Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Applying Salutogenesis to the Experiences of Students with Disabilities in the Netherlands
Dell'Olio, M. ; Vaandrager, L. ; Koelen, M.A. - \ 2018
Journal of Postsecondary Education and Disability 31 (2018)1. - ISSN 2379-7762 - p. 75 - 89.
Students with disabilities face several barriers during their academic lives. However, as many of them manage to access a variety of resources, their experiences can be examined through the lens of salutogenesis, which is employed to analyze the mechanisms whereby people succeed in preserving their wellbeing while dealing with stress and difficulties. This study seeks to explain how students with disabilities identify and use resources to reach their academic goals, and to understand how their sense of coherence (namely, a global orientation that expresses the extent to which a person feels that the world is comprehensible, manageable, and meaningful) developed over time. This exploratory study has a dual focus: to test the applicability of salutogenesis to students with disabilities and to investigate their life experiences. A life course perspective has been adopted to allow for an in-depth exploration of the life histories of 11 students with disabilities at Wageningen University. After the participants designed a timeline of their life, semi-structured interviews were conducted. The identified general resistance resources included social support and supportive environments, as well as flexibility, persistence, and awareness of their own skills and limits. Specific resistance resources ranged from aids and treatments to institutional services and disease information. Such resources were identified through reflexive processes that led the students to understand first the stressors that they were facing and then the resources that they needed to deal with these stressors. Finally, some recommendations for disability services providers are reported.
Care-physical activity initiatives in the neighbourhood : Study protocol for mixed-methods research on participation, effective elements, impact, and funding methods
Wagemakers, Annemarie ; Mulderij, Lisanne S. ; Verkooijen, Kirsten T. ; Groenewoud, Stef ; Koelen, Maria A. - \ 2018
BMC Public Health 18 (2018)1. - ISSN 1471-2458
Care - Effective elements - Funding models - Health in all policies - Participation - Physical activity - Socioeconomic status

Background: In the Netherlands, people with a low socioeconomic status (SES) live approximately 6 years less and are less engaged in physical activity (PA) than high SES citizens. This contributes to the persistent health inequalities between low and high SES citizens. Care-PA initiatives are deemed effective for stimulating PA and improving health and participation among peoples with a low SES. In those initiatives, multiple sectors (e.g. sports, health insurers, municipalities) collaborate to connect primary care and PA at neighbourhood level. This study focuses on two Dutch municipalities that aim to invest in Health in All Policies (HiAP) and care-PA initiatives to improve the health of people with low SES. The aim is to gain insight into (1) the short-term (3 months) and long-term (1 year) outcomes of participating in care-PA initiatives for low SES citizens in terms of health, quality of life, and societal participation, (2) the effective elements that contribute to these outcomes, (3) the direct and perceived societal costs and benefits of care-PA initiatives, and (4) alternative ways to fund integrated care, prevention, and care-PA initiatives at neighbourhood level. Methods: The study will be built on a mixed-methods design guided by action research to continuously facilitate participatory processes and practical solutions. To assess outcomes, body measurements and questionnaires will be used as part of a pre-test/post-test design. Focus groups and interviews will be conducted to gain an in-depth understanding of outcomes and action elements. Action elements will be explored by using multiple tools: concept mapping, the logic model, and capacity mapping. Direct and perceived societal costs will be measured by administrative data from healthcare insurers (before-after design) and the effectiveness arena. An alternative funding model will be identified based on literature study, expert meetings, and municipal workshops. Discussion: Initiatives addressing multiple factors at different levels in an integral way are a challenge for evaluation. Multi-methods and tools are required, and data need to be interpreted comprehensively in order to contribute to a contextual insight into what works and why in relation to HiAP and care-PA initiatives.

