Dr Alexandra Potts

Title: Evaluating Systems Approaches to Physical Activity: Lessons from Three Case Studies in England Chair: Andy Daly-Smith, University of Bradford Purpose: In 2020, ISPAH published the “Eight Investments That Work For Physical Activity”. A systems approach can facilitate the integration of the eight investments by providing a framework for bringing together organisations and communities to create a shared understanding of a complex issue, and to identify where to act, collectively. We have recently seen an increased utilisation of systems approaches, but we now need more robust and innovative evaluations to understand how these approaches work, for whom, and in which circumstances. Description: In this symposium we present three examples of how physical activity-orientated systems approaches in England have been evaluated, challenges faced, and how novel methods are being used to investigate their complex and adaptive natures. The chair (Dr Daly-Smith) will provide a background to systems approaches for physical activity (5 minutes), before introducing the symposium speakers, who will each present for 20 minutes. 1. JU:MP – a research-practice approach to systems change in Bradford, UK: Dr Hall will discuss the benefits and challenges of integrating qualitative and quantitative data across different system ‘levels’ to capture complexity, and to inform evidence-based delivery, of JU:MP. 2. Capturing the wider impacts of a systems approach in Gloucestershire: Dr Nobles shall home in on the issues of adaptability, emergence, and heterogeneity within a systems approach. The talk will focus on the use of Ripple Effects Mapping; a participatory method that helped to capture the unanticipated impacts and messy nature of We Can Move in Gloucestershire. 3. Community reporting: An insight-generating approach to inform the development and evolution of a systems approach to district-wide physical activity behaviours: Dr Potts will highlight the importance of working with the community when evaluating – and continuously evolving – a systems approach. She will introduce the community reporting method which has been rolled out across several communities as part of Active Calderdale.

Sports coaching has been identified as a naturally stressful occupation (Fletcher & Scott, 2010). An individual’s stress experiences can impact their psychological well-being (Berjot & Gilet, 2011; Waters & Moore, 2002), which can have detrimental consequences for an individual’s experiences at work. This, in turn, can lead to coaches withdrawing themselves from the coaching environment, which has ramifications for not only the coaching climate but also for sport and physical activity engagement of the general population. A lack of engagement in sport and physical activity has consequences for individuals’ psychological and physical health, which could therefore put strain on our National Health Service. Given the importance of retaining coaches within the coaching occupation, it is imperative that researchers understand coaches’ experiences of psychological stress and psychological well-being in an effort to help inform practitioners, National Governing Bodies (NGBs), and policy makers of ways in which coaches can be best supported to create positive experiences and therefore help keep them within the occupation. Informed by the constructivist paradigm in which I operate, this thesis makes an original contribution to the sport psychology and coaching psychology literature in three main ways: (1) by providing a rigorous qualitative program of research exploring coaches’ experiences of stressors, primary appraisals, coping, and psychological well-being, (2) exploring the impact primary appraisals can have on coaches’ psychological well-being, and (3) exploring the experiences of both men and women coaches and those operating on full-time, part-time, and voluntary bases. The findings in this thesis are constructed between myself and 30 coaches (eight women and 22 men) who were operating on different occupational bases. The coaches took part voluntarily in three empirical qualitative studies which used semi-structured interviews (Sparkes & Smith, 2014) and longitudinal daily diaries (Bolger, Davis, & Rafaeli, 2003) to explore the coaches’ experiences. The findings are presented via verbatim quotes, trajectory pathways (Grosseohme & Lipsein, 2016), and composite vignettes (Ely, Vinz, Downing, & Anzul, 1997) which collectively offer ways in which other coaches can resonate with the experiences being presented. This thesis has implications for practitioners, policy makers, and NGBs of ways in which they can work with coaches to optimize their environment and help provide them with positive coaching experiences. More specifically, the practical implications of this thesis highlight the challenges faced by both men and women coaches and those working on part-time and voluntary bases. NGBs would do well to turn their attention towards these implications to help provide positive experiences for coaches and help retain them in the occupation.

