Sport England Research Articles

Stakeholder perceptions of physical literacy: results from a national consultation in England

BackgroundThere is a lack of evidence of stakeholder perspective and understanding of physical literacy among relevant stakeholders from England. As part of research commissioned by Sport England to develop a physical literacy consensus statement for England, this study presents findings from the first national consultation with stakeholders in England.MethodsOne hundred and ninety-three individual stakeholders (50.3%) from education, community sport, national governing bodies of sport, physical activity and sport coaching sectors completed an online survey consisting of fixed item and open ended questions designed to examine their knowledge, understanding, perceptions and practices relating to physical literacy.ResultsResponses from stakeholders suggested there was confusion in use of the term physical literacy in practice and confusion regarding the definition of physical literacy. Most respondents suggested they were involved in physical literacy related activity and understood the term. However, when probed the physical literacy related activity they referred to was likely not actually physical literacy related. Understanding of the term physical literacy was inconsistent in general. Stakeholders considered the affective, social, physical and cognitive areas (domains) of learning to be most important for developing a positive relationship with movement, sport and physical activity for life.ConclusionsWhile stakeholders are aware of the term “physical literacy” and hold value of it within their practice, there remain key misconceptions relating to what physical literacy is, and debate as to whether any existing definitions truly capture the construct of physical literacy.

Process evaluation of a primary care-based type 2 diabetes remission project in the North East of England.

A type 2 diabetes remission project, Remission in Diabetes (REMI.D), funded by Sport England, was developed by stakeholders based in the North East of England and begun in early 2020. This local delivery pilot sought to tackle health inequalities by working with multiple organisations to demonstrate a way of scaling up an effective type 2 diabetes remission strategy which included both physical activity and dietary components. The intended delivery of the original project was impacted by the COVID-19 pandemic and changes were made to the project delivery in 2022. The aim of this process evaluation was to learn from the reactive decisions taken by stakeholders which altered the REMI.D project in response to the COVID-19 pandemic. Twelve stakeholders (from local authorities, secondary care, universities, NHS England commissioning, Diabetes UK, Sport England, Everyone Active and Active Partnerships) involved in the design and delivery of the intervention took part in a semi-structured interview lasting up to 60 min. Interviews were recorded and transcribed verbatim. Thematic analysis used the pre-determined 'core content' themes from the Medical Research Council and National Institute for Health Research framework for developing and evaluating complex interventions. Three topics for discussion emerged as follows: (a) lack of effective collaboration, (b) perception of change and (c) scalability of the intervention. Hierarchy within the stakeholder group initially hampered collaboration. Change was reactive as a result of the COVID-19 pandemic. Project changes reduced project sustainability and scalability but offered valuable learning about the need for explicit project theory for partnership working, co-production with service users and project flexibility for long-term health behaviour change.

S5-2 Co-creating a feasible and valid physical literacy assessment tool for children for use in both educational and community physical activity settings, within England

Abstract Purpose Physical literacy (PL) has been described as a gateway to lifelong participation in physical activity, with relevance to the education, health, and sports contexts. That said, it remains a contested term in research and practice, meaning existing PL assessment tools (PLAT) are inconsistent, with divergent ways to assess PL and the encompassing domains. Furthermore, PLATs often lack feasibility, especially when looking to gain population-level data. Therefore, we are developing a feasible and valid PLAT for children (ages 5-11) for use in both educational and community physical activity settings, within England. Method To develop an England-specific PLAT, the project includes four stages: (1) a review of reviews to identify existing strengths and weaknesses of existing tools, (2) identifying stakeholders’ facilitators and barriers to using a PLAT in an education and/or community sports setting, (3) co-developing a feasible PLAT through a multi-stakeholder co-creation event (researchers, practitioners, policymakers), and (4) pilot testing to assess the tools validity and feasibility. Results The results of the scoping review of reviews revealed very few tools exist that assess all domains of PL. Of the identified tool, where the validity and reliability of the tool were more promising, the feasibility of the tool lacked. These findings were akin to tools assessing one domain of PL. Stages 2 and 3 are currently in process. We anticipate sharing findings from the stakeholder survey, and insights from the co-creation event that will have led to a newly developed PLAT for England. Conclusion The co-created PLAT tool will bring together stakeholders across the education, sport, and health sector to gain consensus around the importance of assessing children’s PL in a bid to improve their physical activity levels. We anticipate the co-developed tool will provide surveillance data on children’s PL levels, which will enhance our understanding of the specific needs of children and young people to improve their PL. Thus, better targeting and tailoring support for children and young people to be physically active throughout their lives. Support/Funding Source The project has been externally funded by Sport England and the London Marathon Group.

