Dr Jackie Hargreaves

Objective: Quality of life (QoL) needs to be improved in people with psychosis (Department of Health, 2011). Physical activity (PA) is increasingly advocated as an adjunct to treatment, yet few studies in the mental health arena address how PA can be beneficial and aid in improving QoL. This exploratory study aims to gain insight into the lived experiences of participation in PA and QoL in people with psychosis. Design: This study takes a qualitative hermeneutic phenomenological approach. Method: 4 females and 4 males, each with a psychosis diagnosis, participated in in-depth semi-structured interviews lasting between 45-70 minutes. These were recorded and transcribed verbatim. A thematic hermeneutic phenomenological analysis was undertaken. Results: Four major themes emerged: 1) The struggle to be motivated, 2) Experiencing a snapshot of reality, 3) Being normal, 4) Time out from voices and challenging situations. PA was found to be a struggle because of the lethargy associated with the living environment, medications and the illness itself. However, engaging in PA permits participants entry into the ‘real’ world; one which was often described as inaccessible. Participation in PA also assists in the quest to feel ‘normal’ by helping to create a new identity and promoting re-integration into society. Conclusion: This in-depth exploration discusses how PA can be beneficial for QoL in those with psychosis. Evidence is provided for the promotion of PA in this population, building on previous research. Guidance is offered, based upon these experiences explaining how PA can be implemented in mental health services.

Background: Weight gain is commonly observed during and after breast cancer treatment and is associated withpoorer survival outcomes, notably in women with oestrogen-receptor positive disease. The aim of this qualitativestudy was to investigate the experiences and perceptions of oestrogen-receptor positive (ER +) female breast cancerpatients (BCPs) regarding weight management behaviours during and after treatment. Secondly, to gain insight intothe experiences of healthcare professionals (HCPs) regarding the provision of weight management advice to patientsundergoing treatment. Methods: Four focus groups involving 16 BCPs having a median (range) age of 51 (35–70 y) and three focus groupsinvolving 21 HCPs aged 46 (29–62) were held at a university campus, local cancer support centre or clinical site. Datawere analysed using Framework analysis. Results: Four overarching themes (and 10 subthemes) were identified: (1) Treatment; (2) Support for lifestyle behav-iour change; (3) Information availability for BCPs; (4) Knowledge of current evidence amongst HCPs. The physical andpsychological consequences of treatment influenced motivation for weight management amongst BCPs. Social sup-port for health promoting behaviours was viewed as important but was conflicting, requiring context-specific consid-erations. BCPs said they would have welcomed access to credible information (guided by HCPs) about the potentialdetrimental health effects of excess body weight and weight gain, together with advice on weight managementvia healthy eating and physical activity. HCPs felt that they had insufficient knowledge of public health dietary andphysical activity recommendations or evidence-based interventions to confidently offer such advice. HCPs expressedconcern that raising weight management issues would exacerbate distress or invoke feelings of guilt amongst BCPs,and cited time pressures on patient consultations as additional barriers to providing weight management support.

Background: Physical activity (PA) has been found to improve physical and mental health and aid recovery in those with serious mental illness (SMI). However, individuals with SMI conduct less PA than the general population but little is known about how people with SMI adopt PA and what is involved in their behaviour change processes. The aim of this study was to explore individual experiences of PA to elucidate the behaviour change processes of PA in people with SMI who are in recovery. Method: A hermeneutic phenomenological approach was undertaken. Eight active participants (4 male, 4 female) who were in recovery with either bipolar disorder or schizophrenia, were interviewed and their data thematically analysed. Findings: Four main themes emerged which identified behaviour change facilitators when initiating and maintaining engagement in PA. Three themes revealed how participants became more active: ‘Not ready to engage’; ‘Initial steps to engaging in PA’ and ‘Becoming more active’. Within these themes, a variety of findings emerged, including: an awareness of the body in existence, a PA enabling environment and feeling real and normal. The fourth main theme, was labelled ‘Doing PA’, this outlined the experienced acts of PA. The type of PA conducted had different beneficial outcomes on the perceived symptoms of SMI. Individuals developed related PA preferences, which motivated them to continue with those activities. Conclusions: Individuals with SMI could be encouraged to conduct more PA by supporting individually meaningful PA. Strategies are suggested which may help individuals to initially engage in PA, but also to continue engaging in PA by enhancing their PA experience.