Abstract

Background: Systems approaches are currently being advocated and implemented to address complex challenges in Public Health. These approaches work by bringing multi-sectoral stakeholders together to develop a collective understanding of the system, and then to identify places where they can leverage change across the system. Systems approaches are unpredictable, where cause-and-effect cannot always be disentangled, and unintended consequences – positive and negative – frequently arise. Evaluating such approaches is difficult and new methods are warranted. Methods: Ripple Effects Mapping (REM) is a qualitative method which can capture the wider impacts, and adaptive nature, of a systems approach. Using a case study example from the evaluation of a physical activity systems approach in Gloucestershire, we: a) introduce the adapted REM method; b) describe how REM was applied in the example; c) explain how REM outputs were analysed; d) provide examples of how REM outputs were used; and e) describe the strengths, limitations, and future uses of REM based on our reflections. Results: Ripple Effects Mapping is a participatory method that requires the active input of programme stakeholders in data gathering workshops. It produces visual outputs (i.e., maps) of the programmes activities and impacts, which are mapped along a timeline to understand the temporal dimension of systems change efforts. The REM outputs from our example were created over several iterations, with data collected every 3-4 months, to build a picture of activities and impacts that have continued or ceased. Workshops took place both in person and online. An inductive content analysis was undertaken to describe and quantify the patterns within the REM outputs. Detailed guidance related to the preparation, delivery, and analysis of REM are included in this paper. Conclusion: REM may help to advance our understanding and evaluation of complex systems approaches, especially within the field of Public Health. We therefore invite other researchers, practitioners and policymakers to use REM and to continuously evolve the method to enhance its application and practical utility.

High-performance sports coaches work in achievement-oriented environments that have the potential to enhance or undermine psychological well-being (PWB). Despite context-specific understanding of PWB being important, we know little about what PWB means to high-performance coaches and have minimal understanding of how to help coaches and governing bodies to nourish and protect PWB. Underpinned by our constructivist paradigm and our relativist and subjectivist onto-epistemological stance, we worked with eight high-performance sports coaches to: 1) qualitatively explore what PWB means to high-performance coaches to generate new understanding of the fundamentally important elements of their PWB and 2) build a clearer picture of factors that facilitate and or inhibit coaches' PWB. Using reflexive thematic analysis, we constructed six themes from data collected via semi-structured interviews: 1) from balance to self-awareness: PWB means something different to everyone; 2) curiosity fuels development of self and others, which builds PWB; 3) enjoyment of coaching and escapism from it sustain PWB; 4) being surrounded by good people and seeing them achieve are routes to happiness; 5) coaching can feel like being “stuck in the trenches” whilst waiting to be found out as a fraud; and 6) boundary management is a form of self-preservation that protects PWB. These findings give voice to high-performance sports coaches' understanding of PWB, help to develop an evidence base from which individualized interventions can be developed, and promote the need for systemic changes in sport that will help coaches to live well and be well.

Background: Sports coaching has been identified as a naturally stressful occupation. Coaches must be able to competently and effectively manage stress that is inherent in competitive sport and perform under pressure. Yet, limited research exists that has explored coaches’ experiences of psychological stress. The research that does exist has mainly focused on full-time, elite coaches who represent just 3% of the coaching workforce in the United Kingdom (U.K.). Despite the voluntary coaching workforce contributing to 72% of the total U.K. coaching personnel, little is known about the stressors that volunteer coaches experience or the ways in which they cope with these stressors. Purpose: To explore the stressors that voluntary coaches experience and the coping strategies that they use. Methods: Following institutional ethical approval, four (Mage = 38.5±11.68 years) voluntary coaches were interviewed using a semi-structured interview guide. Each interview was conducted face-to-face and lasted between 56.44 and 84.25 minutes (Mduration= 66.95±12.19 minutes). Rich, in-depth data was collected during the interviews, which provided a thick description of knowledge. Thematic analysis was used to organise and analyse the data. To ensure the study has rigor and provides a significant contribution to the literature, self-reflexivity was used by the primary researcher throughout. Results: The coaches reported 28 different stressors, which were categorised into four higher-order themes: personal, athlete-related, organisational, and external/uncontrollable. Thirty nine different coping strategies were discussed, which were categorised into two higher-order themes: problem-focused and emotion-focused coping. Overall, the stressors and coping strategies reported by the voluntary coaches in this study were similar to those reported in previous literature by paid coaches. Conclusion: This research represents some of the first to explore voluntary coaches’ experiences of stressors and coping strategies. Further research is warranted to explore voluntary coaches’ motivation to continue their engagement, despite the stressors they experience. The findings of this study may be of interest to national governing bodies and coaches who are at the forefront of the coaching sector.

