Local Leisure Centres Research Articles

The engagement of older people living with chronic lung disease in a peer support community-based exercise programme: A qualitative study.

Chronic lung disease is a common and complex condition. Pulmonary rehabilitation programmes-either hospital-based or in the community are recommended in evidence-based clinical practice guidelines. To explore the experience of older people with chronic lung disease involved in a peer support community-based exercise maintenance programme. Participants were a part of the Lungs in Action programme run in a local community leisure centre through Lung Foundation Australia. All the programme participants (n = 25) were invited by an independent person through email and/or letter to participate in the study and provided with a participant information and consent form. Participants who returned consent forms were scheduled for group interviews. Participants were recruited over a 2-week period between 30 August and 13 September 2022. We conducted qualitative group interviews using a semi-structured interview guide to explore the experiences of older people living with chronic lung disease. Data were analysed using reflexive thematic analysis. A total of 14 participants (eight female and six male) aged between 64 and 86 years were interviewed. Three themes emerged from the data: motivation, authentic social engagement, and sustainable achievement. Motivation stemmed from the participants' perceived health benefits, and from the trainers' motivation and encouragement. Participants discussed how sharing experiences created an environment of trust and understanding, fun and friendship. Social engagement and creating authentic relationships were key aspects raised by participants. Feeling more confident in themselves and being able to accomplish physical tasks, making activities of daily living more manageable featured highly in participants' responses. Community-based peer support exercise groups enable environments for people with chronic lung disease to maintain physical fitness, and to connect with others to form friendships and have fun.

A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme.

Objectives:The Cycling against Hip Pain programme is a 6-week exercise and education treatment pathway for people with hip osteoarthritis. Preliminary results of the Cycling against Hip Pain programme found significant improvements in clinical and patient-reported outcome measures for patients referred from primary care. This article evaluates the effectiveness of the changes made to the pathway in a quality improvement replication programme.Methods:The replicated Cycling against Hip Pain programme was delivered between February 2018 and September 2019 in a region of England with a high percentage of adults aged over 65 years. All participants were referred from the orthopaedic outpatient department of the funding hospital (secondary care). The programme was delivered at a local leisure centre and combined 30 min of education on osteoarthritis with 30 min of progressive static cycling, once a week for 6 weeks.Results:The participants on the replicated Cycling against Hip Pain programme did not differ from the original cohort in terms of age or pre-programme weight, however, presented with worse hip symptoms at baseline. Consistent with the findings from the original cohort, participants demonstrated significant improvements to their Oxford Hip Score, 30-s chair stand performance, Timed Up and Go score, Hip Osteoarthritis Outcome Score function and pain, EQ5D health rating, EQ5D-5L score and pain at rest and on weight bearing. In addition, participants reported an increase in knowledge, confidence and motivation to exercise.Conclusion:A 6-week cycling and education intervention for the treatment of hip osteoarthritis provided benefits to function, pain and quality of life for patients referred from secondary care. These results are consistent with findings from patients who were referred from primary care and further support the potential of the pathway in the conservative management of hip osteoarthritis.

270 Tackling Chronic Disease Burden and Building Resilience in Frail Community Populations in an Integrated Model- the ExWell Project

Abstract Background ExWell is a research validated, large scale, community-based chronic illness rehabilitation service. It is a collaborative project between local acute hospital, community organisation, local authority, and exercise medicine specialists. The mission of ExWell is to transform the lives of people with chronic illness through Physical-activity based rehabilitation. Participants are medically prescribed to the ExWell program by hospital physicians or their GP. Methods Referred participants have a two-day induction which includes strength and fitness testing that are covered by key metrics - hip/waist ratio, BMI, grip strength (upper body strength), sit to stand time for 10 repetitions (lower body strength), 6 minute time trial and posterior chain flexibility. These metrics are retested in 3 and 6 month intervals to assess progress. Participants are instructed on exercise technique and class fundamentals. These comprise of 4 stations (1) strength/resistance training; (2) Aerobic conditioning; (3) Balance/core strengthening; and (4) Dynamic movement. The regular full class comprises of 10min warmup, 40minute exercise and 10min cooldown. Results Since its inception in May 2018, ExWell based in the local leisure centre has grown exponentially with classes having tripled to 6 pw, with a further 3 classes pw starting in May 2019. Over 600 referrals have been received in the first year, 85% of these were from hospital services. Approximately 400/600 of referred participants were inducted into classes. Reasons for non-induction include diminished motivation, transport, work commitments. The average attendance each week is approximately 150 visits with an age range 27-92 years. (Average 68.3 years with 63.5% over the age of 65 and 10.7% over the age of 80). Conclusion ExWell demonstrates a scalable integrated partnership model for delivering sustainable exercise based programs to target chronic illness and frailty in community populations. Next steps include consolidating the ExWell program here and in two partner sites, with subsequent expansion to other areas.

