Advocating for implementation of the Global Action Plan on Physical Activity: challenges and support requirements

Background: There is limited understanding of the challenges experienced and supports required to aid effective advocacy of the Global Action Plan on Physical Activity (GAPPA). The purpose of this study was to assess the challenges experienced and supports needed to advocate for the GAPPA across countries of different income levels. Methods: Stakeholders working in an area related to the promotion of physical activity were invited to complete an online survey. The survey assessed current awareness and engagement with the GAPPA, factors related to advocacy, and the perceived challenges and supports related to advocacy for implementation of the GAPPA. Closed questions were analyzed in SPSS, with a Pearson’s chi-square test used to assess differences between country income level. Open questions were analyzed using inductive thematic analysis. Results: Participants (n = 518) from 81 countries completed the survey. Significant differences were observed between country income level for awareness of the GAPPA and perceived country engagement with the GAPPA. Challenges related to advocacy included a lack of support and engagement, resources, priority, awareness, advocacy education and training, accessibility, and local application. Supports needed for future advocacy included guidance and support, cooperation and alliance, advocacy education and training, and advocacy resources. Conclusions: Although stakeholders from different country income levels experience similar advocacy challenges and required supports, how countries experience these can be distinct. This research has highlighted some specific ways in which those involved in the promotion of physical activity can be supported to scale up advocacy for the GAPPA. When implementing such supports, consideration of regional, geographic, and cultural barriers and opportunities is important to ensure they are effective and equitable

Whole-of-system approaches to physical activity;

Background: The literature on whole of system approaches (WSAs) has been largely theoretical in focus. The Australian Systems Approaches to Physical Activity is a national project designed to contribute a practical implementation focus to such approaches at the population level. Methods: National meetings were convened with federal and state government sector stakeholders to identify physical activity (PA) related policies and programs. Policies and programs were audited to develop an understanding of the existing PA system. A WSA conceptual map for PA was developed using feedback from system stakeholders, existing WSAs, and related work in obesity. Results: Completion of the policy audit has revealed key areas of need regarding policy governance, coordination, financing, and evaluation. An initial WSA conceptual map for Australia has been developed incorporating governance, translation, and advocacy. Stakeholder co-production of an integrated framework for PA and design plans for a community of practice knowledge hub has commenced. Conclusions: In Australia, Australian Systems Approaches to Physical Activity project partners have developed a conceptual whole of systems map that is guiding progress beyond the theoretical to application in the real world: A national PA policy audit, co-production of an integrated PA policy framework, and planning for a PA community of practice knowledge hub.</p

‘It's about collaboration’: a whole-systems approach to understanding and promoting movement in Suffolk

Abstract Background Population-levels of physical activity have remained stagnant for years. Previous approaches to modify behaviour have broadly neglected the importance of whole-systems approaches. Our research aimed to (i) understand, (ii) map, (iii) identify the leverage points, and (iv) develop solutions surrounding participation in physical activity across an English rural county. Methods A systems-consortium of partners from regional and local government, charities, providers, deliverers, advocacy groups, and health and social care, and public health engaged in our research, which consisted of two-phases. Within Phase 1, we used secondary data, insight-work, a narrative review, participatory workshops, and interviews in a pluralistic style to map the system-representing physical activity. Phase 2 began with an initial analysis using markers from social network analysis and the Action Scales Model. This analysis informed a participatory workshop, to identify leverage points, and develop solutions for change within the county. Results The systems-map is constructed from biological, financial, and psychological individual factors, interpersonal factors, systems partners, built, natural and social environmental factors, and policy and structural factors. Our initial analysis found 13 leverage points to review within our participatory workshop. When appraised by the group, (i) local governing policies, (ii) shared policies, strategies, vision, and working relationships, (iii) shared facilities (school, sport, community, recreation), and (iv) funding were deemed most important to change. Within group discussions, participants stressed the importance and challenges associated with shared working relationships, a collective vision, and strategy, the role of funding, and management of resources. Actions to leverage change included raising awareness with partners beyond the system, sharing policies, resources, insight, evidence, and capacity, and collaborating to co-produce a collective vision and strategy. Conclusions Our findings highlight the importance and provide insight into the early phase of a whole-systems approach to promoting physical activity. Our whole-systems approach within Suffolk needs to consider methods to (i) grow and maintain the systems-consortium, (ii) create a sustainable means to map the system and identify leverage points within it, and (iii) monitor and evaluate change

A situational analysis of community physical activity participation by children and young people with neurodisability

Physical activity (PA) brings health benefits. Children and young people (C&YP) with neurodisability face challenges to PA, participate less than typically developing peers, and have fewer community opportunities and choices. I examined the situation using interview data involving families and community PA providers and applying situational analysis (SA). Cardiff University ethically approved the study. Participants included C&YP with neurodisability (4-17 years), parents, and service providers supporting community PA participation. All participants gave informed consent/assent for participation. SA of participants’ interview data answered three research questions: 1. What community PA participation opportunities are available and where do C&YP participate? 2. What are the barriers/facilitators to participation? 3. What are key action areas to increase participation? SA findings showed C&YP participated in informal play and sport within families, school, and community neighbourhoods/groups. They participated in therapeutic exercise with healthcare professionals and in formal sport in community groups/sport programmes. Most community opportunities were sport, supported by charities and volunteers. Barriers and facilitators fitted into eight situational categories: people, organisations, resources, information, organisational/institutional, discursive, environmental, and temporal. Barriers and facilitators connected and interacted in a complex network of relations that enabled or hindered participation. Thus, presence of facilitators did not guarantee participation. Overall, a fragmented situation made navigating participation difficult for families and providers. Influential disability discourses could hinder participation, while C&YP’s participation altered over time. SA identified three areas for future action: 1. Develop participation-focused healthcare education. vii 2. Co-ordinate situation elements e.g., people, information and resources. 3. Assist families and providers navigate participatio