Background Systems approaches are currently being advocated and implemented to address complex challenges in Public Health. These approaches work by bringing multi-sectoral stakeholders together to develop a collective understanding of the system, and then to identify places where they can leverage change across the system. Systems approaches are unpredictable, where cause-and-effect cannot always be disentangled, and unintended consequences – positive and negative – frequently arise. Evaluating such approaches is difficult and new methods are warranted. Methods Ripple Effects Mapping (REM) is a qualitative method which can capture the wider impacts, and adaptive nature, of a systems approach. Using a case study example from the evaluation of a physical activity-orientated systems approach in Gloucestershire, we: a) introduce the adapted REM method; b) describe how REM was applied in the example; c) explain how REM outputs were analysed; d) provide examples of how REM outputs were used; and e) describe the strengths, limitations, and future uses of REM based on our reflections. Results Ripple Effects Mapping is a participatory method that requires the active input of programme stakeholders in data gathering workshops. It produces visual outputs (i.e., maps) of the programme activities and impacts, which are mapped along a timeline to understand the temporal dimension of systems change efforts. The REM outputs from our example were created over several iterations, with data collected every 3–4 months, to build a picture of activities and impacts that have continued or ceased. Workshops took place both in person and online. An inductive content analysis was undertaken to describe and quantify the patterns within the REM outputs. Detailed guidance related to the preparation, delivery, and analysis of REM are included in this paper. Conclusion REM may help to advance our understanding and evaluation of complex systems approaches, especially within the field of Public Health. We therefore invite other researchers, practitioners and policymakers to use REM and continuously evolve the method to enhance its application and practical utility.

An exploration of psychological stress and performance enhancement: Are performance enhancing substances used to cope with stress in elite rugby players? Alexandra J. Potts (@alexpotts1993) and Faye F. Didymus (@FayeDidymus) Carnegie Research Institute, Leeds Beckett University, United Kingdom Background: The professionalization of rugby union and rugby league has led to a growth in research and support for the players. Research findings highlight the demanding nature of the professional game but little is known about rugby players’ experiences of stress and coping. In addition, despite the World Anti-Doping Agency (WADA) indicating there has been an increase in the use of performance enhancing substances (PES) and anti-doping rule violations in rugby, it is not yet clear why players turn to PES during their careers. One hypothetical explanation is that athletes may use PES to cope with stressors in sport. Lazarus’ ([2000]. Stress, appraisal, and coping: A new synthesis. New York: Springer.) cognitive-motivational-relational theory is an appropriate framework to interrogate this explanation. Purpose: The purpose of this study was to identify whether there is a link between stress and PES use in elite rugby players. To achieve this aim, we explored stressors, appraisals, emotions, coping, and PES use. Methodology: Following institutional ethical approval, seven (Mage= 22.9, SD=2.04 years) elite rugby union (n=4) and league (n=3) players were interviewed using a semi-structured interview guide. Each interview was conducted face-to-face and lasted between 25 and 47 minutes (Mduration = 35:27 mins, SD=8:07 mins). Thematic analysis was used to organise and analyse the data.

A dual-career that combines academic and sporting pursuits can be stressful, as such, it is of importance to explore how dual-career athletes appraise and cope with stress. Existing dual-career literature is limited by retrospective methodologies. In seeking to address these limitations, this study utilized ecological momentary assessment three days a week for four consecutive weeks to explore the stress and coping experiences of six highly trained dual-career student badminton athletes aged between 18 and 26 years (Mage =20.75, SD = 2.4). Deductive thematic analysis of EMA diaries highlights that dual-career athletes experience various competitive, organizational, and personal stressors. Situational characteristics underpinning identified stressors were novelty, ambiguity, imminence, duration, and timing, which aligned predominantly with threat and harm appraisals and occasionally with challenge appraisals. The applied implications of study findings are discussed, particularly regarding EMA methodology for future dual-career research and coping interventions for dual-career student-athletes.

