TACKLING INACTIVITY What we know: Key insights from our Get Healthy Get Active pilots.
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TACKLING INACTIVITY What we know: Key insights from our Get Healthy Get Active pilots.
02 Sport England – Get Healthy Get Active 03
CONTENTS FOREWORD
Foreword 03
Programme goals 04
Get Healthy Get Active an overview 05 Tackling inactivity is a key feature of our new strategy.
Project impact so far 08
And for us, it’s a natural progression from attitudes to physical activity. The projects
Findings and learning 20 the work we’ve already done to explore have not only provided us with a wealth of
how we engage and support inactive insight – but have transformed so many lives.
Improving the evidence base 38
people to become active. We would like to thank the many people
Conclusions 39 that have supported the delivery of the Get
In 2012 we commissioned a review into if – Healthy Get Active projects.
and how – sport can engage inactive people.
Appendix 42 The report recommended that while there Our long-term ambition is to make physical
was some evidence available, there was a activity the norm and decrease inactivity
References 55
need for further research. So we introduced on a large scale. But we can’t do it alone.
a series of pilot projects designed to reach There is already so much great work to
inactive people and change their behaviour. tackle inactivity happening now. And there
is a wealth of guidance and learning from
We kick-started the ‘Get Healthy Get Active’ other organisations and physical activity
fund which to date has invested £13.8m into professionals.
33 independently-evaluated pilot projects.
These projects would serve to give us fresh We hope you’ll find the inactivity insight pack
insight and build evidence for how we can a valuable and complementary resource
tackle inactivity. They have started to explore as you come to plan your own strategy,
if and how sport and physical activity projects projects or services to tackle inactivity. We will
can be designed to improve public health, continue to learn and share further insight as
reduce health inequalities and manage or these projects develop. We look forward to
This report was published in November 2016. This GHGA projects are evaluated by a range prevent long-term health conditions. working alongside partners on the delivery of
report replaces the initial Learning Report for GHGA of academic partners, including:
projects that was published in October 2014. A third this important work.
report is due in 2017. Brunel University London, British Heart Foundation National We have learnt so much already and this
Centre for Physical Activity and Health (BHFNC) at Loughborough report attempts to summarise key learning
Authors: Dr Nick Cavill (Cavill Associates Ltd); Emma University,CFE Research, University of Wolverhampton, Oxford
Adams (BHF National Centre for Physical Activity and Brookes University, University of Surrey, University of East Anglia,
from April 2013–August 2015 across a broad
Health, Loughborough University); Suzanne Gardner Newcastle University, University of East London, University of range of projects. They test everything from
(Sport England) and Sarah Ruane (Sport England). Derby, Sheffield Hallam University, University of Salford, Kings the role of health care professionals and
College London, Nottingham Trent University, Edgehill University,
Please note, the Get Healthy Get Active projects University of Central Lancashire, Canterbury Christchurch University,
volunteers, to how we might include physical Sarah Ruane
detailed in this report were originally promoted as Middlesex University, University of the West of England. activity in healthcare pathways or change
Get Healthy Get into Sport. Strategic Lead for Health
04 Sport England – Get Healthy Get Active 05
PROGRAMME GET HEALTHY
GOALS GET ACTIVE:
The Get Healthy Get Active projects are designed to
AN OVERVIEW
support inactive people to increase their physical activity
levels. We want to learn about what works and what A handy overview of the Get Healthy
doesn’t and explore if sport can play a role in tackling Get Active projects
inactivity and improving the nation’s health. Length of projects How people were recruited
Partners were given funding to deliver The projects use a variety of recruitment
When we talk about ‘sport’, we mean projects which were 2–3 years in length. methods – sometimes more than one.
everything from traditional team sports Some projects enabled the participants Of the 33 projects, at least two-thirds
– football, hockey, basketball etc. – to to take part for the full lifetime of the project include referrals or ‘signposting’ from
individual activities such as running, gym whereas others enabled participants to take health professionals.
and fitness classes, and recreational part for shorter lengths of time such as
10 weeks. Clients are usually ‘referred’ when they’ve
cycling. This can be everything from
83,111
already had a consultation with their health
informal, non competitive activities or
Projects collect baseline and follow-up worker and there’s been a transfer of health-
adapted sports to more structured,
physical activity level data at specific time related information with the physical activity
competitive opportunities.
points – usually after three, six and 12 specialist. ‘Signposting’ usually means
The Get Healthy Get Active projects tend to months. This enables them to understand directing a new client to a programme they
focus on non-competitive, informal physical how an individual’s physical activity are interested in or would benefit from.
activity in various community locations. This behaviour has changed for up to a year,
as recommended in the Standard Evaluation Nearly a third of the projects include referrals
is driven by their audience insight.
Framework for Physical Activity. or signposting from other sources, such as
This report highlights the impact of the slimming clubs, schools and community
projects so far, and also sets out some Number of inactive people the GHGA Locations organisations etc. And almost half include
of the key lessons we’ve learnt. projects will support to become active Locations are diverse and chosen based self-referrals.
on the audience and the outcomes they are
Projects have also used media, social media
seeking to achieve. They include community
and word-of-mouth approaches to recruit.
venues, leisure facilities, sports clubs,
The Get Healthy Get Active projects aim to engage with over healthcare facilities, workplaces and at
300,000 people to find those who are inactive, and support outdoor locations.
over 27% of those who were previously inactive to take part in
at least 30 minutes of sport and physical activity per week*.
