'This is the beginning of the new me': process evaluation of a group fitness intervention to promote wellbeing in formerly homeless individuals

A Proposal to Optimize Satisfaction and Adherence in Group Fitness Programs For Patients With Major Depressive Disorder

It is clear that exercise can be a source of great support for patients with major depressive disorder. However, it is important to recognize that several multifactorial and intersecting challenges are associated with exercise for this patient population. Group fitness programs for this patient population have the potential to be cost-effective while serving as an avenue of social interaction for participants. From an administrative perspective, it is challenging to balance satisfaction and adherence in group fitness programs targeting patients with major depressive disorder. This article presents a proposal that highlights what the challenges may look like in practice and discusses 3 strategies for improving satisfaction and adherence with a group fitness program: diagnosis and needs assessment, exercise diversity, and ongoing evaluation.

A Kirkpatrick Model Process Evaluation of Reactions and Learning from My Strengths Training for Life™

Underpinned by the New World Kirkpatrick model, and in the context of a community-based sport psychology programme (My Strengths Training for Life™) for young people experiencing homelessness, this process evaluation investigated (1) young peoples' reactions (i.e., program and facilitator evaluation, enjoyment, attendance, and engagement) and learning (i.e., mental skills and transfer intention), (2) the relationship between reaction and learning variables, and (3) the mediators underpinning this relationship. A total of 301 young people living in a West Midlands housing service completed questionnaires on demographics and reaction and learning variables. Higher levels of programme engagement were positively associated with more favourable reactions to the programme. Enjoyment positively predicted learning outcomes, which was mediated by transfer intention. Recommendations are made for (1) a balance between rigor and flexibility for evaluation methods with disadvantaged youth, (2) including engagement as well as attendance as indicators of meaningful programme participation, (3) measuring programme experiences (e.g., enjoyment) to understand programme effectiveness, and (4) providing opportunities for skill transfer during and after programme participation. Our findings have implications for researchers, programme commissioners, and policymakers designing and evaluating programmes in community-based settings.

Quotidiano de equipes de consultório na rua: tecendo redes para a promoção da saúde

Resumo Objetivo compreender as potências e limites para a promoção da saúde de pessoas em situação de rua no quotidiano da equipe de Consultório na Rua. Método estudo de casos múltiplos holístico-qualitativo, fundamentado na Sociologia Compreensiva do Quotidiano, realizado com dois informantes-chave e 20 profissionais de equipe de Consultório na Rua de duas capitais do Sul do Brasil. Utilizou-se a Análise de Conteúdo Temática. Resultados as potências para a promoção da saúde de pessoas em situação de rua advêm da articulação da rede intrasetorial e intersetorial pela equipe de Consultório na Rua, além do vínculo e da redução de danos. Os limites enfrentados para desenvolver ações de promoção da saúde se deparam na especificidade e características desse público na terceirização da assistência social, na gestão, na política. Conclusões e implicações para a prática a promoção da saúde ainda é um desafio para a equipe a ser superado perante as demandas de agravos, o tratamento do adoecimento e a lógica biomédica. As estratégias intrasetoriais e intersetoriais podem ser estabelecidas para alcançar ações em rede e efetivamente promover saúde, contemplando direitos fundamentais à vida de pessoas em situação de rua, mesmo em um quotidiano com condições desfavoráveis de viver e conviver.

A systematic review of the use and reporting of evaluation frameworks within evaluations of physical activity interventions

BACKGROUND

Evaluation of physical activity interventions is vital to inform, and justify, evidence-based policy and practice to support population-wide changes in physical activity. Several evaluation frameworks and guidance documents have been developed to facilitate the evaluation and reporting of evaluation studies in public health. However, there is a lack of evidence about whether frameworks are being used to guide evaluation. There continues to be claims of poor and inconsistent reporting in evaluation studies. The aim of this review was to assess the use of evaluation frameworks and the quality of reporting of how they were applied within evaluation studies of physical activity interventions.

OBJECTIVES

1. To identify whether evaluation frameworks are reported to have been used within evaluation studies of physical activity interventions, and which frameworks have been used. 2. To appraise the quality of reporting with regards to how evaluation frameworks have been used.

METHOD

We developed a checklist of indicators to enable a critical appraisal of the use and reporting of different evaluation frameworks in evaluation studies. We conducted a systematic search and review of evaluation studies published between 2015 and the date of the search to appraise the use and reporting of evaluation frameworks. A narrative synthesis is provided.

RESULTS

The review identified 292 evaluation studies of physical activity interventions, only 69 (23%) of these mentioned using an evaluation framework, and only 16 different frameworks were referred to. There was variation in the quality of reporting of framework use. 51 (74%) studies were identified as being explicitly based on the stated framework, however only 26 (38%) provided detailed descriptions consistently across all the checklist indicators. Details of adaptations and limitations in how frameworks were applied were less frequently reported. The review also highlighted variability in the reporting of intervention components. More consistent and precise reporting of framework and intervention components is needed.

