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Abstract Background Children and adolescents’ physical inactivity is a global problem. Financial incentives are increasingly utilised to support children’s participation in sport, with programs introduced in multiple jurisdictions globally, however few programs have comprehensive evaluations. This study used a Delphi methodology to develop evaluation recommendations for an existing population-wide financial incentive program based in South Australia. Methods A three-round Delphi study was conducted from October 2022 to April 2023. A diverse range of stakeholders including end-users, government representatives, academics/researchers, and Non-Government Organisation representatives participated in the Delphi panel. Round 1 focussed on the perceived importance of various evaluation components, including reach, process, and effectiveness. Round 2 focussed on identifying evaluation approaches and tools, while Round 3 determined methodological priorities and timeframes. A consensus level of ≥ 70% was set a priori (rating 6 or 7 on 7-point scale). Round 3 results were used to formulate evaluation recommendations. Results Sixty-seven stakeholders agreed to participate, with an average response rate of 76% (87%; 73% and 67% for each round, respectively). All evaluation components gained consensus in Round 1. In Round 2, consensus was gained on 14 evaluation measures, including measuring the cost of sport, awareness of the program amongst eligible families, and reasons for non-participation, with evaluation methods generated for each measure. Round 3 results determined participants’ preferred methods of evaluation and informed the development of evaluation recommendations. Recommended evaluation methods included mixed method approaches for provider and user process evaluations and measuring program awareness using an epidemiological survey. Conclusion This Delphi study sought the views and opinions from diverse stakeholders to create evaluation recommendations for a population-wide sports voucher program. Results suggested that a comprehensive evaluation strategy is needed to understand the reach, effectiveness, and impact of the program. Additionally, there was a consensus on reallocating program funds for this evaluation.

Abstract Parents and caregivers who participate in regular physical activity have improved physical and mental health and can influence the physical activity behaviors of children in their care. This study aimed to assess the association between psychological distress and physical activity levels of parents/caregivers in New South Wales, Australia during different COVID‐19 restriction periods. A repeat‐cross‐sectional design was adopted. Parents/caregivers involved in a government‐led children's sport and recreation voucher program were recruited to participate in an online survey as part of the program's evaluation. In response to COVID‐19, parents and caregivers' psychological distress and physical activity levels were assessed using validated items. Binary logistic regression models were used to examine the relationship between physical activity and probable mental illness, and differences across different COVID‐19 restriction periods in 2020 and 2021. In 2020, 10,990 parents/caregivers responded to survey questions and in 2021, 17,106 parents/caregivers responded. Parents/caregivers who were physically active on 7 days per week had lower odds of reporting high psychological distress (odds ratio [OR]: 0.40, 95% confidence interval [CIs]: 0.33, 0.49) than parents/caregivers physically active on fewer days per week. In 2020 9.8% of parents/caregivers (n = 1076) reported high psychological distress, which decreased to 8% in 2021 (n = 1366). In 2021, parents/caregivers had lower odds of reporting high psychological distress (OR: 0.79, 95% CIs: 0.72, 0.86). Socioeconomic disadvantage negatively impacted psychological distress and physical activity levels. Australian parents and caregivers who reported high psychological distress, during and after COVID‐19 restrictions, were participating in low levels of physical activity. Greater collaboration between the mental health, and sport and recreation sectors is recommended to harness the co‐benefits of physical activity throughout parenthood, particularly in low socioeconomic areas.

Abstract Background Sports have a focus on increasing participation, which contributes to increasing population levels of physical activity, social cohesion and longevity of the sport. The primary aim of this study was to examine reasons for drop-out of a popular team sport in Australia, Field Hockey and identify opportunities to increase participation. Methods This longitudinal study obtained routinely collected registered player data from Hockey New South Wales over two consecutive years, and survey data from registered players who dropped out. Logistic regression models identified demographic subgroups who were more likely to drop out of sport, and the reasons for dropping out. Results In 2018, 8463 (31%) of hockey players did not return to play hockey after the previous season and 805 (10%) of these completed a survey. Specific groups who were more likely to stop playing included 5–6 years (OR: 2.1, 95% CI 1.8–2.6; reference: 12–17 years), females (OR: 1.1, 95% CI 1.0–1.2; reference: males), Indigenous (OR: 1.2, 95% CI 1.1–1.4; reference: non-Indigenous), most disadvantaged (OR: 1.1, 95% CI 1.0–1.2; reference: least disadvantaged) or regional and remote (1.1, 95% CI 1.0–1.2; reference: major cities). Top reasons for drop out were medical/age (17%), change in circumstances (16%) and high cost (13%), lack of time (13%) and lack of enjoyment (7%). Conclusions Although Hockey successfully reaches a large proportion of underrepresented groups in sport, these groups are more likely to drop out. Sports should consult these groups to develop enjoyable, flexible, and modifiable versions of the game that are appropriate to their needs.

