Respondent characteristics are presented in Table 2. Although there were some changes in (local) coordinators after the funding period, most representatives of NSFs and sports clubs were involved in the sporting program for multiple years. Representatives of sports clubs were mainly the trainers that provided the program to participants. Furthermore, a diverse sample of sports clubs was represented, including sports clubs of different sizes and from all regions in the Netherlands (see also Table 2). Sports clubs that discontinued programs had provided the programs for an average of three years (range 1-8 years; not in Table).
Table 3 describes continuation of and changes made to the sporting programs after the funding period by the NSFs. Six and a half years after the funding period ended, ten of the fourteen NAPSE funded sporting programs were sustained at the level of the NSFs, but one program without direct involvement of sports clubs. Previously, people could participate in this program on an individual basis or at a sports club, but the NSF only continued the individual training option. Many sports clubs, however, still provided their own training programs for inactive people or people novice to the sport. For eight of the sustained programs, a NSF program coordinator was present and nine NSFs still provided support (e.g. materials, advice) to their associated sports clubs to run the programs. During the years, some changes were made in target group (n=6 programs) and/or content (n=9 programs) of the programs. The other four NAPSE funded sporting programs were directly stopped at the level of the NSF after the funding period. However, one program was still offered by sports clubs without involvement of the NSF. For another program, coordination of the NSF was not necessary anymore, because sports clubs (and event organizations) could run the program on their own.
The sustained programs varied widely with regard to the number of activities offered per year, their actual reach and the number of participants becoming a member of a sports club/the NSF (see Table 4). When there was no NSF program coordinator or a program was completely stopped at the level of the NSF (but not at the level of sports clubs), this information was often unknown.
Key factors influencing the long-term sustainability of sporting programs aimed at inactive population groups
In Table 5, the key facilitating (+) and impeding factors (-) influencing the long-term sustainability of the sporting programs are presented per main theme. Inductively added factors are presented in bold. Most factors were mentioned by both NSFs and sports clubs (n=17, e.g. Program design: program adaptation (+)). However, some factors were more important to NSFs (n=5, e.g. Implementation: program evaluation (+)) or sports clubs (n=9, e.g. Program design: social aspect (+)). The results are described in more detail below under the five main themes - program design, implementation, trainer/coach, organizational setting NSF/sports club and broader community environment. Since the impeding factors were often the inverse of the facilitating factors, they are not always explained separately. Factors common to both NSFs and sports clubs are described first (common factors), followed by description of factors specific to NSFs or sports clubs (specific factors).
NSFs and sports clubs continued sporting programs because they aligned with the inactive target group’s needs. For inactive people, the threshold to participate in sport in general or at a sports club in particular may often be too high. The sporting programs provided opportunities for this target group to become acquainted with the sport in an easy and appropriate manner without getting injuries. Afterwards, these people are experienced enough to continue the sport in a beginner’s group at the club.
Program adaptation was another program design factor enhancing programs’ long-term sustainability. During the years, sporting programs were adapted (i.e. with regard to content or organizational aspects) both by NSFs and sports clubs, to constantly meet the needs of the (previously) inactive target group and the sports clubs. Continuous sporting programs were, for instance, (gradually) adapted to the (previously inactive) participants becoming more physically active (e.g. creating a beginner’s and more advanced group). Changes were also made to programs due to the availability of new knowledge or technologies (e.g. including more strength and flexibility exercises in training sessions to prevent injuries with inactive people, using a running app instead of a training schedule per email), new partnerships (e.g. changing program name in sponsor name) and sometimes decreased financial resources (e.g. providing less training sessions in schools). Mostly, only minor adaptations were made (see also Table 3):
“We changed the program from six training sessions of 2 hours to four training sessions of 3 hours, based on feedback of participants. First, they had to plan six weekends free, now only four weekends. And with 2 hour sessions, there was actually little time left to cycle, because you had to move to the starting location of the training and due to the time needed to startup the training. So now they have more time to cycle.” (NSF, continued program)
(Trainers of) sports clubs continued sport activities due to their social and fun characteristics: The social opportunities provided during the program (e.g. drinking coffee/tea before, during or after training, going to and participating in a sport event together), the acquired social relationships and having fun during participation were main reasons for (previously) inactive sport participants to attend and keep attending the programs (according to trainers) and also for trainers to stay motivated themselves.
High program costs (e.g. due to the use of expensive program materials, intensive guidance of participants or the need to rent a specific (sports) accommodation), which could not be financed from participant fees alone and for which external financial resources were needed, resulted in discontinuation of programs by NSFs.
Key implementation factors influencing the long-term sustainability of programs are described below. It should be noted that these factors were not only important during the three-year funded implementation period but also thereafter.
