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Case studies have many different applications. Hakim (1992) classified the case study approach into three types: experimental, descriptive and selective. Stake (1995) also classified case studies into three categories: Collective studies, which are used when a researcher wants to study more than one case together; Intrinsic case studies which are cases of interest to the researcher: this would be consistent with “descriptive” case studies (Yin, 2003); and Instrumental case studies, which use one case to try to understand another thing. In contrast, Yin (2009) suggested that case studies can be classified into three types:

explanatory, descriptive and exploratory. Explanatory case studies are used to connect an incident with its impacts and are appropriate to verify causality, whereas exploratory case studies are often conducted to determine study hypotheses and research questions. On the other hand, descriptive case studies are used to explain incidents and their context. Through a review of the literature, it is clear that each of these applications can be used in single or multiple case studies. However, researchers should choose the type that is capable of being adapted to their particular research problems (Burton, 2000). Through understanding these

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three classifications, I excluded an explanatory and descriptive case study and found that the appropriate type for the present study is an exploratory case study, because this research involves gathering information from different sources, such as observation, interviews with students and teachers and document analysis to explore any factors that affect body weight among Saudi students in primary schools. Many scientists believe that the case study approach is appropriate in the exploratory phase of an investigation (Yin, 2009).

Case studies have a long history in many fields, such as social science (Burton, 2000), medicine and law (Burns, 2000). In spite of the extensive use of case studies, there is still debate about how they should be defined. In fact, in 1992 this controversy led to a book being written on the issue (Burton, 2000). Overall, cases can be defined as “individuals”

“events” and “programmes” (Yin, 2009), or as countries or organisations (Burton, 2000).

Moreover, a case can be a class, a school, or a student (Burns, 2000). However, according to Yin (2009), case studies attempt to draw attention to one or more issues and to answer in detail what causes these issues, how they are carried out, and what are the consequences.

As stated by Burns (2000), this approach focuses on discovery instead of confirmation. The focus of the present study was on factors that affect children’s body weight. There have been numerous previous studies of children’s body weight undertaken outside the school setting, and many of the studies conducted inside schools have focused only on the prevalence of obesity among students. However, controlling obesity among children requires strong efforts and collaboration. My two supervisors and myself discussed at length whether students or school will be the case, and because this study focused on schools we agreed that the ‘school’

is a single case study, using a variety of methods for data collection to represent the most appropriate information for this study. This approach also allows comparison of the final findings between cases of different types (private school, Islamic school and public school).

Thus, each case was a school, chosen because it typified one of the three types of school in Saudi Arabia.

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Many sources state that there are different types of case study. Burns (2000), in his book, presents six types of case study: clinical case studies, historical case studies, situational analysis, oral history, observational case studies, and multi-case studies. Hilliard (1993) also mentions a number of case studies, such as single case experiments, narrative case studies, single case quantitative analysis, and combined qualitative and combined quantitative studies (Brewerton and Millward, 2001). Yin (2009) suggests four types of case study designs, single-case (holistic) designs, single-case (embedded) designs, multiple-case (holistic) designs and multiple-case (embedded) designs. The present study took a multiple case study approach. Burns (2000) was of the view that a case study with a bounded system will be stronger. This study used a bounded system to study how boys in Saudi Arabia perceive body weight by geographicaly area (Makkah), type of school (Public schools, Islamic schools and Private schools), grade (6) and time (second term) The role of this bounded system is

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Although case studies have many positive points, such as using multiple sources of evidence and collecting in depth information, the case study method has faced criticism. The greatest concern is representativeness and whether the result of a case study can be generalised (Burton, 2000). This issue can be described as generalisation (Brewerton and Millward, 2001). The second objection to the case study approach is lack of rigour(Yin, 2009), which increases subjective bias (Burns, 2000). The third concern is that when a case study uses different methods, it can be very time-consuming and end up with massive data collection (Burton, 2000, Burns, 2000). I found that this was a challenge, so with more reading, I found that there are various recommended strategies that can help to resolve these issues (Burns, 2000). One such strategy for making a strong case study is what Burgess (1984) called

‘multiple strategies’ which means the use of a variety of methods, investigators, theories and data within the study.

