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Settings-based approaches have become an increasing health promotion focus since the World Health Organization's 1986 Ottawa Charter. While schools, cities, and prisons have implemented this approach, its development within sports environments is recent. Sports are a popular leisure-time activity, requiring validated tools to measure health promotion activity. This study's aim was to develop a measurement tool based on international consensus that measures perceptions of health promotion within sports clubs. It is grounded in the settings-based approach and builds on theory from previous works expanding their context and knowledge. An online, three-round international Delphi study was conducted, inviting experts in sports and health fields to participate in designing the tool. Round 1 created a collaborative list of items; Round 2 validated items based on relevance, importance, and feasibility; and the final round classified items into one determinant category--social, cultural, environmental, or economic. Panelists (69 experts) from 13 countries participated, creating a final list of 62 items at 3 organizational levels; the sports club level included 23 items, the officials level retained 20 items, and the coaching level contained 19 items. This study provides several innovations: (1) applying the settings-based approach to health promotion within sports clubs, (2) defining each club level (sports club, official, coaching) and determinants (social, cultural, environmental, economic) within 3-levels, (3) creating a tool that measures perceptions of health-promotion activities per level and determinant, and (4) obtaining expert consensus on included items. These advancements allow further research on promoting health within sports clubs.

Many researchers and authorities have recognized the important role that sports clubs can play in public health. In spite of attempts to create a theoretical framework in the early 2000s, a thorough understanding of sports clubs as a setting for health promotion (HP) is lacking. Despite calls for more effective, sustainable, and theoretically grounded interventions, previous literature reviews have identified no controlled studies assessing HP interventions in sports clubs. This systematic mapping review details how the settings-based approach is applied through HP interventions in sports clubs and highlights facilitators and barriers for sports clubs to become health-promoting settings. In addition, the mapped facilitators and barriers have been used to reformulate previous guidelines of HP in sports clubs. Seven databases were searched for empirical research published between 1986 and 2017. Fifty-eight studies were included, principally coming from Australia and Europe, describing 33 unique interventions, which targeted mostly male participants in team sports. The settings-based approach was not yet applied in sports clubs, as more than half of the interventions implemented in sports club targeted only one level of the socio-ecological model, as well as focused only on study participants rather than the club overall. Based on empirical data, the analysis of facilitators and barriers helped develop revised guidelines for sports clubs to implement settings-based HP. This will be particularly useful when implementing HP initiatives to aid in the development of sports clubs working with a whole setting approach.

Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the opinions of a group (panel) of Finnish experts. A list of learning outcomes was compiled via an extensive literature review of documents from all levels of health education (physical activity and nutrition) policy development and implementation. A general inductive analysis method was conducted, resulting in education themes which were then compiled into health literacy-constructed learning outcomes to present to the panel in the two Delphi rounds. Findings: The study question is answered in the form of a ranked list of the 24 most important learning outcomes of physical activity and nutrition education in Finnish schools. The analysis of variance pair-wise comparisons with Bonferroni indicated that six items were statistically possibly more important than the 18 others. The three most important items being: first, understand the importance of a varied and balanced diet; second, the ability to analyse their own lifestyle; third, understand the link between physical activity and health. The study also identified topics/themes which could be either under-represented or over-represented in the current literature and teaching. Originality/Value: This study is the only one of its type, and researches an as yet unknown area of health education. The value of this study lies in its role in the further development of school health education, in terms of identifying the "most important" contemporary issues to teach in the classroom, and may also be used as a topic prioritisation and curriculum planning tool.

Background: Given the benefits of participating in sport, sports clubs have been recognised as health promoting organizations. To examine health-promotion activities in Finnish sports clubs, Kokko et al. developed a set of standards for health-promoting sports clubs (HPSC). Objective: The present study extends this line of research, by (1) measuring coaches' perceptions of health promotion activities in French sports clubs and comparing them to earlier Finnish results, (2) measuring coaches' perceptions of the health-promotion aims of sports clubs and (3) examining the links between HPSC and coaches' self-determined motivation. Methods: Coaches (N = 125) completed a modified version of the HPSC questionnaire and a scale assessing their motivation to coach. Results: Coaches perceived French and Finnish sports clubs as fairly health promoting, but with wide variability between clubs. In both countries, sports clubs scores showed the same patterns: high scores for "ideology" and "environment" activities, and low scores for "policies," "practices" and "partnership". Coaches' perceptions of clubs' aims also followed the same pattern, but with higher scores for each dimension, meaning that coaches considered health promotion as a relevant aim for sports clubs. Finally, controlling for demographic variables, the HPSC index and sub-indices were related to coaches' self-determined motivation. Conclusion: This study strengthens the previous findings for health promotion in the setting of sports clubs and the positive role of these activities on coaches' motivation to coach.

Purpose: This paper aims to clarify the extent to which youth sports clubs guide their coaches to recognise health promotion as a part of the coaching practice. The guidance activity of clubs is seen parallel to internal organisational communication. Design/methodology/approach: A survey of 93 (from 120, 78 per cent) youth sports clubs in Finland was carried out, and a total of 273 sports club officials acted as respondents. The clubs' guidance activity was examined under three domains: sports performance time, non performance sports club time, and health topics. Findings: In general, youth sports clubs were passive on guiding their coaches on health promotion. Guidance activity was evident concerning actual sports performance time, whereas non-performance sports club time received much less attention. Health topics were guided to a varying degree in that the clubs had been active in guiding the coaches on topics such as the risks of being physically active when ill, injury prevention, and sleep/rest, whereas topics such as nutrition and the use of various substances were much less acknowledged. Research limitations/implications: The study limitations relate to self-reported data, and the complexity of assessing sports clubs. As one of the first studies in the area, all the measurement instruments and methods were created from the outset. Therefore, further studies are required for validation purposes. Despite the limitations, this study provides pioneering baseline information. Practical implications: The results indicate that youth sports clubs are still discipline and competition oriented. Health promotion guidance especially regarding non-performance sports club time and several health topics needs to be addressed by the clubs in order to meet the clubs' own health-related intentions. Originality/value: These findings are unique in this relatively new setting for health promotion, and they can act as a baseline for research methodology development and further studies. (Contains 4 notes and 5 tables.)