Activating the 'peerness' of youth leaders in a community sports programme through techne and phronesis.

Peer-to-peer approaches engage groups of people considered to share one or more characteristics that identify them as peers and draw on rationales of credibility, identification and role modelling in peer-to-peer interactions. Despite the popularity of the approach, the ways in which the peer leadership component specifically contributes to health promotion is not thoroughly understood. We suggest that a first step for making use of peer leader characteristics is to make explicit what the peer leadership component is expected to bring to a programme. To approach such an understanding, we investigated how peer leaders can be supported in activating their 'peerness' in health promotion programmes, using as a case the peer leader education of a youth-led, peer-to-peer community sports programme, implemented by the non-profit street sports organization, GAME. We analysed the peer leader training programme's learning objectives and field notes from observations of the training programme. The empirical material was analysed using an abductive approach by drawing upon contemporary interpretations of two forms of knowledge originally proposed by Aristotle. In so doing, this article explores how the development of techne (practical knowledge) and phronesis (practical wisdom) was supported in a peer leader training programme for young people. Findings suggest that supporting the development of both these types of knowledge can strengthen programme planners' attention to the contribution of peers. Concurrently, an emphasis on promoting phronesis in peer leader training can support and encourage peer leaders in activating their 'peerness' in peer-to-peer health promotion programmes.

Peer-to-peer approaches are commonly used in the health promotion. Peer-led programmes engage groups of people considered to share one or more characteristics that identify them as peers. Peer leaders are suggested to be credible sources of information and provide identification and role modelling to their peers. However, despite the popularity of the approach, the ways in which peer leaders specifically contribute to health promotion are not thoroughly understood. It is thus unclear how the 'peerness' of peer leaders is activated in health promotion programmes. In this study, we investigated how peer leaders can be supported in activating their 'peerness' during peer-led activities. To do so, we observed and analysed the peer leader training programme of a youth-led community sport programme, implemented by the non-profit organization, GAME. As a theoretical framework, we employed two forms of knowledge originally proposed by Aristotle; namely, techne (practical knowledge) and phronesis (practical wisdom). Our results suggest that supporting the development of both these types of knowledge can strengthen programme planners' attention to the contribution of peers. Concurrently, an emphasis on promoting phronesis in peer leader training can support and encourage peer leaders in activating their 'peerness' in peer-to-peer health promotion programmes.

Translation and Validation of a Brief Health Literacy Instrument for School-Age Children in a Danish Context.

Low health literacy (HL) is associated with adverse health behaviors and poor health, and brief, high-quality instruments for measuring HL in children are scarce. The Health Literacy for School-Aged Children (HLSAC) instrument is a 10-item theory-based and internationally validated tool for measuring HL. The purpose of this study was to translate and validate the HLSAC instrument among Danish school-aged children. The instrument was translated into Danish by a standardized forward-backward translation process, and then pre-tested for face validity with 61 pupils from four schools. Thereafter, the instrument was tested among 805 pupils in grades 6 to 7 (age 11-14 years) from 15 schools. When HL was modeled as one latent factor with all 10 items loading on this factor, the confirmative factor analysis showed standardized factor loadings from 0.52 to 0.75 (p < .001) and an excellent model fit. The association between HL and food intake as a health behavior example (p < .001, r2 = .027) indicates the predictive validity of the instrument. The internal consistency was high (Cronbach's alpha = 0.86). Thus, a valid and reliable version of the HLSAC instrument is available in Danish for future surveys to monitor HL and guide health promotion targeting children and adolescents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e25-e29.].

Perceptions of public health and cross-sectoral collaboration in low SES neighbourhoods in Denmark.

Cross-sectoral interventions in low socio-economic status (SES) neighbourhoods are an important contribution to reducing social inequities in health. This article investigates the health perceptions among professionals from public health, social and place-based initiatives, all working in low SES neighbourhoods in Denmark, and what implications these perceptions have on their work with health promotion and on collaboration between the initiatives. Empirically, we draw on 63 semi-structured interviews with frontline professionals across area-based initiatives (ABIs), social housing development plans (SHDPs) and municipal public health departments (PHDs). Our study shows that professionals across all sectors perceive it as important to work with a broad understanding of health to motivate and reach hard-to-reach groups in low SES neighbourhoods as opposed to a more narrow perspective on health and health promotion focussed on lifestyles and monitoring risks. The aims and practice of ABIs and SHDPs support work in line with a broad understanding of health, whereas frontline workers from the PHDs in practice more often end up applying a more narrow understanding of health. Consequently, real collaboration is infrequent and often confined to the coordination of activities. This limits the possibilities of implementing effective interventions in low SES neighbourhoods to reduce inequities in health. This article claims that there is a greater potential for synergy among different initiatives in low SES neighbourhoods if a broad understanding of health can be applied in practice across sectors.

Sports-based recreation as a means to address social inequity in health: why, when, where, who, what, and how.

