4. Data completeness as recorded by the percent of outcome measures completed by schools, parents and children and young people. 5. Acceptability of trial processes and intervention: This relates to both the intervention and the research process and will be assessed based on descriptive results of the quantitative data of the school sessions carried out and qualitative interviews with participants.
Key secondary outcome measure(s)	The following potential primary and secondary outcome measures are collected at 3 time points, (baseline); initial follow-up (week 12); and final follow-up (week 24) for both groups: Primary outcome measure: 1. The child's emotional and behavioural difficulties, measured using the Strengths and Difficulties Questionnaire (SDQ) parent and teacher versions Secondary outcome measures 2. The child’s health-related quality of life, measured using the Child Health Utility 9D (CHU9D) questionnaire, self-completed by the child (or proxy for younger children) 3. The child’s psychological wellbeing, measured using the WHO-5 Child Wellbeing Index, self-completed by the child 4. School attendance, measured using attendance registers from Forest School sessions and general school attendance, collected throughout the term 5. The child’s executive functioning behaviours, measured using the Behaviour Rating Inventory of Executive Function (BRIEF), completed by parents and teachers 6. The child’s connection to nature, measured using the Nature Connection Index (NCI), self-completed by the child 7. The classification of the school's outdoor environment, measured using the UK Habitat Classification (UKHab) system, collected by the research team during initial site visits. 8. The local environmental context of the school, measured using online data tools like Natural England's Green Infrastructure map and SHAPE Atlas, at baseline. 9. The spatial analysis of urban green areas around schools, measured using high-resolution data from the Urban Atlas (Copernicus), within 1 km, 3 km, and/or 5 km buffer zones around school buildings, collected at baseline 10. The characteristics of each Forest School session, measured using a self-report checklist completed by the lead Forest School Facilitator after each session 11. The child’s health resource use, measured by collecting data on relevant healthcare services used 12. School resource use, measured using school and staff questionnaires to assess expenditures on infrastructure, equipment, staff time for planning and delivery, and additional resources for children with SEND
Completion date	30/06/2026

Eligibility

Participant type(s)	Learner/student, Other
Age group	Child
Lower age limit	7 Years
Upper age limit	11 Years
Sex	All
Target sample size at registration	200
Key inclusion criteria	1. Schools with existing capacity and training to deliver Forest School as defined in the study intervention 2. Outdoor space available within school grounds 3. All Key Stage 2 children within the specified class
Key exclusion criteria	As this is a feasibility study, we will not exclude schools unless they have no access to outdoor space of any type and are not practically able to run Forest School. We are keen to test the feasibility of delivery across a variety of habitats in recognition that this improves accessibility and diversity.
Date of first enrolment	01/09/2024
Date of final enrolment	31/03/2026

Locations

Countries of recruitment

United Kingdom
England

Study participating centre

The University of York

Heslington
York
YO10 5DD
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Available on request
IPD sharing plan	The datasets generated during and/or analysed during the current study will be available on request from Professor Peter Coventry, Peter.coventry@york.ac.uk. The type of data that will be shared are processed data that will include individual-level outcome data for participants, along with descriptive socio-demographic data; and anonymised qualitative data as transcripts. Data will be kept and stored for 10 years; there will be a 12-month initial embargo period on availability to support the publication of core outputs from the trial. Data sharing with others (including researchers at bone fide research and higher education institutions) and public dissemination to support other research in the future is permitted within the current consenting process; no further consent is required. All responses from participants will use pseudonymised identifiers i.e. assigned an ID number kept separate from names. There are no ethical, legal or additional comments.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Protocol article		18/09/2025	21/10/2025	Yes	No
Other files		07/11/2024	31/07/2025	No	No
Other files		07/11/2024	31/07/2025	No	No
Other files		07/11/2024	31/07/2025	No	No
Other files			31/07/2025	No	No
Other files	version 1.0		31/07/2025	No	No
Other files	version 1.0		31/07/2025	No	No
Other files	version 1.0		31/07/2025	No	No
Other files	version 1.0		31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files		07/11/2024	31/07/2025	No	No
Other files			31/07/2025	No	No
Other files		13/11/2024	31/07/2025	No	No
Other files		13/11/2024	31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files			31/07/2025	No	No
Other files	version 4		31/07/2025	No	No
Participant information sheet			31/07/2025	No	Yes
Participant information sheet			31/07/2025	No	Yes
Participant information sheet	version 1.0		31/07/2025	No	Yes
Participant information sheet	version 1.0		31/07/2025	No	Yes
Participant information sheet	version 1.0		31/07/2025	No	Yes
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes
Protocol file	version 1.3	03/09/2024	10/09/2024	No	No
Protocol file	version 2		04/11/2024	No	No
Protocol file	version 4	14/05/2025	15/05/2025	No	No
Protocol file	version 4	14/05/2025	31/07/2025	No	No

