Designing programmes of physical activity through sport: Learning from a widening participation intervention, 'City of Football'

Background: Implementation profoundly influences how well new audiences engage with sport-based physical activity programmes. Recognising that effective implementation relies on concurrently generating supportive contexts, systems and networks for the least engaged ‘target’ groups; this paper aims to address what underpins children’s (non) engagement with football-based physical activity. Methods: An observational research design, using a non-probability sample of N=594 primary and secondary schoolchildren assessed outcomes of a three-year ‘City of Football’ (CoF) programme. Pupils self-reported football participation, personal friendship networks and exposure to six concurrent sources of influence (SoI). A 2-step hierarchical cluster analysis and univariate analyses assessed between-cluster differences. Results: Girls played football least regularly (χ2 [4] = 86.722, p = 0.000). Overall, participation was significantly associated with personal networks engaged in football. Boys’ personal networks were more stable and structurally effective. Football participation was also positively and linearly association with SoI scores. Girls and pupils with no personal networks around football reported the lowest SoI scores. Three clusters emerged, dominated by social network influences. The Traditional Market (n=157, 27.7%) comprised 81.7% boys; they regularly played football, had the most effective network structure and scored highly across all six domains of SoI. The Sporadically Engaging Socialisers (n=190, 33.5%) comprised 52.9% girls who rarely played football, reported low SoI scores and an inferior network structure. In the Disconnected cluster (n=220, 38.8%), 59.3% were non-footballing girls who reported the lowest motivation and ability SoI scores; and no personal networks engaged in football. Conclusions: This study reveals new insights about the primacy of social network effects for engaging children in football-based physical activity programmes. With little or no attention to these social-oriented issues, such interventions will struggle to attract ‘target’ children, but will readily engage already well-connected, experienced football-playing boys. The challenge for drawing non-footballing children into football-based interventions lies with engaging children – especially girls - whose social networks are not football-focused, while they also find football neither personally motivating nor easy to do

The delivery and management of telephone befriending services – whose needs are being met?

Purpose – This article aims to describe an evaluation of a national pilot programme of telephone support services for older people in England and Scotland and is focussed on organisational outcomes. Design/methodology/approach – The “Call in Time Programme” was funded by the national charity Help the Aged and comprised eight telephone support projects in different locations, managed by different voluntary or charitable organisations. Researchers used semi-structured interviews and a Delphi questionnaire to obtain the views of project coordinators. Findings – Although the projects were found to provide a much needed service for socially isolated and lonely older people, the study identified four key areas of concern: operational structure; promotion and publicity; recruitment of volunteers; referral processes. Project coordinators wanted more autonomy and the flexibility to respond to older people's needs. Projects were limited by restrictions imposed by funding bodies or services themselves. Practical implications – Project coordinators recommended more local control over project finances, clear referral pathways linking voluntary and statutory bodies, long-term funding involving project coordinators and older people in planning and delivery, more training for project coordinators, clear record keeping and a coordinated approach to promotion and publicity. Originality/value – While other studies have highlighted the importance of user involvement, this study provides valuable evidence demonstrating that those responsible for managing and delivering telephone support services, and service users, are instrumental in decision making and planning processes. As organisations are streamlined in efforts to increase efficiency and effectiveness, there is a need for a wider cultural change in the way supportive programmes are viewed and funded

What makes a good children’s doctor? Exploring the child perspective in the OSCE setting

Background: Patient feedback is increasingly important in clinical practice, and this should include children’s views. 28 children aged 8-10 years participating in a large-scale OSCE underwent cranial nerve examination by student candidates. They scored each out of 10 for the question: ‘If you had to see a doctor again, how happy would you be to see this one?’ An age-adapted qualitative focus group methodology was used to explore why they scored some students more highly than others. Results: Children’s scores for the 256 medical students ranged from 2 to 10 (median 9; mean 8.46). 76% of scores were ≥ 8. ‘Good doctor attributes included: ‘friendly’, ‘funny’, ‘knowledgeable’, ‘confident’; ‘bad’ doctor attributes were: ‘making mistakes’, ‘not paying attention’, ‘forgot everything’, ‘serious’. Children’s reasons for specific scores are further explored. Discussion and conclusion: Scores were positively skewed, in line with most patient/simulated patient feedback, and children discriminated between candidates. It should not be assumed that clinician examiners can accurately represent the views of child patients who may value different qualities in doctors. Children participating in our study had clear views of what they want from a doctor: a consultative approach with clear and kind explanation of the process of examination

Comparison between electrically evoked and voluntary isometric contractions for biceps brachii muscle oxidative metabolism using near-infrared spectroscopy

This study compared voluntary (VOL) and electrically evoked isometric contractions by muscle stimulation (EMS) for changes in biceps brachii muscle oxygenation (tissue oxygenation index, ΔTOI) and total haemoglobin concentration (ΔtHb = oxygenated haemoglobin + deoxygenated haemoglobin) determined by near-infrared spectroscopy. Twelve men performed EMS with one arm followed 24 h later by VOL with the contralateral arm, consisting of 30 repeated (1-s contraction, 1-s relaxation) isometric contractions at 30% of maximal voluntary contraction (MVC) for the first 60 s, and maximal intensity contractions thereafter (MVC for VOL and maximal tolerable current at 30 Hz for EMS) until MVC decreased ∼30% of pre-exercise MVC. During the 30 contractions at 30% MVC, ΔTOI decrease was significantly (P < 0.05) greater and ∼tHb was significantly (P < 0.05) lower for EMS than VOL, suggesting that the metabolic demand for oxygen in EMS is greater than VOL at the same torque level. However, during maximal intensity contractions, although EMS torque (∼40% of VOL) was significantly (P < 0.05) lower than VOL, ΔTOI was similar and ΔtHb was significantly (P < 0.05) lower for EMS than VOL towards the end, without significant differences between the two sessions in the recovery period. It is concluded that the oxygen demand of the activated biceps brachii muscle in EMS is comparable to VOL at maximal intensity. © Springer-Verlag 2009