* This does not include walking.
06 Sport England – Get Healthy Get Active 07
How projects Exclusion criteria Project activities
targeted specific audiences Variety of audiences Exclusion criteria for each of the projects have The projects provide access to a range
All projects were designed to target Here are some examples of our been developed based on local priorities and of informal and formal physical activities –
audiences who were least likely to be active. GHGA projects showing how we're the qualifications and experience of the staff. including sports such as swimming, running,
For example, by recruiting those within certain working with a huge variety of cycling, boxing, athletics, rugby, football,
demographics such as men aged 40–60, There can be some inaccurate self-reporting climbing etc.
audiences and organisations in through the Single Item Measure. Some
women during or after pregnancy or from a range of settings.
certain geographical locations or through people who select 1 or 2 (suggesting they
certain settings e.g. workplaces. Drug or alcohol misuse – Lancashire do 30–60 minutes of activity per week) might
Sports Partnership are using sport as still be accepted onto the project if their more
a way to improve the outcomes for detailed IPAQ score suggests that they are
“Projects led by national health inactive people in recovery from drug or actually inactive.
charities such as MIND are alcohol misuse. Only the three non-targeted ‘universal’
using physical activity to help Dementia and learning disabilities – projects can accept those who are already
those who use their services.” Sefton Metropolitan Borough Council active. This allows us to compare if the
are focusing on supporting inactive targeted approaches are more successful
Several projects target people who have, people with dementia or learning in recruiting inactive people.
or are at risk of having, specific health disabilities into sport.
conditions. For example, projects led by
national health charities such as Macmillan Older people – Active Norfolk are
Cancer Support, the British Lung Foundation targeting older people living in sheltered
and MIND (the mental health charity) are and residential accommodation.
using physical activity to help those who Women during and post-pregnancy –
use their services. Kingston upon Hull City Council’s Us
Inclusion criteria Mums and Us Mums To Be project
is helping inactive women during
All projects aim to engage inactive people pregnancy and post-pregnancy to
aged 14 years or over. Project organisers benefit from an active lifestyle.
were asked to follow our evaluation guidance
to identify people who are inactive. A
screening question called the “Single Item
Measure” was used to ask people’s level
of activity in a week.
Most projects use the short International
Physical Activity Questionnaire (IPAQ) for
collecting baseline and follow-up data.
Those who select 0 (meaning they are
doing less than 30 minutes of moderate
physical activity per week), were accepted
onto the projects.
08 Sport England – Get Healthy Get Active 09
PROJECT
Figure 2: T
he conversion rates for GHGA projects purely
targeting inactive people
Total No. of people engaged
in targeted GHGA projects:
IMPACT SO FAR 44,055
Project attendance, delivery records and the IPAQ was used to understand the impact of the
projects. The figures shown relate to April 2013 - August 2015. 75% of people (33,137)
classed as ‘inactive’
of those people (15,217)
Figure 1: The conversion rates for all of the GHGA projects 46% became ‘active’
of those people (8,674) }
Total no. of people engaged
in all GHGA projects: 57% still ‘active’ after 3 months
145,749
48.5% ofclassed
people (70,778)
as ‘inactive’
of those people (28,885)
41% became ‘active’
of those people (16,464)
34.5% of all those engaged in the targeted projects were inactive people
who were then helped to take first steps towards becoming active
(15,217 out of 44,055). That’s significantly above our 27% aim.
57% still ‘active’ after 3 months
Projects which used recruitment methods that
purely targeted inactive people found that
It’s essential to engage with lots
75% of those they initially engaged with were
of people to find those who are
inactive, with 46% being ready to change and
inactive and ready to change. Of the
start getting active. This illustrates the power
145,749 people we talked to, 77,778
of appropriate targeting in comparison to
(48.5%) were inactive and 28,885
universal projects when tackling inactivity.
(41%) were ready to change.
Footnote: Please note that the outcomes shown here reflect the Round 1 GHGA projects, which are now in their third and final year. Round 2 projects,
begun in April 2015, are in the set-up phase and are due to finish in 2018.
10 Sport England – Get Healthy Get Active 11
259 420
GPs and health qualifications gained by sports
professionals coaches and volunteers
trained to support
the delivery of the
projects
553 4,966
workplace health workplaces involved
champions have in sporting activities
been trained to through sign-up to the
support employees Workplace Challenge
to get more active programme
Analysing the different types of intervention
The emerging findings suggest the following The influence and impact of different types
elements combine to influence the uptake of interventions will be considered as we
and impact of projects: continue to learn from these projects.
• the recruitment methods (referral processes,
use of patient records etc)
• the intensity of the initial support and
Case study:
engagement given by professionals, Strengthening delivery through partnerships
coaches and volunteers
Kingston upon Hull City Council’s ‘Us Mums and Us Mums To Be’
• the activities on offer and how they meet the
experiences wanted by the audience. Most of us are aware of the wonderful and activities that will create supportive, fun, active
chaotic disruption that a newborn baby social groups for them.
can bring to a home. Even if we haven’t
experienced it ourselves, we’re likely to The project removes the hassle factor for new
know people who have been through it. mums by encouraging them to get active
Old habits go out the window and new with their babies, children and wider families
ones are developed. during sessions, with no need for babysitters
or crèches. In fact, a lot of the sessions are
The ‘Us Mums and Us Mums To Be’ project aligned to activities that mums are already
in Hull is designed to support women at this attending – for instance, baby-weighing or
unique point in life to get active and improve toddler sessions at their nearest children’s
the health and wellbeing of their loved ones, centre – helping to embed their new activity
as well as themselves. habits even further into mum-based routines.