It is essential to understand sports coaches’ experiences of psychological stress and psychological well-being (PWB) on a daily basis to better equip coaches to manage stress and improve well-being. Coaches make a vital contribution to sport and, given the potentially stressful nature of coaches’ roles (Potts et al., 2023), are required to manage their own PWB and performance alongside that of the athletes with whom they work (Baldock et al., 2022). To better understand how to support coaches, we explored coaches’ experiences of stressors, primary appraisals, coping, and PWB using a close proximity longitudinal daily diary approach. Five sports coaches (one woman and four men) each completed an interval-contingent, daily diary over a 28-day period. The diary facilitated understanding of the coaches’ experiences of their worlds (Alaszewski 2006) and captured descriptions of the coaches’ daily lives (Polit & Beck 2006). Underpinned by our constructivist paradigm and following an abductive approach to data analysis, four experiences are presented (preparing for major events and championships, competition, admin and national governing body-related tasks, and work-life balance) using a trajectory approach. This method of data presentation allows understanding of each coach’s journey through their experiences as they occurred over the 28-day period. The experiences are categorized into themes representing stressors, primary appraisals, coping, and PWB. Collectively, the findings highlight that coaches experienced certain stressors (e.g., athlete-related) on a regular basis, and that they appraised (e.g., as a challenge) and coped with these experiences in different ways (e.g., via information seeking). The findings also demonstrate that stress experiences influenced different elements of the coaches’ PWB (e.g., relationships with others, personal growth) and that, occasionally, coaches may experience delayed or inaccessible appraisals of a stressor.

Psychological stress is inherent in sport, particularly at the higher levels of competition, and has implications for individuals’ well-being and performance. Athletes, coaches, officials, and parents alike are influential stakeholders in sport and each of these groups of individuals are likely to experience stress at some point during their own or others’ sport careers. Psychological stress is an umbrella term that refers to many concepts that are each interrelated and idiosyncratic. This makes stress a complex area to learn about. This chapter will focus on some of the most widely studied components and outcomes of stress (i.e., stressors, appraising, coping, and well-being) and their relationships with performance to offer an introductory text that encourages further reading. Theoretical perspectives of stress are covered briefly to offer frameworks from which stress can be understood. Exercises are offered at regular intervals throughout the chapter to facilitate transference of readers’ knowledge. The chapter closes with implications for practitioners, national governing bodies, and researchers, and with concluding comments that consolidate important points from the chapter.

Whole systems approaches are increasingly being advocated as a way of responding to complex public health priorities such as obesity and physical inactivity. Due to the complex and adaptive nature of such systems, researchers are increasingly being embedded within host organisations (i.e., those which facilitate the whole systems approach) to work with key stakeholders to illuminate and understand mechanisms of change and develop a culture of continuous improvement. While previous literature has reported on the benefits and challenges of embedded researchers in health care, little is known about the experiences and learnings of those situated within these complex whole systems approaches. In this paper, we present our reflections of being embedded researchers within four distinct whole systems approaches and outline recommendations and considerations for commissioners working with or seeking support from an embedded researcher.

Background Cardiac rehabilitation (CR) provides proven benefits, yet only 50% of eligible individuals participate, with females and ethnic minority groups being particularly underrepresented. This study aimed to explore healthcare professionals’ (HCPs) views on factors influencing referral and attendance to phase III CR services in the United Kingdom (UK), with the purpose of identifying evidence-based recommendations and strategies to enhance access and participation. Methods Thirty-eight HCPs involved in the cardiac care or rehabilitation of patients with coronary heart disease (CHD) participated in a three-round Delphi study. Participants were asked about staff competencies, CR core components, referral criteria, referral pathways, and the impact of sex and ethnicity on referral and attendance. Results 108 statements were proposed by the participants. Consensus was achieved on 53 statements covering 10 key aspects of CR. HCPs identified significant disparities in referral practices and attendance, attributing these to HCP knowledge gaps, lack of streamlined referral pathways, and non-inclusive referral processes. They emphasised the need for educational initiatives within general practitioner surgeries and the development of direct referral pathways to improve CR access. Additionally, HCPs highlighted the importance of educating ward staff on inclusive practices and cultural sensitivity to improve referrals, particularly for females and ethnic minority groups. Conclusions The study highlights disparities in CR referral and attendance, particularly by sex and ethnicity. It provides evidence-based recommendations to ensure equitable access to CR services. Future interventions should focus on tailored education for HCPs and streamlined, direct referral pathways to ensure inclusive access for diverse populations in the UK.