NSFs (e.g. national or regional trainer courses) and sports clubs (e.g. trainers transmitting knowledge and skills to other trainers) provided trainer courses specific for the sporting programs on a regular basis (i.e. once or multiple times a year). These were very important for sustaining the programs: they provided trainers of sports clubs with the necessary skills to guide the inactive target group and assured sufficient (professional) trainers were available.
Another implementation factor facilitating the long-term sustainability of programs was their effectiveness. When a program showed positive effects with participants, like participants learning the sport and becoming more physically active, NSFs and sports clubs were more likely to continue it. Also, partners and sponsors were more willing to contribute (and keep contributing) to effective programs:
“The schoolteachers think the sport lessons are very important. They see the positive effects of the lessons on the behavior of the children and how they interact with each other. So we keep continuing the lessons. We bought training suits together.” (Sports club, continued program)
The sporting programs were aimed at increasing participation in sport by inactive target groups. The NSFs promoted their programs via national press, the internet (including social media), television and partner organizations. The actual recruitment of participants was done locally by sports clubs through the distribution of posters, flyers and leaflets. Also, adverts were placed in local newspapers and on social media and participants were recruited by word of mouth. When sufficient participants were recruited, a large part was often already somewhat physically active at the start. In general, it was difficult to recruit large numbers of inactive people through these standard recruitment strategies and trainers of sports clubs did not always have the knowledge or resources to get in contact with the inactive target group. This also resulted in discontinuation of programs:
“The inactive and overweight target group was difficult to reach. We underestimated this. To get in contact with this target group you need more. You need other expertise and contacts next to a sport trainer.” (NSF, discontinued program)
It should be noted, however, that some NSFs and sports clubs did manage to reach larger numbers of inactive people through collaboration with organizations or people that are close to this target group (e.g. organization for older adults, physiotherapist, general practitioner). These organizations or people promoted the sporting program to inactive people or referred inactive people to the programs (see also factors Broader community environment).
Program evaluation contributes to the long-term sustainability of programs according to NSFs. It was done by the NSFs to demonstrate program effectiveness and to ensure the program fitted with the target group and sports clubs. NSFs used different methods for evaluation, like (online) questionnaires, interviews and group meetings with participants and/or trainers:
“Every year, we evaluate with all 70 involved trainers. We ask for their opinions: the opportunities they see, the barriers they experience. What do they notice with the target group? They are close to the participants, so they are well-informed about their experiences. Also, participants receive an online questionnaire. Based on the results, we give feedback to the trainers, so that they can further develop themselves. We also use the results to improve the courses and clinics.” (NSF, continued program)
For sports clubs, low participant numbers (also in relation to the difficulty to recruit large numbers of inactive people) was an important factor hindering sustainability of their sporting programs.
The sporting programs aimed to encourage (constantly new) inactive people to participate in sport. Both NSFs and sports clubs agreed that for their long-term sustainability it is very important that the appointed trainers have the knowledge and skills to guide this particular target group. This ensures that participants have positive sport experiences and gladly come back to the club to participate in (additional) sport activities. In this regard, a personal approach of participants is desired:
“The person in front of the group is very important. Participants want to have the feeling ‘he (the trainer) sees me’, ‘he knows what I am doing’.” (Sports club, continued program)
As mentioned previously, providing training and education opportunities to trainers is a way to realize this (see Implementation factors).
There were no trainer/coach factors specific to NSFs or sports clubs.
Organizational setting NSF/sports club
Most retrieved factors important for the long-term sustainability of programs were related to the organizational setting of the NSFs and sports clubs.
Sustained programs aligned with the NSFs’ and sports clubs’ core values and activities:
“This program fits with the DNA of our organization. It’s the DNA of our sport. There will always be a concept like this within our organization.” (NSF, continued program)
Programs were also continued by NSFs and sports clubs due to the acquired benefits, such as more people becoming familiar with the sport or sports club, a better image of the sport, attracting new target groups, more participants, new club members and people who are willing to do club volunteer tasks. However, programs were stopped when they did not align with the organizations’ core values and activities and program benefits were absent:
“We are not the right organization to do something with this target group. The program has no advantages for us. It even has no societal advantages.” (NSF, discontinued program)
Sustained programs secured their financial resources. For both NSFs and sports clubs this included internal financial resources, participant/membership fees and in some cases sponsorship fees. Financial resources were not only used to run the programs, but also to educate trainers, to promote the program, to buy (sport) materials and to further develop the program. On the other hand, a lack of program financing, sometimes in combination with high program costs (see Program design factors), was an important reason for NSFs and sports clubs to discontinue programs.
