Sport4HealthNet

New Health Foundation is partner of the Sport4HealthNet project. This project addresses the topic: encourage participation in sport and physical activity especially by supporting Council Recommendations on HEPA and EU Physical Activity Guidelines.

Many working people sit too much and suffer health disadvantage. Sitting for long periods is not only harmful, our muscles and bones also become less fit and strong, our immune system deteriorates and the risk of chronic diseases increases significantly. Within the Sport 4 Health program, 6 European countries are jointly developing a practical prevention and activity program for people who do sedentary work and people who sit for a long time at all. This program offers an exercise program with exercises that can be performed in the workplace in between. Agility, balance and muscle strength are discussed and there is a focus on the prevention of neck and shoulder complaints.

During the past decade, several EU countries faced an increased frequency of lifestyle-influenced diseases (e.g. obesity, cardiovascular disease, diabetes type B, cancer) as countries become more industrialised, lifestyle becomes more sedentary, the food and the environmental factors become more important, as people live longer. For example, over 50% of both men and women in the WHO European Region were overweight (http://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity/data-and-statistics) while there are about 60 million people with diabetes in Europe, or about 10.3% of men and 9.6% of women aged 25 years and over (http://www.euro.who.int/en/health-topics/noncommunicable-diseases/diabetes/data-and-statistics, Accessed at March 27, 2019). Lifestyle diseases are quickly turning into top-most economic burden on the health services across Europe, with many countries urgently in need of the most effective and affordable community programs to recognise health risk factors and positively impact wellbeing outcomes. Being physically active appears to positively affect health outcomes, with regular physical activity (³ 150 minutes per week of moderate-intensity activity) recognised as a basic lifestyle behaviour in tackling lifestyle diseases (https://www.who.int/dietphysicalactivity/factsheet_adults/en/). According to the Council Recommendation on Health Enhancing Physical Activity (HEPA), physical activity is a 'prerequisite for a healthy lifestyle and a healthy workforce'. Highlighting that 60% of European citizens are not engaging in sufficient physical activity, it recommends the promotion, monitoring and evaluation of physical activity levels across Europe.

The World Health Organisation's European Policy Framework and Strategy for the 21st century prioritises investing in health promotion programmes by utilising existing social networks such as the one in the workplace. As workers generally spend more time in the workplace than any other location, the workplace can have a direct impact on workers' physical, mental, economic and social health. The European Network for Workplace Health Promotion has defined workplace health promotion in their Luxembourg Declaration as 'the combined efforts of employers, employees and society to improve the health and wellbeing of people at work'. The European Agency for Safety and Health at Work find that 'well-implemented workplace health promotion can lead to improved working environment and a decrease in absenteeism' and therefore recommend that policies continue to emphasise the importance of workplace health promotion. The most recent Eurobarometer on Sport and Physical Activity (published in 2018) identifies that 13% of physical activities take place at work, with no changes seen as compared to previous report in 2013.

Focus area
It appears that a majority of Europeans do not meet the physical activity recommendations, while staying more sedentary during both leisure time and work. According to a recent report (Special Eurobarometer 472 – Sport and Physical Activity), nearly half of Europeans (46%) never exercise or play sport, and this proportion has increased gradually from 2013 to 2017. On a usual day, around two thirds of Europeans (69%) spend between 2.5 and 8.5 hours sitting, while 15% of respondents do not walk for 10 minutes at a time at all in a weekly period. The amount of regular activity that people do tends to decrease with age, with an engagement in sport and physical activity being less prevalent among people with lower levels of education and among those with financial difficulties. Considering socio-professional categories, 26% of managers never exercise or play sport, compared with 37% in other white-collar jobs, 36% of self-employed people and 49% of manual workers. Furthermore, people in white collar occupations tend to spend more time sitting down. The proportion that spends more than 8.5 hours per day sitting down is 17% among managers and 19% among other white-collar workers. In addition, it appears that the lack of time is the principal obstacle to take part in regular exercise, while informal sport settings (e.g. home, parks, outdoors) are more popular than sport clubs and health or fitness centres. Only 13% of Europeans play sport or engage in other physical activities at work. This perhaps opens a window of opportunity to develop and implement specific exercise programs that are straightforward, time-efficient and highly applicable to different categories of employees for advancing physical activity at an informal setting such as workplace.