Abstract Background Sports should endeavour to provide inclusive opportunities for all people to participate. More evidence is required to understand who joins sports clubs and what keeps participants engaged throughout their lifetime. Little is known about who plays netball or what drives participation and retention of players in netball. This study aimed to identify the sociodemographic characteristics of Netball New South Wales (NSW) members, their odds of re-registering in the sport, and explore their motivations to play, experiences during participation and the perceived benefits of playing netball. Methods We used longitudinal sport registration data from all Netball NSW members in 2018 and 2019. A cross-sectional online survey was sent to all players registered during the two-year study period (n = 157,152). We used logistic regression to determine the odds of individuals returning to netball in 2019 after playing in 2018 and linked the sports registration data with the survey responses, calculating frequencies and proportions. Results Netball NSW members were mostly female (98 %) and aged less than 18 years old (69 %). Netball NSW retained 68 % of members in 2019 who played the previous year. Members who were male, aged 18–44 years old, lived in low SES areas, lived in regional/remote locations, identified as Aboriginal or Torres Strait Islander, spoke a language other than English at home or were born outside Australia had lower odds of returning to play from 2018 to 2019. Survey participants (n = 10,795) rated their experience playing netball highly and reported that playing netball improved their health and wellbeing. The main reason to play netball reported was ‘fun and enjoyment’ while the main reason to consider quitting was the ‘skill/experience of umpires and officials’. Conclusions This study highlights the strengths of netball in engaging and retaining females, who often participate in less sport than males. The positive experiences reported by netball participants should be fostered to retain current participants throughout the lifecourse. The data provided by members should be inform strategic actions to enhance netball participation for sociodemographic groups who had greatest odds of dropout. Routine surveillance using linked registration and player feedback should be utilised by sports to enhance sport delivery and increase participation.

Abstract Background There is an urgent need for scaled-up effective interventions which overcome barriers to health-enhancing physical activity for children and adolescents. In New South Wales (NSW), Australia, the state government implemented a universal voucher program, ‘Active Kids’ to support the cost of structured physical activity registration for school-enrolled children aged 4.5–18 years old. The objective of this study was to understand the effects a financial incentive intervention delivered in a real-world setting has on children and adolescent’s physical activity participation. Method In 2018, all children and adolescents registered for an Active Kids voucher provided sociodemographic characteristics, physical activity and research consent. This prospective cohort study used an online survey with validated items to measure physical activity and other personal and social factors in children and adolescents who used an Active Kids voucher. Generalized linear mixed models were used to examine changes from registration to after voucher use at ≤8 weeks, 9–26 weeks and ≥ 6 months. Results Study participants reported increasing their days achieving physical activity guidelines from 4.0 days per week (95%CI 3.8, 4.2) at registration (n = 37,626 children) to 4.9 days per week (95%CI 4.7, 5.1) after 6 months (n = 14,118 children). Increased physical activity was observed for all sociodemographic population groups. The voucher-specific activity contributed 42.4% (95%CI 39.3, 45.5) to the total time children participated in structured physical activities outside of school. Children and adolescents who increased to, or maintained, high levels of activity were socially supported to be active, had active parent/caregivers, had better concentration and were overall happier than their low-active counterparts. Conclusion The Active Kids program significantly increased children’s physical activity levels and these increases continued over a six-month period. The Active Kids voucher program shows promise as a scaled-up intervention to increase children and adolescents’ physical activity participation. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12618000897268 , approved May 29th, 2018 - Retrospectively registered.

Abstract Background Organized, leisure time physical activities are an important part of a population approach to increase total physical activity participation. Dancing is a type of organized leisure time activity which may be utilized to enhance public health. Individuals commonly participate in dance during childhood however few maintain participation into adulthood, dropping out of the activity while young. This study aimed to investigate who participates in an emerging dance activity, “No Lights, No Lycra”, which encourages people to participate in free-form dancing in the dark for 60 min designed as an inclusive, nonjudgmental, drug and alcohol-free community setting. This version of dance provides a modified opportunity for organized leisure time physical activity. No Lights, No Lycra has recorded increases in attendance at their events over the past decade. This popularity warrants an investigation into participant’s demographic characteristics, their total physical activity, as well as their motivations for dancing in the dark and any impacts on health and wellbeing. Methods This study invited No Lights, No Lycra participants from across Australia to complete a cross-sectional, self-report online survey. Participants were recruited while attending an organized session or through social media channels. The descriptive data provided through survey responses were analyzed using IBM SPSS Statistics. Results Participants (n = 1190, 92% Female) reported their main reason for dancing in the dark was to have fun. Most participants were insufficiently active, with 88% of responders not meeting physical activity guidelines. The No Lights, No Lycra dance sessions contributed 23% of their total annual participation in organized physical activities. Conclusion No Lights, No Lycra attracts adult women, rather than the typical dance participants – children; These women did not meet physical activity guidelines and typically had low levels of engagement in organized physical activity. Participation in No Lights, No Lycra, shows promise to increase women’s physical activity. This study into No Lights, No Lycra demonstrates how dance can be modified to engage a relatively inactive portion of the community. More should be done to understand how modifications to organized sport and physical activities can motivate and maintain engagement of typically inactive people.

There has been limited population-level success in tackling overweight and obesity. The Active Kids program is a universal intervention that aims to increase participation in structured physical activity and sport among children and adolescents in New South Wales (NSW), Australia. This study examined the prevalence of overweight and obesity across subgroups and by social disadvantage in this large broadly representative sample. A cross-sectional study was conducted including all children (n = 671,375) who registered for an Active Kids Program voucher in 2018. The child’s height and weight were obtained from an online registration form. Among children and adolescents who registered in the Active Kids Program, the prevalence of overweight and obesity was 17.2% and 7.6%, respectively. A large number of children and adolescents who lived in the most disadvantaged areas (n = 99,583; 14.8%) registered for the program. There was a clear socio-economic gradient for obesity prevalence across areas of increasing disadvantage, with children and adolescents living in the most disadvantaged area being 1.87 (95% CIs 1.82, 1.93) times more likely to be overweight or obese. The Active Kids program successfully reached a substantial proportion of children who are overweight and obese from socio-economically disadvantaged areas, providing financial support and opportunities for these children to participate in structured sport and physical activity. However, the program did not reach all children, and additional physical activity promotion strategies may be needed in a comprehensive approach. Nonetheless, these findings support government investment in reaching children who are overweight or obese with large-scale programs.

Objective: The Live Life Well @ School program aims to establish, reinforce and support primary school students (aged 5–11 years) and their families to adopt healthy eating and physical activity behaviours through the implementation of an evidence-based program that focuses on the school curriculum, the school food and physical activity environment, and teacher professional development. This paper examines Live Life Well @ School monitoring data to provide practical insights into program adoption and changes in primary school environments across NSW, particularly in schools characterised as disadvantaged. Type of program: The Live Life Well @ School program provides a universally delivered, state-wide approach to childhood obesity prevention in the primary school setting. The program is a joint initiative between health and education sector agencies. Methods: The program includes health promotion strategies for primary schools relating to physical activity and nutrition. Adoption of the program is indicated by achievement of evidence-based desirable practices, which are monitored routinely by local health promotion staff using a purpose-built online Population Health Information Management System. Monitoring data are used to provide feedback to schools and identify a staged approach to achieving more desirable practices. Health promotion staff tailor support locally to suit school and community needs, and have additional funding to support socio-economically disadvantaged schools. Results: The program has achieved high reach to schools (82.7% of the 2570 schools in New South Wales, Australia). Adoption of desirable practices within schools participating in 2017 was 72.9%. Equitable reach was achieved for schools in areas of socio-economic disadvantage, schools in remote areas and schools with a high propotion of Aboriginal students, who are likely to have higher rates of childhood overweight and obesity. Curriculum-based strategies were more frequently adopted; environmental changes and teacher professional development components were less well adopted. Lessons learnt: The desirable practice approach allows health promotion officers to tailor support by building on school strengths and taking a staged approach to change. Ongoing monitoring of the program provides useful insights that inform quality improvements to the program and implementation process, as well as information on progress towards outcomes. State-wide program targets were adjusted to strengthen impact and focus on desirable practices that were less well achieved. Intentional targeting and tailoring in areas of disadvantage are required to achieve equitable adoption of such a universal health promotion program. Strong relationships at the local level between school champions (teachers and principals) and health promotion staff characterise success.

Facebook, the most widely used social media platform, has been adopted by public health organisations for health promotion and behaviour change campaigns and activities. However, limited information is available on the most effective and efficient use of Facebook for this purpose. This study sought to identify the features of Facebook posts that are associated with higher user engagement on Australian public health organisations' Facebook pages. We selected 20 eligible pages through a systematic search and coded 360-days of posts for each page. Posts were coded by: post type (e.g., photo, text only etc.), communication technique employed (e.g. testimonial, informative etc.) and use of marketing elements (e.g., branding, use of mascots). A series of negative binomial regressions were used to assess associations between post characteristics and user engagement as measured by the number of likes, shares and comments. Our results showed that video posts attracted the greatest amount of user engagement, although an analysis of a subset of the data suggested this may be a reflection of the Facebook algorithm, which governs what is and is not shown in user newsfeeds and appear to preference videos over other post types. Posts that featured a positive emotional appeal or provided factual information attracted higher levels of user engagement, while conventional marketing elements, such as sponsorships and the use of persons of authority, generally discouraged user engagement, with the exception of posts that included a celebrity or sportsperson. Our results give insight into post content that maximises user engagement and begins to fill the knowledge gap on effective use of Facebook by public health organisations.