This idea came from Denzin (1970), who classified triangulation into four types: data triangulation, investigator triangulation, theory triangulation and methodological triangulation (Burgess, 1984). Triangulation is a case study, using two or more methods of data collection, which improves its internal validity(Burns, 2000). Therefore, I used many strategies, such as studying more than one case so we have three cases of schools. This brings evidence from multiple case studies making it more robust than single case studies. This also allows comparison and contrast between the three cases. Moreover, I used random sampling of schools to make high generalisability of the findings.

Many methods can be used to generate case study data. Yin (2009) stated that there are six major sources of data in cases studies: documentation, archival records, interviews, direct observation, participant observation and physical artefacts. Data can also be generated using the methods of previous research or reports as examples the Foresight Obesity System Map in the present case (Butland et al., 2007). Each method has its own classification and

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principles. For example, interviews are classified into two types, structured and unstructured (Yin, 2009). Documents can be classified into primary and secondary sources (Burgess, 1984).

Burns (2000) outlines many important issues with regard to case study sources: for example, the fact that using one source of data leads to poor results, whereas using more than one source of data leads to stronger results, even though it creates more pressure for the researcher. He also indicates that interviews are a good method for generating information.

The Foresight Obesity System Map (Butland et al., 2007) includes seven themes: the physiology cluster, the individual activity cluster, the physical activity environment cluster, the food consumption cluster, the food production cluster, the individual psychology cluster, and the social psychology cluster. Six of the themes are useful as they provide a framework and guidance on obesity and its complexities in this study but the physiological cluster was excluded, because it is beyond the scope of the present study, and it would have been difficult to get approval from the Ministry of Education in Saudi Arabia to investigate this aspect. Therefore, I used the six remaining themes from the Foresight Obesity System Map as a guide during each stage of the data collection process in the current study. The six clusters are explained in Table 3.1.

Table 3.1: The Themes from the Foresight Obesity System Map

Themes Observation Documents Interviews

Teachers Students

1 The individual activity cluster, which consists of:

 Exploring school timetables and how many physical exercise lessons are provided.

 Understanding students’ health information about body weight.

 Observing students in school during physical exercise lessons.

√ √ √

2 The individual psychology cluster, which involves

 Observing students dealing with each other during the school day.

√ √ √

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 Understanding factors that affect students’

food choices.

 Exploring the level of parental control of students; food.

3 The social psychology cluster, which captures:

 Factors at a social level, such as media.

 Social attitudes to body weight.

√ √ √ √

4 The food consumption cluster, which includes:

 The food market in schools.

 The level of food in school canteens.

 The variety of canteen food.

 The nutritional quality of food and drink.

√ √ √ √

5 The physical activity environment cluster, which includes:

 Exploring schools’ facilities for physical activity

 Exploring schools’ barriers to physical activity

√ √ √ √

6 The food production cluster, which includes:

 Schools’ canteen systems

 School canteens and headteachers' responsibility

 Schools canteens and teachers' responsibility

√ √ √ √

Much of the literature about children and healthy eating has focused on those aged below 13 years of age(Babooram et al., 2011; Welch et al., 2004; Gualdi-Russo et al., 2008; Wofford, 2008; Brown and Summerbell, 2009). In 2010, children accounted for 28.8 % of the Saudi population, and the majority of them were in primary schools. This study focused only on boys rather than both genders, because in Saudi Arabia, boys and girls study in separate schools and do not mix due to cultural and religious beliefs. Therefore, as a male researcher, I would not be permitted access to girls’ schools. This qualitative study used three data collection methods - semi-structured interviews, observations and documentary review - to examine factors promoting healthy eating and balanced activity levels, and factors contributing to obesity, in boys’ schools in Saudi Arabia.

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