Coping with malaria in camps and campusses in Cameroon: a salutogenic perspective
Makoge, Valerie ; Maat, H. ; Vaandrager, L. ; Koelen, M.A. - \ 2018
Unravelling salutogenic mechanisms in the workplace : The role of learning
Pijpker, Roald ; Vaandrager, Lenneke ; Bakker, Evert Jan ; Koelen, Maria - \ 2018
Gaceta Sanitaria 32 (2018)3. - ISSN 0213-9111 - p. 275 - 282.
Cross-sectional survey - Effect modifier - Health promotion - Learning - Nurses - Sense of coherence - Workplace
Objective: To explore the moderating and mediating role(s) of learning within the relationship between sense of coherence (SOC) and generalized resistance resources. Method: Cross-sectional study (N = 481), using a self-administered questionnaire, of employees working in the healthcare sector in the Netherlands in 2017. Four residential healthcare settings and one healthcare-related Facebook group were involved. Multiple linear regression models were used to test for moderating and mediating effects of learning. Results: Social relations, task significance, and job control significantly explained variance in SOC. Conceptual, social, and instrumental learning, combined, moderated the relationship between SOC and task significance. Instrumental learning moderated the relationship between job control and SOC. Social learning also mediated this relationship. Conceptual learning did not show any moderating or mediating effect. Conclusions: The relationship between SOC and the three GRRs seems to be strengthened or explained. -to a certain extent. -by instrumental and social learning. Healthcare organizations are recommended to promote learning through formal activities as well as through cooperation, feedback, sharing experiences, and job challenges. This requires employee participation and a multilevel interdisciplinary approach.
Health dynamics in camps and on campuses: stressors and coping strategies for wellbeing among labourers and students in Cameroon
Makoge, Valerie ; Maat, Harro ; Vaandrager, Lenneke ; Koelen, Maria - \ 2018
International Journal of Qualitative Studies on Health and Well-being 13 (2018)1. - ISSN 1748-2631
Purpose: For many people living in low-income countries, poverty implies an increased exposure to conditions that threaten health and wellbeing as well as reduced capacity to maintain health. Despite the challenging conditions caused by poverty, people may consider themselves healthy because they have learned to cope with their situation probably as a result of life experiences which expose people to both challenges and potential solutions. In this paper we present results from studying health and wellbeing challenges and mechanisms to cope with challenges among two different groups of people who are living under conditions of poverty: workers of the Cameroon Development Corporation (CDC) and students of the university of Buea and the university of Yaoundé. Methods: We performed a cross-sectional study, interviewing 21 CDC workers and 21 students. Results Our study reveals context-specific stressors emerging from poor work conditions and study pressure as well as non-context-specific stressors perceived by respondents as living conditions, poor healthcare and financial uncertainty. Respondents devised coping mechanisms to overcome exactly those stressors such as searching for additional money sources, preventive action towards hazardous living conditions and alternative medical support. Conclusion: We conclude that supporting and promoting such avenues is essential for enhanced and continuous coping with stressors.
Food stories : Unraveling the mechanisms underlying healthful eating
Swan, Emily ; Bouwman, Laura ; Aarts, Noelle ; Rosen, Leah ; Hiddink, Gerrit Jan ; Koelen, Maria - \ 2018
Appetite 120 (2018). - ISSN 0195-6663 - p. 456 - 463.

The biomedical model of health (BMH) studies the causes and origins of disease. When applied to nutrition research, eating is studied as a behavior that supports physical health. However, the lack of attention the BMH pays to social and historical circumstances in which health behaviors are constructed has been widely addressed in literature. When people are studied without considering contextual influences, the relevance to everyday life is limited. As a result, how individuals actively deal with their context to manage healthful eating is poorly understood. This research applies a complementary model, salutogenic model of health (SMH), and uses life course research methodology to study a group of healthy eaters. The purpose of this research is to unravel how healthful eating develops in everyday life. Healthy eaters (n = 17) were identified and recruited from the NQplus research panel at Wageningen University, the Netherlands. Life course experiences were examined through narrative inquiry. Participants recalled and visually explored life experiences with food and health using timelines. Results indicate that healthful eating results from exposure to individual- and context-bounded factors during childhood and adulthood and involves specific mental and social capacities relevant to coping including amongst others, critical self-awareness; flexibility, craftiness, and fortitude. Through life-course learning moments, participants were able to develop proactive coping strategies which strengthened their sense of agency and helped them in overcoming stressors and challenges. Findings show that nutrition strategies should not only focus on strengthening food-specific factors like cooking skills and nutrition knowledge, but other factors like stress management, empowerment, and participation. Such factors support the development of adaptive skills and behaviors, enable individuals to deal with the demands of everyday life, and are building blocks for health promotion.

