Care - physical activity initiatives. Research on participation, action elements, impact and funding models

This research focuses on the evaluation of national health policy that aims to stimulate Health in all Policies (HiAP) at local level and integrated care–physical activity (PA) initiatives at neighbourhood level. It aims to unravel the action elements contributing to outcomes of HiAP and care–PA initiatives that aim to increase PA participation among socially vulnerable adults. The research is innovative because it studies processes and outcomes at multiple levels (i.e. municipal, care–PA initiative and citizen level) not in isolation, but in connection with one another. Moreover, the research design builds on the existing local context; this generates not only insight into what is effective and why, but also actionable knowledge to improve policy and practice immediately. The research will be conducted in two municipalities (Veenendaal and Arnhem), supporting five deprived neighbourhoods (Veenendaal Central, North-West and South-West, and Arnhems Broek and Malburgen East-South) in implementing care–PA initiatives targeting socially vulnerable adults. Meetings with local stakeholders and citizens in Veenendaal and Arnhem revealed that, despite a strong motivation to make HiAP and care–PA initiatives work, several factors hinder participation in, and implementation of, HiAP and care–PA initiatives for socially vulnerable groups. These factors are supported by international literature, indicating the breadth of the problem. With this research, we aim to gain improved insight into how local care–PA initiatives and HiAP can be best implemented, facilitated and evaluated. The four research questions are: 1. What is the impact of socially vulnerable groups’ participation in care–PA initiatives in terms of health, quality of life and societal participation? 2. What are the action elements contributing to expected output and short- and long-term outcomes of HiAP and care–PA initiatives? 3. What are the (perceived) societal benefits and costs of HiAP and care–PA initiatives? 4. What funding model is most adequate for strategies that provide integrated care, prevention and PA at neighbourhood level? The research questions will be answered using participatory, responsive and action-oriented research techniques with the aim of capturing the different perspectives of all stakeholders and engaging socially vulnerable citizens. Health will be positively addressed by focusing on assets and resources. The research activities include literature study, in-depth interviews, focus group discussions, concept and capacity mapping, a societal business case, a societal cost-benefit analysis and a natural experiment with an alternative funding model. Although the proposed research is ambitious, the project group is confident of bringing the project to success. Factors that contribute to feasibility are 1) a multidisciplinary project group including relevant stakeholders from science, policy and practice; 2) a strong motivation among stakeholders to be involved in this research, as shown by the large number of support letters declaring (in kind) support; 3) the usage of existing collaborations, activities and data; 4) a large capacity through the assistance of master and applied university students and finally 5) previous research experience with similar complex community projects. Key outputs are: • Insight into the benefits of participation in HiAP and care–PA initiatives • Strengthened program set up for both Veenendaal and Arnhem in which research activities and capacities are integrated as part of activities • (Improved) methods and tools to facilitate and evaluate HiAP and care–PA initiatives at local level • Overview of action elements of HiAP and care–PA initiatives at local level • Policy recommendations for adequate funding models stimulating intersectoral collaboration at local level • PhD dissertation with scientific papers in (inter-)national journals NEDERLANDSE SAMENVATTING Lokaal-integraal beleid en praktijk is nodig om gezondheidsverschillen in de wijk aan te pakken en burgerparticipatie te bevorderen. Veenendaal en Arnhem hebben een integrale aanpak. Onderdeel hiervan zijn zorg-beweeg initiatieven waarin burgers begeleid worden in het gaan en blijven bewegen in wijken met gezondheidsachterstanden. Op basis van gesprekken met beleidsmakers, professionals en burgers wordt in dit project onderzoek gedaan naar 1) de impact van participatie van burgers in zorg-beweeg initiatieven, 2) werkzame elementen in beleid en praktijk, 3) de maatschappelijke baten en kosten en 4) een alternatief bekostigingsmodel. In het onderzoek worden acties en uitkomsten op het niveau van de gemeente, zorg- en beweeginitiatieven en burgers gefaciliteerd en geëvalueerd samen met alle betrokkenen. Het project is mogelijk door de inzet van ruim 20 organisaties: gemeenten, zorgverzekeraars, beweegcentra, burgers. Zij dragen ook bij aan het verspreiden van de resultaten.