The project works with a range of partners –
including midwives, health visitors, children’s
centres and community groups who are
supporting mums-to-be, mums and families
– to help direct people to specially-tailored
12 Sport England – Get Healthy Get Active 13
Participation in sport at the three-month Individual projects have reported a range of outcomes in their
follow-up point interim and final evaluation reports, as shown below.
As mentioned, a participant’s physical activity
and sport levels are measured using the
International Physical Activity Questionnaire
(IPAQ) at baseline, then after three months,
six months and 12 months.
Leicester-shire and CSP Network Workplace
Rutland Sport Challenge
When asked three months after they start, an
average of 57% (16,464) of previously inactive
Inactive people in New Parks Ward The Interim Evaluation Report (June
people engaging with projects are active
in Leicester and Greenhill Ward in 2015) for the programme highlights that
in sport for at least 30 minutes per week.
North West Leicestershire are supported participants frequently said activity levels
(This data is taken from the interim and final
to become more active through decreased once the national eight-
evaluation reports from projects – the range is
combining tailored one-to-one mentoring week challenge had ended, suggesting
between 49–65%.)
and group-supported delivery of sports initial spikes in activity may be harder to
As a comparison, in NHS ‘stop smoking’ in their local communities. maintain. The project’s steering group is
targets, a conversion rate of 50% or more has considering how to address this.
been considered successful for ‘four week • Preliminary results suggest that
participants tend to be more active • Overall there was a significant increase
quit rates’, where self-reporting approaches
after three and six months relative in the proportion of inactive individuals
are used to measure whether someone hasn’t
to baseline. reporting taking part in 1 x 30 minutes
smoked in the previous four weeks.1 & 2
The emerging findings suggest that of sport between baseline and three
In the case of one particular GHGA project engaging and participating in projects • The physical activities participants try month follow-up (40.5% and 59.7%
– the County Durham Sport Move into Sport offering sporting activities, designed to during the sessions with their mentor respectively).
project – at least 1,919 (77%) participants meet audience needs, has a significant seem to impact on the types of physical
impact on the amount of weekly physical activities they choose to do once the • There was a significant increase
have become sports club members through
activity undertaken (away from the mentoring sessions have finished. in mean total minutes per week of
the programme.
sports sessions) by previously inactive Participants often chose to engage in physical activity reported overall, and by
The physical activity findings are based on people up to three months after initial physical activity at the gym. inactive and active participants between
the latest follow-up data. Collecting this data engagement. baseline and three-month follow-up.
has been a challenge for a lot of projects, and • Overall, participants reported enjoying
The IPAQ data so far has shown significant the one-to-one mentoring sessions, and • Active individuals logged more activities
methods are still being developed to increase
average increases in wider physical activity some indicated they would not have on a weekly basis than inactive
follow-up response rates (which range from
levels across the projects. This is ranging from started to do sport or physical activity individuals but the average number
15–80%).
214–813 metabolic equivalent of task (MET) without these sessions. of activities logged per week declined
Physical activity participation – minutes per week at three months. This is a each week in both groups over the
activity level change at three and six- value that takes into consideration the time eight-week period.
month follow-up engaged in an activity and the intensity of it.
The data shown in this section is taken from This includes increases in all types of physical
the interim and final evaluation reports for activity, not just sport.
individual projects. It represents analysis This could have significant implications for
from IPAQ data at three and six-month health, given that every 1 MET increase in
follow-up points. This data identifies changes aerobic capacity is associated with a 13%
in behaviour over and above the sporting reduction in all-cause mortality and a 15%
sessions offered by the projects. These are reduction in cardiovascular events.3 & 4
interim findings and are likely to change by
the end of the programmes.
14 Sport England – Get Healthy Get Active 15
ukactive’s Let’s Get County Durham Sport’s
Moving programme Move into Sport project
The Let’s Get Moving programme The Move into Sport project worked
implements brief interventions and with local sport and activity providers
motivational interviewing support for to help them deliver sports sessions
inactive people in primary care settings, that effectively targeted and engaged
to support them in taking up activity. people who are inactive and at risk of
cardiovascular disease and Type
At 12 weeks after the motivational 2 Diabetes.
interview point, the programme
measured: • 82% have reported an increase in total
physical activity after three months.
• 240% increase in the total sporting
sessions attended per week •An increase in participation in sport from
0.93 days per week average at baseline
Case study:
• 220% increase in the number of to 1.8 days of sport at three months.
individuals completing 1 x 30 minutes
of sport • Hours of sport have increased from 38
minutes at baseline to 62 minutes at
• 68% increase in walking (MET minutes three months. Macmillan Cancer Support – Get Healthy Get into Sport programme
per week)
• 1,919 previously inactive people took
• 53% increase in moderate physical “I was diagnosed with prostate cancer in I enrolled at the excellent ‘Lifestyle’ gym
out a sports club membership to help
activity (MET minutes per week) April 2013 and put on a course of hormone at Radbrook, under the exercise referral
them maintain their behaviour change in
therapy in preparation for radiotherapy. I was scheme, and have been attending three days
• 80% increase in vigorous physical the longer term.
feeling very fatigued and was apprehensive a week for just over a month now. As soon as
activity (MET minutes per week) about the hormone treatment making this I started I began to feel the benefits physically,
worse. It was suggested that I get referred via and can see and feel a difference in my legs.