Experiences of physical activity for individuals with spinal cord injury: A meta-study

Objectives: The purpose of this study was to critically examine the qualitative research on experiences of leisure time physical activity (LTPA) for individuals with spinal cord injury (SCI). Meta-study methodology was used as a diagnostic tool to assess the theory, methods and findings of the current literature contributing to the literature by considering both the process and product of this body of research. This meta-study therefore provides a fresh perspective on research in this field. Methods: A comprehensive search of 6 sport and exercise electronic databases and manual journal searches yielded an initial total of 675 peer reviewed articles once duplicates were removed, reduced to 57 papers read in full after analysis of titles and key words. Of these 57 papers, 25 papers were identified as suitable for full based on the inclusion criteria. Studies were reviewed using meta-study methods, comprising analysis of theoretical perspectives, methodologies and findings. Results: Research guided by occupational theory is common in this field, and has contributed by identification of numerous barriers, benefits and facilitators of LTPA for individuals with SCI. More recently, narrative inquiry has revealed health narratives that are associated with SCI, narratives existing in the LTPA environment (chaos, restitution and quest) and exercise narratives restitution, exercise is medicine and exercise is progressive redemption. Conclusion: Theoretical and methodological opportunities were identified for future research that suggest a need for greater attention to be paid to the structural and contextual conditions that shape and influence the physical activity experience

Tackling physical inactivity and inequalities: implementing a whole systems approach to transform community provision for disabled people and people with long-term health conditions.

Background Physical inactivity is a global public health priority. There are known health and well-being consequences of being inactive, and the benefits of being physically active are well established. However, there are persistent inequalities when it comes to how physically active people are, with disabled people, people living with long-term health conditions, and people residing in areas of socio-economic deprivation being particularly affected. Methods such as whole system approaches (WSAs), which are dynamic, multifaceted, and engage all relevant stakeholders, have gained momentum as an approach to address such complex public health problems. However, evidence relating to the implementation of WSAs to address physical inactivity is lacking. The aim of the Prevention and Enablement Model (PEM) was to take a whole system approach in Essex to encourage and support disabled people and/or individuals living with long-term health conditions to be more active, happier, and to live more independently. Methods The aim of this study was to explore the enablers, challenges, and reflections associated with the process of designing and implementing the PEM. Semi-structured interviews (n = 12) were used to collect data from people involved in the PEM's design, implementation and/or delivery. Data was analysed using Braun and Clarke's reflexive thematic analysis. Results Four themes were identified: (1) Working collaboratively: Specific enablers of time and space were identified as important in the planning and implementation of a WSA (2) Leadership and planning: Distributed and flexible leadership was identified as central to successful implementation (3) Re-orientating practice: Highlighted the transformative potential of a whole system approach and how it contrasts with conventional work practices, and (4) Reflection and learning: Informing ongoing refinements and further implementation of successful system change. Conclusions These findings highlight the challenge and complexity of implementing a WSA that involves diverse stakeholders from across adult social care, the NHS, and the third sector. Several important enablers are identified, such as leadership and planning, and the challenges and discomfort that can arise whilst changing systems. Ongoing efforts are required to ensure that different elements of the system collaborate effectively to address inequalities in physical activity participation, through the implementation of a WSA

Tackling physical inactivity and inequalities: implementing a whole systems approach to transform community provision for disabled people and people with long-term health conditions

Data availability: The data that support the findings of this study are available on request from the corresponding author, (AP). The data are not publicly available due to their containing information that could compromise the anonymity of research participants.Electronic supplementary material is available online at: https://link.springer.com/article/10.1186/s12889-024-18051-6#Sec17 .Background: Physical inactivity is a global public health priority. There are known health and well-being consequences of being inactive, and the benefits of being physically active are well established. However, there are persistent inequalities when it comes to how physically active people are, with disabled people, people living with long-term health conditions, and people residing in areas of socio-economic deprivation being particularly affected. Methods such as whole system approaches (WSAs), which are dynamic, multifaceted, and engage all relevant stakeholders, have gained momentum as an approach to address such complex public health problems. However, evidence relating to the implementation of WSAs to address physical inactivity is lacking. The aim of the Prevention and Enablement Model (PEM) was to take a whole system approach in Essex to encourage and support disabled people and/or individuals living with long-term health conditions to be more active, happier, and to live more independently. Methods: The aim of this study was to explore the enablers, challenges, and reflections associated with the process of designing and implementing the PEM. Semi-structured interviews (n = 12) were used to collect data from people involved in the PEM’s design, implementation and/or delivery. Data was analysed using Braun and Clarke’s reflexive thematic analysis. Results: Four themes were identified: (1) Working collaboratively: Specific enablers of time and space were identified as important in the planning and implementation of a WSA (2) Leadership and planning: Distributed and flexible leadership was identified as central to successful implementation (3) Re-orientating practice: Highlighted the transformative potential of a whole system approach and how it contrasts with conventional work practices, and (4) Reflection and learning: Informing ongoing refinements and further implementation of successful system change. Conclusions: These findings highlight the challenge and complexity of implementing a WSA that involves diverse stakeholders from across adult social care, the NHS, and the third sector. Several important enablers are identified, such as leadership and planning, and the challenges and discomfort that can arise whilst changing systems. Ongoing efforts are required to ensure that different elements of the system collaborate effectively to address inequalities in physical activity participation, through the implementation of a WSA.Essex County Council, as part of an evaluation of the Sport England funded Essex Local Delivery Pilot