Background
Methods
Study design
Selection and study population
Primary care professionals | Sport professionals | Welfare professional | Others | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Focus group | Structure of the collaboration | GP | Physio-therapist | Others | Sport club | Others | With PA offer | Without PA offer | Municipality representative | CSC | Total |
1. | Partnership | 0 | 0 | 2 | 1 | 0 | 1 | 0 | 2 | 1 | 7 |
2. | Partnership | 1 | 1 | 0 | 2 | 1 | 0 | 1 | 3 | 1 | 10 |
3. | Partnership | 1 | 0 | 0 | 1 | 1 | 1 | 1 | 3 | 2 | 10 |
4. | Partnership | 0 | 1 | 0 | 2 | 1 | 1 | 0 | 1 | 0* | 6 |
5. | Project basis | 1 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0** | 3 |
6. | Project basis | 0 | 2 | 0 | 0 | 2 | 1 | 0 | 0 | 1 | 6 |
7. | Project basis | 0 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 4 |
8. | Project basis | 0 | 3 | 1 | 2 | 1 | 0 | 0 | 0 | 1 | 8 |
9. | Project basis | 0 | 3*** | 1 | 0 | 0 | 0 | 2 | 0 | 2 | 8 |
Total | 3 | 13 | 5 | 8 | 7 | 3 | 5 | 9 | 9 | 62 |
Procedure
Data analysis
Themes | Top-down codes | Bottom-up codes |
---|---|---|
CSC role | • Attitude | • Broker role |
• Added value | • Referral | |
• Facilitator | ||
Collaboration in the connection between the primary care and the PA sector | • Role | • Attitude |
• Partnership | • Expectations | |
• Project basis | ||
Barriers and facilitators relating to sector | • Time and money | • Reimbursement |
• Lack of knowledge of the PA offer | ||
• Awareness of the PA offer | ||
• Own interest | ||
• Suitable PA activities | • Competitive position | |
• Adequate PA instructors | ||
Barriers and facilitators not relating to the sector | • Personal perceptions | • Effectiveness |
• Policy | ||
• Target group |
Sport (n = 10) | Primary health care (n = 20) | Welfare (n = 7) | |
---|---|---|---|
1. Acts like a broker and matcher between the demand determined and the supply realized | 5.5 (SD = 4.2) | 5.1 (SD = 3.1) | 5.7 (SD = 2.8) |
2. Takes care of/arranges the inventory of the needs for sport and exercise activities within the work field (s) | 3.5 (SD = 1.6) | 4.8 (SD = 2.7) | 6.3 (SD = 2.8) |
3. Creates a network with the parties from the care, sports, and welfare sectors relevant to the target group or links up with existing networks and expands these, if necessary | 3.4 (SD = 2.6) | 3.8 (SD = 2.3) | 3.4 (SD = 2.1) |
4. Maps out the range of activities available to the target group and also considers the exercise activities made available by other sectors like welfare, apart from the regular sports and exercise activities provided | 5.5 (SD = 2.3) | 3.5 (SD = 1.6) | 3.7 (SD = 1.3) |
5. Helps sports and exercise providers in developing an appropriate range of activities | 5 (SD = 2.5) | 6.8 (SD = 2.6) | 6.7 (SD = 2.3) |
6. Organizes and coordinates at the execution level a coherent range of activities in the areas of sports and exercise | 6.2 (SD = 2.0) | 6.4 (SD = 2.2) | 4.7 (SD = 3.3) |
7. Acquires/scouts active participants for various activities at the relevant target group’s specific care and welfare organizations | 6 (SD = 3.2) | 5.8 (SD = 2.9) | 7 (SD = 2.2) |
8. Guides participants towards sports and exercise activities, in consultation and, if necessary, in collaboration with a care and welfare organization | 5.5 (SD = 2.9) | 4.4 (SD = 3.1) | 3.1 (SD = 2.9) |
9. Provides information and arranges for the enhancement of the expertise of trainers and managers at sport-providing organizations | 7.9 (SD = 1.7) | 8.6 (SD = 1.7) | 8.9 (SD = 1.1) |
10. Organizes, coordinates, and performs other health promoting activities in the neighbourhood in collaboration with relevant parties from the neighbourhood | 6.5 (SD = 3.2) | 5.9 (SD = 2.6) | 5.4 (SD = 3.2) |
Results
Role of the care sport connector
Broker role
“I believe that, right now, to me it is important that the CSC makes it so that the separate domains… that preferably there are no separate domains anymore between care, sports, and welfare. That these come into contact and start using one another’s strength.” (Physiotherapist, #9)
Referral
“Guiding our patients towards appropriate exercise activities so that they will visit me less frequently and also feel better both physically and mentally.” (GP, #2)
“That she also encourages the target group towards exercise and sports and helps people find their way to PA activities more easily.” (Sport instructor, #6)
Facilitator
“You will then have to properly map out what range is available and apart from regular sports… it would be nice if a professional, if we did not have to do so in our own time, our limited time.” (GP, #5)
Added value of the CSC
“What I believe to be an added value is that she is visible through… that she actually does something… Like, ehm, just as you put it: ‘I am glad, I am glad, for if I call the CSC, some action is taken’.” (Welfare professional, #6)
“Well, you can sometimes hear someone say: ‘it is somewhere in the proximity of the [welfare organization] and not visible enough in other areas of the neighbourhood’.” (Welfare professional, #3)
Connection between the primary care and the PA sector
Focus group | Structure of the collaboration | Role professionals | Attitude connection | Expectations of the connection |
---|---|---|---|---|
1. | Partnership organized by the municipality | ▪ Part of partnership ▪ Activities to promote PA | ▪ Good start ▪ Takes time ▪ Not a clear mission in the steering group ▪ Not many concrete actions | ▪ Other organizations should be involved in the partnerships ▪ Continuity of CSC funding and the steering group ▪ More contact with one another |