Background Cardiovascular rehabilitation (CR) is a crucial element in the management of coronary heart disease (CHD). However, only 52% of those eligible for CR participate in it, with lower engagement among females and minority ethnic groups. Despite reported barriers to participation, healthcare professionals’ (HCPs) perspectives on referral and attendance remains unexplored. Aim To explore the perspectives of HCPs on factors influencing referral and attendance to CR services in the UK. Methods A three-round Delphi study (May to September 2023) involved 38 HCPs recruited via snowball sampling. In Round One, 12 open-ended questions enquired about participants’ views on staff competencies, core components of CR, referral criteria, referral pathways, and the associations between sex and ethnicity related to referral and attendance. Content analysis informed a structured five-point Likert scale questionnaire used in Round Two. Consensus was defined a priori as ≥ 70% agreement among the participants. In Round Three, participants were asked to retake the questionnaire after receiving feedback for individual and group responses. Results Consensus was achieved on 53 of the 108 statements, covering 10 key aspects of CR. HCPs acknowledged significant disparities in UK CR programmes, attributing these to knowledge gaps. HCPs emphasised the need for educational initiatives within general practitioner (GP) surgeries and direct referral pathways as effective strategies for enhancing sex-specific referrals to phase III CR. Furthermore, HCPs suggested education for hospital ward staff on inclusion and cultural training, alongside building relationships with local communities, to improve ethnic-specific referrals to CR (table 1). Conclusion This study highlights HCPs perspectives on referral and attendance to CR programmes in the UK, focusing on sex and ethnicity. HCPs emphasised the urgent need for initiatives to enhance clinicians’ knowledge and ensure inclusivity in CR services. Future research should build on these findings to promote equitable access to CR for diverse UK populations.

The final phase of Sport England’s consultation on their new 10-year strategy, due early 2021, is coming to a close. Their purpose to “transform the nation’s relationship with movement, physical activity and sport” got us thinking about what we would like to see in the new document, especially in relation to our shared interest in inclusive community sport practice.

Approximately 200,000 coaches cease coaching each year in the United Kingdom alone. The reasons for this dropout are not fully understood, but they could be linked to the stressful nature of coaching and the potential for this to impede health and psychological well-being (PWB). The aim of this meta-synthesis is to systematically search for and draw together the qualitative research evidence on coaches’ experiences of stressors, primary appraisals, emotions, coping, and PWB. Using a rigorous and systematic search protocol, 11 studies were identified, assessed for research quality, and synthesized thematically to generate new insight. The findings highlight the plethora of stressors that coaches can experience, the impact of coaches’ appraisals on PWB, and the coping families that coaches can use to foster adaptation. In doing so, the meta-synthesis deepens our understanding of coaches’ stress transactions and their experiences of PWB. There is a significant lack of qualitative research evidence on coaches’ appraisals and PWB. Qualitative and or longitudinal research is warranted to develop knowledge in these areas. Such research should be used to develop interventions that are applicable to different coaching populations (e.g., working parents and part-time coaches) to help minimize stressors, facilitate positive appraisals and emotions, and foster PWB.