Mid-term follow up and analysis of the subsequent need for hip replacement following completion of the chain (cycling against hip pain) programme

Purpose: The CHAIN (Cycling against Hip Pain) programme is a six-week exercise and education treatment pathway for people diagnosed with hip osteoarthritis. It is designed to promote the self-management of hip pain based on the National Institute for Health and Care Excellence (NICE) guidelines that recommend education and advice, exercise (aerobic and local muscle strengthening) and weight loss where appropriate. It is a conservative treatment option designed to help patients avoid the need for, or to delay the need for hip replacement surgery. Participants attend a local leisure centre for a thirty minute education session, delivered by a physiotherapist, followed by thirty minutes of indoor cycling led by a spin instructor. The sessions are progressive and supplemented with home exercises. Education topics include: the benefits of exercise for osteoarthritis, diet and nutrition, pain relief, pacing of activities and lifestyle change. The short-term clinical results of the intervention have previously been published, with patients reporting improvements to pain and function; having an increased confidence in self-managing hip pain, and having increased motivation to exercise. However, a mid-term analysis on the subsequent need for hip replacement patients has not been completed. Therefore, this follow-up analysis aimed to interrogate patient hospital records to establish the number of CHAIN participants that had returned to their local hospital for treatment of hip osteoarthritis with hip replacement surgery. Methods: One hundred and nineteen participants were enrolled onto the first CHAIN programme between October 2013 and February 2015. Of the 96 participants who completed the programme (Table 1), 95 patient records could be found on their local NHS Trust computer system in November 2018. These records were systematically reviewed, with any theatre admissions, orthopaedic outpatient appointments or radiology reports opened for investigation. Patients who had returned to their local NHS hospital for total hip replacement were recorded. Results: Of the 95 records interrogated, 32 patients (33.7%) had returned to their local NHS hospital for total hip replacement surgery. At up to five year follow up (range: 3 to 5 years) thirty one patients received unilateral total hip replacement and one patient received bilateral total hip replacement. Sixty three patients (66.3%) did not return to their local hospital for surgical intervention. Of the hip replacements that were performed following conservative treatment through the CHAIN programme, six were in 2014, eleven were in 2015, six were in 2015, five were in 2017 and five were in 2018. Conclusions: Following conservative treatment of osteoarthritis through a cycling and education programme, 66.3% of participants had not returned for a hip replacement surgical intervention at the local NHS hospital from the region in which they were referred. This may have significant economic implications for practice, given the high cost of surgical interventions and the increasing numbers of people with osteoarthritis.

Activate your back: collaborating with council services to encourage people with low back pain to self-manage in community settings

Purpose: Moving care out of hospital settings and into the community is a key focus of the NHS Five Year Forward View. We explored if it was feasible for NHS physiotherapists to deliver free back classes within local council leisure centres, and if they effectively helped to increase participant activity levels. A review of the back pain pathway within Wiltshire generated a desire to use a stratified approach to interventions. We chose to begin with those scoring low risk on the STarT back tool, aiming to deliver messages to foster a positive approach to exercise and prevent unhelpful beliefs developing. This service evaluation will inform the wider back pain pathway in Wiltshire and may provide insight to other physiotherapists planning similar projects.

‘He’s Running, Ref!’ An ethnographic study of walking football

This paper explores the experience of playing walking football (w/f) in the south of England. Ethnographic research was carried out at a local authority leisure centre and non-league football club. Data were accumulated through an ethnographic approach which consisted of participant observation, informal conversations with walking footballers and facilitators and documentary collection. The research period ran throughout 2015–2016 for a period of 18 months. The data, which were analyzed reflectively using insights from feminist scholarship, suggest that players experienced a number of benefits from participation. Whilst some previous studies have sought primarily to measure physiological benefits, this study is suggestive of less tangible health gains. In particular, players reported an increased appetite for life and positivity engendered by playing w/f, together with enhanced levels of social engagement. They reported feelings of social connectedness, enjoyment and inclusion as members of a supportive community. However, there is some evidence of conflict over the philosophy and purpose of w/f/, especially in relation to the spirit of the game and the competitive tournament environment. Further work around these areas is recommended.

