Figure 1
Overview of the study procedure.
Table 1
Characteristics of the participating professionals.
| Profession | Age (years) | Gender | Work experience (years) | Type of practice | Population (%) |
|---|---|---|---|---|---|
| GP (16) | 44.79 (33–62) | 7 men 9 women | 15.43 (2–34) | 3 solo practice 3 duo practice 4 group practice 2 primary care centre 3 health care centre 1 observer | Seniors: 31.07 (4–70) Natives: 74.43 (1–99) Low education: 44.29 (10–85) Single parent families: 17.43 (5–41) |
| NP (15) | 45.17 (27–56) | 1 men 14 women | 8.63 (2–15) | 2 solo practice 3 duo practice 4 group practice 6 health care centre | Seniors: 40.08 (9–80) Natives: 51.55 (2–95) Low education: 38.55 (8–65) Single parent families: 19.36 (0–40) |
| Physiotherapists (30) | 44.29 (26–59) | 12 men 18 women | 21.98 (2–38) | 2 solo practice 1 duo practice 16 group practice 7 health care centre 2 nursing homes 2 different | Seniors: 54.36 (1–100) Natives: 61.12 (4–99) Low education: 39.19 (9–81) Single parent families: 26.12 (7–75) |
| Dieticians (25) | 40.35 (21–59) | 25 women | 17.54 (4–40) | 9 solo practice 6 health care centre 2 nursing homes 2 hospitals 1 rehabilitation centre 2 home care 3 different | Seniors: 49.50 (5–96) Natives: 47.22 (4–96) Lower education: 43.22 (5–100) Single parent families: 17.23 (2–50) |
| MHS (9) | 35.29 | 2 men 7 women | 5.18 | ||
| SNT (14) | 43.78 | 6 men 8 women | 1.72 | ||
| SPO (25) | 42.95 | 17 men 8 women | 5.4 | 1 walking group 3 fitness 3 (table) tennis 5 football 1 korfball 5 field hockey 1 gymnastics 1 swimming 5 multiple sports | |
| CSC (48) | 33.06 (22–57) | 23 men 25 women | 3.08 (0.16–15) | Seniors: 33.3 Youth: 30.55 Adolescents: 19.44 Adults: 8.33 Inactive people (all ages): 2.78 Disabled/with a chronic condition: 25 All ages: 25 |
[i] Abbreviations: GP, general practitioner; NP, nurse practitioner; MHS, municipal health service; SNT, social neighbourhood team; SPO, sports and other physical activity facilities; CSC, care sport connector; PA, physical activity.
Table 2
Reasons for respondents to accept or reject a statement in rounds 3 and 4.
| Profession | Facilitators | Barriers |
|---|---|---|
| Physical activity promotion task | ||
| GP | Secondary prevention | Time pressure; No priority; No general advice; Activity costs; Impossible to get an overview of activities; Patient’s responsibility |
| NP | Patient’s physical state; Time pressure; Knowledge deficit; Unreachable to stay up to date about the activities | |
| Physiotherapist | CSC guidance; Fittest; Patient’s pleasure/wish; Final stage of care | Concurrent activities; Impossible to get an overview of activities; Guidance by physiotherapist; No reimbursement |
| Dietician | CSC guidance; Current network; | Reaching the target group; Only if PA is relevant to discuss; Permission is needed; Update social cart; Knowledge deficit; Time pressure; Physiotherapist too expensive |
| SNT | Our task to succession; Using own strength; Own guidance; Guidance of CSC; Formulation of goals and actions PA as a means | High caseload; Patient needs guidance of SPO; Own responsibility |
| MHS | Other professionals; Local support hours | If necessary, not constant; Collective approach |
| SPO | Free sports are not motivating; Flexible membership | Traditional function is the primary task; Noncommittal; Hard to form a team; Own responsibility; Deficit of frame |
| Collaboration | ||
| GP | Advise; Availability of nurse practitioner; Use of other means | Not our task; Priority; Time consuming; Patient’s responsibility |
| NP | Existing network; Motivated NP; Knowledge of each other’s existence is enough | Time consuming; No reimbursement; GP’s permission; Not our task |
| Physiotherapist | Essential element | No reimbursement |
| Dietician | Interplay of disciplines; Strengthens practice; Other means for information distribution | Concurrence; Time consuming; No reimbursement |
| SNT | Network is key | |
| MHS | Focus on the arrangement | Time consuming |
| SPO | Skilled CSC; Own contact | Time consuming; No volunteers |
| Expectations Care Sport Connectors | ||
| GP | Knowledge deficit about CSCs | |
| NP | Integrated care organization; Feedback | No contact with CSCs; Patient’s permission; Patient’s responsibility CSC should connect to my network; Unclear role of CSCs |
| Physiotherapist | Guidance CSC | CSC should connect to my network; Knowledge deficit about CSCs Concurrence; Unclear role of CSCs |
| Dietician | CSC should connect to my network; Patient’s permission; Knowledge about CSCs; Patient’s responsibility; Unclear role of CSCs | |
| SNT | Guidance of CSC Give substance to goals and actions | Working hours of CSC; Unmotivated group; No CSC; A member of SPO should be the CSC; CSC should connect to my network |
| MHS | Guidance of CSC | Intermediary role; CSC’s role is context dependent |
| SPO | Role dependent on municipality; Unclear role of CSC | |
| CSC | Collaboration Other coordinating parties Existing networks | Direction is intermediary instead of executive; No individual approach – other colleague; Difficult target group; Demand driven; Content PA only; Medical knowledge deficit; Municipality chooses direction |
[i] Abbreviations: GP, general practitioner; NP, nurse practitioner; MHS, municipal health service; SNT, social neighbourhood team; SPO, sports and other physical activity facilities; CSC, care sport connector; PA, physical activity.
Table 3
Professions’ tasks concerning PA promotion.
| Statements | GP | NP | PH | DI | SNT | MHS | SPO |
|---|---|---|---|---|---|---|---|
| Goals: | |||||||
| As a professional, it is my task to pay attention to physical activity promotion in the daily lives of patients | C* | C | C | C | C | C | – |
| 1* | 1 | 1 | 1 | 1 | 1 | ||
| Inform: | |||||||
| As a professional, it is my task to provide patients insight into the necessity and importance of getting a sufficient amount of physical activity | C | C | C | C | – | C | – |
| 0 | 1 | 1 | 1 | 1 | |||
| As a professional, it is my task to provide patients insight into the possibilities for staying physically active in daily life | NC | NC | C | NC | C | NC | – |
| 1 | 1 | 1 | 2 | 2 | 1 | ||
| Refer: | |||||||
| As a professional, it is my task to motivate patients to be physically active in their daily routine | C | C | C | C | – | – | – |
| 0 | 1 | 1 | 1 | ||||
| As a professional, it is my task to try to be, as much as possible, aware of the regular sports and physical activities that are present in the neighbourhood | NC | NC | C | C | C | NC | – |
| 2 | 0 | 1 | 1 | 1 | 2 | ||
| As a professional, I will actively refer patients to regular sports and physical activities in the neighbourhood if these are suitable for the patient | NC | NC | C | C | – | – | – |
| 2 | 0 | 1 | 2 | ||||
| Execute: | |||||||
| As a professional, it is my task to use physical activity as a means | – | – | – | – | NC | NC | – |
| 4 | 1 | ||||||
| If a CSC asks me to, I am willing to give group sessions to inform people about the need and benefits of sufficient physical activity | NC | NC | C | – | – | – | – |
| 4 | 3 | 1 | |||||
| If a CSC asks me to, I am willing to offer sports and physical activities for people with (an increased risk for) health problems | – | – | – | – | – | – | NC |
| 1 | |||||||
| If a CSC asks me to, I am willing to be a social involved club | – | – | – | – | – | – | C |
| 1 | |||||||
[i] C, consensus; C*, consensus reached in 4th round due to a lower response rate; NC, no consensus reached; –, statement was not provided to this profession. Interquartile range is presented for each statement, with a occurred range from 0–4.
Abbreviations: GP, general practitioner; NP, nurse practitioner; PH, physiotherapist; DI, dietician; SNT, social neighbourhood team; MHS, municipal health service; SPO, sports and other physical activity facilities; CSC, care sport connector.
Table 4
Intersectoral collaboration.
| Statements | GP | NP | PH | DI | SNT | MHS | SPO |
|---|---|---|---|---|---|---|---|
| Goal: | |||||||
| As a professional, I am willing to collaborate with other professionals in the neighbourhood to stimulate residents to be physically active | NC | NC | C | C | C | C | C |
| 2 | 1 | 1 | 1 | 1 | 1 | 1 | |
| Participate in meetings: | |||||||
| As a professional, I will participate in (network) meetings in the neighbourhood that are dedicated to promoting a healthy lifestyle among neighbourhood residents | NC | NC | C | C* | C | C | C* |
| 3 | 2 | 1 | 1 | 1 | 1 | 3 | |
| Arranging activities: | |||||||
| As a professional, I am willing to develop multidisciplinary programs with other professionals to promote the overall lifestyles of participants | NC | NC | C | NC | C | C | NC |
| 3 | 2 | 1 | 2 | 2 | 1 | 1 | |
| As a professional, I am willing to contribute to activities organized in the district to promote a healthy lifestyle (e.g., fitness tests, health fairs) | NC | NC | C | NC | C | – | C |
| 3 | 3 | 1 | 1 | 2 | 1 | ||
| Contact: | |||||||
| As a professional, I would like to become acquainted with sports and exercise professionals or health and welfare professionals from the neighbourhood | NC | NC | C | C | C | NC | C* |
| 1 | 1 | 1 | 1 | 1 | 3 | 1 | |
| As a professional, I would like to have contact with sports and exercise groups from the neighbourhood | NC | NC | C | NC | C | NC | NC |
| 2 | 2 | 1 | 2 | 1 | 2 | 2 | |
[i] C, consensus; C*, consensus reached in 4th round due to a lower response rate; NC, no consensus reached; –, statement was not provided to this profession. Interquartile range is presented for each statement, with a occurred range from 0–4.
