Using Realist Interviews to Improve Theory on the Mechanisms and Outcomes of Sport for Development Programmes

The complex nature of Sport for Development (SfD) programmes makes impact evaluation challenging. Realist evaluation has been proposed as a new, theory-driven approach to evaluate complex programmes. The present study aimed to explore the value of conducting realist interviews to gain improved insight into the mechanisms and outcomes of three SfD programmes in the Netherlands: a programme that promotes sports participation among socially vulnerable youth; a combined lifestyle intervention for adults of low social economic status; and a sports-based programme for marginalised adults. In addition, the study aimed to investigate the applicability of a conceptual model from the field of social enterprise (Roy, Baker, & Kerr, 2017) as the preliminary programme theory for those interviews. First, for each programme, a realist interview was conducted with one researcher as the key informant. Thereafter, the findings from and experiences with the individual realist interviews were discussed among the informants in a group meeting. The results revealed that the conceptual model functioned well as preliminary programme theory for the SfD programmes. The realist interviews contributed to theoretical awareness and trustworthiness. Importantly, the interviews highlighted knowledge gaps and generated ideas for programme improvement. Hence, the realist interview technique is recommended as a methodological tool to generate, validate, and improve programme theory in the field of SfD. This study had, however, an explorative character, and more research is needed to confirm and generalize the findings and to learn how a greater number of stakeholders might contribute to this type of realist evaluation

S(up)port your future! : A salutogenic perspective on youth development through sport

Background Sport is often recognised as an avenue for the positive development of young people. In line with this, policymakers and health professionals in the Netherlands, and elsewhere in the world, encourage socially vulnerable youth to participate in sport. Socially vulnerable youth are characterised as having an accumulated amount of negative experiences with the societal institutions in their lives, leading to distorted relationships with those institutions and, eventually, to feelings of isolation and low self-esteem. As socially vulnerable youth participate less in sport than their non-vulnerable peers, encouraging them to participate may support these youths in leading a healthy and productive life. However, to date, our understanding of the role of sport in positive youth development has been primarily based on research conducted in non-vulnerable populations and very little research has been conducted among socially vulnerable youth. The research that has been conducted for this thesis has been inspired by the salutogenic model of health, allowing us to examine the underlying mechanisms and processes of sports participation in alleviating social vulnerability. Aim The overall aim of this thesis is to unravel the value of sports participation for socially vulnerable youth. Four research objectives were formulated: To provide insights into the mechanisms underlying people’s capacity to cope with stressors (sense of coherence) to underpin health promotion activities that aim to strengthen this coping capacity. To provide insights into the relation between sports participation and youth development for socially vulnerable youth; To examine if and how community sports coaches can create optimal conditions for the personal development of socially vulnerable youth; To explore how socially vulnerable youth experience their participation in sport and the value they derive from sports participation in a socially vulnerable childhood. Methods This study has adopted a mixed-methods research design. More specifically, this study has used literature review (objective 1 and 2), questionnaire research (objective 2), semi-structured interviews (objective 3), and narrative interviews and life-course interviews (objective 4). Results The findings provide insights into the mechanisms underlying sense of coherence which reflects people’s capacity to deal with stressors in a health promoting way ( i.e., research objective 1). Sense of coherence consists of three components: the extent to which people experience the world as consistent and structured (comprehensibility); the extent to which people feel that there are resources available to meet the demands of everyday life (manageability); and the extent to which people feel that dealing with the stressors of everyday life is worthy of investment and engagement (meaningfulness). Based on a literature review of the salutogenic model of health, two opportunities for strengthening this sense of coherence in health promotion activities were identified: the behavioural mechanism and the perceptual mechanism. Both empowerment and reflection processes are important for the development of sense of coherence and can strengthen the healthy development of individuals. The findings provide insights into the relation between sports participation and youth development for socially vulnerable youth (i.e., research objective 2). In the systematic review, it was demonstrated that relatively few studies have been conducted regarding the life skill development of socially vulnerable youth in sports programs and that the evidence that is available is inconclusive regarding the benefits of sports. In the quantitative study, a positive relation was found between sports participation and several youth developmental outcomes (i.e., pro-social behaviour, subjective health, well-being, school performance and sense of coherence) but not with problem behaviour and the self-regulation skills. However, no conclusions can be drawn about a causal relationship between sports participation and youth development based on these data. The findings also demonstrated the crucial role of the sports coach in reaching optimal social conditions for life skill development and transferability (i.e., research objective 3). The community sports coaches mainly adopted an implicit approach to life skill transferability, meaning that they did not employ explicit strategies to stimulate the transfer of life skills from the sports setting to other societal domains. Nonetheless, the sports coaches believed that socially vulnerable youth could develop life skills in the sports setting that could also be used in school, the family or in the community. Coaching actions were directed at creating meaningful, comprehensible, and manageable sports experiences for socially vulnerable youth. Finally, the findings shed a light on how socially vulnerable youth experience their participation in sport and the role that sports participation could play in a socially vulnerable childhood (i.e., research objective 4). The youths’ positive and negative sports experiences rested on an intricate balance of the extent to which they experienced visibility of their skills, the extent to which they felt confident while playing their sport, and the extent to which they felt sport was a nice challenge that they liked to take on. The roles that sports participation could play in a socially vulnerable childhood are diverse: sport as a safe place, sport as a learning experience, sport as an instrument to reach goals, and sport as a purpose in life. As the challenges that socially vulnerable youth face in the sports setting can resemble some of the struggles they find in everyday life, their negative sports experiences could also potentially increase feelings of vulnerability. Conclusion Sports participation can support socially vulnerable youth in their personal development, but we also have to remain critical towards to use of sport as a means to reach positive youth development. The results from this thesis provide a deeper understanding of the conditions under which sport can contribute to positive youth development and offers recommendations for professionals in the field.</p

