Highlights • Sense of coherence (SOC) was stronger after a physical activity intervention.• Adult... more Highlights • Sense of coherence (SOC) was stronger after a physical activity intervention.• Adults’ SOC may be strengthened, particularly when SOC is initially low.• SOC may be an alternative success indicator for physical activity interventions.
Facilitating processes for coordinated action in the field of health promotion is a challenge. Po... more Facilitating processes for coordinated action in the field of health promotion is a challenge. Poorthuis and Bijl's (2006) Participatory Network Mapping Tool (PNMT) uses visualization and discussion to map the positions and roles of network actors, stimulate learning processes, and elicit actionable knowledge. This article describes the results from the application of the PNMT in networks of two Dutch health promotion programmes (Health Race and BeweegKuur) with the aim of determining the value of the PNMT to partners in health promotions networks. A qualitative secondary analysis (QSA) was conducted to clarify positions and roles, learning processes, and actionable knowledge of network actors in existing data sets including five group interviews of the Health Race programme and 16 individual interviews and 15 group interviews of the BeweegKuur programme. The PNMT maps both positions and roles of (missing) actors and makes successes (e.g. knowing each other) and challenges (e.g....
This article presents a practitioner-based approach to identify key combinations of contextual fa... more This article presents a practitioner-based approach to identify key combinations of contextual factors (C) and mechanisms (M) that trigger outcomes (O) in Dutch community-based health-enhancing physical activity (CBHEPA) programs targeting socially vulnerable groups. Data were collected in six programs using semi-structured interviews and focus groups using a timeline technique. Sessions were recorded, anonymized, and transcribed. A realist synthesis protocol was used for data-driven and thematic analysis of CMO configurations. CMO configurations related to community outreach, program sustainability, intersectoral collaboration, and enhancing participants’ active lifestyles. We have refined the CBHEPA program theory by showing that actors’ passion for, and past experiences with, physical activity programs trigger outcomes, alongside their commitment to socially vulnerable target groups. Project discontinuity, limited access to resources, and a trainer’s stand-alone position were neg...
Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target t... more Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10-13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time.
Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, soci... more Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, socially vulnerable groups are relatively less active than groups with higher socio-economic status. Community-based health-enhancing physical activity (CBHEPA) programs aim to empower socially vulnerable groups by improving participants' health and wellbeing through physical activity. CBHEPA programs often revolve around group-based principles for action, such as active participation, enjoyment, and fostering group processes. As such principles are rarely made explicit, our study aims to identify which of the group-based principles for action are considered important by participants. Respondents (n = 76) from ten focus groups scored their individual appreciation of group-based principles for action - active participation, enjoyment, and fostering group processes - on a three-point, statement-based scale. Opinions were further discussed in the focus group. Focus group discussions were transcribed and analysed by a team of investigators. The coding procedures, identifying elements appreciated in group-based principles for action, were thematic and data driven. Statements about participatory programming generated much less consensus in appreciation among respondents than statements about enjoyment and fostering group processes. To some extent, group members participated in the development of program content. Participation in group formation or community initiatives was less frequently perceived as something within group members' control. Enjoyment, expressed as physical and emotional experiences, was found to be an individual driver of group exercise. Fostering group processes, expressed as social support, was found to contribute to enjoyment and learning achievements. Responsive leadership, ensuring responsive guidance, by an enthusiastic exercise trainer acting as a role model, were identified as additional necessary principles for action. Group-based principles for action in CBHEPA programs are not clearly demarcated. Fostering group processes is an overarching principle, conditional for the spin-off in terms of enjoyment and active participation. This, in turn, leads to a sense of ownership among participants, who take up responsibility for the exercise group as well as their individual activity behaviour. CBHEPA programs thrive on participants having fun together and exercise trainers' leadership skills. A professional, competent, responsive exercise trainer plays a key role in the organisation and maintenance of CBHEPA programs.