Background Weight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, particularly in women with oestrogen receptor-positive (ER +) disease. The aim of this study was to co-design (with patients) a programme of tailored, personalised support (intervention), including high-quality support materials, to help female breast cancer patients (BCPs) with ER + disease to develop the skills and confidence needed for sustainable weight loss. Methods ER + BCPs were recruited from two UK National Health Service (NHS) Trusts. The selection criteria included (i) recent experience of breast cancer treatment (within 36 months of completing primary treatment); (ii) participation in a recent focus group study investigating weight management perceptions and experiences; (iii) willingness to share experiences and contribute to discussions on the support structures needed for sustainable dietary and physical activity behaviour change. Co-design workshops included presentations and interactive activities and were facilitated by an experienced co-design researcher (HH), assisted by other members of the research team (KP, SW and JS). Results Two groups of BCPs from the North of England (N = 4) and South Yorkshire (N = 5) participated in a two-stage co-design process. The stage 1 and stage 2 co-design workshops were held two weeks apart and took place between Jan–March 2019, with each workshop being approximately 2 h in duration. Guided by the Behaviour Change Wheel, a theoretically-informed weight management intervention was developed on the basis of co-designed strategies to overcome physical and emotional barriers to dietary and physical activity behaviour change. BCPs were instrumental in designing all key features of the intervention, in terms of Capability (e.g., evidence-based information, peer-support and shared experiences), Opportunity (e.g., flexible approach to weight management based on core principles) and Motivation (e.g., appropriate use of goal-setting and high-quality resources, including motivational factsheets) for behaviour change. Conclusion This co-design approach enabled the development of a theoretically-informed intervention with a content, structure and delivery model that has the potential to address the weight management challenges faced by BCPs diagnosed with ER + disease. Future research is required to evaluate the effectiveness of the intervention for eliciting clinically-important and sustainable weight loss in this population.

Sarcopenia and frailty share a dynamic interplay, significantly influencing the quality of life and functionality in older adults. Defined by the progressive loss of muscle mass and strength, sarcopenia often precedes and contributes to frailty—a state marked by heightened vulnerability to adverse health outcomes. Yet, sarcopenia’s progression is also exacerbated by factors associated with frailty, including inflammation, hormonal changes, and impaired nutritional status. Furthermore, the presence of additional comorbidities can amplify the impact of sarcopenia. This chapter explores the intricate relationship between these geriatric syndromes, shedding light on the bidirectional influences that intensify their effects. Importantly, potential interventions designed to mitigate these conditions are discussed. Comprehensive understanding of sarcopenia and frailty’s interconnectedness is pivotal. Such insights pave the way for interventions targeting both conditions simultaneously, aiming to enhance the quality of life and preserve functional independence during the aging process.

Objectives: For the effective treatment of childhood obesity, intervention attendance and behaviour change at home are both important. The purpose of this study was to qualitatively explore influences on attendance and behaviour change during a family-based intervention to treat childhood obesity in the North-West of England ([INT]). Design: Focus groups with children and parents/carers as part of a broader mixed-methods evaluation. Methods: 18 focus groups were conducted with children (n=39, 19 boys) and parents/carers (n=34, 5 male) to explore their experiences of [INT] after 6 weeks of attendance (/18 weeks). Data were analysed thematically to identify influences on attendance and behaviour change. Results: Initial attendance came about through targeted referral (from healthcare professionals and letters in school) and was influenced by motivations for a brighter future. Once at [INT], it was the fun, non-judgemental healthy lifestyle approach that encouraged continued attendance. Factors that facilitated behaviour change included participatory learning as a family, being accountable and gradual realistic goal-setting, whilst challenges focussed on fears about the intervention ending and a lack of support from non-attending significant others. Conclusions: Factors that influence attendance and behaviour change are distinct and may be important at different stages of the family’s change process. For optimal intervention effectiveness, practitioners should identify specific strategies to encourage initial attendance, continued attendance, initial behaviour change and sustained behaviour change.

Introduction: Physical activity is known to be beneficial for people with mental health problems, although engagement is low. Football, provided by professional football club community trusts could aid engagement in physical activity, however little is known about the behaviour change processes which engage individuals in this type of PA. One factor which is often overlooked is affect and exploring this could help identify the behaviour change processes, which engage individuals in a professional football club-led mental health intervention. The aim of this study was to explore the experiences of individuals attending football provided by a professional club community trust to further our understanding of the behaviour change processes involved in facilitating engagement in this provision.

Introduction: Physical activity is known to enhance mental health, physical health and recovery in people with mental health problems. However engagement and maintenance in physical activity is low. Football, provided by professional football teams has been found to be beneficial for people – especially men, with mental health problems. However, what happens during the football experience which engages individuals requires further exploration. The aim of this study was to explore the experiences of football provided by a professional club for people with mental health problems. A secondary aim was to explore, how people initially engage in football and how they maintain their engagement in football. Method: Individual interviews were conducted with twelve men who played football. This football was provided by a professional football team. A hermeneutic phenomenological approach was undertaken for the thematic analysis. Results: The analysis followed a journey from the initial engagement in football to exploring what happens to maintain engagement in football. Support and football being meaningful was essential for the initial engagement. Maintenance in football was facilitated by experiences of flow and enjoyment, through providing an optimum physical and social environment. The professional football club brought feelings of belonging and responsibility, as well as providing knowledge and skills. Conclusion: Provision of football by a professional team was central to engaging men in the football sessions. Furthermore, to maintain engagement in football, the experiences should be enjoyable and enable experiences of flow. Outcomes could inform future football led mental health improvement programmes.

Objectives: To evaluate the impact of the GOALS (Getting Our Active Lifestyles Started) family-based childhood obesity treatment intervention during the first 3 years of implementation. Design: Single-group repeated measures with qualitative questionnaires. Setting: Community venues in a socioeconomically deprived, urban location in the North-West of England. Participants: 70 overweight or obese children (mean age 10.5 years, 46% boys) and their parents/carers who completed GOALS between September 2006 and March 2009. Interventions: GOALS was a childhood obesity treatment intervention that drew on social cognitive theory to promote whole family lifestyle change. Sessions covered physical activity (PA), diet and behaviour change over 18 2 h weekly group sessions (lasting approximately 6 months). A Template for Intervention Description and Replication (TIDieR) checklist of intervention components is provided. Primary and secondary outcome measures: The primary outcome measure was child body mass index (BMI) z-score, collected at baseline, post-intervention and 12 months. Secondary outcome measures were child selfperceptions, parent/carer BMI and qualitative changes in family diet and PA (parent/carer questionnaire). Results: Child BMI z-score reduced by 0.07 from baseline to post-intervention (p<0.001) and was maintained at 12 months (p<0.05). There was no change in parent/carer BMI or child self-perceptions, other than an increase in perceived social acceptance from baseline to post-intervention (p<0.05). Parents/carers reported positive changes to family PA and dietary behaviours after completing GOALS. Conclusions: GOALS completion was associated with small improvements in child BMI z-score and improved family PA and dietary behaviours. Several intervention modifications were necessary during the implementation period and it is suggested childhood obesity treatment interventions need time to embed before a definitive evaluation is conducted. Researchers are urged to use the TIDieR checklist to ensure transparent reporting of interventions and facilitate the translation of evidence to practice.

The rise of mental health concerns in today’s Higher Education (HE) students is a growing concern. Integrating mental health principles into curricular design can enhance the student experience and improve outcomes such as continuation, completion, and success. This paper aims to integrate mental health guidance into the design of a revalidated curriculum in sport, exercise, and health sciences. A further aim is to provide recommendations for future mentally healthy curricular design. A case study design exploring how mental health does, and might, feature across curricula was undertaken, employing a qualitative methodology. A range of stakeholders, including students, participated in workshops, interviews, and revalidation events over a 4-month period. The analysis and interpretation of the resulting transcripts proposed two main lines of action; ‘building students’ (centring on helping them navigate the nuances of the academic process and developing confidence in their university self, for example, through systematic scaffolding) and ‘building connections’ (focusing on enhancing social connections and psychological safety, for example learning student names). Recommendations proposed by this research highlight that induction should be primarily social, progressing to more fundamental skills, behaviours, and knowledge. Systematic scaffolding and mapping of relevant skills, behaviours, and knowledge throughout the course are fundamental to building students’ confidence. This could reduce both academic staff and students’ frustrations about a lack of ‘know-how’. Staff–student interactions and a focus on micro-behaviours could further enhance a student’s sense of belonging and desire to engage.