• 73% increases in the total physical
the Macmillan staff onto the Get Active Feel
activity (MET minutes per week) Just as importantly, though, it has helped
Good scheme.
enormously in transforming my mental and
I attended a session at the Hamar Centre and emotional state. I have set myself a goal of
they gave me some advice on ways to start going on a cycling holiday in Scotland with my
getting active. I came away feeling it was very brother next year, which I am now sure I can
manageable – but at that stage I didn’t really do. Two or three years ago it was never going
act on it. Looking back, I think the reason was to happen.
possibly mental more than physical – for me
personally, it was just the wrong time… I suppose it’s possible I might have found
my way to this point without the programme,
I underwent extensive radiotherapy, and but it’s very unlikely. I cannot overstate how
afterwards I was very weak. I started to use much the help, guidance, encouragement
a home exercise bike, beginning slowly and and support I’ve received has benefited me
setting myself targets. I felt I was making mentally and emotionally, as well as physically.
progress but suddenly relapsed. I spoke I am very grateful.”
to my GP and consultant who convinced
me that I needed a supervised exercise Participant in the Shropshire Get Active,
programme tailored to meet my needs. Feel Good Macmillan project
16 Sport England – Get Healthy
HealthyGet
GetActive
Active 17
Leeds City Council’s Let’s Active Norfolk’s Fun and
Get Active programme Fit Norfolk
The Leeds Let’s Get Active project The Fun and Fit project provides inactive
provided a programme of gym, swim people with ten-week programmes of a
and exercise-for-free sessions at certain variety of sports in a phased approach.
times in the city’s leisure facilities, with Recent programmes have had up to 70
increased community activity offers in the different ten-week sessions for people to
Case study:
most deprived communities. choose from.
The project also considered how to The project’s interim findings show that:
improve the take-up of specialist exercise
• Participation in the Fun and Fit
referrals offers in the city. Scalability of delivery: County Sports
programme was associated with
• 80% of participants identified as inactive significant increased average weekly Partnerships Network Workplace Challenge
at baseline were no longer classified as physical activity across all participants
inactive at follow-up. at ten-week* (+813 MET minutes) and The CSP Network Workplace Challenge, This support includes:
six-month follow-up (+659 being delivered across England through the guidance on how to maximise the delivery
• An additional 799 MET minutes of MET minutes). County Sports Partnerships, is an example of the workplace challenge in their area
physical activity per week at three- of a project that has been scaled up over (including case studies from those delivering
month follow-up. • The greatest average increase in weekly its initial two years to maximise delivery and it successfully)
activity was observed in participants effectiveness. It has used a phased approach
There were statistically significant • marketing support
with low baseline activity levels at ten- to bring 37 CSPs into the programme.
reductions in sitting time from baseline week*, (+792 MET minutes) and six- • training on the functions of the
(296 minutes/weekday ±193.7) to follow- month follow-up, (+669 MET minutes), It provides an online platform and app online platform
up (257 minutes/weekday ±211.7), t [956] compared to baseline. alongside national and local challenges to • training for Workplace Challenge Champions
= 5.275, p
18 Sport England – Get Healthy Get Active 19
Return on investment Health England for a bespoke offer and
Many of the projects plan to do economic platform for their staff. They’ve also
analyses to determine the return on secured £30,000 from the Department
investment for their interventions. Two for Culture, Media and Sport for a
projects have done this so far. similar Civil Service Workplace Challenge.
The County Durham Sport Move into Sport The CSP network are looking to roll out this
project used a locally developed economic business development model in future years
analysis tool that indicated a final return of and have launched an invitation to partner.
£2.43–£3.64 for every £1 invested. It’s hoped it will be possible to collaborate
with a range of organisations to help more
The Black Country Consortium’s assessment workplaces to be active, and to grow and
has indicated an interim return on investment sustain the Workplace Challenge.
of £3.18 for every £1 invested in their
community asset-based approach to sport. Scalability of projects
Longer-term future for projects Two projects have built on their initial results
and made the first steps towards scaling up
Four projects have already secured, or are
to deliver similar projects in other areas of
close to securing, long-term funding to
England and the UK.
sustain the activities well beyond our funding.
• Macmillan received Sport England funding
•L
eeds City Council have secured an
to deliver a model in six areas, and this
additional year of investment from Public
has now been scaled up by the charity in a
Health to continue project delivery.
Case study:
further 36 UK areas, using investment from
•S
uffolk County Council have received the charity and local partners. Estimates for
£30,000 of funding from Public Health to investment total £1.8 million.
bridge the gap between the project end and
the new commissioning contract for lifestyle • ukactive are scaling their delivery model up Engaging with the NHS
services. to other parts of the UK, including Essex,
The ukactive Let’s Get Moving pathway took Commissioner’s office, the head of
•A
ctive Norfolk are in advanced discussions Birmingham and Kent.
into account insight from health professionals Information Governance at Public Health
with Public Health commissioners regarding about the challenges and barriers they England, the local clinical commissioning
investment into the successful elements have in talking to patients about physical group Caldicott Guardian, and
of the programme. activity. These were namely lack of time Commissioning Support Unit head of
•T
he County Sports Partnership Network in appointments, lack of knowledge, and Information Governance, in order to access
(CSP Network) Workplace Challenge have prioritising the complex needs of patients patient registers and send a letter to patients
secured £30,000 funding from Public when they present at an appointment. diagnosed with hypertension.
