Sports Club for Health : updated guidelines for health-enhancing sports activities in a club setting

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Sports Club for Health : updated guidelines for health-enhancing sports activities in a club setting Koski, Pasi; Matarma, Tanja; Pedisic, Zeljko; Kokko, Sami; Lane, Aoife; Hartmann, Herbert; Geidne, Susanna; Hämäläinen, Timo; Nykänen, Ulla; Rakovac, Marija; Livson, Matleena; Savola, Jorma Koski, P., Matarma, T., Pedisic, Z., Kokko, S., Lane, A., Hartmann, H., Geidne, S., Hämäläinen, T., Nykänen, U., Rakovac, M., Livson, M., & Savola, J. (2017). Sports Club for Health : updated guidelines for health-enhancing sports activities in a club setting. Suomen Olympiakomitea. https://www.scforh.info/content/uploads/2017/03/scfh2017_verkko.pdf 2017 1 Sports Club for Health (SCforH) – updated guidelines for health-enhancing sports activities in a club setting Pasi Koski Tanja Matarma Zeljko Pedisic Sami Kokko Aoife Lane Herbert Hartmann Susanna Geidne Timo Hämäläinen Ulla Nykänen Marija Rakovac Matleena Livson Jorma Savola 2 3 This book was prepared and published as part of the “Promoting National Implementation for Sports Club for Health (SCforH) Programmes in EU Member States” (‘SCforH 2015-17’) project, funded by the Erasmus+ Collaborative Partnerships grant (ref: 556953-EPP-1-2014-1-FI-SPO-SCP). Copyright© 2017 by the authors and Finnish Olympic Committee. Except where otherwise noted, content of this report is copyrighted in accordance with the provisions of the Creative Commons Attribution-NonCommer- cial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. ISBN: 978-952-5794-51-9 (print) ISBN: 978-952-5794-52-6 (eBook) Enquiries regarding this book may be directed to: Professor Pasi Koski Department of Teacher Education, Rauma Unit, University of Turku PL 175, 26101 Rauma, Finland Phone: +358 50 339 0373 E-mail: [email protected] Publisher: Finnish Olympic Committee Radiokatu 20 00240 Helsinki, Finland E-mail: [email protected] Suggested citation: Koski, P., Matarma, T., Pedisic, Z., Kokko, S., Lane, A., Hartmann, H., Geidne, S., Hämäläinen, T., Nykänen, U., Rakovac, M., Livson, M. & Savola, J. (2017). Sports Club for Health (SCforH) – updated guidelines for health-enhancing sports activities in a club setting. Helsinki, FI: Finnish Olympic Committee. Sports Club for Health (SCforH) – updated guidelines for health-enhancing sports activities in a club setting 4 5 Sports Club for Health (SCforH) – updated guidelines for health-enhancing sports activities in a club setting Pasi Koski, Tanja Matarma, Zeljko Pedisic, Sami Kokko, Aoife Lane, Herbert Hartmann, Susanna Geidne, Timo Hämäläinen, Ulla Nykänen, Marija Rakovac, Matleena Livson & Jorma Savola Contents Background ............................................................................................. 6 What is the SCforH approach? ................................................................. 8 For whom are the SCforH approach and guidelines intended? ............... 10 Why implement the SCforH approach? .................................................. 11 Improving health through physical activity and sports ....................... 12 The sports club as a setting for health promotion ............................. 20 How should the SCforH approach be applied? .................................. 22 Guiding principles ............................................................................ 23 Application Model ............................................................................ 25 Special considerations for different age groups ................................. 37 Conceptual framework .......................................................................... 42 Acknowledgments .................................................................................. 45 References .............................................................................................. 47 6 7 Background public health potential of sports clubs. The SCforH approach was officially initiated and the first guidelines were published in 20091, and these guidelines were updated in 20112. The idea of SCforH approach was conceived in 2007 in Finland. At that time, the potential of sports to promote health-enhancing physical activity had been recognised at the political level in Europe. Initially, the White Paper on Sport by European Commission (2007) introduced the promotion of health-enhancing physical activity as a key objective of the EU sports policy3. Thereafter, in 2013, the Council of the European Union suggested SCforH implementation as one of the 23 indicators that should be used to evaluate health-enhancing physical activity levels and policies in EU member states4. In addition, representatives of the World Health Organization (WHO) and the International Olympic Committee (IOC) have expressed their interest in SCforH approach. The mission of the International Olympic Movement is stated in the Olympic Charter5 and, among other things, this states that its aims are to educate youth through sports and encourage and support incentives to improve the medical care for and health of athletes. Accordingly, the current Agenda of the International Olympic Committee, Agenda 2020, also refers to the educational and health values of sports6. Physical activity recommendations issued by the EU, US, Australia, WHO, and many other countries and organisations have highlighted the value of both vigorous- and moderate- The core business of sports clubs is to organise sporting activities in a given sport or sports. These club activities commonly place a strong focus on competitive sports and emphasise athletic development and sports performance, with a lesser focus on recreational sports and increasing physical activity through sports. A plethora of evidence exists on the manifold health benefits of physical activity and participation in sports. Due to its many health benefits, physical activity has been conceptualised as and termed health-enhancing physical activity (HEPA). This term is usually used to describe aerobic physical activities of moderate- to vigorous-intensity, such as walking, jogging, skiing, and swimming. The findings of recent research have indicated that vigorous-intensity physical activity may produce even greater health benefits than moderate-intensity physical activity. Given that high intensity levels characterize many sports disciplines, it is reasonable to suggest that