Understanding empowerment for a healthy dietary intake during pregnancy

Purpose: In order for health professionals to encourage pregnant women with a low socioeconomic status (SES) to move towards empowerment for a healthy dietary intake, crucial steps are to understand the perspectives of pregnant women of food and eating and to identify opportunities for empowerment. This study aimed to examine the perspectives of pregnant women on food and eating and to identify the opportunities for empowerment towards a healthy dietary intake.Methods: This was a qualitative participatory study. Thirteen semi-structured interviews were conducted with low SES pregnant women in the Netherlands and analysed using an inductive approach.Results: Five perspectives on food and eating emerged: 1) health-promoting foods and products, 2) challenges in healthy eating, 3) risky products, 4) strategies for healthy eating, and 5) motivational aspects. Opportunities for empowerment were: searching balanced and personalized information, developing strategies to implement healthy diets, navigating the social environment, and dealing with different motivations.Conclusion: Pregnant women hold diverse perspectives regarding food and eating, signalling the need to adjust dietary support from health-care professionals. Professionals in antenatal care could optimize their interactions by engaging in pregnant women’s empowerment processes to make healthy modifications to their dietary intake

The relationship between individual, social and national coping resources and mental health during the COVID-19 pandemic in the Netherlands

BackgroundThe COVID-19 pandemic has a potential negative impact on mental health. Adopting the salutogenic model of health, this study examined the predictive value of personal (sense of coherence), social (social support, trust in institutions), and national (sense of national coherence) resources for mental health in the Netherlands during the COVID-19 pandemic.Participants and procedureAn online survey was administered in the Netherlands (N = 622) in April 2020. A multiple regression analysis was performed to test the predictive value of the resources for mental health.ResultsMental health was significantly predicted by the sense of coherence, social support and sense of national co-herence, but not by trust in institutions. The results showed that personal and social resources were most strongly related to mental health.ConclusionsThe results suggest that mental health is predicted by various resources. Hence, strengthening resources seems vital in promoting mental health in times of crisis

A salutogenic perspective on sport-for-development research

RationaleResearch on positive youth development through sport is confronted with a number of limitations: it lacks a clear theoretical basis of mechanisms underlying life skill development through sport, it has a narrow focus on the sports setting thereby neglecting the interplay between life domains in reaching positive youth development, and the mechanisms underlying the transfer process of newly acquired skills and competences from the sports setting to other life domains are unclear.ObjectiveThis study aims to advance research in in this field by applying theoretical insights from the salutogenic model of health to address the aforementioned limitations.InnovationThe salutogenic model of health describes how health and well-being develops in challenging or stressful situations and offers an interesting perspective on the mechanisms underlying youth developmental processes while simultaneously aligning well with the tenets of the positive youth development approach. The application of the salutogenic model of health offered a number of interesting theoretical insights to further understand 1) the mechanisms underlying positive youth development through sport (i.e., enhancing comprehensibility, manageability and meaningfulness), 2) that youth development arises in the interaction between an individual’s stressors, resources and sense of coherence across different life domains, and 3) the central role of both generalized and resistance resources and sense of coherence in the transfer of life skills between life domains. Given that sense of coherence plays a vital role in the healthy development of individuals and the transfer of life skills across life domains, it would make sense to strengthen the sense of coherence of youths in sports programs.ConclusionBased on this theoretical analysis, several recommendations and considerations for further research on positive youth development through sport are provided

De kracht van sport in de wijk voor: Kwetsbare jongeren

Lezingenreeks 2017: Kracht van Sport in de WijkBiedt sport kwetsbare jongeren meer structuur in hun dagelijkse leven? Voelt een vluchteling zich eerder welkom door sportdeelname? Leert sport mensen met psychiatrische problemen beter om te gaan met tegenslag? In de vijfdelige lezingreeks ‘Kracht van Sport’ stond in 2017 de problematiek en inzet van sport bij diverse doelgroepen in de wijk centraal.In de lezingenreeks Kracht van Sport in de Wijk gingen experts op zoek naar manieren waarop welzijnswerkers, zorgverleners en professionals sport gezamenlijk als middel kunnen inzetten om de leefkwaliteit van wijkbewoners te verhogen.<br/