Individual, social-environmental, and physical-environmental factors that underlie sense of coherence in Dutch adults
Swan, E. ; Bouwman, L. ; Hiddink, G.J. ; Aarts, N. ; Koelen, M. - \ 2018
Global Health Promotion 25 (2018)1. - ISSN 1757-9759 - p. 33 - 42.
Antonovsky’s salutogenesis is a theoretical perspective on health development that explores physical, mental, and social factors that contribute to a ‘healthy life orientation’ and also a theoretical approach to behavior change. Previous studies applying salutogenesis show that a high sense of coherence (SOC), a composite measure from salutogenesis indicating one’s capacity to cope with stress, is associated with a healthy life orientation and lifestyle behaviors, including healthy eating patterns. However, limited evidence exists on the factors that underlie SOC, which could be used to strengthen this capacity as a means to enable healthier eating. Dutch adults (N = 781) participated in a cross-sectional study examining the relationship between SOC and a set of individual, social-environmental, and physical-environmental factors. The main findings indicate that high SOC was associated with a diverse set of factors including lower doctor-oriented health locus of control; higher satisfaction with weight; higher perceived levels of neighborhood collective efficacy; higher situational self-efficacy for healthy eating; lower social discouragement for healthy eating; and higher neighborhood affordability, accessibility and availability of healthy foods. These findings can inform the design of nutrition interventions that target these factors that strengthen SOC and provide the building blocks for a healthier life orientation.
The role of community sports coaches in creating optimal social conditions for life skill development and transferability - a salutogenic perspective
Super, S. ; Verkooijen, K.T. ; Koelen, M.A. - \ 2018
Sport, Education and Society 23 (2018)2. - ISSN 1470-1243 - p. 173 - 185.
Sport is widely recognised as having the potential to enhance the personal development of socially vulnerable youth, yet there is very limited knowledge on how community sports coaches can create optimal social conditions for life skill development and transferability. We adopt a salutogenic approach in order to study whether and how community sports coaches create these optimal social conditions. Based on the salutogenic framework, a thematic analysis was conducted of 15 in-depth interviews with community sports coaches providing sports lessons to socially vulnerable youth. As part of the interviews, the sports coaches were presented with several training scenarios and asked how they would respond in specific training situations. The results showed that the sports coaches aimed to create meaningful sporting experiences for youths. These meaningful sporting experiences were considered a precondition for keeping youths engaged in the sporting activities, as well as a precondition for life skill development. The sports coaches specifically focused on creating little moments of success and on making sure that the youths felt they belonged to a group. In order to ensure that the youths could experience moments of success, specific coaching strategies were implemented to increase the youths’ comprehensibility and manageability in specific sport situations. According to the sports coaches, experiencing little moments of success could contribute to an increase in socially vulnerable youths’ understanding of the everyday challenges that they face, as well as contribute to their ability to deal with these challenges. Creating meaningful sporting experiences may help youths ‘to learn to cope' – a skill that could be beneficial over their lifespan and in different societal domains.
Poverty-related diseases: factors that predict coping in two Cameroonian settings
Makoge, Valerie ; Hogeling, Lette ; Maat, Harro ; Vaandrager, Lenneke ; Koelen, Maria - \ 2017
Health Promotion International 2017 (2017). - ISSN 0957-4824 - 12 p.
In this paper, we explore the connection between poverty and health (poverty-related diseases: PRDs) by investigating the factors that play a role in how two groups of people in Cameroon cope with health challenges: workers in a large agro-industrial organization (living in ‘camps’) and students in two major universities (living on ‘campuses’). We investigated factors reported in the literature as being associated with coping, summarized under the ‘salutogenic umbrella’, as well as demographic, social and environmental factors. A total of 509 respondents from camps and campuses participated in this study. We used a combination of standardized and un-standardized survey instruments to measure coping. We used χ2 and ANOVA tests to investigate bivariate differences and multiple logistic regression analysis to determine which significant survey factors predicted coping. Our results showed expected and unexpected differences between the settings. Individual dispositional factors such as sense of coherence (SOC), self-efficacy (SE), subjective wellbeing and self-rated health differed significantly between the settings. Expected coping resources such as income and SE did not differ between non-copers and copers. Two factors emerged as predictors of coping: living environment (setting) and SOC. Our results highlight the need for a multidimensional perspective on poverty and also the need to apply the salutogenic approach in PRD research. In particular, the emphasis this approach puts on stressors and the capacity to employ a variety of resources to overcome stressors is a fruitful way to better understand PRDs and the importance of location-specific circumstances where poverty, health and diseases are connected.
Care-PA initiatives in the neighbourhood: the first results of X-Fittt 2.0
Mulderij, L.S. ; Wagemakers, A. ; Ravenhorst, Corine van; Verkooijen, K.T. ; Groenewoud, S. ; Koelen, M.A. - \ 2017
Care-PA initiatives in the neighbourhood: the first results of X-Fittt 2.0, a combined lifestyle intervention for low SES overweight people
Mulderij, L.S. ; Wagemakers, A. ; Ravenhorst, C. van; Verkooijen, K.T. ; Groenewoud, S. ; Koelen, M.A. - \ 2017
In: 13th annual meeting and 8th conference of HEPA Europe, final programme and book of abstracts / Jurakić, Danijel, Rakovac, Marija, Zagreb : University of Zagreb - ISBN 9789533170541 - p. 108 - 109.
Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies
Makoge, Valerie ; Vaandrager, Lenneke ; Maat, Harro ; Koelen, Maria - \ 2017
PLoS Neglected Tropical Diseases 11 (2017)11. - ISSN 1935-2727 - 16 p.
Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking) of reported responses. Using logistic regression analysis, we looked for trends in people’s response to malaria. We calculated the odds ratio of factors shown to have an influence on people’s health, such as food, water, sanitation challenges and seeking formal healthcare for malaria. Malaria (40.3%), cholera (20.8%) and diarrhoea (17.7%) were the major PRDs perceived by camp dwellers. We found a strong link between what respondents perceived as PRDS and hygiene conditions. Poverty for our respondents was more about living in poor hygiene conditions than lack of money. Respondents perceived health challenges as stemming from their immediate living environment. Moreover, people employed self-medication and other informal health practices to seek healthcare. Interestingly, even though respondents reported using formal healthcare services as a general response to illness (84%), almost 90% stated that, in the case of malaria, they would use informal healthcare services. Our study recommends that efforts to curb the devastating effects of PRDs should have a strong focus on perceptions (i.e. include diseases that people living in conditions of poverty perceive as PRDs) and on hygiene practices, emphasising how they can be improved. By providing insights into the inter-linkages between poverty and disease, our study offers relevant guidance for potentially successful health promotion interventions.
Study protocol: Why pregnant women eat what they eat : Socio-ecological determinants of antenatal diet and development of a tool for midwives
Beulen, Y.H. ; Wagemakers, M.A.E. ; Geelen, A. ; Koelen, M.A. ; Feskens, E.J.M. - \ 2017
- 1 p.
Back to Basics: applying a salutogenic approach to understand the origins of healthful eating
Bouwman, L.I. ; Swan, E.C. ; Koelen, M.A. - \ 2017
- 1 p.
The value of the participatory network mapping tool to facilitate and evaluate coordinated action in health promotion networks: two Dutch case studies
Wijenberg, Evianne ; Wagemakers, Annemarie ; Herens, Marion ; Hartog, Franciska den; Koelen, Maria - \ 2017
Global Health Promotion (2017). - ISSN 1757-9759 - 9 p.
Introduction: Facilitating processes for coordinated action in the field of health promotion is a challenge. Poorthuis and Bijl’s (2006) Participatory Network Mapping Tool (PNMT) uses visualization and discussion to map the positions and roles of network actors, stimulate learning processes, and elicit actionable knowledge. This article describes the results from the application of the PNMT in networks of two Dutch health promotion programmes (Health Race and BeweegKuur) with the aim of determining the value of the PNMT to partners in health promotions networks.
Methods: A qualitative secondary analysis (QSA) was conducted to clarify positions and roles, learning processes, and actionable knowledge of network actors in existing data sets including five group interviews of the Health Race programme and 16 individual interviews and 15 group interviews of the BeweegKuur programme.
Results: The PNMT maps both positions and roles of (missing) actors and makes successes (e.g. knowing each other) and challenges (e.g. implementing new activities) visible. Thus, the PNMT provides a starting point for discussion and reflection and eliciting actionable knowledge such as involving new actors and target populations in the programme.
Conclusion: The PNMT contributes to the facilitation of coordinated action in health promotion networks by making positions and roles of network partners visible. In combination with dialogue and reflection the PNMT helps to elucidate factors influencing coordinated action and outcomes. The PNMT is valuable in grasping intangible aspects between actors by stimulating collective learning. These insights can be used by researchers and network actors to achieve more successful coordinated action for health promotion.
Exploring the impact of the care sport connector in the Netherlands
Leenaars, Karlijn E.F. ; Smit, Eva ; Wagemakers, Annemarie ; Molleman, Gerard R.M. ; Koelen, Maria A. - \ 2017
BMC Public Health 17 (2017). - ISSN 1471-2458 - 10 p.
Background: Regular physical activity (PA) is deemed to contribute to the primary and secondary prevention of several chronic diseases, like diabetes mellitus, cancer, cardiovascular diseases, and osteoporosis. In 2012, Care Sport Connectors (CSC), to whom a broker has been ascribed, were introduced in the Netherlands to stimulate PA and guide primary care patients towards local sport facilities. The aim of this study was to explore which structural embedding is the most promising for CSCs’ work.
Methods: In three rounds of interviews, 13 CSCs were followed for 2 years in their work. In these interviews, a network survey was used to identify organisations in the CSCs’ network, whether they collaborated with these organisations, and the role of the organisations in the connection. Data from the network survey were analysed using the RE-AIM framework and disaggregated into how CSCs were structurally embedded (Type A: only PA sector; Type B: different sectors; Type C: partnership). A related samples Wilcoxon signed rank test was performed to study how the CSCs’ network developed between 2014 and 2016.
Results: All CSCs established a connection between the primary care and the PA sector in which the average number of organisations with which CSCs collaborated increased significantly between 2014 (8.3) and 2016 (19.8) (p = 0.002). However, differences were identified in the way CSCs were structurally embedded and in the way they established the connection. Type A CSCs established the connection mostly around their own activities, supported PA organisations with their activities, and collaborated with primary care and welfare professionals around their own activities. Type B and Type C CSCs established the connection by organising, supporting, and implementing different kinds of activities targeting different kinds of audiences, and collaborated mostly with primary care professionals around the referral of professionals’ patients.
Conclusions: The results of this study suggest that adopting an integral approach (Type B and C) for the structural embedding of the CSC is more promising for reaching the desired outcomes. Whether CSCs really improve the target groups’ PA level and health needs to be further studied.
S(up)port your future! : A salutogenic perspective on youth development through sport
Super, Sabina - \ 2017
University. Promotor(en): Maria Koelen, co-promotor(en): Kirsten Verkooijen. - Wageningen : Wageningen University - ISBN 9789463436489 - 284
sport - youth - quality of life - disadvantaged youth - health promotion - community health - coaching - child development - jeugd - kwaliteit van het leven - minder bevoorrechte jongeren - gezondheidsbevordering - gezondheid op regionaal niveau - coachen - kinderontwikkeling