© 2018 Informa UK Limited, trading as Taylor & Francis Group The stressor and coping experiences of full-time and paid coaches have been reported in the literature, yet researchers have largely overlooked the experiences of part-time and voluntary coaches who make a substantial contribution to the coaching workforce. This study aimed to begin addressing these voids by exploring volunteer, part-time and full-time coaches’ stressors and coping strategies. In addition, this study aimed to explore both men and women coaches’ experiences of stressors and coping because most published literature has focused on the experiences of male coaches. Guided by our interpretive paradigm and blended constructionist and critical realist perspective, theoretically informed semi-structured interviews were conducted with 19 men and women coaches who represented a range of team and individual sports. Data were thematically analysed using an abductive approach. We constructed 141 codes that were represented by three themes of stressors (coach-related, athlete-related and organisational) and 131 codes relating to coping, which we grouped into seven themes (problem-solving, information seeking, escape, negotiation, self-reliance, dyadic coping and support seeking). Based on these findings, we propose several impactful recommendations for researchers and practitioners. For example, we recommend that researchers continue to generate rich understanding of stressors and coping among coaches who are working on different employment bases to work towards the development of effective stress management interventions. Further, we encourage national governing bodies work with practitioners to incorporate specific foci on stress and stress management during coach education programmes to contribute to more effective performance under pressure.

Objective: To systematically search for, appraise, and synthesize peer-reviewed literature on interpersonal coping (IC) in sport. Design: A systematic review adhering to PRISMA-P guidelines. Method: Systematic searches of CINAHL, PsycArticles, APA PsycInfo, and SPORTDiscus were conducted. To be eligible for inclusion, papers had to be published in full in the English language in a peer-reviewed journal and had to contain empirical data that focused on IC among individuals in sport (i.e., athletes, coaches, sport parents, practitioners). Results: The final sample consisted of 28 studies (22 qualitative, five quantitative, one mixed methods) spanning from September 01, 1981 to July 10, 2023. The results highlight eight antecedents and facilitators of IC (closeness, commitment, communication, complementarity, cultural values, environment and situations, sharing of demands, support), three mediators and moderators of IC (appraisal of own and others’ emotions and or coping, gender, individuals within the relationship), and three outcomes of IC (performance, relationships, regulation or management of emotions). The findings were used to develop an initial working definition of IC in sport. Conclusion: A volte-face of thought is needed to shift attention toward the interpersonal manifestation of coping. IC has wide-reaching implications for individuals, relationships, and other psychological constructs. Methodological innovation is needed to realize stepwise changes in intellectual and practical progress and to develop quantitative measures of IC. Coaches, family members, practitioners, and retired athletes are considerably underrepresented in research on IC. This systematic review offers a vantage point from which composed and coordinated action can be taken to develop research on IC.

Background: The small Atlantic island of St Helena is a United Kingdom Overseas Territory (UKOT) with a high prevalence of childhood obesity (over a quarter of 4-5 and 10-11 year olds) and, anecdotally, adulthood obesity and its associated health detriments. St Helena have taken a whole systems approach to obesity (WSAO) to address the issue. A WSAO recognises the factors that impact obesity as a complex system and requires a ‘health in all policies’ approach. UK academic and public health technical support was provided to the local St Helena delivery team. This process evaluation sought to explore the early stages of the WSAO implementation and implications for the transferability of the approach to other small island developing states and UKOT. Methods: Data was collected via eight semi-structured interviews, paper based and online surveys, and document analysis. Thematic analysis was used to analyse the data. Results: The analysis identified three factors which aided the first phase of WSAO implementation: (1) senior leaders support for the approach; (2) the academic support provided to establish and develop the approach; and (3) effective adaptation of UK Government resources to suit the local context. Key challenges of early implementation included: maintaining and broadening stakeholder engagement; limited local workforce capacity and baseline knowledge related to obesity and systems thinking; and limited capacity for support from the UK-based academic team due to contract terms and COVID-19 restrictions. Conclusions: Early stages of implementation of a WSAO in a UKOT can be successful when using UK’s resources as a guide and adapting them to a small island context. All participants recommended other small islands adopt this approach. Continued senior support, dedicated leadership, and comprehensive community engagement is needed to progress implementation and provide the foundation for long-term impact. Small island developing states considering adopting a WSAO should consider political will, senior level buy-in and support, funding, and local workforce knowledge and capacity to enable the best chances of successful and sustainable implementation.