by performing their core duties, sports clubs may make a valuable contribution to health promotion and public health. Health promotion is usually not among the main activities pursued at a sports club. However, good health is indisputably beneficial for all sport club members, who range in skill level from amateurs to top athletes and in age from children to seniors. With millions of members, sports clubs are the largest setting at which an opportunity exists to promote health-enhancing physical activity and health in general through the conduit of sports. Therefore, the Sports Club for Health (SCforH) approach was developed to help utilize the great intensity physical activity. Participation in sports club activities can help adult and elderly members of society meet these recommendations. Although children and youths who participate in organised sports often have higher levels of physical activity as compared to their peers7,8, studies indicate that not all of them meet the physical activity recommendations.9-13 A strong wish to advance the SCforH concept has been expressed by members of the European research, policy and sports communities. The widespread adoption of the SCforH approach may increase participation in sports and, at the same time, help improve the health of sports club members. This is expected to result in greater recognition of the significance and stronger social and public health implications of sports. This book of guidelines is primarily targeted toward the sports clubs located in EU member states. We acknowledge that the contexts, organisational structures, and practices of sports clubs may vary substantially in the different countries14. This book of guidelines offers a standardised approach that may be used in any country and which can subsequently be adapted to fit specific circumstances in a given country or in an individual sports club. In this book, the principles of SCforH are described along with an application model that can be applied to help sports clubs integrate healthenhancing physical activity and a broader health perspective into their routine activities. This publication represents an updated version of the previouslypublished SCforH guidelines1,2 and places a special focus on specific age groups – from childhood to old age. 8 9 What is the SCforH approach? SCforH is an expert-based approach that supports clubs as well as national and regional sport organisations to recognise the health potential of their sports disciplines and organise health-enhancing sports activities in the sports club setting. The purpose of SCforH is to encourage sports clubs and national sport organizations to invest more in using the health potential of their particular sport. In practice, this primarily means promoting health-enhancing sports activities within sports clubs. Additional health benefits may be gained by offering health education and promoting health in the sports club setting, which is the focus of the Health Promoting Sports Club (HPSC) initiative15. Achieving good health is a desirable goal of sports clubs members and society as a whole, regardless of the reasons an individual engages in sports. SCforH encourages sports clubs to review their own activities and sport discipline(s) in the light of their health potential and promote greater participation in healthenhancing sports activities. The SCforH approach is based on the following ideas: • The SCforH approach is intended for use in all sports clubs. It can be implemented in any type of sports club, from the small, purely voluntary club to the large club staffed by paid professionals. • Clubs also differ in terms of their sporting aims and programmes. The SCforH approach can be applied in any kind of sports club, regardless of its aims and the sport disciplines offered. • According to the SCforH approach, health is defined broadly to encompass three main dimensions: physical, mental, and social. The aims of SCforH initiatives in sports clubs can be modified such that they place a focus on any or all of these dimensions of health. • The SCforH approach can be applied in practice as a philosophy that guides the way the sports club and/ or its activities are run or the way a scheduled project or programme is conducted. • Rather than maintaining the SCforH as an independent initiative, the aim should be to ultimately integrate the SCforH approach into the club’s daily activities, such as coaching. • The SCforH approach has been designed to serve members of sports clubs and participants in all age groups: children, adolescents, adults, and seniors. * The data was collected as part of the Social Inclusion and Volunteering in Sports Clubs in Europe (SIVSCE) project (Erasmus+ Collaborative Partnerships grant, reference number 556994-EPP-1-2014-1-DK-SPO-SCP). SCforH is a large international initiative supported by the European Commission, European network for the promotion of health-enhancing physical activity – HEPA Europe, European Non-Governmental Sports Organisation (ENGSO), European Federation for Company Sports (EFCS), International Sport and Culture Association (ISCA), and The Association for International Sport for All (TAFISA). More than 30 partner, associate, and supporting institutions from 12 European countries have been involved in two funded SCforH projects. SCforH has been mentioned more than 30 times in academic publications and 140 times in other published media. In 2016, 42% of the European national umbrella sport organisations and national Olympic committees, 54% of national sport-for- all organisations, and 20% of national sport organisations indicated that they were aware of the SCforH approach. Furthermore, there are almost a million sports clubs and more than 60 million sports club members in Europe. Recent findings from nine European countries* have indicated that 37% of the sports clubs offer health-enhancing physical activity programmes, whilst 75% feel that their sport disciplines are suitable as health-enhancing physical activities. Overall, this shows that a great potential exists for the future implementation of the SCforH approach in sports clubs across Europe. 10 11 For whom are the SCforH approach and guidelines intended? The SCforH approach is applicable in sports clubs as well as in national and regional sport organisations. In an ideal situation, the SCforH approach would be implemented at all levels within the sports system, with each level supporting the other. However, this publication has been developed to specifically target audiences in sports clubs, that is, the directors, elected trustees, paid officials, coaches and instructors, members and participants, and other stakeholders of sports clubs. Of course, all sport organisations interested in supporting sports clubs’ activities are encouraged to use this book of guidelines. Additional useful material that has been tailored to meet the needs of national sport organisations can be found on the SCforH website**. The main aim of this book of guidelines is to help sports clubs recognise the connections between the sport disciplines they offer and health and implement the SCforH approach into their sports club setting, targeting members belonging to any age group – children, adolescents, adults, or seniors. ** Electronic Toolkit: Hartmann et al. 201716. Sports Club for Health (SCforH). A good practice guide to inspire and support sport associations and their clubs. Web-site: http://www.scforh.info. Figure 1. Potential benefits to sports clubs and their participants of applying the SCforH approach FOR PARTICIPANTS: •Increasedlevelofhealthenhancing physical activity •Healthierlifestyle •Reducedriskofchronicdiseases •Improvedmentaland social well-being •Bettersocialisationofchildrenand adolescents •Preventionoffallsand loneliness among seniors •Increasedmotivationtoparticipate in sports BENEFITS FOR CLUBS: •Increasedparticipationrates •Reduceddropoutrates •Greaterclubmembersatisfaction •Broaderrangeofactivitiesattract wider audience and new members •Healthierathletesperform better in sports •Providesopportunitiesfor targeting members of all age groups •Strongerroleoftheclubinits community Why implement the SCforH approach? Sports clubs can expect to obtain several benefits from applying the SCforH approach. First, the SCforH approach offers a way in which the club can be developed by reaping benefits of promoting health among its members. The improved health of the members is likely to lead to improvements in their performance and satisfaction as well as in increased participation rates. This may directly improve the success of sports clubs’ core business. Second, the implemented SCforH initiatives may arouse the interest of new potential members and facilitate recruitment. Third, by adopting the SCforH approach, clubs can define themselves apart from other sport and fitness providers and gain marketing advantages in competitive environments. Fourth, by taking the SCforH approach, opportunities may be created for partnerships to be formed among practitioners, researchers, and policy makers in the sports and health sectors. This may, in turn, help to position the sports clubs and national organisations as relevant and important stakeholders in the field of public health. Figure 1 highlights the main potential benefits to sports clubs and their participants of applying the SCforH approach. 12 13 In addition to generating positive outcomes for sports clubs and their participants, the SCforH approach can also be applied to directly benefit local, regional, and national sports organisations. Adopting the SCforH approach may increase opportunities for these organisations to obtain funding from both the sport and public health sectors, establish stronger roles in the community, and reach wider audiences by promoting their sports among members of all age groups. The benefits to sports clubs can be obtained in two ways; first, by promoting and increasing health-enhancing physical activity through sport (SCforH approach), and second, by using the sports club as a setting for a broader health promotion (Health Promoting Sports Club [HPSC] approach). This book of guidelines places a focus on the former approach (SCforH approach), whilst more information about the latter approach (HPSC approach) can be found elsewhere15. Improving health through physical activity and sports The WHO defines health as a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”17. Scientific evidence has shown the major beneficial effects of physical activity on all three aspects of health18. Numerous physical, mental, and social health benefits of physical activity are presented in Figure 2. The physical fitness and health status of children and adolescents may be substantially improved by regular participation in physical activity. Compared to their inactive peers, physically active children and adolescents have higher levels of cardiorespiratory fitness, muscular endurance, and strength. The well-documented health benefits include a reduced risk of obesity, more favourable cardiovascular and metabolic disease risk profiles, enhanced bone health, and improved mental health18,19. In both adults and seniors, physical activity reduces the risk of all-cause, cardiovascular disease, and cancer mortality. Other key health benefits of physical activity include a reduced risk of cardiovascular disease, hypertension, diabetes, and certain forms of cancer. In addition, physical activity positively affects mental health by reducing symptoms of anxiety and depression, improves the ability to cope with psychosocial stressors, and potentially delays the adverse effects of different forms of dementia. Furthermore, physical activity is a key determinant of energy expenditure and is, therefore, fundamental to achieving energy balance and weight control18. Physical activity may improve physical functioning. Throughout childhood and adolescence, physical activity is necessary for the development of basic motor skills as well as musculoskeletal development21. Physical activity helps adults maintain muscle strength and improve their cardiorespiratory fitness and bone health. It also helps seniors maintain health and mobility needed for their functional independence and social participation18,20. The current physical activity recommendations for health22 (Table 1) indicate that children and adolescents should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity every day, with preferably at least three sessions of vigorous-intensity activity each week. Adults and seniors should undertake at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity, and at least two sessions of musclestrengthening activities, each week. Higher levels of physical activity may provide both children and adults with greater health benefits; however, even a small amount of activity is better than none. Therefore, persons who cannot adhere to all physical activity guidelines for health-related or any other reasons should be as active as their circumstances allow. 