Sport is often recognised as an avenue for the positive development of young people. In line with this, policymakers and health professionals in the Netherlands, and elsewhere in the world, encourage socially vulnerable youth to participate in sport. Socially vulnerable youth are characterised as having an accumulated amount of negative experiences with the societal institutions in their lives, leading to distorted relationships with those institutions and, eventually, to feelings of isolation and low self-esteem. As socially vulnerable youth participate less in sport than their non-vulnerable peers, encouraging them to participate may support these youths in leading a healthy and productive life. However, to date, our understanding of the role of sport in positive youth development has been primarily based on research conducted in non-vulnerable populations and very little research has been conducted among socially vulnerable youth. The research that has been conducted for this thesis has been inspired by the salutogenic model of health, allowing us to examine the underlying mechanisms and processes of sports participation in alleviating social vulnerability.


The overall aim of this thesis is to unravel the value of sports participation for socially vulnerable youth. Four research objectives were formulated:

To provide insights into the mechanisms underlying people’s capacity to cope with stressors (sense of coherence) to underpin health promotion activities that aim to strengthen this coping capacity.

To provide insights into the relation between sports participation and youth development for socially vulnerable youth;

To examine if and how community sports coaches can create optimal conditions for the personal development of socially vulnerable youth;

To explore how socially vulnerable youth experience their participation in sport and the value they derive from sports participation in a socially vulnerable childhood.


This study has adopted a mixed-methods research design. More specifically, this study has used literature review (objective 1 and 2), questionnaire research (objective 2), semi-structured interviews (objective 3), and narrative interviews and life-course interviews (objective 4).


