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Allez Hop, a Nationwide Programme for the Promotion of Physical Activity in Switzerland: What Is the Evidence for a Population I

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Allez Hop, a Nationwide Programme for the Promotion of Physical Activity in Switzerland: What Is the Evidence for a Population I Original article Br J Sports Med: first published as 10.1136/bjsm.2009.070201 on 11 June 2010. Downloaded from Allez Hop, a nationwide programme for the promotion of physical activity in Switzerland: what is the evidence for a population impact after one decade of implementation? Miriam Wanner,1,2 Eva Martin-Diener,1,2 Georg F Bauer,2,3 Hanspeter Stamm,4 Brian W Martin1,2 1Swiss Federal Institute ABSTRACT effectiveness of sports programmes in promot- of Sport Magglingen, Objectives To present evidence for a population impact ing physical activity at the population level and Magglingen, Switzerland 2Institute of Social and of a national physical activity promotion programme only a few national multi-year physical activity Preventive Medicine, after a decade of implementation. promotion programmes have been systematically University of Zurich, Zurich, Methods The programme Allez Hop offered local physi- analysed.7–10 Switzerland cal activity courses (mainly walking and Nordic walking) Switzerland (population of 7.1 million in 3 Centre for Occupational and once a week over 12 weeks. Data from a pretest 1996) has a strong tradition of sports clubs, with Organisational Sciences, ETH Zurich, Zurich, Switzerland posttest survey in 2005 course participants (N=2157 approximately one quarter of the adult popula- 4Observatory Sport and at baseline (of 4130, 52.2%), 1587 at fi rst follow-up tion being members;11 it has successfully imple- Physical Activity, Lamprecht & (73.6%); smaller subsample with second follow-up) and mented the national programme ‘Youth and Stamm (L&S) Sozialforschung from repeated cross-sectional national surveys have Sport’ for adolescents since the 1970s, and it und Beratung AG, Zurich, Switzerland been analysed regarding changes in physical activity has an excellent walking infrastructure includ- behaviour. ing a network of approximately 60 000 km Correspondence to Results The total number of Allez Hop courses was hiking trails. Nevertheless, the fi rst national rep- Dr Miriam Wanner, Institute 18 684 between 1997 and 2008. 89.2% of participants resentative data on physical activity behaviour in of Social and Preventive were women, the mean age was 48.5 years. The Switzerland showed that the proportion of indi- Medicine, University of Zurich, Pestalozzistrasse 24, CH-8032 proportion meeting the physical activity recommen- viduals reporting less than one vigorous exercise Zurich, Switzerland; dations was 31.7% at baseline, in participants with episode per week increased from 35.7% in 1992 miriam.wanner@ fi rst follow-up data it increased from 33.1% to 42.3% to 39.4% in 1997.12 physicalactivityandhealth.ch (p<0.001). On the population level in the main user Allez Hop as a nationwide programme for the group of Allez Hop (middle-aged women) the propor- promotion of physical activity was launched in Accepted 13 April 2010 tion not engaging in any sport decreased from 50.1% 1997 as a joint initiative of three Swiss health Published Online First http://bjsm.bmj.com/ 11 June 2010 (1997) to 47.2% (2002) and to 43.1% (2007) (p<0.01). insurance companies and the Swiss Olympic Walking/hiking was the second most frequently Association, the umbrella organisation of Swiss performed sport (33.7%) in 2007, with the most remark- sports federations. Later, the single health insur- able increase since 2000 (+11.1%). ance companies were replaced by Santésuisse, Conclusions Allez Hop was successfully implemented their national umbrella organisation, and the for more than a decade, reached middle-aged women foundation Health Promotion Switzerland as well and a high proportion of insuffi ciently active individu- as the Swiss Federal Offi ce of Sport joined the als. Changes in participants’ physical activity behaviour partners behind the project. In 2003 the overall on September 27, 2021 by guest. Protected copyright. must be interpreted cautiously because of low response responsibility for the programme changed from rates and short follow-up. However, indications for the Swiss Olympic Association to the Federal behavioural changes were observed at the population Offi ce of Sport. The core of the programme were level, even though these data do not allow a causal link local physical activity courses offered by trained to Allez Hop. and qualifi ed Allez Hop instructors once a week for approximately 12 weeks, targeted at inac- tive and insuffi ciently active adults. Course dis- Physical activity has been recognised as an ciplines included gymnastics, walking, tennis, important public health issue,1 and many coun- water gymnastics, Nordic walking, running and tries are currently in the process of developing Fitgym (indoor conditioning exercises). The bud- and implementing respective policies and strate- get of Allez Hop was approximately €1.5 million gies.2 Attempts at promoting sports for all have per year between 1998 and 2001 and approxi- an even longer