In the UK, professional football clubs are being used as settings for the delivery of interventions that promote mental health in a number of ways including (i) the delivery of physical activity interventions to improve the mental health of the general population, (ii) the delivery of physical activity interventions for people experiencing mental illness, and (iii) the delivery of community mental health services within the confines of the football club. This research note offers insights into mental health interventions delivered within, and by, professional football clubs and the available evidence concerning their reach, effectiveness and impact. The findings suggest that professional football clubs can help to facilitate access to mental health services, particularly among young people, for whom accessing such services may be highly stigmatized. Furthermore, the findings highlight that such interventions have a positive impact on health. However, in order to capitalize on this opportunity funding agencies and commissioners must provide appropriate resources (human and financial) for effective delivery and evaluation. Furthermore, a more strategic approach to working towards the mental health agenda must be adopted. It is argued that this change in practice would allow professional football clubs to offer those in need access to high-quality interventions.

Background: A growing body of evidence advocates a multidisciplinary, family-focused approach to childhood obesity management, but there is a need to explore familial factors associated with intervention success. Aim: This study explored the relationship between adult BMI change and child BMI SDS change following completion of a community-based, lifestyle change intervention for obese children and families (Getting Our Active Lifestyles Started (GOALS)). Method: Sixty of 121 families with overweight children completed the GOALS intervention between September 2006 and March 2009.Complete pre- and post-intervention (6 months) BMI data was available for 47 of these families, 26 of whom attended 12-month follow-up. Child BMI was converted to age- and sex-specific standard deviation scores (SDS) using the 1990 UK growth references. Results: There was a strong correlation between adult BMI change and child BMI SDS change from pre- to post-intervention (r = 0.53, p < 0.001) and from pre-intervention to 12-month follow up (r = 0.72, p < 0.001). Over both time periods, children with adults who reduced BMI were more likely to reduce BMI SDS (p < 0.01) and showed a greater reduction in BMI SDS (p < 0.01) than children with adults who maintained or increased BMI. Conclusion: The results showed a strong positive association between adult BMI change and child BMI SDS change, particularly during the post-intervention period where therapeutic contact was minimal. The findings suggest active involvement of adult family members in the weight loss process improves child treatment outcomes.

With the epidemic of childhood obesity and apparent decreasing levels of children’s physical activity and fitness, the Government have attempted to put into place policies to stem the tide toward poor health (DH,2004, Foresight Report, 2007). These policies have focused on reducing childhood obesity (PSA 12), and increasing physical activity through physical education and school sport to 4 hours per week (PSA22, subsequently increased to 5 hours in 2007). The Sportslinx programmes of health promotion, and fitness and lifestyle assessment have worked in tandem with schools sports partnerships to deliver 4 hours of physical education and school sport. Unfortunately there is no robust scientific evaluation of the effects of the 4 hour promise on children’s health, lifestyle and fitness. The A-CLASS (Active City of Liverpool, Active Schools and Sportslinx) project was designed to assess the effectiveness of the extra 2 hours of after school sport on the health, fitness, skill and fatness of 160, 9-10 year old Liverpool girls and boys who lived in deprived areas of the city.

Introduction Socially disadvantaged women (SDW) have lower levels of physical activity (PA), health inequalities and poorer health outcomes. These are associated with social determinants of health, e.g. Socioeconomic position and ethnic minority. Developing effective behaviour change programmes for SDW is complex due to disparities such as limited income and/or culturally inappropriate settings. These intricacies are often overlooked in PA policy. Consequently, interventions aimed at SDW often fail to show adequate reach, adoption and/or maintenance of PA. Therefore, we aim to inform policy and practice by developing needs-led PA interventions with SDW using Intervention Mapping (IM). IM begins with a needs assessment and follows an iterative six step process for planning interventions. Method Needs assessment tasks involved regular researcher participation in local PA sessions with SDW. The researcher also conducted 17 semi-structured interviews with SDW and community PA practitioners on the topic of PA. This data was thematically analysed and used within the first step of IM: to create a logic model of the PA health problem. Results Data gathered from interviews shows PA variety and suitable opportunities in Leeds and surrounding areas are lacking for SDW. These insights have demonstrated that the needs of SDW are essential to inform IM, PA policy and practice. Conclusion IM begins with a needs-led approach when tackling the health problem of inactivity for SDW. IM will continue to be used to design a comprehensive tool for practice and inform PA policy for SDW.

