Sami Kokko

Health promotion profile of youth sports clubs in Finland: club officials' and coaches' perceptions.

SUMMARY The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (≥ 15 fulfilled standards), and every third as lower health promoting (<11 fulfilled standards). The variation between clubs was wide. The clubs that had been recognized as exemplary and hence certified by the Young Finland Association were more likely to recognize health promotion than non-certified clubs (OR = 2.36, p = 0.016). The sports club officials were twice as likely to evaluate their clubs as higher health promoting than the coaches (OR = 2.04, p = 0.041). Under the sub-indices, ideologies were recognized best, others less. These findings indicate that minority of the youth sports clubs have realized health promotion comprehensively as a part of their activities. There is a lot of need for development, especially in the area of health promotion policies and practices. The instruments used proved valid and reliable and can therefore be recommended for international use.

Health benefits of different sport disciplines for adults: systematic review of observational and intervention studies with meta-analysis

The aim was to assess the quality and strength of evidence for the health benefits of specific sport disciplines. Electronic search yielded 2194 records and the selection resulted in 69 eligible studies (47 cross-sectional, 9 cohort, 13 intervention studies). 105 comparisons between participation and non-participation groups in 26 different sport disciplines were reported. Moderately strong evidence showed that both running and football improve aerobic fitness and cardiovascular function at rest, and football reduces adiposity. Conditional evidence showed that running benefits metabolic fitness, adiposity and postural balance, and football improves metabolic fitness, muscular performance, postural balance, and cardiac function. Evidence for health benefits of other sport disciplines was either inconclusive or tenuous. The evidence base for the health benefits of specific sports disciplines is generally compromised by weak study design and quality. Future research should address the health effects of different sport disciplines using rigorous research designs.

A review of settings-based health promotion with applications to sports clubs.

Sports clubs have a long and traditional history in many countries, yet they remain underdeveloped and underutilized settings for health promotion. Leisure time settings, in general, have been in minor role among settings-based health promotion initiatives. Current health concerns in western countries, such as sedentary lifestyles and obesity, have aroused a need to expand health promotion to include also settings with greater potential to reach and engage children and adolescents in more vigorous activity. To develop these alternative, most often non-institutional, settings to the level of the established ones, it is important to review what has been done, what has been accepted and what is known from research, theory and practice to have contributed to health. Given that settings approaches have been implemented with diverse scope and without close cooperation between different initiatives, the first aim of this paper is, on the basis of a review of commonly used theories and practices, to propose a mutual definition for the settings approach to health promotion. The second is to examine the applicability of the theoretical basis to youth sports club settings. Sports clubs are used as a reflective setting when reviewing the traditional ones.

Sports clubs as settings for health promotion: Fundamentals and an overview to research

This paper explores the efficacy and value of sports clubs as a setting for health promotion. Sports clubs for children and adolescents are the primary focus of the paper, and the aims are two-fold. Aims: Firstly, the paper aims to review the basis for and elements of the health promoting sports club (HPSC) concept. Secondly, the aim is to overview the international evolution of the HPSC concept and its usefulness in the research. The settings-based health promotion approach forms the basis for the HPSC concept and it is introduced first. Thereafter, both obligating and prospecting factors, to justify the importance for sports clubs to address health promotion, are expressed. Major prospecting factors relate to the facts that sports club activities reach a lot of children and adolescents, and that its educational nature is informal due to voluntary participation. The paper also presents multilevel structure of sports clubs, as well as the determinants affecting the settings-based work. The research concerning health promotion in sports-related settings is evolving worldwide, and Nordic countries are in the front line of this new-wave of settings-based health promotion. Indeed, it has been claimed that, for the settings approach to assimilate to current societal challenges, there is a need to widen the reach of the approach to non-traditional, non-institutional settings, like sports clubs.

Results from Finland's 2014 Report Card on Physical Activity for Children and Youth.

The Finnish 2014 Report Card on Physical Activity (PA) for Children and Youth is the first assessment of Finlands efforts in promoting and facilitating PA opportunities for children and youth using the Active Healthy Kids Canada grading system. The Report Card relies primarily on research findings from 6 Research Institutes, coordinated by the University of Jyväskylä. The Research Work Group convened to evaluate the aggregated evidence and assign grades for each of the 9 PA indicators, following the Canadian Report Card protocol. Grades from A (highest) to F (lowest) varied in Finland as follows: 1) Overall physical activity-fulfillment of recommendations (D), 2) Organized sport participation (C), 3) Active play (D), 4) Active transportation (B), 5) Sedentary behaviors (D), 6) Family and peers (C), 7) School (B), 8) Community and the built environment (B), and 9) Government (B). This comprehensive summary and assessment of indicators related to PA in Finnish children and youth indicates that Finland still has many challenges to promote a physically active life style for youth.

Piecing the puzzle together: case studies of international research in health-promoting sports clubs

This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely ‘research into HPSC activity’ and ‘research into HPSC networks’. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) – both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation.

Coaches’ perceptions of French sports clubs: Health-promotion activities, aims and coach motivation

Background: Given the benefits of participating in sport, sports clubs have been recognised as health-promoting organizations. To examine health-promotion activities in Finnish sports clubs, Kokko et al. developed a set of standards for health-promoting sports clubs (HPSC). Objective: The present study extends this line of research, by (1) measuring coaches’ perceptions of health- promotion activities in French sports clubs and comparing them to earlier Finnish results, (2) measuring coaches’ perceptions of the health-promotion aims of sports clubs and (3) examining the links between HPSC and coaches’ self-determined motivation. Methods: Coaches (N = 125) completed a modified version of the HPSC questionnaire and a scale assessing their motivation to coach. Results: Coaches perceived French and Finnish sports clubs as fairly health promoting, but with wide variability between clubs. In both countries, sports clubs scores showed the same patterns: high scores for ideology and environment activities, and low scores for policies, practices and partnership. Coaches’ perceptions of clubs’ aims also followed the same pattern, but with higher scores for each dimension, meaning that coaches considered health promotion as a relevant aim for sports clubs. Finally, controlling for demographic variables, the HPSC index and sub-indices were related to coaches’ self-determined motivation. Conclusion: This study strengthens the previous findings for health promotion in the setting of sports clubs and the positive role of these activities on coaches’ motivation to coach.

Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study

Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is close-to-practice, which generates foundations for development work within youth sports clubs.

Promoting health in everyday settings: Opportunities and challenges

The 7th Nordic Health Promotion Research Conference (“Promoting health in everyday settings: Opportunities and challenges”) was held in Vestfold, Norway, on 17–19 June 2013, and it was hosted by Buskerud and Vestfold University College (www.hbv. no). The aim of the conference was to focus on ongoing Nordic health promotion research, as well as international research. The conference had a specific focus on settings and the settings approach to health promotion. In order to respond to the conference’s aim and content, and to reach an international audience, all the keynote speakers and some selected researchers were asked to write scientific articles based on their conference presentations. Thus, this supplement of the Scandinavian Journal of Public Health (SJP) represents the main themes addressed at the conference. The supplement provides articles discussing important challenges for health promotion in general, and for the settings approach to health promotion in particular, covering health promotion research in a wide variety of settings. The keynote speakers’ articles give an overview of research related to a particular topic or setting, and discuss extensively the opportunities and challenges for future health promotion. Moreover, empirical articles provide an evidence base for future discussions, and challenge previous knowledge and thinking of a given issue. All articles published in this supplement underwent a double-blind review process, in line with SJP’s high academic standards.

Guidelines for youth sports clubs to develop, implement, and assess health promotion within its activities.

The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one’s activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples.