Why Physical Activity Promotion Policy Isn’t Helping the Fight Against Cancer… Or Why I’m Joining Cancer Research UK’s Dryathlon

PLEASE SUPPORT CANCER RESEARCH UK: CLICK HERE TO SUPPORT MY DRYATHLON

Think of research into cancer and the image that comes to mind is of laboratory based research into the biological processes that cause or that might cure cancer, but the work of Cancer Research UK is about protection and possible prevention as well as causes and cures. While Cancer Research UK themselves are realistic that their goal of developing cures for all cancers won’t be achieved in our lifetime (although important advances in cancer care can and have been made), they are also clear that immediate benefits can be achieved through both research into what lifestyle choices might protect against cancer, and by understanding how information about healthy lifestyles can be communicated.

Physical Activity Policy Failure – Don’t Recommend What You Can’t Sell

One of the key components of a healthy lifestyle that has been shown to offer some protection against cancers is physical activity. Elsewhere I have argued that depending solely on physiological research into the health benefits of exercise to establish physical activity recommendations without considering how such recommendations might be communicated and received is a recipe for policy failure. And the failure of such policy is reflected in the fact that around two-thirds of men and three-quarters of women do less than the recommended levels of physical activity, with a significant proportion of those being entirely sedentary. In short, recommending what you can’t sell is pure folly.

Cancer Research UK and Physical Activity

As well as funding research into the protective possibilities of physical activity, Cancer Research UK also seeks to communicate such benefits, and to lobby for improved policy for physical activity promotion. In addition to seeking an increase in safe and accessible places for physical activity and lobbying for a greater focus on promoting the benefits of activity among older people, Cancer Research UK’s policy on physical activity is to encourage government to take a more connected and co-ordinated approach to physical activity promotion, and to increase the priority of physical activity in the school curriculum through increasing the range of opportunities for children to become more active. Unfortunately, current government policy isn’t helping on either count.

Why Government Physical Activity Promotion Policy Isn’t Helping

A lack of joined up thinking across government doesn’t make the connections (or recognise the contradictions) between policies to promote competitive sport, wider physical activities, and incidental lifestyle activity such as active travel. Disparate policies fail to recognise: (i) that competitive sport messages put off the least active; (ii) the futility of developing a product (150 minutes of exercise per week as the minimum required for health benefits) that can’t be sold to the least active; (iii) that ‘finger-wagging” at the least active for being unhealthy is counter-productive.  And the Olympics hasn’t helped: government policy needs to understand that chunky Boris Johnson careering along in a suit is a far better role model to inspire the least active to get on their bikes than a lycra-clad Sir Chris Hoy setting records in the Olympic velodrome.

Nowhere, though, is this lack of joined up thinking more evident than in policy for physical education in schools. The Olympic Games has led a misguided government, driven by sport policy imperatives, to suggest compulsory competitive sport in primary schools. Unfortunately, this outdated ideology that competitive sport universally inspires and teaches lessons for life is less likely to invoke a modern day Chariots of Fire than it is to be a throwback to Kes. And with the abolition in the year before London 2012 of School Sport Partnerships, a network of education-led professionals that understood that it takes more than competitive sport to physically educate children and young people, there is now little to offer a counterbalance to the idea of compulsory competitive team games for five year olds.

Two Reasons Why I am Joining Cancer Research UK’s January Dryathlon

This is hardly the joined up thinking or wide range of opportunities for young people to get active that Cancer Research UK are lobbying for. And it is the first reason why I am supporting Cancer Research UK in January 2013 by joining their Dryathlon, in which I won’t touch a drop of alcohol from 9am on 1st January 2013 to 9am on 1st February 2013.

The second reason?  In 2011, the year that my daughter was born, a newborn child had (and still has) a ONE IN THREE chance of being diagnosed with some form of cancer during its lifetime. Supporting an organisation that, firstly, seeks to reduce the likelihood that my daughter will develop cancer by funding research into the lifestyle choices that might protect against it, and, secondly, that supports research to increase the chances that my daughter will survive cancer if she is the unlucky one in three, is the second reason why I am going a month without alcohol, one of my favourite things. And I am not asking anyone to sponsor me, rather to NOT buy me a drink – find out how my Cancer Research UK Dryathlon will work HERE.

I’ll be micro-blogging daily 280 character updates on my Dryathlon progress on my JUST GIVING site, and will re-tweet some of these via @ProfMikeWeed on Twitter. If you would like to support my Cancer Research UK Dryathlon, you might like to know that my usual tipple is a pint or two of Coors, which can probably be bought for around £2.50 in the cheaper parts of the UK. So if you would like to support the work of Cancer Research UK by NOT buying me a couple of drinks in January, please text “COOR52 £5″ to 70070.

Cures for all cancers are some way off, but the work of Cancer Research UK demonstrates that more effective physical activity promotion policy might help individuals make lifestyle choices that might protect against cancer. Please support my Dryathlon and support Cancer Research UK.

Blame the Data and Remove the Goalposts – How to Mask National Olympic Legacy Policy Failings!

In Singapore in 2005, Lord Coe, the Chair of the London Organising Committee for the Olympic and Paralympic Games, secured the 2012 Games for London with a bid presentation including a promise to inspire a new generation to choose sport.  Yet, as the popular press is fond of reminding us, no previous Games has raised national participation in sport and physical activity. Furthermore, a systematic review in the BMJ in 2010 concluded that “the available evidence is not sufficient to confirm or refute expectations about the health or socio-economic benefits for the host population of previous major multi-sport events”.

No Evidence for INHERENT legacies

However, this is not the full picture.  Whilst it is true that no previous Games has resulted in sustained increases in sport and physical activity participation in national populations, it is also true that no previous Games has attempted to raise population levels of sport and physical activity participation.  Participation data has merely been examined ex-poste to explore whether Olympic and Paralympic Games have affected participation levels.  Consequently, the BMJ review should be interpreted to mean that there is no evidence for an inherent sport and physical activity participation legacy effect, in which benefits occur automatically.

Reasonable Legacy Ambitions?

So what does this mean for London 2012?  Was it reasonable to suggest back in 2005 that a national sport and physical activity participation legacy could be delivered?  In short, yes!  The lack of evidence for national participation legacies following previous Games that had not attempted to deliver such legacies is not an indication that a national sport and physical activity participation legacy could not be leveraged from London 2012.  In fact, a worldwide systematic review of evidence, conducted by the Centre for Sport, Physical Education & Activity Research (SPEAR) at Canterbury Christ Church University for the Department of Health, provides evidence that mechanisms associated with Olympic and Paralympic Games have had a positive effect on sport participation where specific initiatives have been put in place to leverage such participation.  However, such initiatives have not been on a large enough scale to affect national levels of sport and physical activity participation, hence the lack of evidence for an inherent effect in the BMJ review.

National Policy Failures

So, armed with this evidence about how sport and physical legacies might be developed, surely good progress must be being made towards delivering a national sport and physical activity legacy from the London 2012 Games?  Well, unfortunately not!  Evidence from Sport England’s Active People Survey shows sport participation in England has increased by an average of only 38,000 a year over the last three years.  The problem is that although evidence suggests London 2012 could have boosted the nation’s sport and physical activity participation given the right strategic approach, national legacy policies have not incorporated this evidence into a coherent national legacy strategy.  Instead, the legacy aspirations of the Department for Culture, Media and Sport, like those of Lord Coe, have been pinned on the hope that there will be an inherent inspiration effect from the Games, with England’s Mass Participation Legacy Plan, Places People Play, focusing almost solely on supply: of facilities, of fields, of leaders, and of opportunities.  However, this is not Field of Dreams – there is no evidence to suggest that if you build a sport supply infrastructure, people will come! People will not come because there is no strategy in place to simulate demand.  Consequently, the lack of progress towards a national sport and physical activity participation legacy from London 2012 is a policy failing, in which national legacy strategy has not been informed by the available evidence.

Blaming the Data

Unsurprisingly, a policy failing is not one of the explanations respectively offered by Lord Coe and Jeremy Hunt, the Culture Secretary.  Lord Coe blames the data, believing that the Active People Survey fails to capture sport participation legacy outcomes, and suggesting that it should not be trusted because Sport England, which commissions the survey, has “singularly failed”.  As alternative evidence, Lord Coe suggests “if you speak to [the British Cycling performance director] Dave Brailsford he will tell you he’s got half a million more cyclists than pre-Beijing”.  However, Active People provides official National Statistics, and since 2005 has been conducted by two highly respected market research companies, IpsosMORI and TNS-BMRB. Each year its sample size exceeds 175,000, which provides accuracy to within 0.2%.  The same cannot be said of the anecdotal view of a national performance director, however genuinely-held it may be.

Removing the Goalposts

In contrast to Lord Coe, Jeremy Hunt does not suggest National Statistics are flawed.  Rather he claims an inappropriate legacy target was set by the previous government, which promised to get one million more adults participating in sport by 2012/13.  The Department for Culture, Media and Sport has now dropped this target, because Mr Hunt believes a “more meaningful national measure” is required.  However, with less than 2012 hours to go to the Games, a more meaningful national measure has yet to be announced.  Consequently, and somewhat conveniently, by effectively removing the goalposts the DCMS has now ensured that there is no nationally endorsed target against which government policy can be judged to have failed to deliver a national sport and physical activity participation legacy.

Delivering or Demonstrating a London 2012 Sporting Legacy?

From the ambitions of the final bid presentation that secured the 2012 Olympic and Paralympic Games for London in Singapore in 2005, through the legacy promises made in the previous Labour government’s legacy action plan published in 2008, to the Coalition government’s rationalised Plans for the Legacy from the 2012 Olympic and Paralympic Games published in December 2010, sporting, social, cultural and economic development legacies have all been referenced. Labour’s legacy action plan and the Coalition’s more recent plans for legacy each appear to give equal billing to legacies in different areas. However, undoubtedly the sport participation legacy is ‘first among equals’ in the minds of the IOC, LOCOG, the government and the UK media.

Sport Legacy Targets

Sport participation legacy ambitions were integrated throughout the Singapore bid presentation, whilst Labour’s legacy action plan allocated almost twice as many pages to the sport promise than to any other legacy area. Unfortunately for the Coalition, with its aversion to targets, the previous government set a very clear and very public legacy target for sport participation – that a million more adults in England would be inspired to play sport at least three times a week by 2012/13 – a target that is easy for the media to understand, and that is derived from the most robust rolling survey of sport participation habits ever carried out in England, the Active People Survey. While the Coalition has tried to distance itself from this target, as yet (Decemer 2011) it has been unable to come up with an alternative.

Following the election in May 2010, the Coalition had ‘quietly dropped’ a related target to get a further million people more active through more general informal activity, such as gardening or walking to work, and in March 2011 the Secretary of State for Culture, the Olympics, Media and Sport, Jeremy Hunt, signalled that the sport participation target would also be dropped: “In an interview with the Guardian, Hunt confirmed the [physical activity] target had been quietly dropped shortly after the coalition government came to power. The [sport participation] target, towards which the sports have made only glacial progress, nominally remains in place for now but it is understood that it too will shortly be dropped in favour of a ‘more meaningful’ national measure.”

More Meaningful Measures?

Nine months after trailing the establishment of a ‘more meaningful national measure’, and with less than 250 days to go to the start of the Olympic Games, a ‘more meaningful’ measure has yet to be announced. Meanwhile, progress towards the one million target, which ‘nominally remains in place for now’ is such that this most prominent and most resonant of legacy goals is likely to be reached sometime around 2035. Unsurprising, then, that something ‘more meaningful’ is being sought, but with less than 250 days to go to the start of the Games it is difficult to see how establishing ‘a more meaningful national measure’ will contribute to the delivery of a sport participation legacy. Undoubtedly, though, changing the success indicator at this late stage could contribute significantly to the government’s ability to demonstrate that a legacy has been achieved.

The difference between seeking to deliver a legacy and seeking to demonstrate a legacy is an important one. If the imperative is the former, then strategies would be established in the belief that they would deliver genuine legacy outcomes over and above what could have been achieved with the same investment if the 2012 Games had not been awarded to London. If the imperative is the latter, then strategies would be established to ensure that the outcomes and impacts of as many programmes as possible could be claimed as demonstrating that legacies have been secured from the 2012 Games. Delivering legacies requires an understanding of what legacies are possible, how and for whom. Demonstrating legacies requires an understanding of methodological smoke and mirrors and political sleight of hand.

A Legacy of Supply?

While a legacy target provides a success indicator, it does not represent a sport participation legacy strategy, and in this respect the Coalition government does have some plans in place. Places People Play, the government’s ‘mass participation legacy plan’ was launched in November 2010, and is funded by £135m diverted from the National Lottery. However, the overwhelming majority of this £135m investment is in supply: £90m for facilities and fields, £2m for leaders and £4m for provision capacity. Even the sum of £32m to be invested in ‘Sportivate’, a programme of opportunities for 14-25 year olds, is for the supply of opportunities. As such, the government’s mass participation legacy plans contain no strategies to harness the London 2012 Olympic and Paralympic Games to stimulate demand. This appears to be because the government believe that there is an inherent inspiration to play sport deriving from hosting the Games in the UK, and that the only requirements of a legacy plan are to provide the supply to satisfy the increase in demand that will inevitably come, something that the Sport Minister, Hugh Robertson, implied at the launch of the plan: “With more Lottery money being invested in facilities, volunteering and protecting and improving playing fields, there will be opportunities for everyone to get involved. When people talk about the legacy of the Games, we want them to talk about Places People Play – and then we want them to get out there and join in.”

The only mention of demand here is that ‘we want them to get out there and join in’. However, ‘wanting’ something does not represent a strategy or a delivery plan, and as such the wholly supply-led mass participation legacy plan appears to be based on the assumption that if new facilities are built, people will come to use them. In this assumption, Robertson and his Coalition colleagues are likely to be correct. New facilities and fields carrying the London 2012 Inspire Mark are likely to be well used, but they are most likely to be used by people who are already participating in sport to play a little more often in a better surroundings, and people playing more often is not the same as more people playing.

However, counting the extent of new provision (numbers of new facilities and fields) and counting the numbers of people utilising such provision will provide some statistics that can be used to demonstrate that a sporting legacy is being achieved. But this will not change the fact that the latest results from the Active People Survey show that the number of adults participating in sport three times a week in England has only increased by an average of 38,000 a year in the last three years. This suggests that no matter how ‘more meaningful’ the Coalition government may wish it to be, counting the number of people, many of whom may be existing participants, that make use of improved provision carrying a London 2012 Inspire Mark does not represent the delivery of a mass participation legacy for sport. The places may be inspired by London 2012, but the people are not.

More Concern with Demonstrating a Legacy than Delivering One?

Following initial enthusiasm for legacy in the wake of winning the right to stage the 2012 Games, and Labour’s subsequent detailed legacy action plan, legacy strategy has more recently been rationalised by the Coalition, as might be expected in tough economic times. However, while legacy strategies for the 2012 Games have been rationalised, the £9.3bn Games delivery budget has not. Consequently, the British public has every right to expect a return from the £150 a head investment being made in the Games by the Treasury on its behalf.

Recent legacy strategy for sport participation has seen both legacy initiatives and success indicators being changed, dropped or re-branded in the final two years before the Games. This would appear to suggest a greater concern with demonstrating that legacies have been achieved than with actually delivering them. In fact, as there remains no politically endorsed ‘meaningful national measure’ for the sport participation legacy, it possible that we will never know whether the £9.3bn Games budget has been a successful legacy investment.

The Difference between What’s Possible and What’s Probable: Why the Centre for Social Justice is Wrong on Olympic Legacy!

The Centre for Social Justice (CSJ) today launches a report “More than a Game: Harnessing the Power of Sport to Transform the Lives of Disadvantaged Young People”, in which it draws a number of conclusions relating to the sporting legacy of the London 2012 Olympic and Paralympic Games.  While the general conclusion that it is probable that the “promise to deliver a sporting legacy across the country is unlikely to be met” is something that I have argued for some time, the CSJ’s four claims about the possibilities of Olympic sporting legacies are each flawed, dated, or just plain wrong.

CLAIM 1) “Previous Olympics such as the Sydney Games in Australia and the Manchester Commonwealth Games, both failed to produce any significant increase”: Setting aside the use of research on a single Olympic Games (Sydney) to make claims about “previous Olympics” in general, there are two problems with this claim.  Firstly, neither Sydney nor Manchester nor any previous major multi-sport event has sought to develop a sport participation legacy.  As such, it is hardly appropriate to draw conclusions about what is possible from events when the events considered have not employed strategies to lever a participation legacy. Secondly, a worldwide systematic review of the evidence for Olympic and Paralympic sport legacies by the Centre for Sport, Physical Education & Activity Research (SPEAR) for the Department of Health showed that there have been changes (increases and decreases) in sport participation following previous Olympic Games and other major sport events.  In particular, the report finds evidence for ‘activity switching’ (people giving up one sport to try another).  This suggests that, for carefully targeted groups, a Demonstration Effect, in which people are inspired by elite sport, sports people and sports events to participate themselves, can increase participation: it can encourage those who have participated in the past to participate again, and it can encourage those who participate a little to participate a little more.  This effect has been seen in previous Games, but has not previously been effectively leveraged.

CLAIM 2) “Nearly half the most popular sports within UK schools, such as cricket, rounders and netball, do not even feature in the Games and will not get any boost from the 2012 event”:  Unfortunately, the CSJ presents no evidence that there is a link between the first and second parts of this sentence.  Clearly, the report misunderstands the nature of a Demonstration Effect, which it claims requires that “a mechanism must be developed for translating three weeks’ worth of publicity for one set of sports into sustainable participation in another, largely different set”.  However, a Demonstration Effect, properly leveraged, is based not on the stimulus from three weeks of the Games, but on the opportunity for new and unusual sports to benefit from four years of media coverage, promotion and development in the run up to the Games.  Certainly, SPEAR’s research across England, Scotland and Wales on National School Sport Week in 2010 showed that the opportunity to try new and unusual Olympic and Paralympic sports appealed to children regardless of whether they liked sport in the first place.  In short, the promotion of these sports within an Olympic and Paralympic themed week was effective in attracting children not normally likely to play sport.  In addition, SPEAR’s evidence-based guide, “Active Celebration: Using the London 2012 Games to Get the Nation Moving”, shows that the key to using London 2012 to encourage lapsed participants back into sport is to create nostalgia for the broader elements of sport (e.g. teamwork, competition, camaraderie), and that this is not linked to specific sports.

CLAIM 3) “The evidence shows that there is no link between national sporting success and increased levels of sporting activity”:  Unfortunately, this is the claim that is just plain wrong.  SPEAR conducted an analysis of the Active People (n=363,000) and the Satisfaction of the Quality of the Sport Experience (n=45,000) surveys for Sport England in 2009, which showed that a quarter of people who had been active at least once in the last year were “highly responsive” to a Demonstration Effect based on the national team’s success (ie, people rated a positive effect on their participation as 8, 9, or 10 out of 10).  Furthermore, among those who participated less than twice a week and were not club members, a third were highly responsive to this effect.  In addition, the SPEAR report identified specific segments within Sport England’s Market Segments among which the percentage highly responsive to this effect was as high as 40%.  The CSJ claims appear to have been undermined by using broad “across the board” participation figures, rather than a more granular approach to participation data.

CLAIM 4) “Specific plans to boost participation unveiled in November 2010 and backed by £135 million National Lottery funding have major weaknesses”:  This is a fair conclusion, but one that is rather dated.  Six months ago SPEAR’s analysis of Places People Play, the government’s Mass Participation Legacy Plan, showed that “it will leave a lasting legacy, but it will not result in a new wave of mass participation in sport”.  Over half a year ago, SPEAR’s analysis concluded that because the plan addresses supply at the expense of demand, “most likely, the Places People Play will be populated by the already sporty making hay while the Olympic and Paralympic sun shines”.

So why has the CSJ reached the right overall conclusion (that it is probable that the sport legacy promise is unlikely to be met) given that their claims about the possibilities for Olympic and Paralympic sporting legacies are flawed, dated or just plain wrong?  In short, while the CSJ claims about the possibilities for Olympic legacies are wrong, their overall conclusion is about the probability that an Olympic sporting legacy will be achieved.  The possibilities, which have been detailed in the critique of the CSJ claims above, represent what sporting legacies could have been achieved if appropriate evidence-based policies and strategies had been developed and implemented immediately following the Beijing 2008 Games.  However, the probabilities for London 2012 Olympic and Paralympic sporting legacies represent what is likely to be achieved given the policies (or lack of policies) that have been implemented since Beijing 2008.  In short, the failure to achieve a sporting legacy from the London 2012 Olympic and Paralympic Games will be a failure of policy not  possibilities.  That’s the difference between what was possible and what’s now probable for the London 2012 sporting legacy!

Physical Activity and Sport: What Should We Recommend?

In his final annual report On the State of Public Health before retiring from the role of Chief Medical Officer (CMO) in 2010, Sir Liam Donaldson highlighted the health benefits of physical activity, including sport, suggesting that “If a medication existed which had a similar effect, it would be regarded as a ‘wonder drug’ or ‘miracle cure’”.  However, Sir Liam also noted that “Over the last 50 years, activity levels, particularly amongst the young, have fallen”.  So why have public health recommendations promoting “nature’s finest cure” been so unsuccessful?

1) What physical science says: Since 2004, the UK Chief Medical Officer (CMO) has recommended that for general health adults should take part in 30 minutes of moderate intensity exercise at least five times a week (5x30mins), whilst children should accumulate 60 minutes of moderate intensity exercise every day.  In the report that underpins these recommendations, these levels are promoted as being the minimum “necessary” for general health according to the scientific evidence.  Related to this evidence, Sport England’s policy goal is to increase participation in sport for thirty minutes at a time at least three times a week (3x30mins), based on the reasonable assumption that people taking part in sport at this level are likely to get another 2x30mins exercise in other ways.  More recently, however, there has been an increasing volume of research on the health benefits of short duration high intensity exercise. Reports of such research have been around for five years or so, but the volume of evidence is now increasing, and a recent University of West of Scotland Study was featured in the media last week.  The UWS study suggests that as little as four bouts of 30 seconds maximum effort exercise, interspersed with 30 second rest periods, on only three occasions each week (3x 4x30secs), may have equal, if not greater, health benefits  than the CMO’s recommendations of 5x30mins.

2) What behavioural science says: We know people can be motivated to be physically active and participate in sport in a number of ways.  There are external motivations such as reward (eg, payment or praise), external motivations that can become internalised (eg, the health benefits, sense of achievement or sociability of exercising or sport), and the truly intrinsic motivation of enjoying the physicality or movement of performing the activity itself (see the SPEAR Model in this report to Sport England, pp. 30-34). In many cases, internalised motivations are wrongly thought to be intrinsic motivations. Exercising to be healthy is not an intrinsic motivation – one does not need to enjoy the physical activity or sport itself to be motivated in this way.  Turning to aims around changing behaviour; we know that behaviour changes require two broad steps: firstly the development of a positive attitude towards a behaviour (thinking about change), and secondly a change in behaviour itself (see stages of change models in SPEAR’s report to the Department of Health, pp. 45-46). The problem group for physical activity and sport promotion is the proportion of the population who don’t even think about change.  These people can be put off physical activity and sport for many reasons: they may think that what is promoted as “necessary” for general health (5x30mins) is beyond their capabilities (this is called a competence gap), they may not be motivated by or value general health as an outcome, or they may react negatively to health messages that they perceive to be threats of consequences (eg, “if you don’t exercise you’ll have a heart attack”).

3) Why do we promote Physical Activity & Sport Participation? This is the vitally important question.  For the CMO and the Department of Health, physical activity and sport is not promoted for intrinsic reasons, but for its health benefits.  However, the sport community promotes sport as being important for intrinsic reasons of enjoyment, but also for a range of externalities such as health, the economy, sociability and socialisation, achievement, national pride and so on.   Now here’s the key: physical activity and/or sport can be valued by individuals for health outcomes, but still be regarded as a chore that isn’t enjoyable.  So, for those who are not yet even thinking about physical activity or sport participation, should we promote physical activity and sport on the basis of health benefits or on the basis of being an intrinsically and socially enjoyable activity?

4) Should we recommend what we can’t sell?  Given what we know about the underpinning physical and behavioural science, can the CMO’s recommendations that it is “necessary” to exercise at moderate intensity for at least 30 minutes at least five times a week for general health benefits be sold to those who are not even considering becoming more physically active or participating in sport?  If 5x30mins can’t be sold to this audience (and the relatively static participation figures across the UK suggests that it can’t) then, regardless of the physical science and medical evidence, the recommendations are pointless.

So, what can be done? Two alternative (or perhaps parallel) strategies suggest themselves.  On one hand, we could accept that doing physical activity and/or sport for health benefits is always likely to be regarded as an unpleasant chore (almost like taking medicine) for many people who are not active, and so we should make the pill as “un-bitter” to swallow as possible.  This is where the growing volume of research into the benefits of short duration high intensity exercise is important.  Performing four 30 second bouts of exercise with 30 seconds rest in between each (a total time of four minutes) three times a week (3x 4x30secs) is a much less bitter pill to swallow for those who do not like exercise than the CMO’s recommendations of 5x30mins exercise per week.  On the other hand, we could accept that health benefits do not appear to be working as motivations to engage those who are not physically active, and that they may even be off-putting to some audiences.  Alternative messages without any health references but focusing on, for example, enjoyment and sociability (eg, “Enjoy 30 Active Minutes”) or on green values in relation to active transport or the natural environment (eg, “Actively Save the Planet”) could be more widely used to capture those who, for whatever reasons, do not respond to health-related promotions of physical activity and sport.  What is clear, though, is that 3x 4x30secs will never be saleable as anything other than the least-bitter exercise for health option, whilst 5x30mins may be too much of a commitment to sell on the basis of health benefits alone.  For physical activity and sport promotion, it seems: For health or not for health…that is the question!

Lies, Damned Lies and Sports Participation Statistics?

Sport England has recently published summary findings for sports participation in 2009/10 from the Active People Survey under the headline “Cycling and running boom shows appetite for sports participation”, with a growth in netball also highlighted. But what do these statistics really show, both for sports participation and for the London 2012 sport participation legacy effort?