Willingness to pay (WTP) is used to assess individuals' value attribution... more Willingness to pay (WTP) is used to assess individuals' value attribution to health-related quality of life interventions. Little is known about predictors of WTP for sport and physical activity in socially vulnerable groups in community-based physical activity (CBHEPA) programs. This study addresses the questions: What is the WTP for sport and physical activity of participants in CBHEPA programs, expressed in WTPmoney and WTPtime? Which factors predict WTPmoney and WTPtime? From the literature, predictors for WTP for sport and physical activity were identified: (1) personal and socio-economic predictors: income, education, age, and ethnic origin, (2) health-related predictors: perceived health, life satisfaction, sense of coherence, self-efficacy, (3) sport and physical activity-related predictors: duration and frequency of participation, leisure-time sport or physical activity, sport club membership, enjoyment, and membership fee. Data were gathered for WTPmoney and WTPtime (n = 268) in 19 groups in an evaluation study of CBHEPA programs. Ordered probit was used for analyses. WTPmoney was a monthly average of €9.6. WTPtime was on average 17.6 min travel time. Income was found as predictor for both WTPmoney and WTPtime. Other predictors for WTPmoney were: duration and frequency of program participation, enjoyment, and (former) sport club membership. Low income and younger age were found as predictors for WTPtime. Predictors for WTPmoney are related to income and sport and physical activity experiences, for WTPtime to income and age. Short-term program satisfaction is probably more decisive for WTPmoney than long-term perspectives of improving health-related quality of life.
Agricultural advisors often act as facilitators in network processes with stakeholders in a joint... more Agricultural advisors often act as facilitators in network processes with stakeholders in a joint search for solutions acceptable to all. The outcome of such processes is hard to predict. Yet most funding agencies require detailed project descriptions, with SMART formulated targets and performance indicators, to keep executing agencies accountable for spending. Regular monitoring and evaluation (M&E) methods, focused on measuring anticipated results and explanations for success or failure, often fail to grasp what really matters in such processes. The Timeline Method and Learning History were designed for reflection on what is actually happening rather than what is supposed to. In the version presented in this paper, monitoring is done with the stakeholders, and this seems to work well for the continuation of the process. Project commissioners also appear to like the results. We begin with a selection of relevant literature highlighting the roots of the methods. Then our paper becom...
Titel: Wat willen mensen in buurtgerichte beweegprogramma’s betalen voor sport en bewegen? Result... more Titel: Wat willen mensen in buurtgerichte beweegprogramma’s betalen voor sport en bewegen? Resultaten van een ‘willingness to pay’ studie Werkveld: onderzoek Trefwoorden (NCVGZ): Gezond leven, Kosteneffectiviteit, Sociaal kwetsbare groepen A: Achtergrond/ doelstelling Willigness to pay (WTP) wordt gebruikt om de waarde die iemand toekent aan gezondheidsinterventies te bepalen. Over factoren van invloed op WTP onder deelnemers uit sociaal kwetsbare groepen in buurtgerichte beweegprogramma’s (BBPs) is weinig bekend. Onze studie onderzoekt de vraag hoeveel deelnemers van BBPs bereid zijn te betalen voor sport en bewegen, gemeten in geld (WTPgeld) en tijd (WTPtijd) en welke factoren hierbij een rol spelen Daarnaast is nagegaan of BBP deelname leidt tot verandering in WTPgeld en zo ja, aan welke factoren een verandering is gerelateerd? B. Methode Literatuuronderzoek leidde tot definiëring van voorspellers van WTP voor sport en bewegen: 1) socio-economische factoren: inkomen, opleidingsni...
Background Community-based physical activity programs often target ethnic minority groups and wom... more Background Community-based physical activity programs often target ethnic minority groups and women of non-Western origin in particular, because they are relatively less active. Factors affecting physical activity initiation are widely studied. Less is known about factors affecting physical activity maintenance in women of non-Western origin. More knowledge of these factors may increase effectiveness of community-based physical activity programs. "What we try to achieve is that we use exercise as a means for these women to develop a positive self-image. They could actually be considered as closed flowers. Through exercise, we try to open them up." [exercise trainer] Objective Conclusions and recommendations The study was conducted by the chair group Health and Society of Wageningen University in collaboration with TNO Innovation for Life and ERC Research.