This suggested that expecting busy GPs and 17,000 letters were sent out over two years,
other health professionals to be in a position with the CEPs making follow-up phone calls
to deliver a ‘brief intervention’ to patients (a to patients (if they had not opted out of being
five-minute motivational chat about exercise, contacted). Ten practices were involved in the
for example) might be unrealistic. project with 9% of patients taking up the offer
of an appointment with the CEP.
Working with the practice managers at
surgeries, ukactive developed an approach The CEPs used motivational interviewing
that saw Community Exercise Professionals techniques to support people (and their
(CEP) embedded in the surgeries as part of families) to explore their feelings towards
a wider multi-disciplinary health team that getting active, and the benefits they’d want
patients could access. to see – and to plan specific short, medium
and long-term goals to help them get active.
ukactive developed an information Support was offered to people throughout the
management policy with the NHS, to first 12 weeks of their journey to get active.
gain permission from the Information20 Sport England – Get Healthy Get Active 21
Community engagement
FINDINGS AND LEARNING First year of delivery
• Project staff have been shown to be gaining been effective methods of recruitment.
This section summarises the themes the trust of communities, often through
Methods working with other trusted community • Social media and word-of-mouth are key
emerging from all projects funded to date.
organisations and delivering sports sessions recruitment tools.
It separates learning from the first year The monitoring forms received from
of activity (for both Round 1 and Round Round 1 and 2 projects were converted at community activities that people are • ‘Social bonding’ approaches have
2 projects) from newer themes that have to text documents and loaded into the already engaged with. For example, parents been useful. These are social events
emerged as the Round 1 projects complete HyperResearch qualitative analysis and toddlers sessions, faith groups, mental such as coffee mornings designed to
their second year of activity. software5. All forms were read and coded health support groups etc. engage inactive people and increase
according to the emerging themes and confidence prior to moving them into
The learning builds on the initial findings from • Tailoring of marketing and the ‘sport’ offer
those reported on previously in the 2014 activity opportunities.
the first year of activity (published in a summary is crucial – for instance, the use of the word
report. These were then combined into the
report by Sport England in Oct 2014). Findings ‘sport’ may be off-putting. • Motivational interviewing techniques
principles shown in the next section.
come from monitoring reports completed by the delivered to family or friendship groups
The bullet points in this section describe • Communities need to be defined by people
projects. rather than individuals are proving
themes or emerging findings that are locally – sometimes it may mean a small
number of streets rather than a ward or useful in improving success and
•R
ound 1 projects received initial funding common across a number of projects.
mapped location. boosting recruitment.
around April 2013, and have submitted Where this is not the case (for example,
monitoring and evaluation reports in August where an interesting finding is noted • Taster sessions are a useful recruitment tool
2013, January and July 2014, and January by only one project) this is stated. for projects.
and August 2015.
The aim is to present not only the
measurable impacts of the projects • Mass mail and online sign-up systems have
•R
ound 2 projects received initial funding from
April 2015 and submitted their first monitoring so far but also the process evaluation
reports in August 2015. issues that the projects have identified
as being important. Careful consideration
of these can help to influence future
delivery of the projects, and could
influence the design of future sport
and physical activity programmes22 Sport England – Get Healthy Get Active 23
Second year of delivery ocused, targeted recruitment
F • Expectation of the number of people who
drives can help to drive up could be proactively engaged in the first
year of the programme and encouraged
• Building community trust is crucial for • The complex needs of participants will
participant numbers at key to begin sport has been too high and
success of the project, but this takes continue to present challenges – for points of the year – for example, has had to be moderated. Reviewing
time. It’s about creating relationships and instance, cultural or language barriers. But one successful drive was carried approaches and progress regularly
rapport with your audience and people they can be tackled by using trained and is important to help ongoing delivery
they come into contact with, and making experienced activators and volunteers, and out at New Year. planning.
sure you have the right kind of visibility by using data and insight to shape delivery.
and behaviours to become trusted. • Workplaces with a real commitment from
• Volunteers who have been the most • ecruitment and retention of inactive
R management, champions and employees
• Uptake is improved if they do not use the successful in the programme are those people remains a challenge. The social have been more effective at engaging
word ‘inactive’ in marketing material. that are seen as ‘just like me’, and aspect of the programme has proved to employees with physical activity.
developed from the targeted communities. be a key factor for this target group.
• Promotional materials that reflect ‘people Using volunteers in marketing has proven
like me’ are effective in engaging with to be an effective way to engage with
• Attitudes towards physical activity have There is definitely not a ‘one
altered, and participants now regard it as
inactive people. For some projects people and create social norms.
enjoyable and necessary. But this is not
size fits all’ model that can be
this has included using real people
photographed in recognisable places. • It can be very helpful to develop a peer formally measured. applied everywhere. Delivery
network amongst the volunteers. This
• he investment of time and effort by
T
needs to be tailored to those
• port and physical activity is not a
S can develop a greater team ethos and
priority to the groups we are targeting, the activators and those working on the being targeted.
a reward structure to help retain and
so we have to capture imaginations projects is crucial to ongoing success.
develop volunteers.
and use other opportunities to engage • Simple improvements to marketing
these groups in activity. One of the most can dramatically increase participant
effective ways of increasing participation Resources and images may enquiries. For instance, one project
in the programmes is through targeting achieved this through modifying the
existing groups, e.g. parents groups, need to be developed to introduction letter and making it less
elderly lunch clubs etc, to offer activities target specific groups and wordy, more inclusive and by including
they would like. Activities can be ‘tagged
on’ to other community activities such
communities at a hyper local a second page that visually shows
participants what the project is and how
as walking football or female-only dance level. This helps make the they can get involved.
and Zumba. local communities feel they
• Targeting sessions at specific groups are part of the programme,
– according to age, gender, family and encourages word-of-
set-up – and marketing the activities mouth promotion.
using appropriate media, messages
and images, can help engagement and
recruitment.24 Sport England – Get Healthy
25 HealthyGet
GetActive
Active 25
Screening and monitoring
First year of delivery
•O
ver-reporting of activity levels is common measures and comparisons to the IPAQ self-
with the self-assessment Single Item report tool.