2. | Partnership organized by the municipality | ▪ Part of partnership ▪ Referral scheme | ▪ Good start, in which the CSC is indispensable ▪ Clear shared vision about the CSC | ▪ More collaboration between professionals ▪ Referral should be a matter of course ▪ Continuity of CSC funding and the steering group |
3. | Partnership organized by the municipality | ▪ Part of partnership ▪ Sport consultation at community health centre, coordination of the PA offer at community centre | ▪ Partially positive. Much has been achieved but there is room for improvement ▪ The connection takes time ▪ No shared mission because of different interests | ▪ More collaboration with other organizations ▪ More time is needed |
4. | Partnership organized by the municipality | ▪ Part of partnership ▪ Activities to promote PA | ▪ Partnership is an added value because they know one another and development of activities ▪ Clear and shared mission | ▪ More organizations involved in the partnership ▪ Create more publicity for the work of the partnership |
5. | Partnership organized by a sport organization | ▪ Part of partnership ▪ Activities to promote PA | ▪ The partnership is valuable because professionals know one another | ▪ CSC should be responsible for the collaboration and the connection ▪ Professionals are willing to help with the implementation of activities |
6. | Project basis | ▪ Organization of fit tests ▪ Referral | ▪ Promising: good start to a first collaboration between professionals ▪ The referral of patients is getting better but is still difficult | ▪ Regular meetings with all partners ▪ Referral should be a matter of course |
7. | Project basis | ▪ Organization of activities to promote PA and referral | ▪ Added value ▪ Hard to refer and guide patients towards local PA facilities | ▪ Regular meetings with all partners so that professionals can meet one another ▪ Referral should be a matter of course |
8. | Project basis | ▪ Organization of fit tests ▪ Sporadic referral | ▪ The connection is difficult because of unfamiliarity with one another ▪ Too passive | ▪ A clear referral scheme ▪ Regular meetings with all partners so professionals can meet one another |
9. | Project basis | ▪ Referral ▪ Organization of PA activities | ▪ Promising start: further development necessary ▪ Takes time | ▪ Involve more organizations in the connection ▪ The connection should be a matter of course ▪ Regular meetings with all partners so that professionals can meet one another |
Partnership: attitude and expectations about the connection between both sectors
“I now have seven people around the table whom I can deploy now. ‘Hey, I have seen you around somewhere, couldn’t we have some time?’ That is a joint part, isn’t it? We also have a joint goal and we also have, well, joint interests.” (Sport professional, #4)
“But I do hear a number of different points of departure here; we have different points of departure. For instance, […] says emphatically that there is a shortage in the range available and I hear others say ‘the range is adequate, there is quite a lot on offer, but there, it doesn’t get here.’ There are, there are a number of things about which we simply reason from different assumptions; that makes it rather…” (GP, #3)
Project basis: attitude and expectations about the connection between both sectors
“A collaboration is simply very difficult if you start from scratch. Everyone needs to be brought together first, with a goal that involves all the sectors.” (Physiotherapist, #6)
“… We simply just are in too little contact with one another, for you just don’t really know what we… You just don’t really know what we do exactly.” (Sport professional, #8)
Perceived barriers and facilitators in the connection between the primary care and the PA sector
Facilitators and barriers relating to the sector
“And you can only refer towards PA activities you know of. For example, I know there are some walking groups on different levels in [neighbourhood], so sometimes I refer patients towards them. But where to I don’t know. They have to, then I say: ‘you have to look it up yourself’.” (Physiotherapist, #8)
“Yes, time, and it is as yet unclear to me as to what the steps are. I would call [name CSS] for the people with a disability, and [name other CSC] for the elderly, I would know whom to call, but I don’t know how things go from there on. It should actually be clearer how ehm.” (Physiotherapist, #9)
“Well, what I believe is important is that the providers, in any field, that they are not known well enough. So, the promotion of those providers is very important, I think. Wherever. A touch of PR.” (Sport professional, #8)
“Make sure that you have good teachers, that you have groups, and that you bring people in. That’s all.” (Sport professionals, #6)
Welfare
Facilitators and barriers not relating to the sector
“Have always practiced a lot of sports, still do actively and passively, and so I am very interested in PA sport in our health centre, so I have been aware of the importance of PA for quite some time.” (GP, #5)
“I say, especially these Exercise Buddies; that really is a fantastic project in my view. That is truly fantastic, for it gets people out of their isolation. Yes, they dare do far more.” (Physiotherapist, #7)
“Yes, I have also noticed this. People who are not used to exercise very soon find reasons to quit. So, some of the participants that he acquired simply stayed away again.” (Sport professional, #2)