14 15 Figure 2. Key health benefits of physical activity (adapted from Pedisic 201120) 28 29 Identify the support and possibilities for implementation of the SCforH approach both within and outside the club First, it is recommended to ask whether the leading officials, members, and participants in your club would support the implementation of the SCforH approach. Support from club officials is particularly important because it ensures that SCforH will eventually become embedded in the club activities. Any reluctance identified at this stage must be overcome before proceeding to the planning stage. It may be useful at this early stage to develop an interest group whose members will help disseminate information about the SCforH concept in the club and help persuade club officials to consider implementation. Those in charge of planning the SCforH initiative(s) in the club should have a common understanding of: 1) what the SCforH approach is; 2) what the characteristics of the club and its sport discipline(s) are; and 3) how the SCforH approach aligns with the characteristics of the club (e.g., possibilities and resources). Before beginning to plan the implementation of SCforH initiatives, a common understanding of these points has to be reached. For further guidance on this subject, see the SCforH Electronic Toolkit16 (Area 2) on identifying resources. A sports club is not a closed and isolated system; on the contrary, it is a ‘living part’ of its environment. At this stage it is, therefore, also worth looking outside the immediate club setting to determine whether other potential partners or actors can be identified who would be interested in collaborating in the SCforH project or supporting it. Stage B: Plan Define the target group of the initiative Depending on the club and its membership structure, it is important to define the target group of the SCforH initiative. Priority groups as well as groups that are likely to respond well to this approach should be identified. It should be considered whether they will focus on all members or a specific group of members such as females, males, children, adolescents, adults, seniors, newcomers, or established members. This focus will determine the steps taken during the remainder of the planning stage. Identify the health potential of your sport and activities for the target group A great deal of evidence supports the positive effect of physical activity on health. Sport disciplines differ in many aspects and on many levels, not least with respect to the amount of physical effort involved. Thus, it is important to specify the particular health benefits of each sport discipline. At the same time, it is important to consider that health benefits may also vary due to other factors such as the age and gender of participants and the amount of exercise. It is, therefore, essential to review the potential health benefits to each of the different target groups. The key health benefits of common types of sports are listed in Table 3 to help sports clubs identify the health potential(s) of their sport(s). Table 3. Assessment of the positive impacts of different types of sports on key health outcomes The general assessment of the health outcomes of sports participation (Table 3) can be used as a basis for a more specific appraisal for a particular sport. For example, the Equestrian Federation of Finland has created a ‘health profile’ for their sports disciplines (Table 4). Improved metabolic function / Reduced risk of obesity Improved cardiovascular function Improved aerobic fitness Improved muscle strength/function Improved gross motor skills Improved balance Improved bone status Reduced risk of type2 diabetes Reduced risk of cardiovascular disease Reduced risk of falls Reduced risk of osteoporosis Type of sports Endurance sports xxx xxx xxx x x(x) x x xxx xxx x(x) Strength sports xx x x xxx x xx xxx xx x xx xxx Power and speed x x x(x) xxx xx(x) xx xxx x x(x) xx(x) xxx Ball games xx x(x) xx xx xx(x) xxx xxx xx xx xxx xxx Racquet sports xx x(x) xx xx xx(x) xxx xxx xx xx xxx xxx Expected health outcomes Aesthetic sports x(0) x x x(x) xxx xxx xx(x) x x xxx xx(x) sports xxx = strong impact; xx = medium impact; x = low or limited impact; 0 = no effect x 30 31 Table 4. Health profiles for equestrian sports (adapted from Hyttinen 201235) Improved metabolic function / Reduced risk of obesity Improved cardiovascular function Improved aerobic fitness Improved muscle strength/function Improved gross motor skills Improved balance Improved bone status Reduced risk of type2 diabetes Reduced risk of cardiovascular disease Reduced risk of falls Reduced risk of osteoporosis Sport Dressage x(0) x x xx xxx xxx 0 x x xx 0 Show jumping xx x x xx xxx xxx 0 x xx xxx 0 Eventing xx xx xx xx xxx xxx 0 x xx xxx 0 Endurance riding xx xx xx xx xx xxx 0 x x xxx 0 Equestrian vaulting x xx xx xx xxx xxx 0 x x xxx 0 Injury risk Expected health outcomes xxx = strong impact; xx = medium impact; x = low or limited impact; 0 = no effect Explore the know-how and support within and/or outside your club Club personnel may offer human resources (i.e., know-how and time) or these may need to be recruited outside the club. It is important to clearly outline the resource requirements early on during the planning stage and subsequently allocate appropriate responsibilities to interested and competent individuals or groups. Extending resource seeking beyond the club setting may also be a good option as it can lead to the formation of beneficial collaborations and help establish supportive relationships. In some cases, the cooperation with organisations and relevant groups outside the club is the key to success. Running an SCforH initiative may also require the investment of additional financial resources. Funding may be obtained from the club or some external source (e.g., local government, philanthropic trusts, and foundations), through fundraising, or through selffinancing. Agree on the aims and develop a strategy and an action plan After mapping out the capacity and support available within and/or outside the club, a strategy and an action plan to implement the SCforH initiative are required. Aims should be as detailed as possible, understandable, and feasible to achieve. Ideally, all aims should be time-bounded and quantifiable. For example: “The aim of the SCforH initiative during the forthcoming season is to establish two new recreational-based soccer teams for adults (one for males and one for females) with about twenty new participants”. After the aims have been formulated, the key activities for each aim should be determined, designed, and described. The activities should be clearly described by defining the respective time frames, resources required, and individuals or groups that are involved in their implementation and supervision. An example of how to outline aims and operating procedures is provided below (Table 5). X XXX XXX XXX XX 32 33 Table 5. An example of how to outline the aims and operating procedures of the SCforH initiative Stage C: Implement When beginning to implement planned activities, the following three recommendations should be considered. Communicate information about the forthcoming actions both internally and externally The communication of information about the SCforH-related actions should preferably be performed both within and outside the club. Internally, existing communication channels such as the club’s bulletin, parents’ meetings, club’s web pages, and mailing lists should be used. It is as important to inform the club officials as it is to inform the parents of young members. Externally, communications can be directed to representatives of the municipality (sports and health sectors), local government, financial supporters, partner institutions, and other clubs. Communicating with members of the local media and posting information using social media channels may be pivotal aspects of successful marketing campaigns for SCforH initiatives. Social marketing might be a helpful method that can be used to communicate information about the SCforH initiative. In social marketing, traditional commercial marketing concepts, tools, and techniques are applied toward changing individuals’ behaviour for the benefit of society. In this case, the SCforH initiative is marketed to address the high rates of physical inactivity in the community. For the best results, when advertising the SCforH initiative, all elements of the ‘marketing mix’ (i.e., product, place, price, promotion, people, physical environment, and process) should be tailored to meet the needs of the SCforH target group. If the AIMS To increase the number of seniors (≥65 years of age) participating in a recreational programme, as part of the SCforH initiative. TARGET GROUP Seniors (including former sport participants) MESSAGE Keep playing at any age! PLAN First year: To recruit a group of seniors who will participate once a week in organised, adapted and noncontact health-enhancing sports activities. Second year: To review member satisfaction with the current programme and make any necessary changes. Noncontact sports will be promoted, through existing contact information, to seniors, including former club players. Sessions will be led by trained instructors to ensure safe participation. A choice of recreational activities will be offered. Sessions will also include social activities. OPERATING PROCEDURES 34 35 Table 6. The key areas of competence of an ‘SCforH’ instructor sports club’s management does not feel competent enough to lead marketing activities, they are encouraged to ask a marketing specialist for his or her advice or assistance. Expert help can improve the chances that the SCforH initiative is successfully marketed (see Electronic Toolkit, Area 6). Ensure the competence of instructors and club managers and support them in delivering the SCforH activities Successful implementation of an SCforH initiative relies upon the competence of instructors with respect to their abilities to deliver the planned activities. The key areas of competence of an SCforH instructor are listed in Table 6. It should be ensured that all instructors have the required knowledge and skills to deliver the activities that have been planned as part of the SCforH initiative. If needed, the club representative should provide the instructors with the proper education internally or provide opportunities for them to receive education externally (see Electronic Toolkit, Area 3). Before starting an SCforH initiative, one must ensure that the instructors are familiar with all the practical procedures and that the required equipment is functioning properly. Receiving feedback and support from members of the club management at regular intervals may motivate instructors, especially if they are working on a voluntary basis. Ensuring the instructors’ competences and providing instructors with quality education is critical for the successful implementation of an SCforH initiative. •AnunderstandingandappreciationoftheSCforHprinciplesandtheability to adhere to these •Anunderstandingofthehealth-enhancingqualitiesoftheirrespectivesport •Thecapacitytoadapttheirsporttotargetdifferentpopulationgroups •Thedeliveryandevaluationofagreed-uponSCforHinitiatives Monitor the implementation of planned activities and gather data for documentation While the SCforH initiative is in progress, it is important to monitor whether the activities are being implemented as planned. This information can be collected from instructors and participants and is of great importance for the evaluation of the feasibility and effectiveness of the SCforH initiative. Stage D: Follow-up Keep records and evaluate the SCforH initiative This evaluation is essential in order to ensure the credibility and determine the effectiveness of the SCforH initiative. This includes both process and outcome evaluations to assess whether the initiative was delivered as planned and whether it was effective with respect to its stated aims. It is particularly important to conduct a process evaluation in the early stages of the SCforH initiative delivery to determine whether the club is a viable setting for these activities. Examples of process evaluation questions can be found in Table 7. To conduct a process evaluation, a record of actions that have been taken to achieve the aims of SCforH initiative should be kept. The aim of the process evaluation is to assess how the planned activities were delivered. The fact that records of actions undertaken is kept will allow reflections upon progress to be made and particularly: 1) to find out whether the SCforH aims and objectives were achieved; 2) to find out what went well and what could be improved; 3) to draw associations between actions and outcomes; and 4) to gather feedback from all participants (e.g., on their satisfaction with the SCforH initiative and instructor(s)). Keeping written records may be the most efficient and easiest way to keep track of which actions have been taken. Such records could include, for example, the number of participants, duration of the activities, level of participants’ enjoyment and satisfaction, participants’ experiences, and resources required (see Electronic Toolkit, Area 5). Table 7. Examples of process evaluation questions •WhatactionsdidtheSCforHintiativeundertake? •HowweretheseactionsreceivedbythoseparticipatingintheSCforHinitiative and other club members? •WhatfactorshelpedsupporttheadoptionoftheSCforHinititiatitive? •WhatfactorshinderedtheadoptionoftheSCforHinitiative? •Whatactionsweretakentodealwiththehinderingfactors? 36 37 local media and community leaders, who can help you share your positive stories with a larger audience (see Table 8 for examples). This can, in return, result in positive publicity for your club and motivate new members to join. By sharing the results of the evaluations within the club and including information about the SCforH initiative in an internal club leaflet, this important information will be communicated to members, parents, and coaches. Posting information on social media channels is a practical and effective way to share your success story with others. Table 8. Examples of ways to communicate the results of an SCforH initiative Share your success inside and outside the club After implementing the SCforH initiative(s) in your club, it is essential to share your success stories with others. By sharing your experiences and the results of the evaluations of your SCforH initiative, you can acknowledge the people and institutions that contributed to the implementation of the initiative, spread the word about the success in your community, and encourage others to start similar initiatives. It may be useful to seek support from representatives of the Internal communications Your club should find a suitable way to communicate with all the participants, from managers and coaches to parents and players. These communications represent opportunities for you to share information about your progress (what has happened), successes, and the participants’ experiences. Examples of such communications could be stories of two or three generations of members in the club, in which you emphasise the role that the new SCforH initiative had in keeping the oldest and youngest members involved in club activities. You can also report on positive changes that the SCforH initiative led to on the club level. External communications The same stories could be shared outside the club with members of sporting associations, local supporters, or sponsors as part of their communications. Local media need news, and your evaluations of the participants’ experiences and success stories can serve as the ideal means to publicise your SCforH actions. The recruitment strategy could also include these stories in order to emphasise the club’s commitment to work with particular target groups. Depending on the results of the evaluation, revert to earlier stages of the process The application model presented here should not be understood as a unidirectional model. The implementation and delivery of an SCforH initiative should involve a continuous process of assessment, learning, and improvement. Special considerations for different age groups Depending on the selected target group, some specific points should be taken into consideration when applying the SCforH approach. Children and adolescents Throughout childhood and adolescence, physical activity is necessary to support the development of basic motor skills and musculoskeletal development. Few young people meet the public health recommendations with respect to the levels of physical activity. Even those who participate in sports do not necessarily achieve the recommended level of physical activity. Although the sports club is not the only place where children and adolescents can be physically active, sports clubs should offer adequate levels and a diversity of activities, especially for younger members. In addition, the club representatives may also promote various kinds of health-enhancing physical activities in different environments outside the club. When choosing children and adolescents as target groups, the educational level of these individuals must be taken into consideration. During their early years, children develop their attitudes toward physical activities and sports as well as toward health. Attitudes towards the level of physical activity (see Koski 200836) and health literacy are developed step by step. Parents, guardians, grandparents, teachers, coaches, siblings, and peers play important roles in these processes, as in many other kinds of socialisation and developmental processes. The coach, for instance, may not only act as an important role model in terms of sports participation, but also promote a generally healthy lifestyle. When applying the SCforH approach with children and adolescents, coaches and other adults with whom the young participants interact in the club should clearly understand their roles and responsibilities. To ensure this, it may be useful to organise meetings with these individuals to reach an agreement on the accepted and preferable ways to interact with children and adolescents. When members of younger age groups are targeted, it may also be beneficial to integrate parents into the SCforH activities. For that reason, it is recommended to organise a parents’ meeting to introduce the aims and principles of the SCforH initiative and explain how it will be delivered. The values of the club – beyond just promoting sports – should be clearly communicated to parents; that is, the values should be associated with aspects of physical, psychological, and social development. Most children and adolescents do not participate in sports clubs primarily to improve their health. However, it may be useful to integrate information about nutrition, rest, and sleep, as well as how 38 39 to avoid doping and substance abuse, into sports activities and coaching. Adults When the target group consists of adults, it is particularly important to make sure that the range and content of the activities is appropriate to keep them engaged over a period of time that is long enough to allow them to gain health benefits. If needed, motivational strategies should be employed to discourage participants from dropping out and ensure that they take part in the planned activities. Depending on the sport and the type of SCforH initiative, the levels of engagement in activities within the sports club may not be sufficient in some cases for adults to meet the physical activity recommendations and, hence, they may need to engage in additional activities outside the club. Adults are most likely to gain the health benefits if they engage in at least 150 minutes (2.5 hours) of moderate-intensity physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity each week. For most adults, the more physically active they are, the greater the benefits they will experience. Although it is still unclear whether a ceiling effect exists, and the optimal amount for specific activities is still unknown, recommending adults to engage in a reasonable amount of additional physical activity outside the sports club is unlikely to do any harm. In addition, it may be useful to include flexibility, warm-up, cool-down, and muscle-strengthening activities in the SCforH activities for adults. While planning and organising activities for this age group, the participants’ fitness levels, motor skills, and previous sporting experience should be taken into consideration. The risk of injuries may be elevated, for instance, if someone who has been heavily involved in a sport in the past makes a comeback after taking a break for many years. In some cases, a preparatory period during which participants undertake only healthenhancing exercises in a controlled environment may be necessary before they can take part in the main sport. In addition, some sports activities may need to be adapted (e.g., the game/playing rules), so that they are more appropriate for amateur participants (see Electronic Toolkit, Area 4). Seniors The key role of physical activity for seniors is to help them maintain a level of health and mobility that sufficiently allows for their social participation and functional independence. Important health aspects to consider as part of the SCforH approach with respect to seniors are their ability to function, social capital, balance, body maintenance, and increased health risks. The key health benefits to this age group include fall prevention, slowing of cognitive decline, and reducing risk of many chronic diseases. Another important aspect to consider is the social nature of sports participation, and special attention should be paid to this while developing SCforH initiatives that target seniors. To achieve potential health benefits, seniors are recommended to engage in at least 150 minutes of moderate-intensity aerobic physical activity such as light sports, walking, and household chores or 75 minutes of vigorous-intensity aerobic physical activity such as swimming and skiing, each week. Seniors are also 40 41 recommended to perform musclestrengthening exercises two days a week and take part in activities that can help them improve their balance and prevent falls at least three times a week. Sport activities may be practiced by most members of the population up until they reach an advanced age. However, seniors usually prefer to participate in more health-oriented and less technically and physically demanding sport activities. Some of the physical activities that are most frequently selected by members in this age group include gymnastics, swimming, cycling, walking, and hiking, but this can vary significantly depending on the country and community. When tailoring an SCforH initiative to meet the needs of seniors in your community, it is important to include activities that are not extremely physically demanding (i.e., practicing them does not require a high level of physical fitness and motor skills). The activities often need to be adapted to meet the special physical and motivational requirements of members in this age group to minimise health risks. Two examples of possible actions that can be taken to achieve SCforH goals, which have been tailored to meet the needs of a specific age group, are shown in Figure 7. More examples of good practice can be found in the Electronic Toolkit (Area 4). Figure 7. Example of important aspects to consider with respect to seniors and examples of actions ACTIONS New and adapted rules will be applied to make the traditional forms of sports safer for the participants (e.g., walking football) Before and after the game, more time will be provided for participants to socialise. Exercise in pairs and small groups will be offered to increase the number of social interactions GOAL To minimize health risks in a SCforH initiative for seniors To support socialisation in a SCforH initiative for adolescents 42 43 Conceptual framework Sports Club for Health The SCforH conceptual framework is presented in Figure 8. The operational concepts of the SCforH approach may not necessarily be applicable to other physical activity promotion initiatives. Within this conceptual framework, the focus of the SCforH approach is placed on health-enhancing sports activity (HESA) and health-enhancing exercise (HEXE). Physical activity (PA) = “Any bodily movement produced by skeletal muscles that results in energy expenditure”37. Health-enhancing physical activity* (HEPA) = Physical activity that produces health benefits. This includes all types of physical activities that are beneficial to one’s health and present no or only minimal health and safety risks. In the SCforH conceptual framework, physical activity is further categorised into areas of lifestyle physical activity (at work, at home, during transport, and during leisure time), exercise, and sports activity. Health-enhancing lifestyle physical activity (HELSPA) = Physical activities other than organised sports and exercise that are performed at work, during transport, at home, or during leisure time. Health-enhancing sports activity** (HESA) = All types of sports activities that are beneficial to health and present no or only minimal health and safety risks. The SCforH approach places a focus on physical activities that are carried out as part of sports club activities. Various types of sport activities can be HESA, but their health effects may vary depending on their type, dose (frequency, intensity, and duration), and the participants’ initial levels of fitness. Health-enhancing exercise (HEXE) = Planned, structured, and repetitive exercises performed to improve or maintain one or more components of physical fitness and health. These can take place, for example, in exercise classes (e.g., Nordic walking, aerobics, and gymnastics) offered at a sports club. Sports Club for Health (SCforH) = Approach in which sports clubs are encouraged to promote health-enhancing sports activities and health-enhancing exercise as part of their activities. (SCforH) * Health benefits are dependent on the amount of physical activity, exercise, and sports. The amount is defined by the frequency, intensity, and duration of the activity. From the health perspective, the advantage of sports activities is that they typically have higher intensities than lifestyle physical activities. ** HESA can also be viewed from a wider perspective as all time spent in sports club activities (the Health Promoting Sports Club [HPSC] approach). 44 45 Acknowledgments This book of guidelines was developed as part of the “Promoting National Implementation for Sports Club for Health (SCforH) Programmes in EU Member States” project funded by the Erasmus+ Collaborative Partnerships grant (ref: 556953-EPP-1-2014-1-FI-SPO-SCP), with the support of the following partner institutions: Finnish Sports Confederation – Valo; Belgian Gymnastics Federation; European Non-Governmental Sports Organisation – ENGSO; Equestrian Federation of Finland; Finnish Boxing Association; Finnish Gymnastics Federation; Finnish Sports Federation – Ostrobothnia region; Finnish Swimming Association; Gaelic Athletic Association; German Gymnastics Federation; International Sport and Culture Association – ISCA, Örebro University; Palacký University; Southern Finland Sports Federation; Swedish Sport Confederation; University of Jyväskylä; University of Leuven (K.U. Leuven); University of Turku; University of Zagreb; and Waterford Institute of Technology. Dr Pedisic’s participation in the project was generously supported by the Victoria University, Melbourne, Australia. A number of people contributed to the development of the SCforH approach as part of this funded project. The project managers/coordinators, work package leaders, members of working groups, participants of project meetings, workshops and symposiums, and several external experts have taken part in this joint effort. The authors express their gratitude to all those who contributed to the SCforH project, which resulted in this book of guidelines. Work package leaders and members of the project team: Zeljko Pedisic (WP2 leader), Marija Rakovac, Herbert Hartman (WP3 leader), Sami Kokko (WP4 leader), Pasi Koski (WP5 leader), Susanna Geidne, Timo Hämäläinen (WP1 and WP6 leader), Aoife Lane, Matleena Livson, Ulla Nykänen, and Jorma Savola The participants of Work Package 2: Pavel Háp, Stjepan Heimer, Danijel Jurakić, Matleena Livson, Pekka Oja, Zeljko Pedisic, Heidi Pekkola, Hrvoje Podnar, Ivan Radman, Marija Rakovac, and Jorma Savola The participants of Work Package 3: Leeni Asola-Myllynen, Inge Doens, Herbert Hartmann, Timo Hämäläinen, Margareta Johansson, Nina Kaipio, Eerika Laalo-Häikiö, Matleena Livson, Ulla Nykänen, Merja Palkama, Colin Regan, and Jorma Savola The participants of Work Package 4: Petr Badura, Minna Blomqvist, Susanna Geidne, Sami Kokko, Pasi Koski, Michal Kudlacek, Aoife Lane, Leena Martin, Jeroen Meganck, Kaisu Mononen, Jeroen Scheerder, Jan Seghers, Aurelie Van Hoye, and Jari Villberg The participants of Work Package 5: Susanna Geidne, Timo Hämäläinen, Herbert Hartmann, Sami Kokko, Pasi Koski, Aoife Lane, Matleena Livson, Tanja Matarma, Ulla Nykänen, Pekka Oja, Zeljko Pedisic, Marija Rakovac, and Jorma Savola The participants of Work Package 6: Timo Hämäläinen, Pasi Koski, Zeljko Pedisic, Marija Rakovac, Herbert Hartman, Sami Kokko, Susanna Geidne, Timo Hämäläinen, Aoife Lane, Matleena Livson, Ulla Nykänen, and Jorma Savola 46 47 References 1. Kokko, S., Koski, P., Savola, J., Alen, M. & Oja, P. 2009. The guidelines for sports club for health (SCforH) programs. Helsinki: Finnish Sport for All Association. 2. Kokko, S., Oja, P., Foster, C., Koski, P., Laalo-Häikiö, E. & Savola, J. 2011. Sports Club for Health (SCforH) – Guidelines for health-oriented sports activities in a club setting. Helsinki: Finnish Sport for All Association. 3. European Commission. 2007. White paper on sport. Luxembourg: Office for Official Publications of the European Communities. 4. Council recommendation. 2013. COUNCIL RECOMMENDATION of 26 November 2013 on promoting health-enhancing physical activity across sectors. Official Journal of the European Union, C/354. 5. IOC. 2016. Olympic Charter – as force as from 2 August 2016. Lausanne: International Olympic Committee. 6. IOC. 2014. Olympic Agenda 2020, 20+20 recommendations. Lausanne: International Olympic Committee. 7. Taliaferro, L., Rienzo, B. & Donovan, K. 2010. Relationships between youth sport participation and selected health risk behaviors from 1999 to 2007. Journal of School Health, Aug;80(8), 399-410. DOI:10.1111/j.1746-1561.2010.00520.x. 8. Marques, A., Ekelund, U. & Sardinha, L.B. 2016. Associations between organized sports participation and objectively measured physical activity, sedentary time and weight status in youth. Journal of Science and Medicine in Sport, Feb;19(2), 154- 157. DOI:10.1016/j.jsams.2015.02.007. 9. Eithsdóttir, S., Kristjánsson, A., Sigfúsdóttir, I. & Allegrante, J. 2008. Trends in physical activity and participation in sports clubs among Icelandic adolescents. European Journal of Public Health, Jun;18(3), 289-293. DOI:10.1093/eurpub/ ckn004. 10. Ekelund, U., Tomkinson, G. & Armstrong, N. 2011. What proportion of youth are physically active? Measurement issues, levels and recent time trends. British Journal of Sports Medicine, Sep;45(11), 859-865. DOI:10.1136/ bjsports-2011-090190. 11. Mäkelä, K., Kokko, S., Kannas, L., Vasankari, T., Heinonen, O.J., Savonen, K., Alanko, L., Korpelainen, R., Selänne, H., Villberg, J. & Parkkari, J. 2016. Physical activity, screen time and sleep among youth participating and non-participating in organized sports - The Finnish Health Promoting Sports Club (FHPSC) Study. Advances in Physical Education, Nov;6(4), 378-388. DOI:10.4236/ape.2016.64038. 12. Van Hoye, A., Fenton, S., Krommidas, C., Heuzé, J-P., Quested, E., Papaioannou, A. & Duda, J.L. 2013. Physical activity and sedentary behaviours among grassroots football players: A comparison across three European countries. International Journal of Sport and Exercise Psychology, Oct;11(4), 341-350. DOI:http://dx.doi.or g/10.1080/1612197X.2013.830432.