Measure, when answers were subsequently
compared to the International Physical Activity • Many projects are looking into the reasons for
Questionnaire (IPAQ). drop-out to help them respond better to the
needs of inactive people.
•T
he IPAQ appears to be best completed
during one-to-one time with participants. • Regular ‘real-time’ evaluations mean project
managers can make assessments and
•T
he consistency of data collection is changes as the project progresses, which
challenging, especially where a range of helps maximise impact and make delivery
volunteers and staff are responsible for systems more efficient.
collecting data.
• Gaining ethics approval has been easier
•L
ow literacy levels and English not being than anticipated in most cases. (An ‘ethical
a participant’s first language have been a approval’ process has to be gone through
challenge for some projects. Some projects before research is undertaken, to make sure
are translating the IPAQ, training staff, and of participants’ informed consent and to cover
producing videos to overcome the challenges data protection issues.)
of using IPAQ.
• One project reported the usefulness of a
•A
ccessing follow-up data is a challenge. To data-sharing agreement that focused on
date, response rates range from 15–80% at
three months and 33–71% at six months.
Various solutions are being found to this,
anonymised data that could be transferred
to the university without the need for a data
protection agreement.
Case study:
including increasing staff capacity for Active Norfolk’s approach to measuring
follow-up processes.
behaviour change and understanding impact.
•A
ccelerometer data is being gathered by
at least four projects to provide objective Active Norfolk have a close working successful parts of their project, and diversify
relationship with the University of East their offer to specific target audiences.
Anglia who are delivering the evaluation
and research for the Fun & Fit project. The findings from the programme have
They have used their monitoring and been presented at a number of conferences
evaluation information to guide future regionally, nationally and internationally.
delivery and maximise impact of the They have used the learning from GHGA to
approaches they are taking. develop a standardised evaluation approach
They have used data on the effects that across all physical activity programmes they
the project is having on behaviour change are delivering and commissioning, so they can
to provide evidence of impact to public better understand the impact of programmes
health and clinical commissioning group for their partners and potential investors. This
commissioners. This has resulted in their approach has aided strategic positioning
project receiving an additional investment and helped lever-in additional investment
from public health funds to sustain the from partners.26 Sport England – Get Healthy Get Active 27
Second year of delivery
• There is a need to focus on retaining Some groups of people appear
participants in projects at this stage to to be hostile towards people • Approaches that have been implemented
maintain participation rates. to improve response rates have included:
or organisations that they are
- improving processes to make sure
• Use of bespoke websites for registration unfamiliar with, and do not officers are aware when follow-up calls
and data collection has solved some of want to provide data. This need to be made
the key issues raised during the co-design
process (where service users, coaches issue has been tackled through - shortening the length of the survey
and volunteers are involved in the design sensitive,well-trained staff. - sending out an email/hard copy of the
of the experience). This, in particular, survey if a telephone survey is unsuc-
avoids the inconvenience of lengthy form- cessful
filling at sessions. • The use of accelerometers in some
- using mentors to support the telephone
projects has provided interesting
• The use of IPAQ continues to be surveys, as they have built a relationship
evaluation information. For instance, in
challenging and has been called a “barrier with the participant.
one project, accelerometer data shows
to success” by a couple of projects. higher increases in weekday activities
In particular, these projects report that - Making it compulsory to enter IPAQ data
(but not weekends), suggesting that there
people find it cumbersome to complete, on data management systems can lead
may be too much focus on weekday
and that it gets in the way of people to lower levels of missing data.
activity within the programme and there • Evaluation data is invaluable for making the
starting their activity programme. Some is a need for projects to provide more case to the council that the programme
communities feel threatened by being activities at weekends or provide support There needs to be close represents value for money, and can be
asked for the information and suspicious
as to how the data will be used. Some
to participants about how to exercise working between the academic sustainable in the longer term.
at weekends. But collecting baseline
projects have tackled this through training accelerometer data has been challenging,
partner and delivery partners
• Collecting clinical indicators can be
of interviewers so they can stress the with some of the monitor equipment lost at the start to make sure any a challenge because processes vary
importance of the monitoring and how it
will be used.
or not returned. data issues are ironed out early. between GP surgeries. This is being
The time commitment required tackled through attempting to automate
• Individual relationships are important: in and simplify the process by which GPs
• Screening is still a challenge: in one
project, the screening criteria to find
one project there was a large increase to collect data should not be are reminded to collect this information.
in people attending six-week reviews,
inactive people were more stringent than due to one instructor who has built up a
underestimated.
traditionally used in local exercise referral • Some projects have received a low
strong relationship with participants and response rate when collecting follow-up
programmes. This meant that a third of colleagues.
people who would previously have been data. Capturing data from hard-to-reach
referred to exercise were unable to access groups may require new approaches,
the programme as they were not classed such as incentivisation for engaging in
as inactive. follow-up data collection and attending
focus groups (e.g. vouchers for free
sessions, local shops). This is being
tested by several projects.