Approximately half of all UK women are insufficiently physically active, with the lowest activity rates among ‘Hard-to-Reach’ or unreached women. In this article, Kathryn Brook, Dr Andy Pringle FRSPH, Dr Jackie Hargreaves and Dr Nicky Kime of Leeds Beckett University outline their research into developing methods to assess and meet the needs of ‘Hard-to-Reach’ women in needs-led and person-centred interventions.

Health improvement is an important strand of the Premier League's 'Creating Chances' strategy. Through community programmes, professional football clubs offer health-enhancing interventions for a number of different priority groups at risk from a range of lifestyle-related health conditions. However, while national guidance recommends evaluating health improvement interventions, concerns remain about how to do this most effectively. This study aims to investigate the popularity of football-based health improvement schemes and assess the challenges associated with their evaluation. Adapted from existing methodologies, a semi-structured questionnaire was administered to an 'expert' sample (n = 3) of football-led health evaluators. The sample was selected because of their experience and knowledge of performing evaluations of football-led health improvement programmes. Our 'experts' offered reasons for the popularity of football settings as channels for health improvement (including the reach of the club badge and the popularity of football), the justification for evaluating such schemes (including confirming effectiveness and efficiency) and the challenges of implementing evaluations (capacity, commitment and capability). Finally, a selection of key considerations for the evaluation of the impact of football-led health improvement programmes (obtaining expert guidance, building capacity and planning for evaluations) are discussed. © 2014 © 2014 Taylor & Francis.

It has been suggested that football and communities are inextricably linked. Healthy lifestyles are an important component in maintaining the sustainability of local communities, not least, because a convincing evidence base supports the holistic benefits that can be derived from health-enhancing behaviours, such as regular physical activity. As such, efforts to promote health improvement through sport and physical activity include those interventions delivered in professional sporting settings. Johnman and colleagues (Johnman and Mackie, ‘The Beautiful Game’) have heralded sports clubs as important venues for the delivery of health improvement interventions for a range of groups across local communities. This includes health improvement activities delivered in professional football club community schemes. While exemplary practice shows how health improvement programmes can be implemented and evaluated, our experience and engagement with professional football club community schemes supports the notion that more needs to be undertaken to help clubs develop monitoring and evaluation strategies in order to assess the impact of their health improvement programmes. In our short communication, we share our plans for helping two professional football clubs develop their monitoring and evaluation strategies for their community health promotion programmes. Potential outcomes emerging from this process are twofold. (1) To help club community schemes in-build and sustain monitoring and evaluation practices within their future health improvement provision. (2) To use the impact and process outcomes emerging from programme evaluations, to successfully secure the necessary resources to sustain future health improvement activities for their local communities. Outcomes emerging from this study will be of interest to football clubs and evaluators alike, as they seek to develop evaluation strategies for their health improvement programmes.

Background Older adults (OA) represent a core priority group for physical activity and Public Health policy. As a result, significant interest is placed on how to optimise adherence to interventions promoting these approaches. Extra Time (ET) is an example of a national programme of physical activity interventions delivered in professional football clubs for OA aged 55+ years. This paper aims to examine the outcomes from ET, and unpick the processes by which these outcomes were achieved. Methods This paper represents a secondary analysis of data collected during the evaluation of ET. From the 985 OA reached by ET, n=486 adopted the programme and completed post-intervention surveys (typically 12 weeks). We also draw on interview data with 18 ET participants, and 7 staff who delivered the programme. Data were subject to thematic analysis to generate overarching and sub themes. Results Of the 486 participants, the majority 95%, (n= 462) were White British and 59.7% (n=290) were female. Most adopters (65.4%/n=318) had not participated in previous interventions in the host clubs. Social interaction was the most frequently reported benefit of participation (77.2%, n=375). While the reach of the club badge was important in letting people know about the programme, further work enhanced adoption and satisfaction. These factors included (i) listening to participants, (ii) delivering a flexible age-appropriate programme of diverse physical and social activities, (iii) offering activities which satisfy energy drives and needs for learning and (iv) extensive opportunities for social engagement. Conclusions Findings emerging from this study indicate that physical activity and health interventions delivered through professional football clubs can be effective for engaging OA.