Preventing weakness and stiffness - A top priority for health and social care.

With growing evidence that sarcopenia, disability and frailty can be prevented with physical activity, people living with pain, stiffness and weakness due to a musculoskeletal condition should be offered physical activity as a preventive strategy. By changing beliefs and attitudes towards ageing and raising the value and importance of physical activity, disability can beavoided or delayed and the costly burden of social care lessened. The effects of ageing and the effects of muscle strength loss are often confused. Older people can increase their strength and decrease their fitness to that of an average person a decade younger by regular exercise by decreasing the fitness gap. For illustration, the inability to get up from a chair and get to the toilet on time is often trigger for social care. People who are homebound are especially at risk of inactivity, and we need to be innovative and creative with ways to get them out of their homes, engaged within the community and using technology to interact with them at home. We need a ubiquitous call to action and cultural shift throughout the health and social care ecosystem to bring all the elements together, providing a platform and tools to be more active and signpost to activity as a therapy for weakness and joint stiffness. Behaviour change and stratified approaches to identify complex cases, and one-to-one interventions are key to the success of this approach. Local leisure centres remain at the very heart of communities and should be wellness centres for our ageing populations making them the frontline of the NHS.

An evaluation of portion size estimation aids: Consumer perspectives on their effectiveness

ObjectiveThis qualitative study aimed to investigate consumer opinions on the usefulness of portion size estimation aids (PSEA); consumer preferences in terms of format and context for use; and the level of detail of guidance considered necessary for the effective application of PSEA. DesignSix focus groups (three to eight participants per group) were conducted to elicit views on PSEA. The discussions were recorded, transcribed verbatim and analysed by two independent researchers using a template approach. SettingThe focus groups were conducted in 2013 by an experienced moderator in various sites across the island of Ireland (three in the Republic of Ireland and three in Northern Ireland) including local leisure, community and resource centres; the home environment; and a university meeting room. ParticipantsGeneral population, males (n = 17) and females (n = 15) aged 18–64 years old. Participants were recruited from both urban and rural locations representing a range of socio-economic groups. ResultsThe majority of participants deemed the coloured portion pots and disposable plastic cup (household measures) to be useful particularly for the estimation of amorphous cereal products (e.g. breakfast cereals). Preferences were evident for “visual” PSEA (reference objects, household measures and food packaging) rather than ‘quantities and measures’ such as weighing in grams or ounces. Participants stated that PS education should be concise, consistent, from a reputable source, initiated at school age and communicated innovatively e.g. mobile app or TV advertisement. Guidance in relation to gender, age and activity level was favoured over a “one size fits all” approach. ConclusionsThis study identified consumer preferences and acceptance of “visual” PSEA such as portion pots/cups to estimate appropriate PS of amorphous grain foods such as breakfast cereals, pasta and rice. Concise information from a reputable source in relation to gender, age and activity level should accompany PSEA.

A pragmatic community exercise programme for young people with cerebral palsy: A pilot study

Introduction andaim: Peoplewith cerebral palsy (CP) are often discharged from paediatric services at the age of 16–21 years. However, as they reach adolescence and body weight and height increases, the energy required to ambulate also increases [1]. In addition, people with CP often show reduced levels of muscle strength [2]. These factors may explain why 75% of people with CP who lose the ability to walk do so at around 25 years. Therefore the aim of this pilot study was to investigate the feasibility of a community based exercise programme and its effects on improving physical fitness and function in adolescents and young adults with CP. Patients/materials and methods: Eight participants with diplegic and hemiplegic CP (GMFCS I-III) (mean age 20 years) took part in an exercise programme which included a mix of strength and aerobic exercises at their local leisure centre under the supervision of a fitness instructor. Instruction was delivered by a physiotherapist on 2–3 occasions. The programme prescribed three sessions per week for weeks 1– followed by two prescribed sessions during weeks 7-12. The participants underwent gait analysis at baseline (BL) and after approximately six (T2) and 12 weeks (T3) of the exercise programme. The assessment also includedmeasures of knee extensor, hip extensor and hip abductor strength (using an MIE Myometer), Gross Motor Function Measure (GMFM) dimensions D and E, a CP-specific 10m shuttle run/walk (SRT), the Rosenberg scale for Self Esteem and step count. Results: Two participants dropped out the exercise programme and did not return for the T3 assessment. The other six participants showed good compliance with the exercise programme (91% and 75% attendance of prescribed sessions for the 1st and 2nd block of sixweeks respectively)with no adverse events. Outcomemeasures at BL, T2 and T3 are shown in Table 1. Statistically significant effects of the exercise programme between BL and T3 for hip extensor strength and the Rosenberg Scale for Self-Esteem between BL and T3 for GMFM dimensions D&E were found. A trend (Cohen’s d=0.90) toward improvement was also found for hip abductor strength. Discussion and conclusions: This pilot study showed that for the majority of the participants with varying levels of function, exercising at a local leisure centre is feasible and safe. Preliminary results also indicate that this pragmatic community exercise programmecanbe efficacious in improvinghip extensor strength, gross motor function and increasing self-esteem.

