Three main themes were identified: 1) awareness of PA interventions; 2) factors contributing to intervention effectiveness; and 3) barriers to participation in PA interventions. Quotations to support the analysis were identified by a code, indicating their source: interviewee (IN), voluntary (V), statutory (S) or focus group (FG).
Theme 1: Awareness of PA interventions
Interviewees highlighted a poor awareness of previous and current PA interventions, other than those in which they had personally been involved, suggesting a lack of interest among community leaders for the effective promotion of PA. Comments from both statutory and voluntary sector leaders reflected this lack of awareness.
“There are schemes [interventions] happening, but they’re not in east Belfast that I’m aware of and that’s the sad thing” (IN5S).
“I don’t know ……..and that doesn’t mean to say that it’s not happening I just don’t know about them” (IN4V).
Their responses indicated that the nature of interventions varied between sectors. Voluntary sector interventions tended to focus on more general community activities and to include PA as a subsidiary component, thus potentially diluting the attention given to it. In contrast, statutory agencies’ relevant interventions focused on PA specifically and targeted specific groups.
“… holistic health and wellbeing programmes but would probably have an element of PA in them” (IN1V).
“Healthwise Scheme….GP referral to the gym” [for people who are obese or have high blood pressure]” (IN5S).
Comments reflected little linkage or shared communication between or within statutory or voluntary sectors or inclusion of local residents in the planning or delivery of initiatives. Leaders of voluntary organisations reported feeling “out of the loop” with statutory agencies, but also reported an absence of collaborative working between community groups.
“You’ve had this gap between the statutory and the non-statutory sector…there is not a huge amount of consultation with or community involvement. … They’ve all got their own programmes and they sort of guard them jealously, there’s very little in terms of joined up thinking........or strategic thinking” (IN2V).
These perceptions were shared by FG participants who were aware of poor co-ordination between organisers of various interventions. Their comments also indicated that residents failed to engage with interventions which they perceived as being personally irrelevant.
“See if it doesn’t affect you and you don’t want to know,… leaflets in the houses advertising activities that are going on......, but people don’t want to know” (FG).
However, they were clear that if information, such as public health messages relating to PA, was perceived as being relevant to individuals within their community, then the strong socio-cultural influences which exist currently would ensure its effective dissemination.
“..... no matter what..... we find it out round here if we want to” (FG).
Theme 2: Factors contributing to intervention effectiveness
Interviewees perceived that there was value in involving members of the community from the outset of planning an intervention to ensure community “ownership” and to guarantee that plans would be relevant and tailored to the local context. Both voluntary and statutory sector leaders considered that it was important to target the ‘right people’ and to offer options regarding details of the intervention’s delivery, to help ensure that it would address people’s needs.
“…initiatives that have been successful have ....... taken into account where people are at and then have developed a programme accordingly” (IN1V).
FGs also emphasised the importance of community participation in developing acceptable plans and considering how to counter possible adverse influences for their implementation and the maintenance of facilities.
“Local organisations and groups are key.... need to involve....... give security to neighbourhood......respect privacy.... antisocial behaviour knowledge” (FG).
“If you get somebody involved in something they’re more likely to use it or they’re less inclined to break it” (FG).
Both interviewees and FG participants acknowledged that securing funding is vital for the success of any intervention. The FGs highlighted the lack of readily available finance and identified that collaboration, rather than competition, would increase the likelihood of applications for funding being successful and gaining resources.
“Money, it’s as simple as that, you can build anything, you can make anything, you can run anything if you have the money” (IN5V).
“ … individual groups but not too many of them are working together and everybody’s trying to get their own funding and they’re all competing with each other” (FG).
However, it was recognised that money alone would not ensure success: several interviewees emphasised how community engagement and volunteer support was necessary for interventions to attract participants. They also emphasised that community volunteers needed to be “looked after”, to foster their continuing involvement.
“Making use of volunteers and their time; it’s key to any of these initiatives” (IN1V).
Interviewees recognised a need for strategic planning, and better linkage between organisations and with the community. They perceived that it was important to have an identified “exit strategy”, whereby interventions promoting PA were not isolated short-term events but were planned to support a sustained change of behaviour, with resources that would be available in the longer term.
“An exit route….extremely important too, in that we try as best possible to put in place and to target activities where that input can be sustained” (INV5).
It was suggested that a multi-sectoral interdisciplinary team, which worked collaboratively and shared information would allow more informed planning in an ongoing context with “very much reduced duplication” and more effective use of resources.
Theme 3: Barriers to participation in PA interventions
Apathy was identified as a barrier to PA promotion. When communities were informed about proposed interventions which were not implemented there was a loss of interest in subsequent proposals.
“Bombarded with potential programmes….overworked or jaded or maybe a wee bit burnt out” (IN1V).
“Over-saturation problem …” (IN9S).
Apathy was also linked to poor self-esteem among individuals within the community and leaders suggested that there was a need for specific programmes to support the development of personal skills. Residents felt they needed “encouragement” to become involved in community interventions; their comments reflected disappointment, to which they appeared resigned rather than surprised, at the failure of community leaders to follow-up initial discussions regarding a succession of suggested initiatives.
“… a lot of low self-esteem, personal development is much needed” (IN4V).
“…you hear one story this week and then a few weeks later another story appears in the press and then another one .........” (FG).
Lack of facilities
Interviewees from voluntary organisations reported that it was difficult to access resources for interventions and considered that having established facilities within the locality would promote engagement in PA in the longer term.
“.. like if you want something that is going to be sustained and continued on, having a resource base in place obviously helps” (IN9S).
FGs also identified difficulties relating to practical facilities (toilets and seats), lack of services (child-minding and carer support) and fears for safety (due to poor lighting and inadequate supervision/security), emphasising the importance of involving local residents to identify specific needs and appropriate plans to address these in specific localities.
Interviewees felt the community lacked knowledge of the benefits of PA for health. They also felt there was a need to have, based in the locality, someone who was trained to support people who wished to become more active. They appeared to recognise a communication gap between themselves and the community in their current approaches to promoting PA and to perceive inadequacy in their own knowledge. However, they showed no recognition of individuals’ personal difficulties in becoming physically active. No comments reflected any awareness of personal, socio-cultural or physical barriers to PA or a sense of understanding of the community’s perceptions of the value of PA.
“There’s some sort of step we need to take to get into people’s mind the importance of PA and how easy PA can be” (IN4V).
“….some kind of local campaign linking in with like a regional based campaign identifying the benefits of PA” (IN8S).
“You’re going to start off telling people first, then you’re going to remind them, then you’re going to re-remind them” (IN5S).
FGs highlighted the importance of face-to-face contacts and social-networking in communication. Personal contacts, involving ‘word of mouth’, were perceived to be the most frequent and effective method of disseminating information. Residents also highlighted how they valued being kept informed about the ongoing progress of interventions and that this encouraged community engagement.
“Keep people up-to-date with how it’s going” (FG).