An Evaluation of the GAA Healthy Club Project
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An Evaluation of the GAA Healthy Club Project By Alex Donohoe B.Sc. A thesis submitted for the Degree of Master of Science School of Health Sciences Department of Health, Sport and Exercise Science Waterford Institute of Technology Head of Department: Dr Michael Harrison Thesis Supervisor: Dr Aoife Lane & Dr Niamh Murphy Date of Submission: 04/11/2015 i Honesty Statement I declare that the work submitted is my own work. Any of the data presented was collected and analysed by myself and is accurate. Appropriate credit has been given where reference has been made to the work of others. Signature: __________________________ Alex Donohoe Date: ______________________________ ii Abstract Introduction The sports club has recently been identified as a new setting for health promotion. In Ireland, a Gaelic Athletics Association (GAA) sports club exists in almost every community with a remit that extends beyond promoting Gaelic games. The Healthy Club Project (HCP) was devised by the GAA and HSE in an attempt to both harness current and encourage future health promotion efforts within a GAA club setting. The purpose of this study was to carry out a process and impact evaluation of the HCP. Methods Eighteen GAA clubs self-selected to take part in phase one of the HCP. Data were collected using pre and post questionnaires containing a healthy club index, adapted from a tool developed by Kokko, Kannas et al. (2009). Club representatives and stakeholders involved in the HCP also took part in focus groups to describe the process, and outcomes of engaging in health promotion through sport. Quantitative analysis was carried out using SPSS and qualitative data was processed using thematic content analysis. Results Twelve clubs completed the baseline and follow up questionnaires, a retention rate of 75%. Analysis revealed that clubs progressed from being on average moderately health promoting at baseline to high health promoting at follow up, scoring lowest for policies and highest for ideologies. In total, clubs delivered 72 health initiatives, with physical activity, emotional wellbeing and health awareness/first aid proving to be the most popular topics covered. Results also showed that clubs viewed health promotion as a natural progression of work already underway in their club, and could see positive implications resulting for engaging in this type of work. iii Conclusion The analysis endorses GAA sport clubs as a viable setting for health promotion in an Irish context. Clubs are actively engaging in some health related activities and are eager to engage further. Clubs however, require support to ensure health is included on the agenda of the club, and embedded into all club operations. iv Acknowledgements I would like to sincerely thank Dr. Aoife Lane and Dr. Niamh Murphy, my supervisors, who allowed me to become part of this wonderful journey. I have learned so much from the guidance and advice you offered. There was always time for a chat, from which I left feeling anything was achievable. Your energy and patience know no bounds and I really do appreciate it. To Colin, Stacey, and Emmet in Croke Park, how you managed to so seamlessly orchestrate the whole project is beyond belief. This project is a testament to your vision and dedication. A huge thank you to all the GAA clubs who took part in this study, without whom this experience would never have been possible. Your passion has been infectious, your words lingering, and your hospitality much appreciated…especially on those bitter winter nights many miles from home. To everyone in the postgrad room – thanks for listening, laughing, and always finding time to share some words of wisdom! You are a constant source of inspiration. Finally, to my family and friends for putting up with me, you know how much it means. I wouldn’t have gotten here without each and every one of you. Silent gratitude isn’t much use to anyone. G.B Stern …so thanks again to all v Table of Contents Chapter 1: Introduction 1.0 Background 1 1.1 Purpose of the study 10 1.2 Study aims 10 1.3 Study objectives 10 1.4 Overview of thesis 11 Chapter 2: Literature Review 2.0 Health 12 2.1 Health promotion 12 2.2 Determinants of health 14 2.2.1 The Socio-ecological model 15 2.2.2 Partnerships 17 2.3 