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UPDATE (1st January 2011): When Mark Twain popularised the phrase “Lies, Damned Lies and Statistics”, his meaning was that statistics are often selectively used to bolster arguments, and that statistics that do not support one’s position are often discounted or disparaged.  This Blogpost was an invitation to consider whether this is the case with sports participation statistics (hence the question mark in the title).  My conclusion in the final paragraph below is that the selection of the statistic should depend on what policy outcome is valued and thus what question is important, not on what arguments one wishes to make.  In the cycling example, the long term participation trend is up, although in the last year participation has dropped.  If one wishes to examine whether any recent policy changes have had an immediate effect, the latter statistic is important; but if one wishes to examine a longer term trend, the former statistic is important (and it would take another year of falling participation to suggest a longer term downward trend).

The intention of this Blogpost is neither to make a particular argument through selecting a particular statistic, nor is it to critique the particular statistic Sport England prioritises.  It is intended to illustrate that the statistic that should be used depends on what policy outcome is valued, and therefore what question is important.  In this Sport England have been entirely consistent for at least three years – their headline statistic is the progress towards a million more people participating three times a week or more for 30 minutes or more at a time (3×30/week) by 2012/13 from a 2007/8 baseline.  In this respect there is no obfuscation and no selective use of statistics to bolster a particular argument, and for this Sport England are to be commended.  However, others may value a different policy outcome, and may therefore quite legitimately make a different statistical choice.

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1) Pick of the Stats: Three different levels of participation are measured, once a month, once a week, and those participating three times a week or more for 30 minutes or more at a time (3×30/week).  It is this latter statistic that is used to measure the “one million target” – the Olympic legacy promise to get one million more people playing regular sport by 2012/13.  We can also choose from three “baselines” against which to compare this year’s participation: that from the first year of the survey, 2005/6, which gives a longer term picture; that from 2008/9 which tells us about the most recent changes; or that from two years ago, 2007/8, which provides the baseline for the “one million target” (there was no survey for 2006/7).  This means that we can choose from nine different statistics for sport participation change, and for individual sports, for which 3×30/week data has not yet been provided, there are six different participation change statistics to choose from.

2) Overall Participation: Progress towards the “one million target” for overall sport participation at 3×30/week has advanced 123,000 since 2007/8, a two year trend which, if it continued, would see the one million target being reached more than ten years late in 2023/24.  Of course, one argument is that the strategic investments towards the one million target need time to bed in.  In which case, we might expect to see a greater increase in participation in the last year as at least some of those investments take effect.  After all, we have known that London is to host the 2012 Games for five and a half years now.  However, the increase in overall participation at 3×30/week in the last year is only 8,000, a figure so small (0.1%) that it is within the margins of error of the survey, and therefore should be taken to mean no change at all.

 3) Netball: Overall, the number of women participating in sport has fallen, so the increase in those playing netball at least once a week by one fifth during the last two years is presented as a success that can help arrest this trend.  However, during the same period, those participating once a month or more has not changed (the small change reported is within the margins of error of the survey).  This means that the increase in women playing netball once a week is almost entirely drawn from those who were already playing once a month or more.  In other words, these are not new participants, but current participants who have increased their participation frequency.

4) Cycling and Athletics:  Unlike netball, cycling and athletics are both Olympic and Paralympic sports, and so a greater 2012-effect on participation might be expected.  In fact, looking at the longest term change available, those participating in athletics at least once a month has increased by over 700,000 since 2005/6, and in cycling by over half a million in the same period.  However, if we are looking for a link to strategic Olympic and Paralympic legacy investments, then the latest changes are most relevant.  In the last year, the increase in those participating in athletics at least once a month has been only 89,000, a figure that is almost entirely offset by a decrease in the number cycling at least once a month by 80,000.  In short, the net contribution of athletics and cycling to increases in those participating in sport at least once a month during the last year has been virtually zero.

5) The Olympic and Paralympic Games: So what does this say about the London 2012 Mass Participation Legacy effort.  In short, in the three sports that are highlighted as successes by Sport England, we have seen an increase in the frequency of participation among those already playing netball in the last two years, and in the last year we have seen a shift of participation from cycling to athletics that has an overall effect on monthly participation figures of all but zero.  Research on sport participation legacies by the Centre for Sport, Physical Education & Activity Research (SPEAR) shows that a ‘demonstration effect’, where people are inspired by elite sport, sports people and sports events to participate themselves, can result in three outcomes: those who are already playing may play more, those who have played before may play again, and people may give up one sport to try another.  The former and the latter are reflected in the recent participation statistics, and unless the recent London 2012 Mass Participation Legacy Plan is amended or extended to include measures that seek to raise demand for sport (rather than simply increasing supply), we are some way from delivering a participation legacy from the 2012 Games. (click HERE for an evidence-based analysis of the Mass Participation Legacy Plan)

In summary, and using cycling as an example, depending on the statistic chosen, participation has either increased by over half a million or fallen by 80,000!  The key question is what’s important?  Over the long-term (since 2005/6) cycling participation has risen significantly, but in the last two years, the rate of that rise has slowed, and in the last year participation has actually fallen.  You pays your money, and you takes your statistical choice!