CONCLUSION

Evaluation frameworks can facilitate a more systematic evaluation report and we argue their limited use suggests missed opportunities to apply frameworks to guide evaluation and reporting in evaluation studies. Variability in the quality of reporting of framework use limits the comparability and transferability of evidence. Where a framework has been used, the checklist of indicators can be employed to facilitate the reporting of an evaluation study and to review the quality of an evaluation report.

"Life Starts for Me Again." The Social Impact of Psychology on Programs for Homeless People: Solidarity Networks for the Effectiveness of Interventions

The role of psychology in the improvement of people’s lives is consistent, according to the scientific literature review. More and more studies within psychology, and other social sciences, are pointing out the importance of the quality of social interactions on physical and mental health and upon perceived wellbeing. When talking about homelessness, psychology has served these individuals mostly by informing intervention programs related to preventing and responding to substance abuse, healthcare, sexual risks, or mental illnesses, and these are key problems that psychology has also studied and found to be connected to homelessness. Such strategies, which were traditionally mostly centered on tackling the weaknesses that homeless people face, are now increasingly considering the role of the social support services. The aim of this study was, on the one hand, to identify evidence on the importance of solidarity as a key factor in the process of overcoming homelessness, and associated substance abuse situations, and the barriers and conditions to achieve it. On another hand, the aim was also to approach the impact of that solidarity on their general wellbeing from the perspective of homeless subjects themselves. To achieve this aim, 20 life stories of people aged 35 to 70 years old were conducted in the metropolitan area of Barcelona. The people interviewed had been homeless in a recent period of their lives and were currently dependent on different services. The communicative methodology allowed deepening into the life stories of these individuals via egalitarian dialogue between the researchers and the participants. The results of the qualitative analysis showed that a strong solidarity network was crucial in the process of overcoming the participants’ homelessness situation and to tackle related circumstances (alcoholism and drug abuse among others), and this has had an impact in their general wellbeing and in the development of more solidarity attitudes. These findings are discussed in light of psychological knowledge and other social sciences literature on the importance of quality social environments to support positive developmental trajectories and considering the potential social impact of the intervention programs that take into account the factor of solidarity during their implementation process.

A theory based evaluation of an intervention to promote positive health behaviors and reduce social isolation in people experiencing homelessness

Homelessness adversely affects an individual's ability to access healthcare, opportunities for social interaction and recreational activities such as physical activity. This study aimed to evaluate the impact of a community-based physical activity and peer support intervention on the health and wellbeing of homeless participants. This study employed semi-structured interviews to investigate the perceived impact of the Street Fit Scotland intervention on the health and wellbeing of 10 homeless adults. Interviews were audio recorded and transcribed verbatim. A thematic analysis was conducted. Participants reported that their health and wellbeing had improved since attending the intervention. This was attributed to improvements in self-esteem, social interaction and mental wellbeing. Participants generally felt that their physical activity had increased since attending Street Fit Scotland, and a number of individuals reported that they were making healthier choices with regards to health behaviors. A theory of change logic model was developed that demonstrated how each component of the intervention influences the observed and intended outcomes. Attendance of Street Fit Scotland had positive effects on participant's health and wellbeing, particularly concerning self-esteem, health behaviors, social interaction, and physical activity. More efforts should be made to evaluate small-scale interventions that are reaching vulnerable population groups.

Promoting physical activity in vulnerable adults 'at risk' of homelessness: a randomised controlled trial protocol

INTRODUCTION

People who are homeless, or at risk of homelessness, have substantially poorer health. Sustained and regular participation in physical activity is beneficial for both mental and physical health. Limited data suggest that levels of physical activity in the homeless and those at risk of homelessness are low, and access to community-based exercise is limited or non-existent for this population. Nonetheless, exercise programmes for the homeless could provide a feasible and scalable intervention for providing beneficial effects on physical and mental health in this population. The primary aim of this study is to evaluate the impact of a group exercise intervention on activity levels in people who are homeless or at risk of homelessness in central London, UK. The secondary aim is to evaluate the impact of the intervention on mental and physical health outcomes.

METHOD AND ANALYSIS

A 2-arm, individually randomised controlled trial in people who are homeless and those vulnerable and at risk of homelessness in central London, UK. Participants will be recruited through a London-based homeless charity, Single Homeless Project. Following baseline assessments and allocation to intervention (exercise classes) or control (usual care), participants will be followed up at 3, 6, 9 and 12 months. The primary outcomes will be change in objective physical activity. The secondary outcomes will include change in fitness assessments and mental health parameters. Changes in drug use and alcohol dependency will also be explored.

ETHICS AND DISSEMINATION

Ethical approval to process and analyse data and disseminate findings was obtained through the Anglia Ruskin University Department of Sport and Exercise Sciences Research Ethics Committee. Results of this study will be disseminated through peer-reviewed publications and scientific presentations.