Highlights • Sense of coherence (SOC) was stronger after a physical activity intervention.• Adult... more Highlights • Sense of coherence (SOC) was stronger after a physical activity intervention.• Adults’ SOC may be strengthened, particularly when SOC is initially low.• SOC may be an alternative success indicator for physical activity interventions.
Facilitating processes for coordinated action in the field of health promotion is a challenge. Po... more Facilitating processes for coordinated action in the field of health promotion is a challenge. Poorthuis and Bijl's (2006) Participatory Network Mapping Tool (PNMT) uses visualization and discussion to map the positions and roles of network actors, stimulate learning processes, and elicit actionable knowledge. This article describes the results from the application of the PNMT in networks of two Dutch health promotion programmes (Health Race and BeweegKuur) with the aim of determining the value of the PNMT to partners in health promotions networks. A qualitative secondary analysis (QSA) was conducted to clarify positions and roles, learning processes, and actionable knowledge of network actors in existing data sets including five group interviews of the Health Race programme and 16 individual interviews and 15 group interviews of the BeweegKuur programme. The PNMT maps both positions and roles of (missing) actors and makes successes (e.g. knowing each other) and challenges (e.g....
This article presents a practitioner-based approach to identify key combinations of contextual fa... more This article presents a practitioner-based approach to identify key combinations of contextual factors (C) and mechanisms (M) that trigger outcomes (O) in Dutch community-based health-enhancing physical activity (CBHEPA) programs targeting socially vulnerable groups. Data were collected in six programs using semi-structured interviews and focus groups using a timeline technique. Sessions were recorded, anonymized, and transcribed. A realist synthesis protocol was used for data-driven and thematic analysis of CMO configurations. CMO configurations related to community outreach, program sustainability, intersectoral collaboration, and enhancing participants’ active lifestyles. We have refined the CBHEPA program theory by showing that actors’ passion for, and past experiences with, physical activity programs trigger outcomes, alongside their commitment to socially vulnerable target groups. Project discontinuity, limited access to resources, and a trainer’s stand-alone position were neg...
Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target t... more Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10-13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time.
Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, soci... more Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, socially vulnerable groups are relatively less active than groups with higher socio-economic status. Community-based health-enhancing physical activity (CBHEPA) programs aim to empower socially vulnerable groups by improving participants' health and wellbeing through physical activity. CBHEPA programs often revolve around group-based principles for action, such as active participation, enjoyment, and fostering group processes. As such principles are rarely made explicit, our study aims to identify which of the group-based principles for action are considered important by participants. Respondents (n = 76) from ten focus groups scored their individual appreciation of group-based principles for action - active participation, enjoyment, and fostering group processes - on a three-point, statement-based scale. Opinions were further discussed in the focus group. Focus group discussions were transcribed and analysed by a team of investigators. The coding procedures, identifying elements appreciated in group-based principles for action, were thematic and data driven. Statements about participatory programming generated much less consensus in appreciation among respondents than statements about enjoyment and fostering group processes. To some extent, group members participated in the development of program content. Participation in group formation or community initiatives was less frequently perceived as something within group members' control. Enjoyment, expressed as physical and emotional experiences, was found to be an individual driver of group exercise. Fostering group processes, expressed as social support, was found to contribute to enjoyment and learning achievements. Responsive leadership, ensuring responsive guidance, by an enthusiastic exercise trainer acting as a role model, were identified as additional necessary principles for action. Group-based principles for action in CBHEPA programs are not clearly demarcated. Fostering group processes is an overarching principle, conditional for the spin-off in terms of enjoyment and active participation. This, in turn, leads to a sense of ownership among participants, who take up responsibility for the exercise group as well as their individual activity behaviour. CBHEPA programs thrive on participants having fun together and exercise trainers' leadership skills. A professional, competent, responsive exercise trainer plays a key role in the organisation and maintenance of CBHEPA programs.