The findings provide insights into the mechanisms underlying sense of coherence which reflects people’s capacity to deal with stressors in a health promoting way ( i.e., research objective 1). Sense of coherence consists of three components: the extent to which people experience the world as consistent and structured (comprehensibility); the extent to which people feel that there are resources available to meet the demands of everyday life (manageability); and the extent to which people feel that dealing with the stressors of everyday life is worthy of investment and engagement (meaningfulness). Based on a literature review of the salutogenic model of health, two opportunities for strengthening this sense of coherence in health promotion activities were identified: the behavioural mechanism and the perceptual mechanism. Both empowerment and reflection processes are important for the development of sense of coherence and can strengthen the healthy development of individuals.

The findings provide insights into the relation between sports participation and youth development for socially vulnerable youth (i.e., research objective 2). In the systematic review, it was demonstrated that relatively few studies have been conducted regarding the life skill development of socially vulnerable youth in sports programs and that the evidence that is available is inconclusive regarding the benefits of sports. In the quantitative study, a positive relation was found between sports participation and several youth developmental outcomes (i.e., pro-social behaviour, subjective health, well-being, school performance and sense of coherence) but not with problem behaviour and the self-regulation skills. However, no conclusions can be drawn about a causal relationship between sports participation and youth development based on these data.

The findings also demonstrated the crucial role of the sports coach in reaching optimal social conditions for life skill development and transferability (i.e., research objective 3). The community sports coaches mainly adopted an implicit approach to life skill transferability, meaning that they did not employ explicit strategies to stimulate the transfer of life skills from the sports setting to other societal domains. Nonetheless, the sports coaches believed that socially vulnerable youth could develop life skills in the sports setting that could also be used in school, the family or in the community. Coaching actions were directed at creating meaningful, comprehensible, and manageable sports experiences for socially vulnerable youth.

Finally, the findings shed a light on how socially vulnerable youth experience their participation in sport and the role that sports participation could play in a socially vulnerable childhood (i.e., research objective 4). The youths’ positive and negative sports experiences rested on an intricate balance of the extent to which they experienced visibility of their skills, the extent to which they felt confident while playing their sport, and the extent to which they felt sport was a nice challenge that they liked to take on. The roles that sports participation could play in a socially vulnerable childhood are diverse: sport as a safe place, sport as a learning experience, sport as an instrument to reach goals, and sport as a purpose in life. As the challenges that socially vulnerable youth face in the sports setting can resemble some of the struggles they find in everyday life, their negative sports experiences could also potentially increase feelings of vulnerability.


Sports participation can support socially vulnerable youth in their personal development, but we also have to remain critical towards to use of sport as a means to reach positive youth development. The results from this thesis provide a deeper understanding of the conditions under which sport can contribute to positive youth development and offers recommendations for professionals in the field.

The Care Sport Connector in the Netherlands
Leenaars, Karlijn - \ 2017
University. Promotor(en): Maria Koelen, co-promotor(en): Annemarie Wagemakers; G.R.M. Molleman. - Wageningen : Wageningen University - ISBN 9789463436106 - 261
sport - sport policy - health care workers - physical activity - public health services - health promotion - primary health care - netherlands - case studies - physical education - sportbeleid - gezondheidswerkers - lichamelijke activiteit - voorzieningen ten behoeve van de volksgezondheid - gezondheidsbevordering - eerstelijnsgezondheidszorg - nederland - gevalsanalyse - lichamelijke opvoeding

To stimulate physical activity (PA) and guide primary care patients towards local PA facilities, Care Sport Connectors (CSC) (in Dutch Buurtsportcoach), to whom a broker role has been ascribed, were introduced in 2012. This function is new, and to our knowledge no study has yet explored a broker role and its impact on improving intersectoral collaboration between both sectors. The aim of this thesis was to explore CSCs’ role and impact in connecting the primary care and the PA sector.
This thesis employed a multiple case study design in which 15 CSCs from nine municipalities spread over the Netherlands were followed in their work from 2014 to the end of 2016. Different data collection methods were used (literature review, interviews, focus groups, document analysis, and questionnaires), and perspectives of different stakeholders (policymakers, professionals, CSCs) on different levels (policy and community) were taken into account (Chapter 2).