S14-5 Girls Active and Change4Life Sports Club - two effective programmes to increase physical activity in schools and colleges

Abstract Purpose Girls Active aims to tackle declining participation in physical activity of girls aged 10 to 18 and its associated implications on health, wellbeing and education. Change4Life Sports Clubs are designed to address inactivity in 7 to 11 year olds and improve healthy lifestyle behaviours with exercise, food and hydration. Both projects aim to reduce physical inactivity of those children suffering the greatest challenges to achieving the recommended daily physical activity level of an average of 60 minutes of moderate to vigorous physical activity every day. Project description Both programmes were developed from evidence reviews and principles that work to engage, inspire and motivate targeted groups of children to be active. They were both developed by the children’s charity Youth Sport Trust, who have used sport and play to improve the lives of children and young people since 1995. They were co-designed with children and implemented through a national network of 450 School Games Organisers. Youth Sports Trust’s ‘content, delivery, structure’ model was used. For Girls Active we used the Active Lives Children Data from Sport England and Change4Life Sports Clubs were aligned to the Department of Health’s National Child Measurement Programme data to target where the programmes were most needed and to ensure that the right groups of children and young people were included in the interventions. Both programmes have been externally evaluated through academic partners using pre and post survey data, case studies and control elements and achieved high quality evidence scores. Both programmes have been scaled through a variety of funding streams including London 2012 Olympic Legacy, Sport England Lottery, Corporate Social Responsibility budgets and local public health funding. Girls Active has been adopted in Wales, Scotland and Northern Ireland. Conclusions We will share the evidence-based principles that have made these two approaches highly effective in addressing inactivity in primary school aged children and adolescent girls that can be applied in multiple contexts and will share resources and content that can be accessed following the session.

O.4.2-3 Physical activity participation among disabled people: secondary analysis of the 2018/19 Active Lives survey

Abstract Purpose Disabled people face significant barriers to being physically active and typically have low levels of activity. To enhance both access to and engagement in physical activity, it is valuable to understand the activity choices of disabled people. This study describes the types and duration of physical activity participation among disabled people and compares this to participation among non-disabled people. Methods This study used data from the 2018/19 sweep of Sport England’s Active Lives survey, a nationally representative assessment of activity levels in adults living in England. From a prespecified list of 212 activities, participants reported their participation in the previous 12 months (yes/no) and duration in the previous four weeks (min/week). For this study, activities were subsequently collapsed into 17 mutually exclusive groups, which included ‘leisure activities’ (for example, walking, and gardening) and ‘invasion games’ (for example, football and rugby). Participants also reported whether they had a long term (>12 months) health condition and whether this affected their normal daily activities; this informed the classification of participants into three groups: limiting disability, non-limiting disability, and no disability. Results Data were available for 171,121 participants, of whom 31,666 (18.5%) had a limiting disability, 34,955 (20.4%) a non-limiting disability, and 104,500 (61.1%) no disability. Leisure activity was the most common activity type and had the highest median mins/week of activity (median, 315 [IQR = 120-705] limiting disability; median, 390 [IQR = 180-750], non-limiting disability; median, 379 [IQR = 165-750] no disability). Across the three participant groups, walking, swimming, and gym-based activity were among the most common activities undertaken. Compared to participants with no disability, participants with a limiting disability reported lower engagement and durations for all activity types, except motorsports. Conclusions The types of activities undertaken by disabled people were largely similar to that of non-disabled people, but engagement and duration was typically lower. The necessary next step is understanding how to improve adoption of and adherence to different activity types among disabled people. Support/Funding Source This research was funded by a University of East Anglia Faculty of Medicine and Health Studentship.

