Building Public Health Capacity through Organizational Change in the Sport System: A Multiple-Case Study within Australian Gymnastics

Sports clubs increasingly are settings for health promotion initiatives. This study explored organizational change processes and perceived facilitators and barriers relevant to implementing a health promotion initiative within gymnastics settings in New South Wales (NSW), Australia. A multiple-case design investigated the experiences of the state association (Gymnastics NSW) and five clubs from one region of NSW in a participatory Health-Promoting Gymnastics Clubs (HPGC) program. The program aimed to build the capacity of Gymnastics NSW to support affiliated clubs to become health-promoting settings. Interviews with organizational representatives explored their experiences of the program and identified factors that enabled or inhibited program adoption, implementation and sustainability. Facilitators and barriers identified included leadership and champions; organizational capacity and culture; priorities and timing; and characteristics of the HPGC framework. This multi-level, organizational change intervention demonstrated potential to create health-promoting gymnastics settings. Tailoring strategies in diverse club contexts required involvement of organizational leaders in program development and action planning. Despite positive impacts, pre-existing organizational culture inhibited integration of health promotion as a core value. Sustained organizational change may result from professional regulatory requirements (e.g., accreditation and affiliation), and policy directives and funding (for organizational change, not program delivery) from relevant government departments.

Novel implementation of experiential learning in health and wellbeing in a university setting

Healthy UCD is a health promotion initiative in University College Dublin (UCD) which aims to create a sustainable healthy campus for all members of the UCD community. In recent years, Healthy UCD has worked with staff from across the university to provide opportunities for experiential learning to UCD students in areas related to health and wellbeing. The initiative currently has involvement in three modules: 1) Practice Placement – a core MSc in Clinical Nutrition and Dietetics module where students plan and implement a university-wide Healthy Eating Week, 2) Event Management – a core module undertaken by second-year BSc Sport & Exercise Management students, and 3) Student Health & Wellbeing – an undergraduate elective module which challenges students to reflect on issues which affect their own health and wellbeing and that of those around them and then develop a student-focused Healthy UCD campaign. This paper will outline how experiential learning is implemented in these modules, how students are assessed, and the perceptions of students who complete these modules.

Art during tough times: reflections from an art-based health promotion initiative during the COVID-19 pandemic

With the current COVID-19 pandemic impacting communities across the globe, diverse health promotion strategies are required to address the wide-ranging challenges we face. Art is a highly engaging tool that promotes positive well-being and increases community engagement and participation. The ‘Create Hope Mural’ campaign emerged as an arts-based health promotion response to inspire dialogue on why hope is so important for Canadians during these challenging times. This initiative is a partnership between a health promotion network based in Vancouver and an ‘open air’ art museum based in Toronto. Families were invited to submit artwork online that represents the concept of hope. This paper discusses the reflections of organizers of this arts-based health promotion initiative during the early months of the pandemic in Canada. Our findings reveal the importance of decolonizing practices, centring the voices of those impacted by crisis, while being attentive to the social and political context. These learnings can be adopted by prospective health promoters attempting to use arts-based methods to address social and health inequities.

How can a coordinated regional smoking cessation initiative be developed and implemented? A programme logic model to evaluate the ‘10,000 Lives’ health promotion initiative in Central Queensland, Australia

ObjectiveThis study used a programme logic model to describe the inputs, activities and outputs of the ‘10,000 Lives’ smoking cessation initiative in Central Queensland, Australia.DesignA programme logic model provided the framework for the process evaluation of ‘10,000 Lives’. The data were collected through document review, observation and key informant interviews and subsequently analysed after coding and recoding into classified themes, inputs, activities and outputs.SettingThe prevalence of smoking is higher in the Central Queensland region of Australia compared with the national and state averages. In 2017, Central Queensland Hospital and Health Services set a target to reduce the percentage of adults who smoke from 16.7% to 9.5% in the Central Queensland region by 2030 as part of their strategic vision (‘Destination 2030’). Achieving this target is equivalent to 20,000 fewer smokers in Central Queensland, which should result in 10,000 fewer premature deaths due to smoking-related diseases. To translate this strategic goal into an actionable smoking cessation initiative, the ‘10,000 Lives’ health promotion programme was officially launched on 1 November 2017.ResultThe activities of the initiative coordinated by a senior project officer included building clinical and community taskforces, organising summits and workshops, and regular communications to stakeholders. Public communication strategies (e.g., Facebook, radio, community exhibitions of ‘10,000 Lives’ and health-related events) were used to promote available smoking cessation support to the Central Queensland community.ConclusionThe ‘10,000 Lives’ initiative provides an example of a coordinated health promotion programme to increase smoking cessation in a regional area through harnessing existing resources and strategic partnerships (e.g., Quitline). Documenting and describing the process evaluation of the ‘10,000 Lives’ model is important so that it can be replicated in other regional areas with high prevalence of smoking.