Most NSFs still supported sports clubs in different ways, for example, by providing them with knowledge and advice, (promotional) materials, financial resources and training and education opportunities (see also Table 3). Promoting the sporting programs nationally and supporting clubs with organizational aspects were other examples of NSF support to clubs. This saved sports clubs a lot of time and made it possible for them to focus mainly on the sport activities and guidance of participants. Both NSFs and sports clubs, therefore, agreed that the support that NSFs offered was of great value to sports clubs for continuing activities.
For some sports clubs, a lack of support of their NSF was a reason why they stopped offering programs:
“First, the NSF had three club advisors, but they left due to cut downs. After that, we were not approached anymore to implement the program. The club advisors always helped us. They made the connections with municipalities and schools. We implemented the program multiple times, but now we have stopped. I think because we are not approached anymore.” (Sports club, discontinued program)
The remaining (specific) organizational factors influencing long-term sustainability were related to human resources. Having one or more persons in the organization responsible for coordinating the program within the organization facilitated the long-term sustainability of programs. On the level of the NSF, this was the employed NSF program coordinator, sometimes assisted by other NSF employees. This person focused, for instance, on (coordinating) national promotion of the program, recruitment and assistance of clubs and recruitment of partners. Sports clubs relied on one or more enthusiastic committed trainers or volunteers who were occupied with the recruitment of (other) trainers and participants and all kinds of other organizational aspects:
“I am the head trainer and I coordinate the program. There are eight assistant-trainers and two other educated trainers. I coordinate all actions and assign tasks to everyone. Every two months, we meet with all trainers to discuss everything, like problems encountered during implementation or problems with participants and so on. The trainers alternate during the training sessions. We do this with a lot of enthusiasm. We like to be in front of a group of participants and to share our enthusiasm for the sport.” (Sports club, continued program)
Programs were less sustainable when there was no national coordinator present. Also, continuation of programs was threatened when the national coordinator would leave. The same was true for sports clubs regarding their local coordinator. For sports clubs, it was even more difficult to find a (new) coordinator due to their reliance on and often a lack of volunteers:
“Well, I am doing this now for the third or fourth year. One day, I will look around to see whether someone could take over my task. When there is no one who wants to do this, this could impede continuation of the program. It is common in volunteering that people want to help and support, but it is sometimes difficult to find a real coordinator or leader.” (Sports club, continued program)
With regard to human resources, sports clubs also mentioned the availability of (enough) professional trainers as an important factor for continuing activities at the sports club level. As described previously, professional trainers enhanced sport experiences of (inactive) participants and, in this way, contributed to continuation of programs (see also factors related to Implementation and Trainer/coach).
Broader community environment
Several factors in the broader community environment were reported that influenced the long-term sustainability of programs.
Long-term partnerships were important for sustaining programs, both at the national and local level. NSFs collaborated, for instance, with (sport) event organizers, municipalities, sport stores and other commercial organizations (e.g. from food and drink industry). Local sports clubs collaborated amongst others with schools, municipalities, organizations for older people, sport stores, health professionals (e.g. a general practitioner, physiotherapist) and other sports clubs. Partners promoted the programs, supported in recruitment of inactive participants (e.g. referral of inactive people to program), provided financial, material or human resources and shared their expertise or facilities. Brand awareness, more participants (e.g. for sport events), attracting new customers (e.g. for sport stores) and contributing to more healthy or physically active people were examples of benefits for partner organizations.
The popularity of a sport in general or of the sporting program in particular supported it’s long-term sustainability according to the NSFs:
“Many people do the sport and the sport is still growing enormously. We encourage people to practice it with this program. We show people that practicing the sport in a safe and appropriate manner is important to us.” (NSF, continued program)
On the other hand, competing programs or sport activities threatened continuation of sporting programs according to sports clubs:
“In our municipality, many children play soccer and handball. And there is hockey and they offer all kinds of other sports. Children have many options to choose from which leaves fewer children for our activities.” (Sports club, continued program)
Results in the ecological perspective
Considering the ecological perspective of the settings-based approach to health promotion [8-10], an ecological model is used to summarize the results. The factors are presented in the form of a checklist, which can be used as guidance to enhance the long-term sustainability of sporting programs aimed at (previously) inactive target groups and implemented in the organized sports setting (see Figure 1). Figure 1 illustrates that the long-term sustainability of a program is a continuous process: it should be considered from the very beginning, i.e. during program development/design (arrow 1). Furthermore, continuous attention should be paid to sustainability during the implementation/continuation phases (arrow 2). Moreover, the long-term sustainability of a sporting program is influenced by all levels of the organized sports setting (arrow 3), either directly or indirectly through program development/design and program implementation/continuation factors (e.g. sport participant level). By taking into account the different factors that influence long-term sustainability, the sustainability process in turn influences program development/design, program implementation/continuation and the different levels of the organized sports setting. This is visualized by reciprocal arrows (arrows 1-3).