Exploring the increasing interdependence of community sport and health policy in England

ABSTRACT Governments in many countries are increasingly interested in using community sport as a vehicle for improving public health through physical activity (PA) promotion. This has been associated with an increasing interdependence between the community sport and health policy sectors. However, there are no empirically grounded studies which have examined this directly and systematically in England. By examining Sport England’s Get Healthy, Get Active (GHGA) initiative, this paper presents novel evidence derived from interviews held with strategic policy-makers from Sport England and a professional football charity (Everton in the Community), and 67 men who engaged in one of the GHGA funded programmes, Active Blues. The findings reveal how the increasing interdependence between community sport and health policy has been characterised by tightly contested and congested relations of power at local and national levels. Although Sport England was the lead organisation which coordinated and was accountable for community sport, it was nevertheless highly dependent on organisations outside of the sector, including health organisations, to deliver their community sport goals. This was indicative of the relatively vulnerable and marginal position which Sport England, and sport policy, occupied in the policy landscape and the associated generalisation of interests from sport to public health. The policy spillover from more powerful policy sectors such as health, to comparatively less powerful ones like community sport, raises questions about the degree to which government can realistically expect to achieve their formal community sport and health policy goals.

A Meta-Analysis of Evidence Synthesis for a Healthy Campus Built Environment by Adopting Active Design Approaches to Promote Physical Activity

The spread of chronic diseases, particularly obesity, has become a significant social issue on a global level concerning human inactivity and unhealthy behavior. The new approach to active design introduced by AIA and Sport England to increase human activity through physical activity in the built environment includes certifications such as Fitwell and LEED. An active design is any design feature that encourages physical activity, thus encouraging the user to be physically, mentally, and socially active in the built environment. This study aims to assemble evidence on the active design approach through physical activity in the campus built environment by using a meta-analysis approach and statistical analyses. There were 1993 papers identified during the search; following the screening, eligibility, and inclusion stages, 10 studies that addressed physical activity in colleges and universities were chosen. Findings indicate that physical activity has a positive impact on human health in the built environment. I² is (96.38%), which indicates considerable heterogeneity with p < 0.0001 and an absence of publication bias. Accordingly, a model was designed to integrate an active design approach and healthy behavior theories for future research. Overall, the evidence shows the importance of active design and physical activity for a healthy built environment to achieve healthy social behavior.

The active practice charter: Movement as medicine

We are all familiar with the term prevention is better than cure. Physical inactivity is one of the major modifiable risk factors for preventable early death and when done in groups has a wealth of benefits for mental health. However, GPs and their teams have not always felt empowered to encourage their patients to move more. The active practice charter concerns a collaboration between GPs and Sport England that aims to support and inspire practices to take steps towards reducing sedentary behaviour and improve physical activity for staff and patients. The charter celebrates practices that have shown initiative in working towards this ever growing, vital goal for the nation’s health. Healthcare is changing with a push towards lifestyle medicine for all: its benefits are invaluable, the costs are low, and the side effects are minimal, so why not tap into this underused resource?

Impact of the first year of the “This Girl Can” physical activity and sport mass media campaign in Australia

IntroductionAddressing gender inequalities in physical activity is an important public health goal. A major campaign, ‘This Girl Can’ (TGC) was conducted by Sport England from 2015, and TGC was licenced in 2018 by VicHealth in Australia for development and use in a 3-year mass media campaign. The campaign was adapted through formative testing to Australian conditions and implemented within the state of Victoria. The purpose of this evaluation was to assess the initial population impact of the first wave of the TGC-Victoria.MethodsWe assessed campaign impact using serial population surveys, with the target population being women living in Victoria who were not meeting the current physical activity guidelines. Two surveys were carried out before the campaign (October 2017 and March 2018), and the post-campaign survey immediately following the first wave of TGC-Victoria mass media (May 2018). Analyses were primarily on the cohort sample of 818 low-active women followed across all three surveys. We measured campaign effects using campaign awareness and recall, and self-report measures of physical activity behaviour and perceptions of being judged. Changes in perceptions of being judged and in reported physical activity were assessed in relation to campaign awareness over time.ResultsOverall, TGC-Victoria campaign recall increased from 11.2% pre-campaign to 31.9% post-campaign, with campaign awareness more likely among younger and more educated women. There was a slight increase of 0.19 days in weekly physical activity following the campaign. Feeling that being judged was a barrier to physical activity declined at follow up, as did the single item perceptions of feeling judged (P < 0.01). Feeling embarrassed decreased, and self-determination increased, but exercise relevance, theory of planned behaviour and self-efficacy scores did not change.ConclusionsThe initial wave of the TGC-Victoria mass media campaign showed reasonably high levels of community awareness and encouraging decreases in women feeling judged whilst being active, but these did not yet translate into overall physical activity gains. Further waves of the TGC-V campaign are in progress to reinforce these changes and further influence the perception of being judged among low-active Victorian women.

Hugh McLeod, Religion and the Rise of Sport in England

Hugh McLeod, Religion and the Rise of Sport in England

Participation and Youth Sport Coaching Good Practice - An Overview and Reflection of the Active Sussex Coach Support Officers Scheme

Summary In order to meet a wide variety of social policy objectives (such as health, educational attainment, community cohesion etc.), ensuring wide access to community and youth sport programmes remains an objective of many governments. In the UK, the post 2012 Olympic Legacy Strategy, overseen by Active Partnerships under the auspices of Sport England, promoted Sportivate and Satellite Clubs programmes (aimed at increasing participation levels) through most of the rest of the decade. In order to ensure minimum standards of operation and to develop the skills of the local coaching workforce, Active Sussex (one of the Active Partnerships) commenced a Coach Support Officer (CSO) scheme with the support of the University of Chichester from 2013 to (through various iterations) time of writing. Through a longitudinal reflection/summary of the various interventions and data collection points over the last nine years, we present an overview of this scheme. Further, we outline a clear philosophy, guidelines, and accompanying set of values that extol what can be considered good (best) practice for sustainable community sport and physical activity programmes.

A gamification-based intervention to encourage active travel

Abstract Purpose ‘Beat the Street’ is a community-wide intervention which aims to increase active travel by turning an area into a 6-week game. Residents earn points and prizes by walking and cycling and tapping a smartcard on RFID readers called ‘Beat Boxes’ placed on lampposts at half-mile intervals. To-date, over 1 million people have taken part in the intervention, however, the impact of the program on adult active travel is yet to be explored. Methods In Autumn 2019, Beat the Street was delivered throughout the London Borough of Hounslow. Prior, and immediately following the intervention, residents were invited to complete a self-report questionnaire (Sport England Active Lives Survey-SF) to assess changes in physical activity. Time-stamp data generated through Beat Box activity provided an objective measure of intervention engagement and a traffic survey camera was used to measure the number of cars travelling along 1 target road between 1-week pre- and 1-week post-intervention. Results 28,219 people took part in the six-week game. Between pre- and post-intervention there was 7% decrease in adults reporting less than 30mins of activity per week and a 13% rise in adults reporting 150+ mins (n = 346, p &amp;lt; 0.01). Beat box data ascertained that 25% of total taps at all Beat Boxes were made between 08:00-08:59am and a further 28% were made between 3:00-3:59pm, typical travel to school/work periods. Further, traffic camera data showed that between the week before and week following Beat the Street, 1199 and 705 fewer cars and 130 and 36 fewer vans were observed travelling along Cambridge Road between 07:00-09:30am and 2:00-4:30pm, respectively. Conclusions These data sources, in combination, suggest gamification may be an encouraging approach to increasing levels of active travel at a community-wide level. Key messages • Gamification based intervention increases physical activity. • Gamification encourages active travel to school and work.