The connection between the primary care and the PA sector: a chain approach
The connection between both sectors can be characterised as a chain in which CSCs guide the target group towards PA facilities after referral by primary care professionals or their own recruitment. In this connection CSCs fulfilled three roles - broker, referral, and organiser – which did not change over time (Chapter 4 and 5).

Barriers at system and sector level hinder the established connection

Barriers related to the primary care (lack of time, money and knowledge) and the PA sector (lack of suitable PA activities and adequate instructors) are currently hindering the connection between both sectors (Chapter 4 and 6). Barriers related to the collaboration between both sectors, like cultural differences and different interests as identified in our literature review (Chapter 3) were not identified.

The importance of an integral approach for CSCs and the connection between both sectors
An integral approach to structural embed CSCs (Chapter 7) seemed to influence CSCs’ work and subsequently their impact. CSCs working in municipalities who structurally embedded CSCs only at the PA sector, connected both sectors mostly by jointly organising activities. CSCs working in municipalities who adopted an integral approach connected both sectors by a variety of activities targeting different audiences, and primary care professionals fulfilled mostly a role in the referral of their patients. The structural imbedding of the CSC according an integral approach seems the most promising in reaching the desired outcomes (Chapter 8).

CSC’ role is promising for establishing a connection between the primary care and the PA sector. However, to make a success of the connection changes are needed at system and sector level. Further research should focus on CSCs’ impact on stimulating PA among primary care patients, and the development of CSC’ role and the connection between both sectors over time.

How young adults reflect on the role of sport in their socially vulnerable childhood
Super, Sabina ; Wentink, Carlijn Q. ; Verkooijen, Kirsten T. ; Koelen, Maria A. - \ 2017
Qualitative Research in Sport, Exercise and Health (2017). - ISSN 2159-676X - 15 p.
Interpretative Phenomenological Analysis - life course - Positive youth development - socially vulnerable youth - sport
Participation in sport has often been related to positive developmental outcomes for socially vulnerable youth. However, we know very little about the role of sports participation in a socially vulnerable childhood. Taking a life-course perspective, we conducted interviews with 10 young adults to reflect on their socially vulnerable childhood and the role of sport in their lives. Using interpretative phenomenological analysis, we discovered that four different roles of sports participation in a socially vulnerable childhood could be discerned. First of all, sports participation offered youths a safe place that allowed them to escape the struggles they faced in everyday life and that provided them with support, appreciation and feedback that they did not find in other life domains. Secondly, sports participation offered learning experiences that contributed to valuable insights about themselves or the world around them. Thirdly, sport could be an instrument to reach goals and as such sport became a resource in itself. Fourthly, sports participation could fulfil a purpose in life for socially vulnerable youth and become an important part of their identity. The participants’ accounts showed how sports participation filled a specific gap in their lives and they mostly shared positive experiences. However, the participants’ accounts also indicated the potentiality of sport to instigate a negative spiral of vulnerability, and therefore we have to remain critical towards the value of sports as a tool for positive youth development.
A Systematic Review of Life Skill Development Through Sports Programs Serving Socially Vulnerable Youth
Hermens, Niels ; Super, Sabina ; Verkooijen, Kirsten T. ; Koelen, Maria A. - \ 2017
Research Quarterly for Exercise and Sport 88 (2017)4. - ISSN 0270-1367 - p. 408 - 424.
Despite the strong belief in sports programs as a setting in which socially vulnerable youth can develop life skills, no overview exists of life skill development in sports programs serving this youth group. Therefore, the present systematic review provides an overview of the evidence on life skill development in sports programs serving socially vulnerable youth and, insofar as it was investigated in the included studies, of the conditions conducive to life skill development in these sports programs. Method: Potentially relevant studies published during 1990 to 2014 were identified by a search in 7 electronic databases. The search combined terms relating to (a) sport, (b) youth AND socially vulnerable, and (c) life skills. Eighteen of the 2,076 unique studies met the inclusion criteria. Results: Each included study reported that at least 1 life skill improved in youth who participated in the studied sports program. Improvements in cognitive and social life skills were more frequently reported than were improvements in emotional life skills. Only a few of the included studies investigated the conditions in the studied sports programs that made these programs conducive to life skill development. Conclusions: Sports programs have the potential to make a difference in the life skill development of socially vulnerable youth. This conclusion needs to be treated with some caution, because the studies experienced many challenges in reducing the risk for bias. Several alternative research strategies are suggested for future studies in this field.
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