Healthy Living and Co-Production: Evaluation of Processes and Outcomes of a Health Promotion Initiative Co-Produced with Adolescents

Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportunity–cost analysis that compared beFood to traditional approaches of public health promotion. The co-production model was successfully implemented and appears to be effective—more than 5000 adolescents were reached by only 49 co-producer adolescents, who reported behavioral changes (e.g., eating better and practicing more physical activity). The cost analysis showed that the co-production approach was also efficient, producing relevant savings and potentially making available more than 3000 h of professionals’ time. This research can support a re-thinking of public institutions’ organization, public initiatives’ design, and public servants’ role.

‘Sheds for Life’: getting the balance right in delivering health promotion through Sheds in Ireland

Summary Men with the poorest health outcomes are, paradoxically, the least likely to access health services or to engage with health promotion interventions. This has focused attention on developing gender-sensitive and strengths-based approaches to engage so-called ‘hard-to-reach’ men. Men’s Sheds (‘Sheds’) are recognized as an alternative space in which to engage older and more marginalized groups of men in health. The aim of this study was to establish key principles that could align the ethos of Sheds with a national health promotion initiative (‘Sheds for Life’; SFL) in terms of methods of engagement, programme content and models of delivery. Qualitative methods incorporating semi-structured interviews, focus groups and observations were conducted with men in Sheds (‘Shedders’; n = 38), oversight/advisory groups (n = 11) and partner organizations (n = 8). The principles of grounded theory were used to inform data collection and analysis. Findings revealed a range of mediating factors in terms of how Shedders engage with or ‘do’ health that were grounded in a recognition of the health-enhancing ‘essence’ of Sheds and in ‘making men’s health men’s business’. Key learnings arising from the process of engaging with Shedders included the importance of investing in relationships, establishing credibility and tailoring SFL programme content and delivery to individual Sheds. In terms of conceptualizing SFL, attention was drawn to the need for a coherent and formalized SFL strategy and ‘rules of engagement’, as well as a robust and sustainable system for implementation. This is the first study that informs a more systematic and formal approach to health promotion in Sheds.

One year update following removal of high sugar sweetened beverages from a university campus

Healthy UCD is a health promotion initiative designed to create a sustainable healthy university campus. The aim of the study was to report on student and staff attitudes and provider attitudes to the removal and income from drinks one year following the removal of carbonated sugar sweetened beverages (HSSBs) on a large university campus, University College Dublin (UCD). In 2018 Healthy UCD, in partnership with the contracted beverage supplier, conducted a seven-week trial where all HSSBs were removed from the main campus and replaced with sugar-free or low-sugar alternatives. This was in advance of a levy on HSSBs to be introduced nationally. During the trial, drinks sales rose by 4%. Following the trial, a survey of students was conducted across the campus which provided the motivation to the University Management Team to approve removal of HSSBs on a permanent basis. Staff and student complaints were monitored over the following year. Drinks sales data was obtained from retail outlets for 2019 and compared to the same sales period for the previous year. Retail sales for drinks continued to grow despite removal of HSSBs, with 8% growth in the year following removal. A small number of complaints were documented. The most important was a query about those staff and students with diabetes mellitus who might need high sugar energy products and the removal of a particular HSSB which is sold in Ireland. This HSSB had not in fact previously been sold in UCD. The national advice regarding access to high sugar products in the case of hypoglycaemia from Diabetes Ireland was provided satisfactorily for all staff and students. Removal of HSSBs from a university campus is possible; advice must be provided to those who may feel negatively impacted by the change. Key messages Removal of high sugar sweetened drinks from a university campus is possible; advice must be provided to those who may feel negatively impacted by the change. Sales can grow despite health-related changes of the food environment.

Addressing Cardiovascular Health Disparities in Minnesota: Establishment of a Community Steering Committee by FAITH! (Fostering African-American Improvement in Total Health)

Despite its rank as the fourth healthiest state in the United States, Minnesota has clear cardiovascular disease disparities between African-Americans and whites. Culturally-tailored interventions implemented using community-based participatory research (CBPR) principles have been vital to improving health and wellness among African-Americans. This paper delineates the establishment, impact, and lessons learned from the formation of a community steering committee (CSC) to guide the Fostering African-American Improvement in Total Health (FAITH!) Program, a CBPR cardiovascular health promotion initiative among African-Americans in Minnesota. The theory-informed CSC implementation process included three phases: (1) Membership Formation and Recruitment, (2) Engagement, and (3) Covenant Development and Empowerment. The CSC is comprised of ten diverse community members guided by mutually agreed upon bylaws in their commitment to FAITH!. Overall, members considered the CSC implementation process effective and productive. A CBPR conceptual model provided an outline of proximal and distal goals for the CSC and FAITH!. The CSC implementation process yielded four lessons learned: (1) Have clarity of purpose and vision, (2) cultivate group cohesion, (3) employ consistent review of CBPR tenets, and (4) expect the unexpected. A robust CSC was established and was instrumental to the success and impact of FAITH! within African-American communities in Minnesota.