Swim for Health evaluation: final report

Abstract

Swim for Health was a Department of Health funded project, run by the Amateur Swimming Association in Hull and the East Riding of Yorkshire. Partners included Hull Leisure, East Riding of Yorkshire Council, Hull & East Riding Public Health Directorates, Hull University, Humber Sports Partnership, Sport England. The project was primarily a participation based intervention, although the rationale involved reducing health inequalities among target groups. Swim for Health had four target Gateway Groups. These were • 1: People in full time employment, • 2: Pre-school aged Children and their families • 3: People over the age of 50 years • 4: People with specific health needs. After the first two years of the project, Swim for Health accounted for 1.4% of the total aquatic participation in Hull. The impact of Swim for Health on aquatic participation in the East Riding was less clear, but additional attendances were in evidence among a number of groups. Developments in Gateway Group 1 were limited by poor uptake among contacted employers. In addition, where work progressed to the consultation stage, employees showed little demand for a work based programme of aquatic activity. Swim for Health therefore failed to achieve its goals with Gateway Group 1. Developments in Gateway Group 2 progressed well with a number of Sure Start organisations. Sure Start swimming programmes were launched in Gipsyville and Newington, Bridlington and Goole. Contact was also made with two more groups in Hull without further action due to poor uptake. In addition, new groups were planned in Driffield and Pocklington. Key barriers to participation in aquatic activity for families were addressed as part of this work, and two groups (Goole and Bridlington) were considered a success. This meant that many of Swim for Health’s goals for Gateway Group 2 were achieved or were close to completion, but not all. Developments for Gateway Group 3 reached an advanced stage in Hull, but were more varied in the East Riding. The close overlap between Gateway Groups 3 and 4 meant that in Hull, the over 50s participated in sessions at all but one centre. Many of these sessions reached sustainable levels, particularly Age concern in the East of the city. In the East Riding, the lack of a concession system for older adults made impact more difficult to assess, and many of the services offered for the over 50s doubled as services for people with health needs. Several of these sessions were considered successful, although many developments did not occur until late in the project. Barriers to participation among the over 50s were examined and addressed in a number of cases. Hence, many of Swim for Health’s goals were achieved for Gateway Group 3 in Hull, while in the East Riding achievement was more varied. Developments for Gateway Group 4 were extensive in Hull, and more varied in the East Riding. GP Exercise Referral aqua in Hull expanded beyond the expectations of many, and next steps had to be negotiated during the project. Additional sessions were run for people with learning difficulties, severe and enduring mental health needs and the blind. In the East Riding, sessions were run that targeted both older adults and people with health needs together. However, data available for GP Exercise Referral in the East Riding suggest that few people in Gateway Group 4 accessed these sessions at most sites. Therefore, it was concluded that Swim for Health achieved the majority of its aims in Hull, but was less successful in the East Riding. The organisation and development of the project was contoured by a number of barriers. These included difficulties in communication between partner organisations, a varied level of support from stakeholders and participants, a lack of needs assessment prior to the project and a paucity of trained staff that could instruct on activities other than swimming lessons and aquafit. A number of key lessons were learned from the development of Swim for Health. These included the requirement for needs assessment and staff training to be undertaken prior to a project. In addition, a participation based rationale is recommended with contextually applicable goals. The formulation of these goals needs involvement of stakeholders at an early stage. In addition the need for ongoing and detailed communication was noted. Finally, a sensitive approach to increasing access that takes into account the needs and preferences of target participants was found to be beneficial in increasing participation. In aquatic activity, these needs and preferences were not always in tune with a health based rationale. It was concluded that Swim for Health provided an excellent base for future aquatic activity interventions. A number of key lessons were learned from this pilot project. Should these lessons be put into practice, there would be scope for aquatic activity interventions based upon inclusion and participation among certain target groups in the UK