S01 Providing policymakers with the evidence and practices to act and improve lives through physical activity

Policymakers often lack the evidence to drive change and improve the lives of citizens through physical activity. This symposium will discuss how two unique global programs, ‘Active Citizens Worldwide' (ACW) and ‘Sport Impacts: Children' (SIC), have bridged the gap between academia and policymakers. Combining advanced data analytics, the latest in health, social and economic research and global benchmarking these programs have delivered unique insights on the drivers and outcomes of physical activity.ACW is a city-based programme formed through a collaboration of 4 cities: London, Stockholm, Singapore and Auckland. The project uses advanced analytics on large datasets covering entire cities to inform policymakers' efforts to enhance participation levels, and to calculate the monetary and non-monetary value that sport and physical activity has on society. Previously unrelated datasets have been integrated to provide completely new analytical insights on the true drivers of the complex physical activity system including facility access, and mindsets and motivations.This is combined with systematic modelling of the broad range of outputs and outcomes of physical activity including health, social, and economic benefits.This standardisation in modelling approach and analysis has enabled multiple cities to compare, benchmark and learn from each other. ACW ultimately enables cities to understand what is working and what is not in their city, and thereby design policies with the best chance of improving their city's health, wealth and wellbeing.Using a similar approach, the SIC initiative is a unique cross-sectorial collaboration between top national sports bodies, charities and academics in England. Through this partnership each organisation shared national participation, workforce and facility databases as well as recent primary research, which was analysed and modelled to give a holistic overview of the drivers and outcomes of childhood participation in sport. This analysis shows that the access to and benefits of sport and physical activity is not equal between different demographic groups. Preliminary findings have also indicated which type of sports and activities contribute the most value to children and their communities. This has led to the creation of a strong evidence base of the social and economic impact of childhood physical activity and sport in England, which is already being used by sport bodies and policymakers to re-evaluate their approaches to childhood participation.These programs illustrate how a collaborative approach using data and analytics has connected research with policy and practice and lead to substantial impacts in countries around the world.Organizer and speaker: Elena Portas, Chair: Charlie Cowen,

O4-5 A gamification-based intervention to encourage active travel

BackgroundThere are enormous economic, human, and environmental costs of inactivity, climate change, air pollution and congestion and active travel can help reduce and prevent these. In England, however, only 26% of all trips are made by walking and only 2% are made by cycling. Walking and cycling contribute just 4% of total distance travelled. ?Beat the Street' is a community-wide intervention which aims to increase active travel by turning an area into a 6-week game. Residents earn points and prizes by walking and cycling and tapping a smartcard on RFID readers called ?Beat Boxes' placed on lampposts at half-mile intervals. To-date, over 1 million people have taken part in the intervention, however, the impact of the program on adult active travel is yet to be explored.MethodsIn Autumn 2019, Beat the Street was delivered throughout the London Borough of Hounslow. Prior, and immediately following the intervention, residents were invited to complete a self-report questionnaire (Sport England Active Lives Survey-SF) to assess changes in physical activity. Time-stamp data generated through Beat Box activity provided an objective measure of intervention engagement and a traffic survey camera was used to measure the number of cars travelling along 1 target road between 1-week pre- and 1-week post-intervention. Data were analysed using a series of ANOVAs and McNemar tests.Results28,219 people took part in the six-week game, of which 56% were female. Between pre- and post-intervention there was 7% decrease in adults reporting less than 30mins of activity per week and a 13% rise in adults reporting 150+ mins (n = 346, p > 0.01). Beat box data ascertained that 25% of total taps at all Beat Boxes were made between 08:00-08:59am and a further 28% were made between 3:00-3:59pm, typical travel to school/work periods. Further, traffic camera data showed that between the week before and week following Beat the Street, 1199 and 705 fewer cars and 130 and 36 fewer vans were observed travelling along Cambridge Road between 07:00-09:30am and 2:00-4:30pm, respectively.ConclusionsThese data sources, in combination, suggest gamification may be an encouraging approach to increasing levels of active travel at a community-wide level.

Listening to children's voices in UK sports clubs: A Foucauldian analysis

AbstractOrganisations funded by Sport England or UK Sport must work towards achieving standards for safeguarding and protecting children in sport as set by the National Society for the Prevention of Cruelty to Children's Child Protection in Sport Unit (CPSU) and encourage a culture of listening to children. The present research was commissioned by the NSPCC CPSU to understand the practices of UK sports clubs regarding this objective. An electronic questionnaire was distributed through the national governing bodies of sport working with the CPSU. Some 64 clubs/squads representing 6,000+ juniors (under 18 years) responded. Quantitative data were analysed using simple statistics and qualitative data were themed utilising Foucault's theory of power and following Braun and Clark's six‐phase guide. Discourse, hierarchical judgement and docility were considered with reference to formal management and cultural environments. Semantic and latent themes were explored. The themes identified were: expectation awareness, reframing voice and preserving discourse. Clubs recognise the value of listening to children. However, existing power relations valorise adult knowledge fields over the experiences of juniors. Technology could provide an effective solution as it is remote, potentially anonymous and culturally accessible. As power is a productive force, problematisation of organisational culture could centralise children's voices and limit/prevent abuse.