A cluster randomised controlled trial of an intervention to promote healthy lifestyle habits to school leavers: study rationale, design, and methods

BackgroundPhysical inactivity and a poor diet predict lifestyle diseases such as diabetes, cardiovascular disease, and certain types of cancer. Marked declines in physical activity occur during late adolescence, coinciding with the point at which many young people leave school and enter the workforce and begin to take greater control over their lifestyle behaviours. The work outlined within this paper sought to test a theoretically-informed intervention aimed at supporting increased engagement in physical activity and healthy eating habits in young people at the point of transition from school to work or work-based learning. As actively engaging young people in initiatives based on health messages is challenging, we also tested the efficacy of financial incentives in promoting initial engagement with the programme.Methods/designA three-arm cluster-randomised design was used. Participants were school pupils from Year 11 and 13 (i.e., in their final year of study), aged 16–18 years. To reduce contamination effects, the unit of randomisation was school. Participants were randomly allocated to receive (i) a 12-week behavioural support intervention consisting of six appointments, (ii) a behavioural support intervention plus incentives (totalling £40), or (iii) an information-only control group. Behavioural support was provided by fitness advisors at local leisure centres following an initial consultation with a dietician. Sessions focused on promoting habit formation through setting implementation intentions as part of an incremental goal setting process. Consistent with self-determination theory, all advisors were trained to provide guidance in an autonomy-supportive manner so that they were equipped to create a social context supportive of autonomous forms of participant motivation. The primary outcome was objectively assessed physical activity (via GT1M accelerometers). Secondary outcome measures were diet, motivation and habit strength. Data were collected at baseline, post-intervention (12 weeks) and 12 months.DiscussionFindings of this trial will provide valuable insight into the feasibility of promoting autonomous engagement in healthy physical activity and dietary habits among school leavers. The research also provides much needed data and detailed information related to the use of incentives for the initial promotion of young peoples’ behaviour change during this important transition.Trial registrationThe trial is registered as Current Controlled Trials ISRCTN55839517.

Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial

BackgroundA recent HTA review concluded that there was a need for RCTs of exercise referral schemes (ERS) for people with a medical diagnosis who might benefit from exercise. Overall, there is still uncertainty as to the cost-effectiveness of ERS. Evaluation of public health interventions places challenges on conventional health economics approaches. This economic evaluation of a national public health intervention addresses this issue of where ERS may be most cost effective through subgroup analysis, particularly important at a time of financial constraint.MethodThis economic analysis included 798 individuals aged 16 and over (55% of the randomised controlled trial (RCT) sample) with coronary heart disease risk factors and/or mild to moderate anxiety, depression or stress. Individuals were referred by health professionals in a primary care setting to a 16 week national exercise referral scheme (NERS) delivered by qualified exercise professionals in local leisure centres in Wales, UK. Health-related quality of life, health care services use, costs per participant in NERS, and willingness to pay for NERS were measured at 6 and 12 months.ResultsThe base case analysis assumed a participation cost of £385 per person per year, with a mean difference in QALYs between the two groups of 0.027. The incremental cost-effectiveness ratio was £12,111 per QALY gained. Probabilistic sensitivity analysis demonstrated an 89% probability of NERS being cost-effective at a payer threshold of £30,000 per QALY. When participant payments of £1 and £2 per session were considered, the cost per QALY fell from £12,111 (base case) to £10,926 and £9,741, respectively. Participants with a mental health risk factor alone or in combination with a risk of chronic heart disease generated a lower ICER (£10,276) compared to participants at risk of chronic heart disease only (£13,060).ConclusionsResults of cost-effectiveness analyses suggest that NERS is cost saving in fully adherent participants. Though full adherence to NERS (62%) was higher for the economics sample than the main sample (44%), results still suggest that NERS can be cost-effective in Wales with respect to existing payer thresholds particularly for participants with mental health and CHD risk factors.Trial registrationCurrent Controlled Trials ISRCTN47680448