• Having secure plans in place as alternatives
to phone calls is recommended for
projects when completing follow-up – for
example, paper questionnaires, e-mails,
drop-in sessions.28 Sport England – Get Healthy Get Active 29
Project development Participant insight from projects
First year of delivery First year of delivery:
•U
sing community insight has been • Projects benefit from a pilot phase to help • Key themes to help understand the • Low-cost ‘pay and play’ opportunities are
crucial for delivering projects effectively to iron out initial problems. perspectives of inactive people include: wanted by communities.
inactive people. It has made it possible to - memories of sport
understand community wants and needs • Flow diagrams and participant journey • Activities need to be ‘on the doorstep’ and
approaches have been useful in - attitudes to sport
and develop experiences that people want reflect perceived community borders.
understanding the participant experience, - experiencing sport and physical activity
to engage with. - hooks and triggers for sport. • Activities should be adapted to the
and understanding potential drop-out points
•U
nderstanding the needs of coaches, and at the design phase of projects. It means individual’s circumstances and needs
• Anxiety, lack of confidence and fear of
providing training to meet these, produces plans can be put in place to reduce the rather than expecting them to attend
exceeding physical limitations are very real
better project delivery. risks of drop-out from projects. existing provision.
concerns for inactive people.
•R
ecruiting specialist staff can be a • One project has developed a quality • Market segmentation analysis (grouping
• Communities want informal, flexible
significant challenge – for example staff assurance and grading system for activities participants by their background, needs or
sessions at venues that are not seen as
trained to the right level to deliver specific to make it clearer to participants which preferences) has been helpful in identifying
‘scary’. They should be led by ‘someone
activities to their target audience (e.g. activities may be most suitable for them. popular activities.
like me’ and not people ‘parachuted in’.
pregnant women). • Patience and perseverance need to be
• Words like ‘sport’, ‘exercise’ and ‘health’
balanced with understanding what is
might need to be avoided in favour of words
not working.
Second year of delivery like ‘energise’, ‘feel better’, and ‘happy’ in
marketing material.
• Project delivery can be significantly nature of students. Working with people • Projects should support families who want
improved by putting a lot of the from the local community who stay with to be active together.
administrative aspects online. Project the programme over the longer term and
websites can: grow with the project has been a more
successful approach.
- help participants find and book onto
courses • It can be helpful to give the instructors
more autonomy and allow them to decide
- collect participant data the most suitable referral pathway for a
participant, rather than always leaving this
- send automated follow-up to the referring health professional.
- provide an activity search database • During year two, projects are becoming
to support participants. more recognised in local communities,
so numbers are increasing. This is
• In one project, an ‘Impact Committee’ primarily through word of mouth –
has helped to independently scrutinise recommendations from people who have
programme performance. This has helped enjoyed the project – along with gradually
to galvanise partners, focus interventions increasing profile.
and produce specific results.
• As projects often have many partners,
• Use of students as volunteers was not it has been invaluable to hold partner
successful in one project, due to the meetings, workshops or learning events.
delay between recruitment, training and
deployment – as well as the transient30 Sport England – Get Healthy Get Active 31
Second year of delivery Working with the NHS
• There are mixed findings about the use • It can be helpful to stamp or brand
of market segmentation: although many activities with project logos so people First year of delivery
projects have found it useful, one project know they are ‘beginner-friendly’.
that directly compared approaches found
that using market segmentation did not • In many communities, sports participation • Early involvement of GPs is vital in • Delivery so far suggests that embedding
result in more or better referrals. is way down peoples list of priorities. getting their buy-in to using the pathways sport/activity professionals into health
More important issues can include poor developed by the projects. settings seems to be an effective tool in
• Insight from one project has shown that literacy, health and social housing, along supporting patients to get active, rather
•Bringing in partners who are skilled in than purely embedding sport and activity
barriers exist for people to move from with English not being a first language. engaging with GPs has helped broker
initial engagement through supported into health professionals’ approaches.
relationships faster and more effectively For example, having an exercise
activity to sustained activity within a • In some cases, the reasons for low for some projects.
traditional sport club structure. retention rates are often nothing to do professional within a GP practice to support
with sport or activity, but more social • The use of GP project champions has patients using motivational interviewing
issues such as benefits, housing etc. This proved useful in bringing on board other techniques has been an effective way of
complexity has resulted in lower levels GPs and practices. recruiting people to an intervention through
Detailed insight work is of participation than expected – but also primary care (rather than training GPs and
important in areas where there • The integration of services can be complex health professionals to undertake this part
helped us become ‘insight rich’.
but it’s more likely to lead to long-term of the physical activity pathway, which is
are problems reaching specific success. It’s worth noting that for this to difficult because of their busy roles).