Peer-led physical activity intervention for girls aged 13 to 14 years: PLAN-A cluster RCT

Background Increasing physical activity among girls is a public health priority. Peers play a central role in influencing adolescent behaviour. Peer-led interventions may increase physical activity in adolescent girls, and a feasibility trial had shown that PLAN-A (Peer-led physical Activity iNtervention for Adolescent girls) had evidence of promise to increase physical activity in adolescent girls. Objective The objective was to test whether or not PLAN-A can increase adolescent girls’ physical activity, relative to usual practice, and be cost-effective. Design This was a two-arm, cluster-randomised controlled trial, including an economic evaluation and a process evaluation. Participants State-funded secondary schools in the UK with girls in Year 9 (aged 13–14 years) participated in the trial. All Year 9 girls in participating schools were eligible. Randomisation Schools were the unit of allocation. They were randomised by an independent statistician, who was blinded to school identities, to the control or intervention arm, stratified by region and the England Index of Multiple Deprivation score. Intervention The intervention comprised peer nomination (i.e. identification of influential girls), train the trainers (i.e. training the instructors who delivered the intervention), peer supporter training (i.e. training the peer-nominated girls in techniques and strategies underpinned by motivational theory to support peer physical activity increases) and a 10-week diffusion period. Outcomes The primary outcome was accelerometer-assessed mean weekday minutes of moderate to vigorous physical activity among Year 9 girls. The follow-up measures were conducted 5–6 months after the 10-week intervention, when the girls were in Year 10 (which was also 12 months after the baseline measures). Analysis used a multivariable, mixed-effects, linear regression model on an intention-to-treat basis. Secondary outcomes included weekend moderate to vigorous physical activity, and weekday and weekend sedentary time. Intervention delivery costs were calculated for the economic evaluation. Results A total of 33 schools were approached; 20 schools and 1558 pupils consented. Pupils in the intervention arm had higher Index of Multiple Deprivation scores than pupils in the control arm. The numbers randomised were as follows: 10 schools (n = 758 pupils) were randomised to the intervention arm and 10 schools (n = 800 pupils) were randomised to the control arm. For analysis, a total of 1219 pupils provided valid weekday accelerometer data at both time points (intervention, n = 602; control, n = 617). The mean weekday moderate to vigorous physical activity was similar between groups at follow-up. The central estimate of time spent engaging in moderate to vigorous physical activity was 2.84 minutes lower in the intervention arm than in the control arm, after adjustment for baseline mean weekday moderate to vigorous physical activity, the number of valid days of data and the stratification variables; however, this difference was not statistically significant (95% confidence interval –5.94 to 0.25; p = 0.071). There were no between-arm differences in the secondary outcomes. The intervention costs ranged from £20.85 to £48.86 per pupil, with an average cost of £31.16. Harms None. Limitations The trial was limited to south-west England. Conclusions There was no evidence that PLAN-A increased physical activity in Year 9 girls compared with usual practice and, consequently, it was not cost-effective. Future work Future work should evaluate the utility of whole-school approaches to promote physical activity in schools. Trial registration This trial is registered as ISRCTN14539759. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information. This trial was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a United Kingdom Clinical Research Commission (UKCRC)-registered Clinical Trials Unit that, as part of the Bristol Trials Centre, is in receipt of NIHR Clinical Trials Unit support funding. The sponsor of this trial was University of Bristol, Research and Enterprise Development www.bristol.ac.uk/red/. The costs of delivering the intervention were funded by Sport England.