School Sport Partnerships – We’ve heard the opinions and anecdotes, but here’s what the evidence says…

For the last eight years I have been funded to research and evaluate the delivery of various sport initiatives in schools and with young people.  This work has been funded by agencies such as the Youth Sport Trust and Sport England, by charities such as 4Children and StreetGames, by sponsors such as Coca-Cola and LloydsTSB, and by sport governing bodies such as the Football Association.

Across these projects data has been collected from many thousands of schoolchildren and many more thousands of teachers.  Collectively and consistently, this evidence provides the following insights relating to the current debate on school sport and the need for school sport partnerships:

1) Primary Teachers: Primary schools very rarely have teachers with PE training or sport delivery experience, and often the PE co-ordinator role is given to early-career teachers because the more experienced teachers lead on subjects such as literacy and numeracy.  Successive research has consistently shown that not only do primary teachers need help to deliver PE and sport, they need help to find help to deliver PE and sport.  Primary teachers have consistently said that they do not have the time to seek out, nor to quality assure, the sport expertise that they need to deliver a quality PE, sport and physical activity programme in their schools.  This suggests a clear need to maintain a ‘supply’ network, albeit necessarily slimmed down from the current school sport partnership system, from which teachers pressed for time and inexperienced in PE and sport, can commission quality provision.

2) Schoolchildren: One of the problems for sport promotion with adults is that around 50% of the adult population are sport averse.  However, children and young people are rarely averse to sport as a whole, this is an attitude that develops in later life.  But, children and young people are often averse to particular sports.  Research has consistently shown that while children and young people may say, for example, “I hate football”, this rarely means that they will not try other sports.  Consequently, the best way to increase sports participation among children and young people is to provide a balanced and extended programme of sports provision.  Recent research with primary school children showed that the novelty of new sports was attractive to the children, regardless of how much they said they liked sport to begin with.  Therefore, an effective PE and school sport system must be structured to provide as wide a range of activities as possible.  Schools themselves cannot be expected to source and quality assure such a wide range of activities, thus a co-ordinating network is needed.

3) Competition: Undoubtedly competition motivates some children and young people, and promoting intra and inter school competition is an excellent way to encourage those children who already play sport to play more often or to improve their performance and skills.  However, research with children and young people has consistently shown that those who are the least active are not only put off by participating in competitions, they are also put off by playing sport in an environment that is shaped by competition.  Detailed qualitative research has shown that for these young people, a focus on skills, delivered by someone perceived to be a leader rather than a coach, is key to developing participation and enjoyment.  High quality provision of this nature is much more difficult for schools to locate than more traditional input from sport coaches, and so a point of contact to identify providers in whom schools can have confidence is required.

4) The Olympic and Paralympic Games: A School Olympics is a high profile way to gain media coverage and involve commercial sponsors, but a competitive Olympic-branded competition will serve only to enhance the competition experience of those children and young people who already play sport.  Research in the last year has shown that the Oympic and Paralympic Games can do several things for young people: i) it can enhance the experiences and enjoyment of those who already play;  ii) it can be a way to introduce a wider range of sporting opportunities to young people who have been put off by traditional sports such as football, rugby and netball; iii) it can use the celebration and carnival of the event to draw the least active into broader physical activities such as streetdance or cheerleading.  However, a competitive School Olympics cannot deliver this, it can only enhance the experiences of those who already play.  A wider expertise in using the values, images and history of the Olympic and Paralympic Games to fire children and young people’s imagination is needed if London 2012 is to have a significant and sustainable impact on sport participation.

In summary, some young people want more competition and are inspired by Olympic and Parlympic stars, but they are already playing.  Less engaged children and young people require a wider range of activities, provision and support to find a sport or activity that will enable them to become lifelong participants.  Unfortunately, as schools and teachers often recognise themselves, they do not have the time, the experience or the expertise to locate or deliver this provision and support.  Empowering schools to make choices about their own provision is a laudable goal, but devolving funding is not the same thing as empowering choice.  Such empowerment requires that schools have confidence that there is a system of high quality sports provision supply from which they can choose, otherwise the most likely choice will be not to commission sport provision at all.