Problem statement
There has been no evidence on the effects of specific types of exercise interventions (e.g. stretching, muscle strength exercises) on specific groups of employees, including inactive individuals. Evidence on traditional interventions (e.g. walking initiatives, active travel) is more developed and robust while no studies evaluated the applicability of stretching or muscular strength exercise on physical activity behaviour, health-related quality of life, healthy lifestyle profiles, or health-related physical fitness in working population. No user-friendly guidelines describing alternative types of on-site exercise interventions has been developed and widely disseminated in working population, and no information is available as to whether such interventions yield an additional benefit for health profiles of inactive employees. Developing and implementing a comprehensible, practical and user-friendly guidelines describing HEPA-endorsed strategies aimed to enhance different types of physical activity and counteract sedentary behaviours at workplace, with all its negative consequences, is of utmost importance to contribute to health promotion for the employees.

Main objective

The main objective of the Sport4HealthNet aims at creating better access and more opportunities in people's everyday lives to engage in exercise and maintain a healthy lifestyle.

The transnational network of 6 European Countries – Sport4HeathNet with a synergise approach will address two issues as major concerns and obstacles for citizens to be more active: lack of time and better sport local infrastructure. In this context Sport4HeathNet will influence changes.

According to the (Special Eurobarometer 472 – Sport and Physical Activity): "Lack of time is the principal barrier" for the working population to be physically active. Employers are not always willing to give extra time to their employees to practice exercises. Sport for Health Network will reconcile the both: employees lack of time to practice sport and employers fear that allowing them physical activities at work will take a part of time of their working activities by developing: "Employee physical health evaluation & guidelines" that will describe innovative and easy-to-do physical exercises (e.g. stretching and muscular strength activities) targeted to improve general pattern of employees' activity both at work and home, but also to tackle specific locomotor problems seen in workforce (including low back pain, poor flexibility or muscular stiffness). Qualified health and fitness professionals will visit employees on site and teach them how to use the guidelines and implement every-day, short (~ 5 min) and easy-to-conduct stretching and strength exercises, using no or minimal resources (e.g. desk, chair, own body, a colleague), and that could be repeated several time a day by not interrupting the working schedule at the workplace.

Special Eurobarometer 472 – Sport and Physical Activity states also: "Most Europeans think that there are opportunities available locally to be physically active, but many do not think their local authority does enough". Sport4HeathNet in this context addresses through EU physical activity guidelines the development of "an inventory of all sport and leisure facilities" as well as to initiate the creation of "offices for support" in 6 Sport4HeathNet cities: Celje, Novi Sad, Sofia, Zagreb, Weert and Brussels" in order to provide to the population a user-friendly searching approach and motivate the sedentary population to be active. In this context, the support of local authorities to provide with better sport facilities e.g. will also be sought.

For implementing the above-mentioned changes participating organisations have relevant experience in HEPA guidelines implementation, healthy lifestyle promotion and research:

- HEPA is the Faculty of Sport Novi Sad (FSPE) partner for organising the 5th Conference on Exercise and Quality of Life (April 11-13, 2019, Novi Sad)
- HEPA executive (Finn Berggren) is an invited speaker for HEPA-endorsed symposium at 5th Conference on Exercise and Quality of Life. Professor Sergej Ostojic from FSPE with the Serbian organisation CHESS is a member of HEPA Europe as a nationally representative body for Serbia and published the following scientific research:
- Presentation of FSPE research in enhancing health-related physical activity at HEPA events (Markovic L, Djordjic V, Jorga J, Bozic, P, Milanovic I, Radisavljevic S, Batez M, Ostojic SM. FPSE also published the following HEPA related scientific works: Guidelines-focused education on diet and physical activity improves health-promoting life-style profiles in Serbian adolescents and adults. 13^thAnnual Meeting | 8^th Conference of HEPA Europe, November 15-17, 2017, Zagreb, Croatia). Kinezioloski fakultet, Croatia participated in the implementation of several ERASMUS HEPA projects related:
- Promoting National Implementation for Sport Club for Health (SCforH) Programmes in EU Member States;
- Sport and Health Enhancing Physical Activity – EPHEPA.

