S3 and S4). Using a large sample of data from the NCMP and a repeated cross-sectional design, this study has examined the possibility of a ‘school effect’ on pupil weight status. The ranking of schools based on the mean ‘value-added’ to pupil weight status, adjusted for individual ethnicity and socioeconomic

status, produced rankings which had little agreement with either the Observed or ‘Expected’ ranking of schools on their mean pupil BMI-SDS. Procter et al. (2008) suggested that such findings provided evidence that Epacadostat individual schools could have a differential impact on pupil weight status; i.e. that some school environments were more or less obesogenic than others. Within our study it was possible to expand upon this analysis and test whether individual school rankings

remained consistent or stable across five years. Our findings demonstrate that the rankings of individual schools, and in particular the ‘Value-added’ rankings, varied considerably from year-to-year. When the rankings were divided into quintiles, the tracking coefficients suggested that only around 5% of the ~ 300 schools remained in the same quintile across the five years in any of the rankings. This year-to-year variability in school rankings demonstrates that current ‘value-added’ inhibitors methods can be misleading. The results also strongly suggest that the school environment and context do not significantly affect GDC-0973 mouse childhood weight status with more than 97% of the variance in BMI-SDS attributable to environments other than the school. A strength of the study was the availability of

a large data set of routinely collected objective weight status data which could be linked to indices of socioeconomic status. The fact that only those pupils in the first (Reception) and last (Year 6) years of primary education were measured in the NCMP was apposite for evaluating ‘value-added’ scores. Access to repeated survey data from five years of the NCMP made it possible to assess consistency of the ‘value-added’ scores. However, as these data were cross-sectional and hence the Reception and Year 6 pupil data Terminal deoxynucleotidyl transferase are from different children, the analysis cannot be considered truly ‘value-added’ and ‘period effects’ could not be ruled out (Amrein-Beardsley, 2008 and Rutter, 1979). For example, there might have been fundamental differences between the Reception and Year 6 pupils, which could account for some of the more extreme (outlying) values observed in the caterpillar plots (Supplementary Material) of the ‘Value-added’ rankings. Using longitudinal data and including additional factors (e.g. parental weight status) alongside ethnicity and socioeconomic status in the calculation of the ‘value-added’ scores may make such rankings more stable and hence reliable.