Research attention has been directed toward coaches’ stressor experiences, yet less is known about the role of stress appraisals and psychological well-being (PWB). Considering the links between PWB, mental health, and retention in the coaching profession, this study will explore primary appraisals and PWB among sports coaches. Guided by our constructivist paradigm that underpinned our relativist ontology and subjectivist epistemology, we conducted theoretically informed semi-structured interviews with six coaches (five men and one woman) who represented both team and individual sports. We analysed data thematically using an abductive approach and constructed 10 composite vignettes that describe a powerful and shared account of the coaches’ lived experiences. The vignettes offer insight to the coaches’ primary appraisals and the impact of stress transactions on PWB. For example, benefit appraisals had a positive impact on environmental mastery and self-acceptance, threat appraisals had a negative impact on autonomy and environmental mastery, and harm/loss appraisals are shown to influence health. Based on these findings, we propose several impactful recommendations for researchers, practitioners, and National Governing Bodies (NGBs). For example, we recommend that practitioners working with coaches should foster positive working relationships with athletes to support coaches’ PWB. Further, we encourage NGBs to work closely with coaches and practitioners to promote safe and favourable working environments, increasing coaches’ autonomy, and maximise flexible working conditions.

Background: The Systems Evaluation Network (SEN) aims to build capability and capacity regarding the use of systems science in public health evaluation. The SEN was established in June 2021 and 3 years from its inception, we undertook a member survey to understand the engagement with, and impact of, the SEN. Methods: An 18-item cross-sectional survey captured quantitative and qualitative responses regarding SEN member perspectives, centring around their experience of the SEN, associated impacts, and future requirements. We analysed quantitative data descriptively and qualitative data through content analysis. Sub-group analyses explored differences between those working in academia vs practice/policy. Results: Seventy-three participants completed the survey, with 60% working in academia and 40% in practice/policy. Considering experiences of the SEN, participants felt the SEN has shared information about innovative methods and evaluation approaches (94.0% agreed), has provided the opportunity to share and learn with other members (86.0% agreed), and has improved knowledge of systems evaluation methods (86.2% agreed). Regarding impacts of the SEN, participants stated that the SEN has increased their capability to apply systems-oriented methods and evaluation of systems approaches (76% agreed) and has facilitated relationships with others (56.9% agreed). Participants shared future capability requirements for evaluation, which focused on methods (e.g. systems dynamics modelling and ripple effects mapping), approaches (e.g. developmental evaluation and embedded researchers), and other ways in which capability could be increased (e.g. by using case studies). Conclusion: This paper illustrates the experiences and impacts of the SEN, identifying its strengths such as the wide range of topics/content and the flexible and accessible delivery format, but contrast against the difficulties of fostering new relationships in an online setting. These findings can help inform the future direction of the SEN and provide insight to other online communities of practice.

INTRODUCTION: A limited number of diet, physical activity and weight management programmes suitable for UK black and Asian populations have been evaluated. We aim to coproduce 'Health Connections'-an ambitious new intervention to support dietary and physical activity choices, and maintaining a healthier weight, tailored to the needs of black Caribbean, black African and South Asian adults. Our existing research and public engagement work suggests that the intervention should be designed to be embedded in communities and delivered by peer educators supported by health professionals. METHODS AND ANALYSIS: The project is underpinned by a systems perspective that posits collective efficacy within communities, behaviour change theory and coproduction. Project activities will be conducted in three stages. Stage 1: semistructured interviews will be conducted with adults from diverse South Asian ethnic groups to understand their experiences, perspectives and intervention needs, adding to our existing data from black ethnic groups. We will synthesise the data, literature, available intervention resources and local practice, and develop the theoretical framework to codevelop intervention goals, programme theory and a draft logic model of change. Stage 2: a theorised list of potential intervention components, session content and mode/s of delivery will be explored in a modified Delphi exercise and workshop to achieve consensus on the intervention format. We will also develop prototype materials and a formal implementation plan. Stage 3: a description of the intervention will be documented. ETHICS AND DISSEMINATION: The study has received ethical approval from the School of Health Research Ethics Committee, Leeds Beckett University. Information on the project aims and voluntary participation is provided in the study participation information sheet. Consent will be certified by the completion and signing of a consent form prior to data collection. Dissemination for a range of stakeholders and audiences will include publications, presentations, short films and an infographic.

This narrative review examines the mechanisms underlying the development of cardiovascular (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are being suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are being explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids, and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are being considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being, and quality of life in older adults with sarcopenia and coexisting cardio-vascular and metabolic diseases.