A randomised controlled trial to compare a range of commercial or primary care led weight reduction programmes with a minimal intervention control for weight loss in obesity: the Lighten Up trial

BackgroundDeveloped countries are facing a huge rise in the prevalence of obesity and its associated chronic medical problems. In the UK Primary Care Trusts are charged with addressing this in the populations they serve, but evidence about the most effective ways of delivering services is not available. The aim of this study is to determine the effectiveness of a range of weight loss programmes for obese patients in primary care and to determine the characteristics of patients who respond to an invitation to a free weight management programme.Methods/DesignLighten Up is a randomised controlled trial comparing a range of 12-week commercial and NHS weight reduction programmes with a comparator group who are provided with 12 vouchers enabling free entrance to a local leisure centre. The weight reduction programmes are: (i) Weight Watchers, (ii) Slimming World, (iii) Rosemary Conley, (iv) a group-based dietetics-led programme (Size Down), (v) general practice one-to-one counselling, (vi) pharmacy-led one-to-one counselling, (vii) choice of any of the 6 programmes. People with obesity or overweight with a co-morbid disorder are invited to take part by a letter from their general practitioner. The sample size is 740 participants.The primary outcome is weight loss at programme-end (3 months). Secondary outcomes are weight-loss at one year, self-reported physical activity at 3 and 12 months follow-up and percentage weight-loss at 3 months and one year.DiscussionThis trial will provide evidence about the effectiveness of a range of different weight management programmes in a primary care population.Trial registrationCurrent Controlled Trials ISRCTN25072883

Hospital versus community-based phase III cardiac rehabilitation

to compare patient and staff perceptions of phase III cardiac rehabilitation delivered in a hospital versus community setting. data were collected by semi-structured interviews with staff and patients. Patients and staff members were interviewed in one of two local leisure centres and in the cardiac unit at Leeds General Infirmary. Five patients who had previously attended a hospital-based phase III programme, four patients who attended a community-based programme, and four hospital and community staff members participated. Data were analysed using a content analysis technique based on the framework' approach. three patients admitted having negative expectations of the community-based phase III programme. Maintaining attendance is more challenging in the community; however, progression rates to phase IV were better. Differences between programmes were identified in adherence to sessions, type and number of staff present, and number of sessions provided each week. All patients found the sessions helped with their rehabilitation and all stated that they would recommend their programme to others. both community- and hospital-based rehabilitation programmes were seen as successful by both patients and staff. The emergence of the community programme has proven to be a valuable additional service for cardiac patients. However, if the future of phase III cardiac rehabilitation in Leeds is to be community-based, then specific issues such as exercise adherence will need to be addressed.

Willingness of young men and women to be tested for Chlamydia trachomatis in three non-medical settings in Glasgow, UK

ObjectiveTo assess the willingness of young men and women to be tested for Chlamydia trachomatis in three non-medical settings.MethodsMen and women aged between 16 and 24 years were invited to...

Water efficiency in leisure centres

Overall use of water in an urban indoor leisure centre can be high, so that there are significant incentives to save water, both for direct cost reduction and for indirect saving through the reduction of embedded energy. In addition, both privately owned- and local authority-run leisure centres need to show savings in order to manage drought requirements. Analysis of the temporal patterns and volumes of water used in the different activities with a leisure centre, such as swimming pools, showers, toilets and others can point to where cost-effective saving measures can be implemented. This paper will focus on the factors that must be considered when attempting to reduce the use of water in ‘power showers’ and is derived from a programme commissioned by United Utilities Plc at Liverpool John Moores University, aimed at reducing domestic water consumption. The results of focus group studies, laboratory trial and home trials can easily be extrapolated to the leisure centre. In order to persuade the user to accept a lower water use it is essential to sustain the ‘shower experience’ to maintain user satisfaction. A range of commercially available domestic showerheads was examined to determine flow characteristics, (pressure–volume) radial spray distributions at different flow-rates, direct and indirect measures of ‘skin pressure’ and measurements of vertical temperature profiles. Some simple correlations were derived but it is not easy to relate these to user satisfaction.