SZ Celje, Slovenia and Bulgarian Cheer Union have a long experience in organising sports events, good sport marketing approach, big networks of sport clubs and can contribute to the successful promotion of the project's intellectual outputs; The European Cooperation Centre has an experience in data analysis, GIS mapping, in conducting research and studies and organising sport events and conferences. Stichting Nieuwe Gezondheid, Dutch partner, in the past 35 years, is putting effort in awareness and guidance of a healthy lifestyle, using the ACSM, WHO and Health Council guidelines of healthy living and prevention. This led to the foundation that is reaching out, free off cost, every two months, to a network of 450 ambassadors the Netherlands, with a lifestyle and prevention item, about for example healthy and active living, healthy eating, increasing motivation, mental strength or physical or mental relaxation. Their experience and standardised healthy lifestyle techniques based on HEPA will be replicated to the Sport for Health Network in order to reach as wider number of new ambassadors throughout Europe and beyond, but also a bigger community of employers, companies, employees, local authorities and public institutions.

Target group and beneficiaries

Target group:
For this project, we will recruit approximately 1000 participants per each of 6 Sport4HeathNet countries who are employed in public and private companies. Both male and female participants, different ethnic and socioeconomic groups will be included on a proportional basis for this interventional study, to ensure a broadly representative sample.

Indirect beneficiaries:
The knowledge we gained through the project will be transferred to the general population across Europe through traditional media and Internet, while specific information will be targeted to public and private stakeholders (employers, employees, public institutions and local authorities) through educational seminars, but also through scientific journals and events.

The overall idea to be evaluated in this project is that advanced practices and knowledge on alternative physical activities in/around the workplace represents a quantifiable health benefit, contributing to increasing healthy lifestyle behaviour in working population, resulting in mood improvement, higher productivity, decrease in absenteeism and lifestyle diseases.

The specific objectives of this project are:

(1) to evaluate target groups of employees for health profiles (see below) before/after an educational intervention;
(2) to develop user-friendly manual for physical activity at workplace that includes multicomponent interventions with innovative activities (including stretching and strength exercise);
(3) to provide an educational intervention and practical demonstration by a HEPA-recognised professional how to implement novel interventions in work settings;
(4) to determine the extent to which the intervention would yield an additional benefit for health profiles ; and
(5) to promote and disseminate project results using popular media, non-professional and professional bodies and relevant events.

The results of the present project will ultimately lead to a more specific and effective manual for physical activity promotion that should facilitate favourable behaviour modification for active healthy living in the working population. It will also aim to influence stakeholders, including particularly local authorities and employers to improve provision for this type of activity, like facilities, space and time during working hours, etc

Coordinator:

University of Novi Sad - Faculty of sport and physical education, Serbia (Short: FSPE)

Partners:

• Sveučiliste u Zagrebu kineziološki fakultet, Croatia (Short: KIF)
• European Cooperation Centre, Brussels, Belgium (Short: ECC)
• Stichting Nieuwe Gezondheid, Weert, Netherlands (Short: Stg Nwe Gezondheid)
• Bulgarian Cheer Union, Sofia, Bulgaria (Short: BCU)
• Športna zveza Celje - Sports federation of Celje, Slovenia (Short: SZ Celje)

Relevant Partner Web Sites:

https://www.uns.ac.rs/index.php/en/faculties/ffaculties/faculty-sport
https://www.kif.unizg.hr/en
http://www.ecc-org.eu/
https://www.new-health.eu/
https://www.facebook.com/bulgariancheerunion/
http://www.szc.si/