Intersectoral action to enhance the social inclusion of socially vulnerable youth through sport: an exploration of the elements of successful partnerships between youth work organisations and local sports clubs

Research shows that participation in sport is positively related to self-esteem, self-regulation skills, and social inclusion. As socially vulnerable youngsters participate less frequently in sports activities than their average peers, youth work organisations try to guide their clients (i.e., socially vulnerable youngsters) to local sports clubs and inclusive sports activities. Inclusive sports activities, however, cannot be provided by youth work organisations alone. Therefore, in the Netherlands, intersectoral action involving both youth work organisations and local sports clubs has emerged. Because youth workers and stakeholders in local sports clubs are not used to collaborating with each other, we explored the factors that contribute to the quality and performance of such intersectoral actions. On the basis of five open interviews with youth workers and three focus groups with stakeholders in local sports clubs, we described factors relating to the organisation of intersectoral action among youth workers and local sports clubs that are preconditions for the success of this specific type of intersectoral action

Examining the relationship between sports participation and youth developmental outcomes for socially vulnerable youth

Background: Research has shown that sports participation is positively related to youth developmental outcomes, but it is still unknown if sports participation relates to these outcomes among socially vulnerable youth. Hence, this research aimed to examine the relationship between sports participation and youth developmental outcomes (i.e., problem behaviour, pro-social behaviour, school performance, subjective health, well-being, self-regulation skills, and sense of coherence) for socially vulnerable youth. In addition, the stability of the relationship between sports participation and the youth developmental outcomes were investigated with a six-month interval. Methods: Two identical questionnaires were administered with a six-month interval by youth professionals from four youth organisations, measuring the youth developmental outcomes and sports participation rates of socially vulnerable youth. In total, 283 socially vulnerable youths (average 14.68 years old) participated at baseline and 187 youths after six months. Results: The results showed that sports participation was positively related to pro-social behaviour, subjective health, well-being, and sense of coherence at both measurements. We found no evidence for the relationship between sports participation and problem behaviour and the self-regulatory skills. In addition, sports participation was only positively related to school performance at the first, but not at the second, measurement. Conclusions: The results of this study show that there are positive relationships between sports participation and several youth developmental outcomes. Based on the current data no conclusions can be drawn about the causal relationship between sports participation and youth developmental outcomes. Given the focus of policymakers and health professionals on sport as a means to achieve wider social and educational outcomes for young people, including in the Netherlands, further research is needed to shed light on the relationship between sports participation and youth developmental outcomes for socially vulnerable youth, with a special focus on this group's heterogeneity. Trial registration: Trialregister.nl NTR4621 Date of Registration: 2 June 2014 (retrospectively registered).</p

De kracht van sport in de wijk voor: Kwetsbare jongeren

Lezingenreeks 2017: Kracht van Sport in de WijkBiedt sport kwetsbare jongeren meer structuur in hun dagelijkse leven? Voelt een vluchteling zich eerder welkom door sportdeelname? Leert sport mensen met psychiatrische problemen beter om te gaan met tegenslag? In de vijfdelige lezingreeks ‘Kracht van Sport’ stond in 2017 de problematiek en inzet van sport bij diverse doelgroepen in de wijk centraal.In de lezingenreeks Kracht van Sport in de Wijk gingen experts op zoek naar manieren waarop welzijnswerkers, zorgverleners en professionals sport gezamenlijk als middel kunnen inzetten om de leefkwaliteit van wijkbewoners te verhogen.<br/

A multilevel transition perspective on embedding intersectoral action in local health policies

Intersectoral action is advocated as a social practice that can effectively address health inequalities and related social issues. Existing knowledge provides insight into factors that may facilitate or hinder successful intersectoral action, but not much is known about how intersectoral action evolves and becomes embedded in local health policies. This is where this study aims to make its contribution, by adopting the multilevel perspective on transitions, which is increasingly used to study social innovation in sustainability transitions but has not yet been applied to public health and health promotion. Through this perspective, it was unravelled how intersectoral action between youth-care organizations and community sports clubs became embedded in local health policies of Rotterdam, a large city in the Netherlands. A single explorative case study was conducted based on content analysis of policy documents and 15 in-depth interviews with policy officers, managers and field workers operating in the fields of youth and sports in Rotterdam. The findings showed that intersectoral action between community organizations and policymakers evolves through congruent processes at different levels that changed institutional logics. Moreover, it emerged that policymakers and other actors that advocate novel social practices and act as boundary spanners can adopt multiple strategies to embed these practices in local health policy. The multi-level perspective adds value to earlier approaches to research intersectoral collaboration for health promotion as it allows to better capture the politics involved in the social innovation processes. However, further sharpening and more comprehensive application of transition concepts to study transitions in public health and health promotion is needed