Changes in self-determination during an exercise referral scheme

Exercise referral schemes (ERSs) are now a common feature of UK primary health care. These schemes involve the referral of patients with specific health concerns (e.g. obesity, high blood pressure and mild anxiety/depression) to a local leisure centre by a health professional, and induction into a 10e12-week structured exercise programme at a reduced fee. Although ERSs are increasing in popularity, it is difficult to draw conclusions about their effectiveness, largely due to a lack of adherence amongst patients. For example, Dugdill et al. reported that of all patients referred to an ERS, 27% never made contact with the scheme. Of those who did make contact, only 34e46% adhered for the full length of the intervention. Adherence to exercise programmes depends on the motives for which exercise is undertaken. Extrinsic motives, such as compliance with external pressures (e.g. from health professionals), have been found to produce lower levels of adherence compared with those exercising for intrinsic reasons, such as feeling good and enjoyment. According to self-determination theory

An outbreak of E. coli O157 associated with a swimming pool: an unusual vehicle of transmission

Escherichia coli O157 causes a range of illnesses from mild diarrhoea to haemolytic uraemic syndrome (HUS) which carries a mortality rate of 3.7%. Infection is more common in the under-5s. Between 1995 and 2000, 106 outbreaks of E. coli O157 were reported in England and Wales. Recreational water is well documented as a transmission route for infectious diseases worldwide. In the United Kingdom there have been very few reported outbreaks associated with swimming pools due to the relative susceptibility of E. coli O157 to adequate levels of free chlorine. This report describes the investigation of an outbreak associated with a local leisure centre pool and makes recommendations about the safe management of such facilities.

‘I feel totally at one, totally alive and totally happy’: a psycho-social explanation of the physical activity and mental health relationship

This paper reports findings from a qualitative investigation into the relationship between physical activity and mental health from the experiences of participants on exercise referral schemes. A grounded theory methodology was adopted which used focus groups and semi-structured interviews with participants from three exercise referral schemes in England. Schemes were representative of different types within the UK, and included a local authority leisure centre, a private health club and a local authority leisure centre scheme with organized countryside hikes. Pre- and post-exercise referral intervention focus groups, and interviews with purposively sampled individuals, were undertaken. Eighteen people participated and interviews were audio-taped, transcribed and analyzed. A conceptual framework emerged, and provides a psycho-social explanation for the physical activity and mental health relationship from the perspectives of the participants' who experienced it. The explanation of the relationship from this perspective identifies the core category 'self-acceptance', and the importance and interrelationship of context-related factors (such as social support and the physical environment), for the elicitation of positive experiences for people on exercise referral schemes. Investigating participant's experiences within the social contexts of exercise referral schemes provides an understanding about whether schemes have the potential to influence the mental health of referred patients.

Untangling the tangibles: 'physical evidence' and customer satisfaction in local authority leisure centres

Previous research has suggested that customer perceptions of service providers may be influenced by the tangibles of the service outlet itself, by service staff and by the service delivery processes. In leisure services little is known about the contribution of these and other elements of service to overall customer satisfaction. This paper reports the development of a customer survey instrument for UK local authority leisure centres which was used to explore the contribution of the different service dimensions to customer satisfaction. It was concluded that the survey results showed that tangible elements of the service were thought by customers to be the most important elements. These tangible elements also had the greatest impact on that variation in overall satisfaction which could be explained by the survey instrument.

Les cafés kabyles de Belleville : entre tradition et innovation

Kabyle «cafés» at belleville : between tradition and innovation This article accounts for the transformation of Belleville «bars» since the operations of urban renovation which have deeply modified the aspect of the district and its social structure. Nearly all these shops are kept by Kabyle people but they cannot be considered as «ethnic businesses» : neither the patrons nor the products offered ; neither the signs nor the decoration are specific. Very different in that from the Kabyle «hotel-cafés» of the 50s and the 60s, these shops are the only public places where, at some moments, the old and new inhabitants of different social status and origin can mix with each other. Some of them have become cultural places of festivity, turning the «café» into the last local leisure centre when all the cinemas and concert-halls which made the reputation of the district have disappeared from Belleville. These changes most often happened on the initiative of the owner’s sons, the salaried employees of their fathers and holders of some cultural wealth. These young people thus resisted professional deskilling and were able to attract and to keep a new population in the district, with more qualifications than the older one and combining praise for multicultural awareness and the glorification of Belleville’s tradition. This survey is the result of field work founded on observation and the selection of interviews which lasted for two years, from 1996 to 1998.