Background: In England we have an ageing population and major health concerns for Older Adults (OA). The financial burden this places on the National Health Service (NHS), alongside government public spending austerity provides a compelling case for preventative medicine. PA offers a valuable method to tackle health concerns in OA. One approach to overcome OA barriers to PA opportunities has been to utilise football clubs as a vehicle to support OA in meeting recommended guidelines for PA. This report will detail an evaluation study that investigates the impact of Golden Goal Activity Club (GGAC), a pilot programme of PA-led health improvement for OA delivered by and at Burton Albion FC. Intervention: Sessions involved the delivery of a weekly moderate-intensity PA sessions led by health coaches employed by the club. Methods: At baseline and at week 12, participants (N=23 males (42.6%) and n=31 females (57.4%) with a mean age of 69.38 (±5.87) (n=40), ranging from 55-85 years engaged the evaluation) completed self-reports for demographics, health screening/complications and EQ5D (quality of life) using the EQVAS. Registers recorded attendance at 12 weekly sessions by the health coaches. Results: The mean attendance was 7.73 (±3.12) sessions for all (n=51). Participants with a number of health complications (two or more) (n=22, 42.3%) attended fewer sessions on average (6.91 ±3.322) compared to those reporting less than two health complications (8.65 ±2.694). EQVAS results highlighted self-rated health was much higher for women (87.32 ±9.573) compared to men (80.16 ±18.557). There was an increase in self-rated health scores by men between post-intervention compared to pre-intervention (81.16 ±17.270), while women reported a marginal decline (86.79 ±8.946). Conclusion: Burton Albion FC can recruit and engage both male and female OA. Whilst the participants appear predominantly healthy, GGAC was able to maintain engagement of those who reported a number of health issues throughout the duration of the intervention. Adopting flexible and varied, participant led PA opportunities worked for participants, notably those with two or more health complications. The key design characteristics of GGAC should be considered by other agencies delivering health improvement work with OA. The partnership with independent Public Health and Academic departments to inform delivery and evaluation of the intervention was both valuable to inform current and future delivery and is recommended. Whilst this pilot offered a unique insight in work of this ilk, further research and evaluation is needed to explore the potential of professional football clubs in engaging inactive OA into health-improvement programmes. Key words: Health, Older Adults, Football Clubs, Community

Older adults are a priority within policy designed to facilitate healthy lifestyles through physical activities. Golden Goal is a pilot programme of physical activity-led health improvement for older adults, 55 years and older. Activities were delivered at Burton Albion Football Club. Sessions involved weekly moderate to vigorous intensity exercise sessions including exer-gaming (exercise-orientated video-games), indoor bowls, cricket, new age curling, walking football, and traditional board games and skittles. Secondary analysis of data collected through the original programme evaluation of Golden Goal investigated the impact of the intervention on participants. Older adults completed self-reports for demographics, health screening/complications and quality of life. Attendees, n = 23 males (42.6%) and n = 31 females (57.4%) with a mean age of 69.38 (±5.87) (n = 40), ranging from 55-85 years took part. The mean attendance was 7.73 (±3.12) sessions for all participants, (n = 51). Older adults with two or more health complications (n = 22, 42.3%) attended fewer sessions on average (6.91 ± 3.322) compared to those reporting less than two health complications (8.65 ± 2.694). Self-rated health was higher for women (87.32 ± 9.573) vs. men (80.16 ± 18.557), although this was not statistically significant (U = 223.500, p = 0.350). Results support the potential of football-led health interventions for recruiting older adults, including those reporting health problems. © 2014 © 2014 Taylor & Francis.

