'To mean something to someone' : sport-for-development as a lever for social inclusion

Background Socially excluded groups are at higher risk of low well-being and poor health. The link between social exclusion and health inequities is complex, and not being involved in society makes it difficult to be reached by standard prevention programs. Sport-for-development (SFD) programs are low-threshold and may be promising settings for inclusive actions. We explore the underlying mechanisms through which SFD might have an impact on social inclusion and examine the necessary conditions that work as a catalyst for these underlying mechanisms. Methods A realist evaluation approach was adopted. A non-profit SFD organization in a middle-large city in Flanders, Belgium, formed the setting for a single case study. Document analysis, participatory observations, interviews, and a focus group, were sources for identifying necessary context elements and essential mechanisms through which SFD could promote its participants' health and wellbeing. Results Among the most efficient mechanisms triggered by the Foundation's activities are learning by fun, connecting with peers (of whom some serve as role model) and engaging as a volunteer with some responsibilities. Building trust in oneself and in others is a necessary process throughout all these mechanisms. Facilitating context factors include the activities' accessibility and unconditional approach (creating a sense of safety), the popularity of the first division football team the Foundation is associated with (leading to a sense of belonging), a steady network of social partners and a strongly positive relationship with the SFD coach(es). Conclusions Our findings demonstrate that a SFD setting may be a vehicle for engaging hard-to-reach population groups. It enhances socially vulnerable persons' sense of competence and connectedness, leading to opportunities to improve life and work skills transferrable outside SFD settings. Based on these findings, suggestions are provided that may enhance the field and help to develop feasible (policy-led) interventions designed to promote social inclusion

Study protocol: SWING – social capital and well-being in neighborhoods in Ghent

Background: Investing in social capital has been put forth as a potential lever for policy action to tackle health inequity. Notwithstanding, empirical evidence that supports social capital's role in the existence of health inequity is limited and inconclusive. Furthermore, social capital literature experiences important challenges with regard to (1) the level on which social capital is measured and analyzed; (2) the measurement of the concept in line with its multidimensional nature; and (3) the cross-cultural validity of social capital measurements. The Social capital and Well-being In Neighborhoods in Ghent (SWING) study is designed to meet these challenges. The collected data can be used to investigate the distribution of health problems and the association between social capital, health and well-being, both at the individual and at the neighborhood level. The main goals of the SWING study are (1) to develop a coherent multilevel dataset of indicators on individual and neighborhood social capital and well-being that contains independent indicators of neighborhood social capital at a low level of aggregation and (2) to measure social capital as a multidimensional concept. The current article describes the background and design of the SWING study. Methods/Design: The SWING study started in 2011 and data were collected in three cross-sectional waves: the first in 2011, the second in 2012, and the third in 2013. Data collection took place in 142 neighborhoods (census tract level) in the city of Ghent (Flanders, Belgium). Multiple methods of data collection were used within each wave, including: (1) a standardized questionnaire, largely administered face-to-face interviews for neighborhood inhabitants (N = 2,730); (2) face-to-face interviews with key informants using a standardized questionnaire (N = 2,531); and (3) an observation checklist completed by the interviewers (N = 2,730 in total). The gathered data are complemented by data available within administrative data services. Discussion: The opportunities and ambitions of the SWING study are discussed, together with the limitations of the database

Development and validation of EMP-3 : an instrument to measure physicians' attitudes towards ethnic minority patients

Background and Objectives: The growing diversity of patient populations challenges health care providers. Physicians' attitudes and perceptions toward cultural diversity in health care could be partly contributing to difficulties in communication between physicians and ethnic minority patients. To evaluate these attitudes and perceptions, an instrument was developed and validated. Methods: A preliminary version of the instrument was developed through literature research and expert consultation and completed by 112 family physicians. Factor analysis was performed and reliability and construct validity tested. Results: The instrument revealed three factors that were interpreted as: (1) physicians' task perception and ideas on cultural differences in health and health care, (2) physicians' attitudes toward physician-patient communication with minority patients, and (3) physicians' perception of minority patients' needs in communication. Moderate but significant correlations were found between factors of the EMP-3 and practice organization, practice location, and physicians' gender. Several factors of the Jefferson Empathy Scale, the Patient Practitioner Orientation Scale, and the Health Beliefs and Attitude Scale related to the first two factors of the EMP-3. Conclusions: This instrument, designed specifically to measure physicians' attitudes toward cultural diversity, showed moderate validity and reliability results. Further adaptations and evaluation could be useful

‘Maybe we can turn the tide’ : an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues. Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico. Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison. Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs. Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles