Over the last 40 years, Sport for All policies – aiming at encouraging the sports participation of all citizens, regardless of age, sex, social class, ethnic origin, etc. – were implemented in a number of European countries. This study examines the extent to which a democratisation of club-organised youth sports has occurred. The data are drawn from a large repeated cross-sectional survey among high school boys and girls (aged 13–18) in Flanders, Belgium. Data collected in 1989 (N = 2088), 1999 (N = 1820) and 2009 (N = 1420) are analysed, using multilevel logistic regression. Results indicate that social stratification of club-organised sports participation still persists. Age, sex and socio-economic status (SES) continue to determine the likelihood of club involvement by Flemish youth. For boys, the impact of SES has increased. Also parental sporting capital affects club participation. However, in terms of sex, differences in participation have diminished over time.
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Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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Background Providing individualized care based on the context and preferences of the patient is important. Knowledge on both prognostic risk stratification and blended eHealth care in musculoskeletal conditions is increasing and seems promising. Stratification can be used to match patients to the most optimal content and intensity of treatment as well as mode of treatment delivery (i.e. face-to-face or blended with eHealth). However, research on the integration of stratified and blended eHealth care with corresponding matched treatment options for patients with neck and/or shoulder complaints is lacking. Methods This study was a mixed methods study comprising the development of matched treatment options, followed by an evaluation of the feasibility of the developed Stratified Blended Physiotherapy approach. In the first phase, three focus groups with physiotherapists and physiotherapy experts were conducted. The second phase investigated the feasibility (i.e. satisfaction, usability and experiences) of the Stratified Blended Physiotherapy approach for both physiotherapists and patients in a multicenter single-arm convergent parallel mixed methods feasibility study. Results In the first phase, matched treatment options were developed for six patient subgroups. Recommendations for content and intensity of physiotherapy were matched to the patient’s risk of persistent disabling pain (using the Keele STarT MSK Tool: low/medium/high risk). In addition, selection of mode of treatment delivery was matched to the patient’s suitability for blended care (using the Dutch Blended Physiotherapy Checklist: yes/no). A paperbased workbook and e-Exercise app modules were developed as two different mode of treatment delivery options, to support physiotherapists. Feasibility was evaluated in the second phase. Physiotherapists and patients were mildly satisfied with the new approach. Usability of the physiotherapist dashboard to set up the e-Exercise app was considered ‘OK’ by physiotherapists. Patients considered the e-Exercise app to be of ‘best imaginable’ usability. The paper-based workbook was not used. Conclusion Results of the focus groups led to the development of matched treatment options. Results of the feasibility study showed experiences with integrating stratified and blended eHealth care and have informed amendments to the Stratified Blended Physiotherapy approach for patients with neck and/or shoulder complaints ready to use within a future cluster randomized trial.
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Sport is often considered as a promising instrument for reaching a wide array of policy objectives. Social inclusion is one of the goals frequently mentioned. Though one can argue about the feasibility of the many claims made, sport can only reasonably be expected to play a role if the targeted population is effectively taking part in sports. This is what is investigated in this study. The focus lies on the sports participation of children (primary school) and adolescents (secondary school), more particularly in a club-organised setting. The purpose of this study is to investigate whether family related factors associated with a higher risk for social exclusion can be considered as determinants of club sport participation among children and adolescents. Data are based on a large-scale cross-sectional survey (2009), collected in 39 schools in Flanders (Belgium), with a total of 3005 children and adolescents (aged 6–18) participating in the research. A multilevel logistic regression has been conducted, controlling also for differences between schools. Income poverty and parental education come forward as important determinants for club-organised sports participation. No evidence was found that living in a single parent-household affects the likelihood of club-organised sports participation. While sport is often considered as an important instrument for social inclusion, the study shows that children and adolescents who are likely to occupy a more vulnerable position in society as a whole, have higher odds to be left out with regard to sport club participation as well.
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Presentation at the European Conference for Social Work Research, Leuven: Belgium
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Background: Neck and shoulder complaints are common in primary care physiotherapy. These patients experience pain and disability, resulting in high societal costs due to, for example, healthcare use and work absence. Content and intensity of physiotherapy care can be matched to a patient’s risk of persistent disabling pain. Mode of care delivery can be matched to the patient’s suitability for blended care (integrating eHealth with physiotherapy sessions). It is hypothesized that combining these two approaches to stratified care (referred to from this point as Stratified Blended Approach) will improve the effectiveness and cost-effectiveness of physiotherapy for patients with neck and/or shoulder complaints compared to usual physiotherapy. Methods: This paper presents the protocol of a multicenter, pragmatic, two-arm, parallel-group, cluster randomized controlled trial. A total of 92 physiotherapists will be recruited from Dutch primary care physiotherapy practices. Physiotherapy practices will be randomized to the Stratified Blended Approach arm or usual physiotherapy arm by a computer-generated random sequence table using SPSS (1:1 allocation). Number of physiotherapists (1 or > 1) will be used as a stratification variable. A total of 238 adults consulting with neck and/or shoulder complaints will be recruited to the trial by the physiotherapy practices. In the Stratified Blended Approach arm, physiotherapists will match I) the content and intensity of physiotherapy care to the patient’s risk of persistent disabling pain, categorized as low, medium or high (using the Keele STarT MSK Tool) and II) the mode of care delivery to the patient’s suitability and willingness to receive blended care. The control arm will receive physiotherapy as usual. Neither physiotherapists nor patients in the control arm will be informed about the Stratified Blended Approach arm. The primary outcome is region-specific pain and disability (combined score of Shoulder Pain and Disability Index & Neck Pain and Disability Scale) over 9 months. Effectiveness will be compared using linear mixed models. An economic evaluation will be performed from the societal and healthcare perspective. Discussion: The trial will be the first to provide evidence on the effectiveness and cost-effectiveness of the Stratified Blended Approach compared with usual physiotherapy in patients with neck and/or shoulder complaints.
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Challenges that surveys are facing are increasing data collection costs and declining budgets. During the past years, many surveys at Statistics Netherlands were redesigned to reduce costs and to increase or maintain response rates. From 2018 onwards, adaptive survey design has been applied in several social surveys to produce more accurate statistics within the same budget. In previous years, research has been done into the effect on quality and costs of reducing the use of interviewers in mixed-mode surveys starting with internet observation, followed by telephone or face-to-face observation of internet nonrespondents. Reducing follow-ups can be done in different ways. By using stratified selection of people eligible for follow-up, nonresponse bias may be reduced. The main decisions to be made are how to divide the population into strata and how to compute the allocation probabilities for face-to-face and telephone observation in the different strata. Currently, adaptive survey design is an option in redesigns of social surveys at Statistics Netherlands. In 2018 it has been implemented in the Health Survey and the Public Opinion Survey, in 2019 in the Life Style Monitor and the Leisure Omnibus, in 2021 in the Labour Force Survey, and in 2022 it is planned for the Social Coherence Survey. This paper elaborates on the development of the adaptive survey design for the Labour Force Survey. Attention is paid to the survey design, in particular the sampling design, the data collection constraints, the choice of the strata for the adaptive design, the calculation of follow-up fractions by mode of observation and stratum, the practical implementation of the adaptive design, and the six-month parallel design with corresponding response results.
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“Municipal Youth Work taken over by Christians”. (Binnenlands Bestuur, 2009) This heading refers to the work of Youth for Christ in an Amsterdam neighbourhood. This organisation, successful in Youth Work nationwide, last year came out first in an open competition of the Amsterdam district De Baarsjes. Because of this they were commissioned to undertake all the youth work in this multicultural neighbourhood. The conditions were not to evangelise and not to limit recruitment of personnel inside their own circle but to recruit from outside the organisation as well. When they later appeared to have put a job advertisement only on their own website, this led to heated debates. Finally Youth for Christ acknowledged and rectified this mistake. This example is a concrete illustration of the actual and sometimes delicate relationships between philosophy of life and social work
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Despite several decades of Sport for All policies, opportunities for sports participation are still unequally divided, with certain socially disadvantaged groups having less access to sports. To reduce this gap, structural efforts are needed. A question that arises is what role nonprofit sports clubs can fulfill in this matter. In this study, first, it is explored how nonprofit sports clubs perceive their role and responsibility towards socially disadvantaged groups and how they act on it. Second, it is investigated which factors predict the presence or absence of efforts from nonprofit sports clubs for lowering barriers. For this second question, we focus on people living in poverty. Data are based on a survey among 580 nonprofit sports clubs throughout Flanders (Belgium). The findings indicate that the human resources capacity of the club is not the main barrier. It is argued that local sports authorities and sports federations have an important part to play in supporting and encouraging sports clubs in terms of social inclusionary policies, for example by instilling awareness.
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Abstract Background: To address the lack of social interaction and meaningful activities for persons with dementia (PWD) in nursing homes an artistic Photo-Activity was designed. The present study aims to develop a digital version of the Photo-Activity and to investigate its implementation and impact on nursing home residents with advanced dementia, and their (in)formal carers. Methods: First, within a user-participatory design, a digital-app version of the Photo-Activity will be developed and pilot-tested, in co-creation with (in)formal carers and PWD. Next, the feasibility and effectiveness of the Photo-Activity versus a control activity will be explored in a randomized controlled trial with nursing home residents (N=90), and their (in)formal carers. Residents will be offered the Photo- Activity or the control activity by (in)formal carers during one month. Measurements will be conducted by independent assessors at baseline (T0), after one month (T1) and at follow up, two weeks after T1 (T2). Qualitative and quantitative methods will be used to investigate the effects of the intervention on mood, social interaction and quality of life of the PWD, sense of competence of informal carers, empathy and personal attitude of the formal carers, and quality of the relationship between the PWD, and their (in)formal carers. In addition, a process evaluation will be carried out by means of semi-structured interviews with the participating residents and (in)formal carers. Finally, an implementation package based on the process evaluation will be developed, allowing the scaling up of the intervention to other care institutions. Discussion: Results of the trial will be available for dissemination by Spring 2023. The digital Photo-Activity is expected to promote meaningful connections between the resident with dementia, and their (in)formal carers through the facilitation of person-centered conversations. Trial registration: Netherlands Trial Register: NL9219; registered (21 January 2021); NTR (trialregister.nl)
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