Introduction
Effective elements are the elements that make an intervention successful. These elements should be included when the intervention is implemented [17].
Methods
Study case
Methodology
Step 1: preparing
By effective elements we mean the elements of X‑Fittt 2.0 that should definitely be included when implementing X‑Fittt 2.0 in another municipality. In other words, which elements of X‑Fittt 2.0 are necessary to make the programme a success?
Step 2: brainstorming
Step 3 and 4: clustering and scoring
Step 5: analysing
Step 6: discussing and interpreting
Results
Adaptations to the clusters
Adaptations to the effective elements
Overview of clusters and active elements
Effective elements | Importancea | ||
---|---|---|---|
1 | Offer proper monitoring | 4.44 | |
84 | Prevent relapse by offering useful tools for after the programme has ended that do not only focus on sports | 4.78 | |
5 | Valid measurements according to protocol | 4.67 | |
34 | Diet with focus on long term perseverance instead of short-term goals | 4.67 | |
72 | Participants set concrete goals | 4.67 | |
29 | Main goal is changing lifestyle and becoming fitter, instead of losing weight and dieting | 4.44 | |
13 | Weekly weighing on the same scale | 4.33 | |
24 | Easy to read and complete information leaflet | 4.33 | |
40 | Diet (checks by dietitian or lifestyle coach) | 4.33 | |
83 | Start and end measurements to monitor results on physical and psychological level | 4.33 | |
89 | Intake, intermediate measurements, final measurements | 4.33 | |
20 | Multiple checks at different times | 4.22 | |
92 | First meeting/intake with lifestyle coach, then intakes with physiotherapist and dietitian, to make sure all questions have been answered | 4.22 | |
2 | Develop internal multidisciplinary collaboration (within X‑Fittt 2.0) | 4.32 | |
4 | All public health practitioners are on the same page | 4.78 | |
53 | Multidisciplinary collaboration of sports coaches, lifestyle coaches, physiotherapists, dietitians | 4.67 | |
6 | Specialised and educated public health practitioners (sports coaches, lifestyle coaches, physiotherapists, dietitians) | 4.44 | |
88 | Committed public health practitioners who do a little extra for each other and the participants | 4.11 | |
78 | Sufficient communication between public health practitioners involved (sports coaches, lifestyle coaches, physiotherapists, dietitians) | 4.00 | |
75 | Contact with lifestyle coach via phone and e‑mail | 3.89 | |
97 | Fixed coordinator/contact person within X‑Fittt 2.0 | ||
3 | Develop external intersectoral collaboration (within the municipality) | 4.25 | |
16 | The same information for everyone (e.g. to municipalities and to participants) | 4.44 | |
93 | Sufficient communication between all public health practitioners involved, including physical meetings | 4.33 | |
45 | Fixed main contact person for participants | 4.22 | |
42 | Network (including public health practitioners from primary care and neighbourhood teams) that helps with recruiting participants | 4.00 | |
4 | Offer structure and sufficient guidance throughout X‑Fittt 2.0 | 4.24 | |
12 | Structure in the first 12 weeks (sports sessions and appointments with public health practitioners) | 4.44 | |
47 | Mapping available sports and physical activity options after the first 12 weeks | 4.44 | |
11 | One format for the programme (using one version) | 4.33 | |
17 | Individual attention | 4.33 | |
77 | Lifestyle coaches use motivational interviewing during conversations with participants | 4.33 | |
81 | Good follow-up after the first 12 weeks (e.g. continuing sports sessions in the same group) | 4.33 | |
22 | Working towards independency | 4.22 | |
86 | Long-term guidance by lifestyle coach (2 years) | 4.11 | |
76 | Fixed short period of sports sessions: 12 weeks | 4.00 | |
80 | Confidential advisor | 3.89 | |
5 | Make well-defined agreements for participation in X‑Fittt 2.0 | 4.22 | |
14 | Expectation management towards the participants | 4.44 | |
30 | Mandatory requirements for participation | 4.44 | |
33 | Well-defined agreements with participants about non-compliance | 4.44 | |
48 | Contract should also include obligations from the side of the organisation of X‑Fittt 2.0 | 4.00 | |
91 | Well-defined and achievable contract for participants: agreements about consequences of non-compliance and early drop-out | 3.78 | |
6 | Offer a suitable physical activity programme in the first 12 weeks | 4.17 | |
23 | Good build-up of sports sessions to prevent injuries | 4.67 | |
26 | Sports sessions in a group | 4.67 | |
57 | Participants can indicate their maximum load and exercise at their own level | 4.56 | |
58 | Appropriate sports and physical activity options | 4.56 | |
96 | Experienced sports coach with affinity for the target population | 4.22 | |
51 | Sufficient variation in sports sessions | 4.22 | |
65 | Preferably one sports coach | 4.00 | |
95 | Minimum of 8 (social support from group) and maximum of 10 (sufficient guidance and attention) participants per group | 3.95 | |
36 | Attention to group processes and atmosphere during the sports sessions | 3.78 | |
18 | 1 sports coach and one intern on a group of 12 participants during the sports sessions (2 sets of eyes are better than 1) | 3.11 | |
7 | Offer a pleasant and accessible sports environment | 4.17 | |
59 | Socially safe environment | 4.67 | |
15 | Easily accessible: everyone is equal | 4.44 | |
46 | Friendly atmosphere in sports centre | 4.44 | |
19 | Making ‘having fun’ important | 4.22 | |
70 | Participants motivate each other | 4.22 | |
71 | No ‘macho culture’ in sports centre (few body builders and girls in crop tops, etc.) | 4.22 | |
66 | Sports centre with a variety of members | 4.11 | |
10 | Social contacts | 4.00 | |
31 | Minimum of 2 trainings sessions per week | 3.78 | |
61 | Sports centre is located in the neighbourhood, close to participants’ homes | 3.56 | |
8 | Use sufficient and proper recruitment strategies | 4.05 | |
63 | Intrinsically motivated participants | 4.56 | |
67 | Lifestyle coach checks whether motivation of participants is sufficient | 4.33 | |
68 | Sufficient amounts of time, money and effort for good recruitment and selection of participants | 4.00 | |
2 | Invitation letter | 3.78 | |
52 | Recruitment: contact by phone with people who want to participate | 3.56 | |
9 | Make sure the preconditions for X‑Fittt 2.0 have been established | 4.04 | |
41 | Combined lifestyle intervention: approach with sports/physical activity, diet, physical checks by physiotherapist | 4.89 | |
87 | Proper equipment for measurements (scale, measuring tape, skinfold calliper, etc.) | 4.56 | |
82 | Proper room for intakes with dietitians and physiotherapists | 4.33 | |
54 | Separate room for intakes | 4.22 | |
62 | Weekly weighing | 4.11 | |
94 | Group sports session in a large, separate room with the right equipment | 3.95 | |
37 | Collaboration with the municipality | 3.89 | |
21 | Low costs for participants | 3.33 | |
3 | List to fill out all information from the physical test for left and right side of the body | 3.11 |