Approaches to health promotion 19 2.3.1 Settings based approach 19 2.3.2 Common settings for health promotion 20 2.3.2.1 Community 20 2.3.2.1.1 Community health promotion initiatives 21 2.3.2.1.2 Success factors in community health promotion 23 2.3.2.2 Workplace 24 2.3.2.2.1 Workplace health promotion initiatives 26 2.3.2.2.2 Success factors in workplace health promotion 27 2.3.2.3 School 28 2.3.2.3.1 School based health promotion initiatives 29 2.3.2.3.2 Success factors in school based health promotion 31 2.4 The value of sport to health 33 2.4.1 Physical activity and health 34 2.4.1.1 Physical health benefits of sport 35 2.4.1.2 Sport and healthy behaviours 39 2.4.2 Sport and emotional wellbeing 40 2.4.2.1 Emotional health in a sports club setting 41 2.4.3 Sport and social capital 42 2.4.3.1 Volunteering 44 2.5 Sport and unhealthy behaviours 47 2.5.1 Sport and injury 47 2.5.2 Unhealthy sports sponsorship 47 2.5.3 Sport and substance abuse 49 2.6 Health promotion potential of a sports club 51 2.6.1 A practical setting for health 53 2.6.2 The healthy sporting environments demonstration project (HSEDP) 56 2.6.2.1 HSEDP outcomes 57 2.6.3 Sport for health initiatives 59 2.6.4 Support structures 62 vi 2.7 Summary 65 Chapter 3: Methodology 3.0 Research approach 66 3.1 Study design overview 66 3.1.1 Effect of the HCP 68 3.1.2 HCP Process 68 3.1.3 Evaluation of initiatives 69 3.2 Participants 70 3.2.1 Clubs 70 3.2.2 GAA Community and Health Team 71 3.2.3 Healthy Club Committee members 71 3.2.4 Executive committee members of participating clubs 71 3.2.5 Initiative participants 72 3.2.6 Key partners 73 3.3 Key Concepts 73 3.3.1 Club characteristics 73 3.3.2 Effect of the HCP 73 3.3.3 Process of the HCP 74 3.3.4 Initiatives 75 3.3.5 Partnerships 75 3.4 Data collection 75 3.4.1 Effect of the HCP 75 3.4.1.1 HCQ 75 3.4.2 HCP process 77 3.4.2.1 GAA Community and Health Team interviews 77 3.4.2.2 Regional focus groups 78 3.4.2.3 Dropout interviews 80 3.4.2.4 Executive committee interviews 80 3.5 Initiative evaluation 81 3.5.1 Selected Healthy Club Committee focus groups/interviews 81 3.5.2 Participant focus groups 82 3.5.3 Partner interviews 83 3.5.4 Participant questionnaires 84 3.5.5 Initiative rating scale 84 3.5.6 Community needs assessment 85 3.6 Ethical considerations 85 3.7 Data analysis 86 3.7.1 Quantitative 86 3.7.2 Qualitative 87 vii Chapter 4: Results 4.0 Club demographics 88 4.1 Club characteristics 89 4.2 Health promotion status of participating clubs at baseline 91 4.3 Effect of the HCP 91 4.3.1 Membership at baseline and follow up 91 4.3.2 Partnerships at baseline and follow up 92 4.3.3 Health promotion activity of participating clubs at follow up 94 4.3.3.1 Health promotion activity and club size 97 4.3.4 Individual standard analysis at baseline and follow up 96 4.3.5 Overall health promotion category at baseline and follow up 99 4.3.6 Perceived effect of HCP on clubs 100 4.4 Process of development of a Healthy Club 102 4.4.1 Introduction 102 4.4.2 Why get involved in the HCP? 103 4.4.3 Healthy Club development 106 4.4.4 What did the HCP lead to? 114 4.4.5 Challenges 118 4.4.6 Recommendations 121 4.5 Evaluation of Initiatives 123 4.5.1 Community health needs 123 4.5.2 Initiatives provided by clubs (action plan analysis) 124 4.5.3 Individual initiative evaluations 128 4.5.3.1 Healthy Food Made Easy 128 4.5.3.2 Anti-smoking policy 131 4.5.3.3 ‘How are you feeling today?’ 133 4.5.3.4 SOAR 136 4.5.3.5 Operation transFAUGHmation 138 4.5.3.6 Cork beats Stress 140 4.5.3.7 Anti-bullying 143 Chapter 5: Discussion 146 Chapter 6: Conclusion 164 Recommendations for Future Research 172 Reference List 175 Appendices 188 viii List of Tables Table 1. Strategies for health promotion 13 Table 2. Health promotion action areas 14 Table 3. SCforH guidelines 59 Table 4. Questionnaire & focus group respondents for initiatives broken down by province 72 Table 5. Number of participants by initiative type 73 Table 6. Size and membership of participating clubs at baseline 89 Table 7. Club characteristics 90 Table 8. Comparison of the perceptions of partnerships at baseline and follow up 94 Table 9. Health promotion characteristics of participating clubs at baseline and follow up 95 Table 10. Change in health promotion activity relative to club size 96 Table 11. Individual standard analysis baseline and follow up 97 Table 12.