The development of a network for community based obesity prevention : the CO-OPS collaboration

Background: Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities.
Methods: Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice.
Results: The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further
evidence generation and translation drawing from process, impact and outcome evaluation of existing communitybased interventions.
Conclusions: The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks.

Developing a theory of sport-based entrepreneurship

Entrepreneurship is an integral part of sport but less is known about how different types of entrepreneurship facilitate innovation. The aim of this paper is to develop a theory of sports-based entrepreneurship that incorporates different sub-categories of entrepreneurship such as social, technological and international. Specifically, the article connects the entrepreneurship and sport management literatures by proposing a theory of sport-based entrepreneurship, which can be used as a theoretical framework for future research. In addition, the paper provides a unique insight for sports practitioners and public policy planners wanting to focus on entrepreneurial ways to manage sport-based organizations.

Process evaluation of a community-based adolescent obesity prevention project in Tonga

Background: The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma’alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention.
Methods: MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models.
Results: While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns.
Conclusions: The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were generally insufficient and not sustained. Also the project confirmed that, while the MYP resulted in increased community awareness of healthy behaviours, Tonga is still in its infancy in terms of conducting public health research and lacks research infrastructure and capacity.

Best practice principles for community-based obesity prevention : development, content and application

Best practice in obesity prevention has generally been defined in terms of ‘what’ needs to be done while neglecting ‘how’. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention.

Sport-based entrepreneurship : towards a new theory of entrepreneurship and sport management

The entrepreneurship and sport management disciplines have grown significantly in the past decade. Sport is an entrepreneurial process as innovation and change are key elements of sport. The aim of this paper is to develop a theory of entrepreneurship in sports management by investigating the relationship between entrepreneurship and sport. The rapidly growing and developing sport marketing discipline provides a basis in which to understand how entrepreneurship occurs through innovation, proactiveness and risk taking activities. This paper discusses the connection between the entrepreneurship and sports management fields and argues that there needs to be more integration with the two fields of study and traditional entrepreneurship theory. A theory of sport-based entrepreneurship is developed and different types of entrepreneurship that occur in sports management are examined. Suggestions for future research and implications for practitioners are discussed.

A social perspective of sports-based entrepreneurship

In this paper I develop the concept of sport-based entrepreneurship and argue that it provides a potential social orientated strategy for the development of sports-related businesses. I maintain that this emerging form of entrepreneurship is usually inherent in the management of sports, which transforms sport-based organisations into an entrepreneur and enterprise. This paper draws on interdisciplinary approaches from the entrepreneurship and sport management literature to discuss the social entrepreneurship inherent within sports-based organisations. The sport sector provides an exploration of the contextual boundaries of social entrepreneurship and provides a useful discussion on the innovation, risk taking and proactive activity. The implications for sport organisations involved in social entrepreneurship are stated and the importance of governments around the world to promote social entrepreneurship in sport are highlighted. In addition, suggestions for future research are stated that highlight the role of sport-based entrepreneurship theory for examining social change.

Incorporating sustainability into community-based healthcare practice

There is now irrefutable evidence that climate change and increasing environmental degradation negatively affect population health. Healthcare plays an important role in addressing these emerging environmental challenges, considering its core aim is to protect and promote health. Preliminary research in Victoria, Australia, suggests that healthcare practitioners are endeavouring to factor in environmental concerns into their practice. Health promotion, an integral part of the healthcare system, is considered an area of practice that can support action on sustainability. Based on five qualitative case studies and key stakeholder interviews, this article explores key barriers and facilitators to incorporating sustainability into community-based healthcare practice. The findings demonstrate that despite multiple barriers, including funding and lack of policy direction, health promotion principles and practices can enable action on sustainability.

The association between urban or rural locality and hip fracture in community-based adults : a systematic review

Urban or rural locality has been suggested to influence musculoskeletal health, with lower bone mineral density (BMD) and greater prevalence of fracture identified in urban residents. A computer-aided search of Medline, EMBASE, CINAHL and PsychINFO, January 1966 to November 2007 was conducted to identify studies investigating the relationship between urban or rural locality and the occurrence of hip fracture. The methodological quality of studies was assessed, and a best-evidence synthesis was used to summarise the results. Fourteen cohort studies and one case-control study were identified for inclusion in this review, indicating a lack of literature in the field. Best-evidence analysis identified moderate evidence for residents of rural regions to have lower risk of hip fracture compared to urban residents. Examining principal mechanisms for the observed relationship between urban/rural locality and hip fracture, such as factors at the person or area level, may help to identify modifiable risk factors and inform appropriate prevention strategies.

Strengthening work integrated learning (WIL) experiences for rural education students : exploring community based partnerships

This paper investigates three areas of priority for rural teacher education: work integrated learning (WIL); attraction and retention of teachers to rural areas; and the potential challenges and benefits of community based partnerships to address these areas of need. The data on which this paper is based focuses on a Victorian project around six case studies that explored the research and scholarship of teaching graduates to be work ready for the needs of rural and regional communities. The project also aimed to explore how preservice teacher education can develop and better support pre-service teachers (PSTs) through rural and regional community-based WIL experiences.
The project investigated what sort of support PSTs undertaking WIL experiences in rural and regional communities need in order to develop positive attitudes and understandings in relation to working in a rural/regional community. Consideration was also given to how support from the university, school,
supervising teacher and broader local community enhances or detracts from the PST’s experience of WIL in rural and regional areas. In order to explore these issues in this paper the authors will outline some recommendations with regards to ways in which teacher education programs may enhance the experiences of stakeholders involved in rural and regional WIL experiences, including PSTs, supervising teachers, university teacher educators and community members.
The project’s underlying conceptual framework of place, productivity and partnerships will be explained in terms of its overlapping dimensions of community, creativity and capital in order to reconceptualise preservice teacher education in local, rural and regional and global contexts as adaptive community-based work integrated learning within a knowledge economy.
The final discussion will make recommendations on how universities and other identified stakeholders can better facilitate WIL and enhance stakeholder engagement in rural and regional areas in order to equip PSTs
and classroom teachers to work creatively together in productive partnerships to meet the future demands of local rural and global contexts of change in a knowledge economy.

Osteo-cise : Strong bones for life': protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

Background : Osteoporosis affects over 220 million people worldwide, and currently there is no 'cure' for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition.

Methods : The 'Osteo-cise: Strong Bones for Life' study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function, and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged 60 years or above will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month 'research to practise' translational phase. Participants will be randomly assigned to either the 'Osteo-cise' intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed.

Discussion : The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial Registration: Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291