• There’s still a need to develop a greater
groups – such as men, ethnic understanding of how hard-to-reach
work, the sport element needs to be fully
integrated in the service offer, and not • Attending GP practice meetings and training
minorities and people from individuals engage with marketing.
viewed as a bolt-on. opportunities has been useful for engaging
deprived areas. They may see and hear a range of with health professionals.
opportunities, but we need to understand • It’s important that the sport and physical
how they experience these messages and activity sector are realistic about what can • The perceptions of health professionals can
interpret the opportunities against their be implemented through primary care, skew which activities they refer/signpost
• Understanding peoples activity journeys
to. Experience so far suggests they often
real-life experiences. because GPs are so busy and may struggle
is important when developing an
to find time to refer patients. In some recommend swimming over other sporting
understanding of how to meet peoples
cases the practice manager or a nurse activities, as they feel comfortable with what
needs. This includes an understanding
may help complete the paperwork for the that entails.
of past and current experiences that
contribute to inactivity, and the ‘hooks’ referral when a GP identifies a patient who • Referral league tables can be a useful tool
or ‘triggers’ that are important in (re) would benefit. to encourage ‘healthy’ competition between
engaging people in activity. • Patient records can be a useful referral routes.
recruitment tool.32 Sport England – Get Healthy Get Active 33
Second year of delivery Partnerships
• Projects have become involved in wider • There are ongoing challenges to recruit
public health campaigns e.g. the Leeds GP surgeries to refer to the projects, First year of delivery
Smart Swaps Campaign to support wider mainly due to a feeling that involvement
lifestyle interventions and maximise the would substantially increase the workload
benefits for participants. for the GPs and surgery staff. One • Consistency and quality of communications • Significant value can be added by widening
successful approach has been to secure with partners is crucial to the success of partnerships during delivery.
• Providing talks for health professionals support from high level physicians at the the projects. • Minimising duplication and maximising
and the public at health support groups Clinical Commissioning Group who can • The use of memorandums of understanding outcomes across partnerships has been
can increase referrals to projects. start the conversation and open doors. and service level agreements to agree a key focus.
delivery can help projects hold partners • Partnership growth and expansion is a key
• Health professionals and Practice
to account. feature of successful delivery.
Managers are incredibly busy people and
many of the projects are continuing to put • Local turbulence in structures and • New partnerships are still being developed
time into making engagement with the staff capacity has been a challenge for by projects to enhance delivery. In
projects as easy as possible for them. For several projects. several cases this has seen increased
example combining referral information • Projects should not be afraid to ask investment levered into the projects through
into a single form, supplying them with a partners to make compromises or consider sponsorship, expansion plans or alignment
‘how to’ guide; asking for an alternative different models. to research and public health funds.
point of contact from the Practice • High-level political support can boost a
Manager to make regular contact with. project’s visibility.
Second year of delivery
• Some partnerships have come under of collaborative partnerships between
pressure, especially in areas where evaluation and delivery leads – and
there have been significant cuts to local the need to have at least a six-month
authority budgets. This results in fewer collaborative development phase included
opportunities for the project to refer to. in the front end of the project.
• Newer partnerships have been • There is great benefit in establishing broad
established with national governing links across a wide range of services,
bodies (NGBs) that have prioritised such as mental health and weight
grassroots and targeting inactive management. Taking a multi-disciplinary
participants. This allows for courses to approach helps create a two-way referral
offer an immediate exit route from the pathway from the project (and back
programme and onto regular activity into again). This has led to an increase in
local communities to support participants referrals to specialist services.
in sustaining activity levels.
• Sometimes effort has to be put into re-
• Undertaking action planning and impact- energising organisations and individuals
assessment sessions – which review who have stopped referring.
existing priorities and develop new ones
– can galvanise key partners and improve • Having a lot of partners involved in the
programme outputs. project is a challenge, especially making
sure everyone is following the processes/
• Evaluation of the projects also appears pathways developed. It can help to have
to benefit from strong partnerships. shared learning events to understand
One project stressed the importance roles and responsibilities.34 Sport England – Get Healthy Get Active 35
Training Second year of delivery
• A lot of the volunteers have no relevant • Training needs are varied, and include (in
First year of delivery qualification when they contact the addition to what’s mentioned above):
projects, so the support and mentoring
needed has been substantially more - marketing and segmentation
A range of training packages have been Training delivery so far has found that: than expected. Support packages,
developed and delivered by the projects that which reflect the higher level of need (for - data collection
focus on behaviour change, and how best to • The delivery of training and learning needs
volunteers from the targeted communities, - basic health understanding
support inactive individuals – and those pro- assessments should be carefully positioned
often in areas of social deprivation) have - cancer rehabilitation
viding sessions for them. A full list is available as an assessment of what would support
had to be developed.
in Appendix C. and help people do their jobs more efficient- - psychology, cancer and physical activity
ly. This will help make sure professionals do - motivational interviewing
A number of projects direct volunteers to- not perceive that their ability to do their job • Retaining volunteers is an ongoing
challenge. Projects have reported a high - first aid in sport.
wards existing courses, including: is being questioned.
turnover, particularly in the first year of
- introduction to fundamentals of movement • Participants engaging with some projects delivery.
- first aid have been identified as having underlying
mental health conditions. Coaches have re- • In one project the long waiting time before
- safeguarding
quested additional training so they are able deployment was a de-motivating factor
- how to deliver engaging sessions to adults to support these participants appropriately. for some volunteers. To counteract this,
- basic strength and conditioning
• Social media approaches can be useful volunteers were offered the chance to
- brief intervention training assist others while waiting to get trained
for longer-term support to people that are
- making every contact count being trained through the programme. and qualified.
- the coaches’ influence on the
participant journey. • Working with County Sports Partnerships
has allowed additional funding to be aligned
from coach bursary schemes, to further
support the training requirements of people
working on the programmes.You can also read