history. Given the solid evidence mately €0.8 million thereafter. The budget was on the health effects of walking,3 many coun- originally participation-driven, with increasing tries are now promoting such activities in par- costs for each additional course. To absorb these ticular, for example, the ‘Walking the Way to costs despite a decreasing budget, a franchising Health’ programme in England4 and the ‘Paths to system was introduced in 2004 requiring Allez Health’ programme in Scotland.5 While there is Hop instructors to obtain a licence in order to some evidence about the effectiveness of inter- offer courses under the label ‘Allez Hop’. In addi- ventions for the promotion of walking,6 there is tion, Allez Hop implemented self-fi nancing strat- only very limited documented evidence for the egies through merchandising and course offers 1202 Br J Sports Med 2011;45:1202–1207. doi:10.1136/bjsm.2009.070201 08_bjsports70201.indd 1202 11/2/2011 10:24:03 AM Original article Br J Sports Med: first published as 10.1136/bjsm.2009.070201 on 11 June 2010. Downloaded from for companies, generating €0.3 million annually by the year calculated using the complex sample command, and z tests 2006. Allez Hop has always been an implementation and not were used to derive p values. The survey is described in more a research project. There was no constant and consistent eval- detail elsewhere.17 uation strategy, but several evaluation projects have been car- Sports surveys in 1999 and 2007 ried out.13–16 Based on fi ndings that a number of participants took part in more than one course, so-called Allez Hop ‘meet- Two representative cross-sectional sports surveys were carried ings’ were created for experienced participants wishing to out in 1999 and in 2007. The main purpose of the surveys was continue their physical activities in a structured format with the assessment of sports preferences and habits in the Swiss qualifi ed guidance. population. In 1999, a representative sample of the population The experiences of a national long-term physical activity aged 14–74 years was selected based on a random–random programme with the promotion of leisure-time walking as procedure and interviewed using computer-assisted telephone one of its main aims may also be of interest to other countries. interviews (N=2064, response 56.8%). In order to represent Therefore, this publication is looking at the following research the Swiss population, the data were weighted according to questions: What was the success in developing the programme age, household size and language region. Similarly, the sur- and what was its reach over more than a decade? What were vey in 2007 was carried out in several regionally represen- the characteristics of its users and what were indications for tative samples aged 15–74 years using a random–random behavioural change in them? What were the indications for procedure. Data were assessed using computer-assisted tele- changes in behavioural patterns at the population level? phone interviews (N=10 262, response 55.0%). To account for the different regional sample sizes and to represent the general Swiss population, the data were weighted according to gen- METHODS der, age and region. The surveys are described in more detail Data assessments elsewhere.11 18 Development and utilisation of the programme Allez Hop The central course registration system used for the fi nancial Outcome measures reimbursement of instructors and the advertisement of courses The main outcome measure in the 2005 course evaluations was provided the Allez Hop course database. Allez Hop instruc- the proportion of participants meeting the health-enhancing tors registered the courses they offered over the internet or by physical activity (HEPA) recommendations (≥30 min of mod- email. Data regarding the development of Allez Hop courses erate intensity activities on ≥5 days per week or ≥20 min of were derived from that database and could be stratifi ed by vigorous intensity activities on ≥3 days per week). At the pop- course discipline and year. ulation level, the proportion of the Swiss population that did Course evaluations in 2005 not engage in any sport, fi tness activities or gymnastics was A written questionnaire survey was carried out among all analysed for 1997, 2002 and 2007. The proportion of individu- course participants of Allez Hop walking and Nordic walking als engaging in specifi c sports activities was assessed in 2000 courses that started in April and ended in July 2005. Participants and 2007 (of respondents who reported participating in any sport). were asked to complete questionnaires with items on course http://bjsm.bmj.com/ expectations, course satisfaction, physical activity behaviour and sociodemographic variables at the beginning (baseline) RESULTS and the end (fi rst follow-up) of the course. In a subsample Participation in Allez Hop in three regions (Aargau representing the German-speaking, Figure 1 shows the development of Allez Hop courses accord- Romandie the French-speaking and Tessin the Italian-speaking ing to the different course disciplines between 1997 and 2008 parts of Switzerland), course participants were furthermore (data for 2008 not available by course discipline).
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