Willingness to pay (WTP) is used to assess individuals' value attribution... more Willingness to pay (WTP) is used to assess individuals' value attribution to health-related quality of life interventions. Little is known about predictors of WTP for sport and physical activity in socially vulnerable groups in community-based physical activity (CBHEPA) programs. This study addresses the questions: What is the WTP for sport and physical activity of participants in CBHEPA programs, expressed in WTPmoney and WTPtime? Which factors predict WTPmoney and WTPtime? From the literature, predictors for WTP for sport and physical activity were identified: (1) personal and socio-economic predictors: income, education, age, and ethnic origin, (2) health-related predictors: perceived health, life satisfaction, sense of coherence, self-efficacy, (3) sport and physical activity-related predictors: duration and frequency of participation, leisure-time sport or physical activity, sport club membership, enjoyment, and membership fee. Data were gathered for WTPmoney and WTPtime (n = 268) in 19 groups in an evaluation study of CBHEPA programs. Ordered probit was used for analyses. WTPmoney was a monthly average of €9.6. WTPtime was on average 17.6 min travel time. Income was found as predictor for both WTPmoney and WTPtime. Other predictors for WTPmoney were: duration and frequency of program participation, enjoyment, and (former) sport club membership. Low income and younger age were found as predictors for WTPtime. Predictors for WTPmoney are related to income and sport and physical activity experiences, for WTPtime to income and age. Short-term program satisfaction is probably more decisive for WTPmoney than long-term perspectives of improving health-related quality of life.
Agricultural advisors often act as facilitators in network processes with stakeholders in a joint... more Agricultural advisors often act as facilitators in network processes with stakeholders in a joint search for solutions acceptable to all. The outcome of such processes is hard to predict. Yet most funding agencies require detailed project descriptions, with SMART formulated targets and performance indicators, to keep executing agencies accountable for spending. Regular monitoring and evaluation (M&E) methods, focused on measuring anticipated results and explanations for success or failure, often fail to grasp what really matters in such processes. The Timeline Method and Learning History were designed for reflection on what is actually happening rather than what is supposed to. In the version presented in this paper, monitoring is done with the stakeholders, and this seems to work well for the continuation of the process. Project commissioners also appear to like the results. We begin with a selection of relevant literature highlighting the roots of the methods. Then our paper becom...
Titel: Wat willen mensen in buurtgerichte beweegprogramma’s betalen voor sport en bewegen? Result... more Titel: Wat willen mensen in buurtgerichte beweegprogramma’s betalen voor sport en bewegen? Resultaten van een ‘willingness to pay’ studie Werkveld: onderzoek Trefwoorden (NCVGZ): Gezond leven, Kosteneffectiviteit, Sociaal kwetsbare groepen A: Achtergrond/ doelstelling Willigness to pay (WTP) wordt gebruikt om de waarde die iemand toekent aan gezondheidsinterventies te bepalen. Over factoren van invloed op WTP onder deelnemers uit sociaal kwetsbare groepen in buurtgerichte beweegprogramma’s (BBPs) is weinig bekend. Onze studie onderzoekt de vraag hoeveel deelnemers van BBPs bereid zijn te betalen voor sport en bewegen, gemeten in geld (WTPgeld) en tijd (WTPtijd) en welke factoren hierbij een rol spelen Daarnaast is nagegaan of BBP deelname leidt tot verandering in WTPgeld en zo ja, aan welke factoren een verandering is gerelateerd? B. Methode Literatuuronderzoek leidde tot definiëring van voorspellers van WTP voor sport en bewegen: 1) socio-economische factoren: inkomen, opleidingsni...
Background Community-based physical activity programs often target ethnic minority groups and wom... more Background Community-based physical activity programs often target ethnic minority groups and women of non-Western origin in particular, because they are relatively less active. Factors affecting physical activity initiation are widely studied. Less is known about factors affecting physical activity maintenance in women of non-Western origin. More knowledge of these factors may increase effectiveness of community-based physical activity programs. "What we try to achieve is that we use exercise as a means for these women to develop a positive self-image. They could actually be considered as closed flowers. Through exercise, we try to open them up." [exercise trainer] Objective Conclusions and recommendations The study was conducted by the chair group Health and Society of Wageningen University in collaboration with TNO Innovation for Life and ERC Research.
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