Opportunities to engage health system leaders in whole systems approaches to physical activity in England

BackgroundPhysical activity plays an important role in maintaining good health and wellbeing, non-communicable disease prevention and can improve healthcare outcomes. Some progress is being made on incorporating physical activity into routine care, but less on engaging health system leaders in the ‘whole systems’ approaches which are increasingly recognised as important for addressing complex public health challenges such as physical inactivity. This commentary builds upon the findings of a recent study and aims to identify opportunities for engaging National Health Service (NHS) systems leaders in whole systems approaches to physical activity.Opportunities for action in EnglandPockets of good practice exist from which lessons can be learned, but there are systemic issues that discourage and create barriers, and a need for meaningful engagement, leadership and action at national, regional and local levels. National and regional actors like Sport England, NHS England, health professional bodies, Active Partnerships, the Local Government Association and the Office for Health Improvement and Disparities can encourage and support government and the NHS to change policy drivers, culture and practices. Emerging opportunities include the 2021 White Paper Integration and Innovation, development of local integrated care systems, leadership from health charities and investment in non-clinical interventions (‘social prescribing’). At local level, public health and physical activity specialists and other organisations have a key role as champions and facilitators of local whole systems approaches and engagement of local NHS leaderships. Finally, although whole systems action is about collaborative leadership, individual champions of physical activity can make a difference in influencing NHS leaders at every level towards whole systems working.

Population level physical activity before and during the first national COVID-19 lockdown: A nationally representative repeat cross-sectional study of 5 years of Active Lives data in England.

SummaryBackgroundTo limit the spread of COVID-19 in March 2020, the population of England was instructed to stay home, leaving only for essential shopping, health-care, work, or exercise. The impact on population activity behaviours is not clear. We describe changes in duration and types of activity undertaken by adults ≥16 years in England between March and May 2016-19 and 2020, by socio-demographic strata.MethodsUsing nationally representative data collected between November 2015 and May 2020 by the Sport England Active Lives Surveys (n=726,257) we assessed trends in amount and type of non-occupational moderate-to-vigorous physical activity. Using data from n=74,430 mid-April to mid-May respondents, we then estimated the odds ratios of reporting any activity in the four-week recall period in 2020 compared to 2016-19. Gamma regressions estimated the mean ratios (MR) of duration amongst those reporting any activity in 2020 compared to 2016-19.FindingsPopulation activity declined substantially after the restrictions were introduced. Compared to 2016-19 levels, the odds of reporting any activity in 2020 were 30% lower (95% confidence interval (CI) 26-34%). The largest declines were amongst non-white ethnicities, the youngest and oldest age groups, and the unemployed; no socio-demographic subgroup had higher odds. Amongst those undertaking activity, weekly duration was similar in the two periods (MR 0.99, 95%CI (0.96-1.01%)). The odds of participating in walking for leisure and gardening were 11% (6-16%) and 15% (9-21%) higher, respectively, whereas the odds for team and racket sport and walking for travel participation were 76% (73-79%) and 66% (64-68%) lower, respectively.InterpretationRestrictions introduced in Spring 2020 likely reduced physical activity levels in England. The magnitude of the declines were not uniform by demographic groups or by activity type, which future policies should consider.FundingTS, KW, SJS, and SB are supported by UK Medical Research Council [grant numbers MC_UU_00006/4 and MC_UU_12015/3] and SB is supported by the NIHR Biomedical Research Centre in Cambridge (IS-BRC-1215-20014).

Increasing the levels of physical activity of patients on an acute medical ward, incorporating a motivational interviewing approach

Purpose: This project forms one part of the Active Hospital pilot at Oxford University Hospitals Foundation Trust, which was supported by Public Health England and funded by Sport England. It aims to explore the feasibility of a multi-disciplinary team, led by Sports and Exercise Medicine consultants, to embed physical activity (PA) within a secondary care environment.

Do people with long-term pain swim? Understanding participation using the active lives survey

Purpose: Physical activity and exercise are recommended for the management of long-term pain. Swimming is often encouraged despite little supporting evidence. To date, there is a lack of information on the profiles of people with long-term pain who choose to swim. The Sport England Active Lives survey measures rates and modes of physical activity, exercise, and sport across England. The objective of this project was to review the Active Lives dataset to understand the profile of people with long-term pain who swim.