This post was original published on Connect Sport here.
Dr Dan Parnell, of the Business School at Manchester Metropolitan University, reflects on how interventions implemented through sporting organisations can help to promote healthy behaviour and/or improve health outcomes.
It has been recently announced within the Cochrane Database of Systematic Reviews that a new review will be undertaken to determine the effectiveness of interventions implemented through sporting organisations to promote physical activity, healthy diet, and reductions in both alcohol and tobacco consumption.
This systematic review will focus on interventions promoting one or several healthy behaviours, in particular, those addressing physical inactivity, unhealthy diets, tobacco use and alcohol consumption. These are the four health behaviours among the most relevant for morbidity and mortality worldwide (WHO 2009).
What have past reviews told us?
The 2008 Cochrane reviews of i) ‘interventions implemented through sporting organisations for increasing people’s participation in sport’ and ii) ‘policy interventions implemented through sporting organisations for promoting healthy behaviour change’, both concluded that there is an absence of high-quality evidence to support interventions designed and delivered by sporting organisations to increase participation in sport and/or healthy behaviour. The authors of the reviews recommend that rigorous evaluation techniques are employed more commonly in this field to illuminate the impact of interventions and/or health promoting policy on outcomes, and the contexts and processes which are likely to be effective in reducing harmful behaviours.
In light of this, and the announcement of a new review, it is worthwhile exploring some of the underlying principles associated with the settings-based approach to health promotion and why this review is both important and relevant for the community sport industry in the UK.
Sport: settings-based approach
Sporting organisations are a setting which interacts with other settings, whether multi-use games areas, sports stadia, residential communities and/or the natural environment. Sport-based interventions have the potential to influence at different structural levels, such as the community, family and the individual, whilst allowing for interactions to occur between groups.
For many people involved in community sport in the UK, they will be able to relate to the role sport can play in influencing healthy behaviour by intra- and interpersonal factors. Furthermore they will have observed the important contribution of systems such as organisational settings, communities, environment and policies play in facilitating healthy lifestyles. Figure 1 outlines the logic model for this principle.
Figure 1: Logic model: interventions implemented through sporting organisations for promoting healthy behaviour (from Flatz, Pfeifer, Radtke, Kriemler, Klerings, Wolfenden and von Elm, 2016)
In sporting organisations, infrastructure often focuses heavily on the delivery of, or practice of sports, to get people engaged in sports activity, which in itself can determine healthy behaviour. However, it should also be noted that participation in sports has a dark side, with a correlation between sport and alcohol/smoking consumption.
Example: The Euro 2016 football tournament in France offers a good perspective to consider UEFA’s policy driven approach and commitment to a tobacco-free tournament (http://www.healthystadia.eu/). Despite this, the tournament also offers challenges related to policy surrounding alcohol consumption, as observed by several media outlets.
Sport and healthy stadia
Besides providing interactions for participants on different levels, many sporting organisations are gatekeepers to a larger part of the population, especially the hard-to-reach groups, and as such are typically accessed by health promotion advocates.
In a study, across 10 European countries, the implementation of healthy policies in sports stadia was found to be relatively low. This was explained by the conflicting interests of sponsors and health promotion activities (Drygas 2013). Furthermore, while policies were found to frequently focus on anti-discrimination or fair-play, topics such as the promotion of healthy food or beverages seem to be underrepresented (Kelly 2010).
However, a recent special issues draws on applied policy work and the growing research in this area to provide a timely update and insight (Parnell, Curran and Philpott 2016). The collection includes applied perspectives; articles which consider sport stadia for public health promotion; research on the outcomes of physical activity and health promotion programmes in football clubs; the role of Physical Education and the implication of current sport policy; contributions on the lessons learned from sport, PA and health promotion interventions, and findings from an older men’s community-based, football-led weight management intervention (for further details please contact D.Parnell@mmu.ac.uk) .
Why is this important to the community sport industry in the UK?
Across our communities, sporting organisations are being considered as a setting which is suitable to promote health and to help tackle the big four health issues experienced by communities and populations. As a consequence government agencies and other bodies are investing in sport organisations with the assumption that they can contribute to health promotion (and then improve health).
Whilst the evidence on the role of sport organisations being used to promote health is limited, we at ConnectSport welcome this new Cochrane Review as it not only recognises the role of sport organisations in health promotion, it will also help uncover whether there is new evidence to help those delivering in this field, and evidence the impact of our work to key deliverers and policy makers in sport and health.
We also encourage those in community sport to invest in research-oriented partnerships with organisations (including academia/universities) to support their working practice, effectiveness and monitoring and evaluation – especially those organisations working towards a health agenda (Lansley and Parnell 2016).
Dr Dan Parnell is an active researcher and senior lecturer in Business Management at Manchester Metropolitan University. His research interests cover the sport and leisure sectors within the UK and he works globally on a number of projects, in particular the social role of sport. Contact firstname.lastname@example.org or follow @parnell_daniel on Twitter or access hisresearch here.
His latest research:
Parnell, D., Curran, K. and Philpott, M. (2016) Healthy stadia: an insight from policy to practice. Sport in Society, DOI:10.1080/17430437.2016.1173914 Available online here.