Hannah Henderson

A qualitative exploration of stakeholder perspectives on a school-based multi-component health promotion nutrition programme.

BACKGROUND Food for Fitness is an on-going multi-component health promotion programme, delivered in primary and secondary schools by community nutrition assistants. The programme uses nutritional interventions aimed at promoting healthier eating practices for children. This service evaluation investigated the receipt and delivery of the programme, as perceived by local stakeholders who had experienced and administered the service. METHODS Semi-structured interviews and focus groups were carried out with three key stakeholder groups: health professionals (n = 9), school teachers (n = 10) and senior health officials (n = 3). Qualitative data were transcribed verbatim and received thematic analysis with deductive and inductive processes. RESULTS Stakeholders reported that the programme contributed to the development of food education and healthy-eating practices of children in the local area. Stakeholders considered that the main concern was the limited capacity and size of the service. They described problems with long-term sustainability in supporting schools with maintaining nutritional interventions, highlighting issues regarding contact, planning and organisation of several interventions. CONCLUSIONS The findings of the service evaluation inform service management, organisation and ground-level delivery. The use of stakeholder opinion provided contextualised information on the factors that impact on the implementation of the programme. The richness of the qualitative results can guide future planning and provision for similar health promotion nutrition programmes delivered in the school environment.

The ‘wild and woolly’ world of exercise referral schemes: contested interpretations of an exercise as medicine programme

Abstract Exercise Referral Schemes (ERS) are programmes commonly implemented in the United Kingdom to increase physical activity levels and ‘treat’ ‘sedentary’ individuals and those diagnosed with non-communicable chronic disease. The views and interpretations of stakeholders are currently under-researched, however. This paper addresses sociologically this research lacuna, presenting data from interviews with 17 ERS stakeholders (seven exercise professionals, five health professionals and five strategic managers) in a case study English county. A figurational sociological lens was adopted to provide novel insights into the meanings attached to ERS, and their contestation through service delivery models. Thematic analysis generated salient themes regarding divergent interpretations of ERS goals, and conflict within both service delivery pathways and perceptions of programme impact. Data highlighted conflicting and inconsistent stakeholder accounts within and across groups, suggesting participants attached specific, interdependent and sometimes contradictory meanings to ERS. This created conflict and generated interesting unintended consequences. Perceived divisions between strategic and local levels, and between professional groups emerged strongly. The consequences of such divisions are discussed, together with implications for future analyses of exercise as medicine programmes. Results suggest that an excessive focus upon programme impact and end-user experiences may overlook the influence of stakeholder interpretation on how and why exercise is employed as medicine, by whom, for whom and in which circumstances.

Reflexivity in Qualitative Research: Two Figurational Studies

There has been something of a “reflexive shift” in sociological research. Sociological researchers are increasingly encouraged to be “present” within their work, and to recognize their own role in structuring the entire research process. One way to achieve this is through engagement in reflexive practice, that is, to reflect on our own values, beliefs, and biographies. It can be difficult to know exactly how a researcher should engage in these practices, however. Here, we discuss our reflexive practice in two case studies, both which utilized the same figurational theoretical framework and collected interview data from staff involved in the provision of physical activity for health. Study 1 focused on provision of Physical Activity to older adults in Copenhagen’s “Activity Centres,” while Study 2 investigated the delivery of Exercise Referral Schemes in a case-study county in the United Kingdom. Reflexive practice in both studies was affected by researcher biographies and by study design. In Study 1, both researchers were reasonably detached from the study context, the theoretical framework was in place from the very beginning, and reflexive practice was embedded in the study design. In Study 2, changes in study goals meant that retrospective reflexive practice was necessary, while the principal researcher had an established relationship with participants in the study, which made reflection on her perspective vital. We conclude by highlighting the importance of methodological and theoretical consistency in reflexive practice, which must also be attuned to the particular needs of a study and perspective of a researcher.

Providing weight management via the workplace

Purpose – The purpose of this paper is to assess the feasibility and benefits of providing weight management support via the workplace. Design/methodology/approach – Quasi-experimental design using non-random assignment to a 12-week Slimming World (SW) weight management programme, either within the workplace or at a regular community group. Weight was recorded weekly and a 39-item questionnaire focused on mental and emotional health, self-esteem, dietary habits and physical activity habits administered at baseline, 12 weeks, six and 12 months. Findings – In total, 243 participants enroled (workplace n=129, community n=114) with 138 completers (defined as those weighing-in at baseline and attending at least once within the last four weeks; workplace n=76, community n=62). Completers reported a mean weight change of −4.9 kg±3.4 or −5.7 per cent±3.8. Mental and emotional health scores increased (p < 0.05) from baseline to 12 weeks. Self-worth scores increased (p < 0.05) from baseline to 12 weeks, six and 12 ...