Health improvement is an important strand of the Premier League’s ‘Creating Chances’ strategy. Through community programmes, professional football clubs offer health enhancing interventions for a number of different priority groups at risk from a range of lifestyle-related health conditions. However, while national guidance recommends evaluating health improvement interventions, concerns remain about how to do this most effectively. This study aims to investigate the popularity of football-based health improvement schemes and assess the challenges associated with their evaluation. Adapted from existing methodologies, a semi-structured questionnaire was administered to an ‘expert’ sample (n=3) of football-led health evaluators. The sample was selected because of their experience and knowledge of performing evaluations of football-led health improvement programmes. Our ‘experts’ offered reasons for the popularity of football settings as channels for health improvement (including the reach of the club badge and the popularity of football); the justification for evaluating such schemes (including confirming effectiveness and efficiency) and the challenges of implementing evaluations (capacity, commitment and capability). Finally, a selection of key considerations for the evaluating the impact of football-led health improvement programmes (obtaining expert guidance, building capacity and planning for evaluations) are discussed.

Older-adults are a priority within policy designed to facilitate healthy lifestyles through physical activity. Golden Goal is a pilot programme of physical activity-led health improvement for older-adults 55 years and older. Activities were delivered at Burton Albion Football Club. Sessions involved weekly moderate-intensity exercise sessions including exer-gaming (exercise orientated video-games), indoor bowls, cricket, new age curling, walking football, and traditional board games and skittles. Secondary analysis of data collected through the original programme evaluation of Golden Goal investigated the impact of the intervention on participants. Older-adults completed self-reports for demographics, health-screening/complications and quality of life. Attendees, n=23 males (42.6%) and n=31 females (57.4%) with a mean age of 69.38 (±5.87) (n=40), ranging from 55-85 years took part. The mean attendance was 7.73 (±3.12) sessions for all participants, (n=51). Older-adults with two or more health complications (n=22, 42.3%) attended fewer sessions on average (6.91 ±3.322) compared to those reporting less than two health complications (8.65 ±2.694). Self-rated health was higher for women (87.32 ±9.573) versus men (80.16 ±18.557), although this was not statistically significant (U= 223.500, p=0.350). Results support the potential of football-led health interventions for recruiting older-adults, including those reporting health problems.

It has been suggested that football and communities are inextricably linked. Healthy lifestyles are an important component in maintaining the sustainability of local communities, not least, because a convincing evidence base supports the holistic benefits that can be derived from health-enhancing behaviours, such as regular physical activity. As such, efforts to promote health improvement through sport and physical activity include those interventions delivered in professional sporting settings. Johnman and colleagues (Johnman and Mackie, ‘The Beautiful Game’) have heralded sports clubs as important venues for the delivery of health improvement interventions for a range of groups across local communities. This includes health improvement activities delivered in professional football club community schemes. While exemplary practice shows how health improvement programmes can be implemented and evaluated, our experience and engagement with professional football club community schemes supports the notion that more needs to be undertaken to help clubs develop monitoring and evaluation strategies in order to assess the impact of their health improvement programmes. In our short communication, we share our plans for helping two professional football clubs develop their monitoring and evaluation strategies for their community health promotion programmes. Potential outcomes emerging from this process are twofold. (1) To help club community schemes in-build and sustain monitoring and evaluation practices within their future health improvement provision. (2) To use the impact and process outcomes emerging from programme evaluations, to successfully secure the necessary resources to sustain future health improvement activities for their local communities. Outcomes emerging from this study will be of interest to football clubs and evaluators alike, as they seek to develop evaluation strategies for their health improvement programmes.

Introduction: Physical activity is known to enhance mental health, physical health and recovery in people with mental health problems. However engagement and maintenance in physical activity is low. Football, provided by professional football teams has been found to be beneficial for people – especially men, with mental health problems. However, what happens during the football experience which engages individuals requires further exploration. The aim of this study was to explore the experiences of football provided by a professional club for people with mental health problems. A secondary aim was to explore, how people initially engage in football and how they maintain their engagement in football. Method: Individual interviews were conducted with twelve men who played football. This football was provided by a professional football team. A hermeneutic phenomenological approach was undertaken for the the- matic analysis. Results: The analysis followed a journey from the initial engagement in football to exploring what happens to maintain engagement in football. Support and football being meaningful was essential for the initial engagement. Maintenance in football was facilitated by experi- ences of flow and enjoyment, through providing an optimum physical and social environment. The professional football club brought feelings of belonging and responsibility, as well as providing knowledge and skills. Conclusion: Provision of football by a professional team was central to engaging men in the football sessions. Furthermore, to maintain engage- ment in football, the experiences should be enjoyable and enable experi- ences of flow. Outcomes could inform future football led mental health improvement programmes.

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.