Additional files

46037_Protocol_V1.3_03Sept2024.pdf: Protocol file
ISRCTN87263624_PROTOCOL_V2.pdf: Protocol file
ISRCTN87263624_Protocol_V4_14May2025.pdf: Protocol file
ISRCTN87263624 Baseline questionnaire child 07Nov2024.pdf: Other files
ISRCTN87263624 Week 12 questionnaire child 07Nov2024.pdf: Other files
ISRCTN87263624 Week 24 questionnaire child 07Nov2024.pdf: Other files
ISRCTN87263624 FINCH Assent Form_Child Discussion Group.docx: Other files
ISRCTN87263624 FINCH_Child Interview_Parental Consent Form only_v1.0.docx: Other files
ISRCTN87263624 FINCH_Interview_PIS_Parent & Child Interviews.docx: Participant information sheet
ISRCTN87263624 FINCH_Parent Interview_Consent Form_v1.0.docx: Other files
ISRCTN87263624 FINCH_PIS_Child Interviews_Parental Consent Form.docx: Participant information sheet
ISRCTN87263624 FINCH Interview_PIS_FS Facilitators_v1.0.docx: Participant information sheet
ISRCTN87263624 FINCH_Interview_Consent Form_FS Facilitators_v1.0.docx: Other files
ISRCTN87263624 FINCH_Interview_Consent Form_School staff_v1.0.docx: Other files
ISRCTN87263624 FINCH_Interview_PIS_Control School staff_v1.0.docx: Participant information sheet
ISRCTN87263624 FINCH_Interview_PIS_Intervention School Staff_v1.0.docx: Participant information sheet
ISRCTN87263624 TOPIC GUIDE - Child Discussion Groups.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Control Class Teacher Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Control Headteacher_Management Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Control SEND Teacher Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Forest School Facilitator Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Forest School Support Staff Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Intervention Headteacher_Management Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Intervention SEND Teacher Interview.docx: Other files
ISRCTN87263624 TOPIC GUIDE - Parent_Carer Interview.docx: Other files
ISRCTN87263624 Baseline questionnaire parent 07Nov2024.pdf: Other files
ISRCTN87263624 SDQ_English parents 4-17 year olds.pdf: Other files
ISRCTN87263624 Week 12 questionnaire parent 13Nov2024.pdf: Other files
ISRCTN87263624 Week 24 questionnaire parent 13Nov2024.pdf: Other files
ISRCTN87263624 FINCH Resource Use Questionnaire_School.docx: Other files
ISRCTN87263624 FINCH Resource Use Questionnaire_Teacher.docx: Other files
ISRCTN87263624 Figure 1 FINCH_SPIRIT_Schedule.jpg: Other files
ISRCTN87263624 Figure 2 S4 Consort Diagram.jpg: Other files
ISRCTN87263624 Figure 3 SPIRIT Checklist S4_page1.jpg: Other files
ISRCTN87263624 Figure 3 SPIRIT Checklist S4_page2.jpg: Other files
ISRCTN87263624 Figure 3 SPIRIT Checklist S4_page3.jpg: Other files
ISRCTN87263624 Figure 3 SPIRIT Checklist S4_page4.jpg: Other files
ISRCTN87263624 FINCH_Forest School Facilitator Checklist.pdf: Other files
ISRCTN87263624_PIS_V4_PARENT.pdf: Other files
ISRCTN87263624_Protocol_V4_14May2025.pdf: Protocol file

Editorial Notes

21/10/2025: Publication reference added.
31/07/2025: Additional files uploaded to study outputs table.
15/05/2025: Protocol version 4 uploaded.
04/11/2024: Protocol uploaded.
08/10/2024: Sponsor details updated.
10/09/2024: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).