Exploring participant appreciation of group-based principles for action in community-based physical activity programs for socially vulnerable groups in the Netherlands

Abstract

BackgroundPhysical 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.MethodsRespondents (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.ResultsStatements 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.ConclusionsGroup-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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2515-6) contains supplementary material, which is available to authorized users.

Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study

“…The observed decline in effect sizes over time may be a result of the fact that participants of short-term programs may have been less represented in the follow up measurements. The findings from this quantitative multilevel study are, however, supported by several qualitative studies on group effects, indicating that group dynamics, group composition and social support, and exercise trainer characteristics contribute substantially to effective PA programs [ 38 , 39 , 83 , 84 ].…”

“…Group dynamics in CBHEPA programs are, however, often implicit and not accounted for. CBHEPA programs are usually group-based for organisational reasons (cost-covering), rather than for behavioural change reasons [ 38 ]. Nevertheless, some studies indicate that group dynamics strategies, explicitly applied in group-based PA interventions, are more effective in establishing change in PA behaviour than individually targeted interventions with social support, which, in turn, are more effective than individual interventions without additional social support [ 39 , 40 ].…”

“We Don’t Assume That Everyone Has the Same Idea About Health, Do We?” Explorative Study of Citizens’ Perceptions of Health and Participation to Improve Their Health in a Low Socioeconomic City District

“…Group sessions could take place during regular meeting times and thus did not put much extra strain on the participants. Thirdly, the participants knew one another and felt secure talking about their own health and health problems [ 73 ]. The participants in several groups corrected one another and gave advice to others on how to deal with the barriers raised.…”

Care–physical activity initiatives in the neighbourhood: study protocol for mixed-methods research on participation, effective elements, impact, and funding methods

“…For the focus groups, the Activate Participation, Enjoyment, and Fostering (APEF) group processes tool [ 23 , 67 ] will be used. Existing statements in the tool will be adapted or replaced to fit operationalisations of PA maintenance, societal participation, main types of factors of the I-Change model, and appreciation of X-Fittt 2.0, professional guidance, and PA in a group.…”

“…The underlying assumption of effective elements is that the effectivity of an initiative is caused by multiple principles or elements in combination. These elements are based on an ecological perspective on human health [ 23 , 24 ], which emphasises the need for actions that are empowering [ 25 ], participatory [ 26 , 27 ], intersectoral, equitable, and sustainable, and that use multiple strategies [ 28 ]. Moreover, effective elements relate to the capacity to develop and implement policy or initiatives that result in the desired output [ 29 ], emerge in practice, and depend largely on contextual factors and the knowledge and skills of the stakeholders involved [ 23 ].…”