Abbreviations: GP, general practitioner; NP, nurse practitioner; PH, physiotherapist; DI, dietician; SNT, social neighbourhood team; MHS, municipal health service; SPO, sports and other physical activity facilities.
Table 5
Expectations and perceptions of Care Sport Connectors’ tasks.
| Statements | GP | NP | PH | DI | SNT | MHS | SPO | CSC |
|---|---|---|---|---|---|---|---|---|
| Goals: | ||||||||
| As a professional, I see the work of a CSC as an addition to my work | – | NC | C | – | – | – | – | – |
| 1 | 1 | |||||||
| As a professional, I am open to a CSC contacting me | C | NC | C | C | C | C | C | – |
| 0 | 1 | 1 | 1 | 1 | 0 | 1 | ||
| Informative: | ||||||||
| As a professional, I expect a CSC to be aware of the sports and physical activities in the neighbourhood | C | C | C | C | C | C | C | C |
| 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | |
| As a professional, I expect a CSC to map the sports and physical activities | C | C | C | C | C | C | C* | C |
| 1 | 1 | 1 | 1 | 1 | 1 | 2 | 1 | |
| As a professional, I expect a CSC to keep me informed about current sports and physical activities | NC | C | C | C | C | NC | – | C |
| 1 | 1 | 1 | 2 | 1 | 3 | 1 | ||
| As a professional, I expect a CSC to create awareness of his/her function and its professional potential for us | C | C | C | C | C | – | – | C |
| 1 | 1 | 1 | 1 | 1 | 1 | |||
| As a professional, I expect a CSC to transfer knowledge which is necessary for the provision of sports and physical activities for people with (an increased risk for) health problems | – | – | – | – | – | – | NC | C |
| 1 | 1 | |||||||
| Executive: | – | |||||||
| As a professional, I expect a CSC to arrange easily accessible sports and physical activities | C | C | C | C | – | C | – | C* |
| 1 | 0 | 1 | 2 | 1 | 1 | |||
| As a professional, I expect a CSC to arrange sports and physical activities that meet the wishes and needs of the target group | – | – | – | – | C | – | – | C |
| 2 | 1 | |||||||
| As a professional, I expect a CSC to provide support to recruit members with (an increased risk for) health problems | – | – | – | – | – | – | C | NC |
| 0 | 3 | |||||||
| Referral: | ||||||||
| As a professional, I would use the guiding service of a CSC | C | C | C | C | C | – | – | – |
| 0 | 1 | 1 | 1 | 1 | ||||
| As a professional, I expect a CSC to guide people, when necessary, to suitable sports and physical activities | – | – | – | – | – | C | – | NC |
| 1 | 1 | |||||||
| As a professional, I expect a CSC to develop a buddy system, so people can exercise together instead of individually | C | C | NC | C | C | – | – | NC |
| 1 | 1 | 0 | 2 | 2 | 2 | |||
| As a professional, I expect a CSC to monitor people to ensure they have made structural changes in behaviour | NC | NC | C | NC | – | – | – | NC |
| 2 | 2 | 1 | 1 | 3 | ||||
| As a professional, I expect a CSC to refer people back to me if they have physical complaints | C | NC | C | – | – | – | – | C |
| 0 | 1 | 1 | 1 | |||||
| As a professional, I expect a CSC to refer people back to me if they quit or do not show up at sports or physical activities | NC | NC | C | – | – | – | – | NC |
| 4 | 3 | 1 | 3 | |||||
| Broker role: | ||||||||
| As a professional, I expect a CSC to take a coordinating role concerning (network) meetings in the municipality | C | C | C | C | NC | NC | C* | NC |
| 0 | 0 | 1 | 1 | 2 | 1 | 1 | 1 | |
| As a professional, I expect a CSC to take a coordinating role to connect care, welfare and sports professionals in the neighbourhood | – | – | – | – | – | C | – | C |
| 1 | 1 | |||||||
| As a professional, I prefer the CSC to act as an intermediary for the contact with sports and PA facilities or care professionals instead of maintaining contact with these professionals myself | C | NC | C* | C | NC | C | NC | C |
| 1 | 0 | 0 | 1 | 4 | 1 | 2 | 1 | |
| If a CSC asks me to, I am willing to help the CSC draft a plan of action for a physical activity intervention | – | – | – | – | – | C | – | – |
| 0 | ||||||||
| If a CSC asks me to, I am willing to introduce a CSC to our network of healthcare professionals | – | – | – | – | – | C | – | – |
| 1 | ||||||||
[i] C, consensus; C*, consensus reached in 4th round due to a lower response rate; NC, no consensus reached; –, statement was not provided to this profession. Interquartile range is presented for each statement, with a occurred range from 0–4.
Abbreviations: GP, general practitioner; NP, nurse practitioner; PH, physiotherapist; DI, dietician; SNT, social neighbourhood team; MHS, municipal health service; SPO, sports and other physical activity facilities; CSC, care sport connector.