The rising global burden of noncommunicable diseases (NCDs) among people with low socioeconomic status (SES) has heightened awareness of the need for primary prevention programs in low-SES neighborhoods. Social inequity in health is apparent in mental, social and physical aspects of health among people living in low-SES neighborhoods. Viewing this problem from a life course perspective and adopting a vulnerable population approach points to the importance of inducing sustainable health behavior changes in children and young people living in low-SES neighborhoods. One important factor in lowering the risk of many NCDs while improving mental health is the promotion of physical activity (PA). In this paper, we argue that lowering the risk of many NCDs and improving mental health is best achieved through setting-based programs that facilitate long-term PA behavior changes in children and adolescents living in marginalized neighborhoods. Empirical evidence indicates that extrinsic motives for participating in physical activities, such as improving health, are insufficient when long-term participation is the goal. Therefore, we argue that interventions with the aim of affecting long-term PA in low-SES neighborhoods and thereby reducing social inequities in health should include activities that aim to create more intrinsic and autonomous motivations by building on more broad and positive understandings of health and participation. Here, we advocate that sports-based recreation (SR) holds several advantages. If implemented well, SR has the potential to be a health-promoting activity that is meaningful and motivating in itself and that involves physiological health-promoting aspects (e.g., PA), a social aspect (e.g., positive relations with others), and a psychological aspect (e.g., positive experiences of oneself). Further, we suggest four practicalities that should be considered when conducting interventions: the cost of participating, the location, the facilities required, and the suitability of the SR activities.

The effect of siblings and family dog ownership on children's independent mobility to neighbourhood destinations.

OBJECTIVE: To investigate the effect of sibling age, gender and dog ownership on children's independent mobility and how this varies according to the destination visited. METHODS: Parents reported whether their child had an older sibling; if the child and older sibling were of the same gender; the number of older siblings; if they owned a dog; and whether their child was allowed to independently travel to school, friends' or family house, park/oval/sporting field and local shop. Data were analysed for 181 children aged 8-15 years. RESULTS: The strongest significant sibling effect for independently mobility to school, local shop and ≥3 destinations was for having an older sibling of the same gender (p≤0.05). For independent mobility to a friend's house and park, the strongest significant sibling effect was for having one older sibling (p≤0.05). Dog ownership was associated with increased odds of being independently mobile to ≥3 destinations (OR=2.43; 95%CI=1.03-5.74). CONCLUSIONS: Parents may be more likely to grant children licence to travel to local places if they are accompanied by an older sibling or the family dog. IMPLICATIONS: Understanding the effects of siblings and dog ownership on children's independent mobility will assist in identifying strategies through which independent mobility can be encouraged.

The Effect of the Social and Physical Environment on Children's Independent Mobility to Neighborhood Destinations.

BACKGROUND: Relationships between context-specific measures of the physical and social environment and children's independent mobility to neighborhood destination types were examined. METHODS: Parents in RESIDE's fourth survey reported whether their child (8-15 years; n = 181) was allowed to travel without an adult to school, friend's house, park and local shop. Objective physical environment measures were matched to each of these destinations. Social environment measures included neighborhood perceptions and items specific to local independent mobility. RESULTS: Independent mobility to local destinations ranged from 30% to 48%. Independent mobility to a local park was less likely as the distance to the closest park (small and large size) increased and less likely with additional school grounds (P < .05). Independent mobility to school was less likely as the distance to the closest large park increased and if the neighborhood was perceived as unsafe (P < .05). Independent mobility to a park or shops decreased if parenting social norms were unsupportive of children's local independent movement (P < .05). CONCLUSIONS: Independent mobility appears dependent upon the specific destination being visited and the impact of neighborhood features varies according to the destination examined. Findings highlight the importance of access to different types and sizes of urban green space for children's independent mobility to parks.

Using accelerometers and global positioning system devices to assess gender and age differences in children's school, transport, leisure and home based physical activity.

BACKGROUND: Knowledge on domain-specific physical activity (PA) has the potential to advance public health interventions and inform new policies promoting children's PA. The purpose of this study is to identify and assess domains (leisure, school, transport, home) and subdomains (e.g., recess, playgrounds, and urban green space) for week day moderate to vigorous PA (MVPA) using objective measures and investigate gender and age differences. METHODS: Participants included 367 Danish children and adolescents (11-16 years, 52% girls) with combined accelerometer and Global Positioning System (GPS) data (mean 2.5 days, 12.7 hrs/day). The Personal Activity and Location Measurement System and a purpose-built database assessed data in 15-second epochs to determine PA and assign epochs to 4 domains and 11 subdomains. Frequencies and proportions of time spent in MVPA were determined and differences assessed using multi-level modeling. RESULTS: More than 90% of MVPA was objectively assigned to domains/subdomains. Boys accumulated more MVPA overall, in leisure, school and transport (all p < 0.05). Children compared with adolescents accumulated more MVPA, primarily through more school MVPA (p < 0.05). Boys spent a large proportion of time accumulating MVPA in playgrounds, active transport, Physical Education, sports facilities, urban green space and school grounds. Girls spent a significant proportion of time accumulating MVPA in active transport and playgrounds. No gender or age differences were found in the home domain. CONCLUSIONS: Large variations were found in PA frequency and intensity across domains/subdomains. Significant gender differences were found, with girls being less active in almost all domains and subdomains. Objectively measured patterns of PA across domains/subdomains can be used to better tailor PA interventions and inform future policies for promoting child PA.