Rather than focusing on illness, a settings-based approach to health promotion shifts the focus towards how flourishing can be fostered within the settings where people spend their everyday life (e.g. schools, colleges and universities, prisons, and sports clubs). This ecological model of health is understood as multi-layered and determined by the complex interactions of personal, social, behavioural and environmental factors that uses a whole system approach (Dooris, Kokko, and Baybutt Citation2022). As an example, youth sports clubs could promote more comprehensively physical activity (PA) within and beyond sporting activities and could be supported by a national sports federation by various activities. This highlights that national and local levels should be considered but also, a single sports club has at least three levels which should be taken into account in settings-based work: macro-level i.e. overall policies and orientation of activities with relation to PA promotion; meso-level i.e. the activities managed by the leading persons, like support materials of PA promotion for coaches; and, micro-level i.e. activities by the coaches integrating the PA promotion actions into daily practice. Furthermore, the extent PA is to be promoted, depends on several factors at different levels, such as support from the club management, the social norms in a club i.e. how much PA is considered as a task for a sports club, resources (time, money and knowhow at club-level) and coaches orientation towards PA promotion and their knowhow of what kind of activities it could require.
Most settings do not have health as their ‘core business’ so it is essential to apply the language normally used in each particular setting to connect different agendas: how does health promotion support learning outcomes in schools or productivity in the workplace? Even PA promotion is not considered as a priority in sports settings where their core business is to develop athletes and optimize sports performance often in particular sports. Insufficient PA through a sedentary lifestyle is one of the most prevalent health concerns, yet not all young sports participants meet the recommended level of weekly PA. One way of enhancing PA level would be activating the transportation modes back and forth between training sessions – commuting by walking, jogging or cycling is not usually considered as a part of a training session, but could be included as warm up activities, if so desired.
The settings approach emphasizes the preconditions the setting provides for its actors to promote and individuals to make health promoting choices. A key development to consider is how virtual and real-world settings could be linked and utilized – for example, how digital gaming could include elements that motivate people to be actually physically active (like Pokémon Go did some time ago!). There remain many health promoting settings yet to be realised – perhaps you are reading this with suggestions?
Reference
- Dooris, M., S. Kokko, and M. Baybutt. 2022. “Theoretical Grounds and Practical Principles of the Settings-Based Approach.” In Handbook of Settings-Based Health Promotion, edited by S. Kokko and M. Baybutt, 23–44. Springer. https://doi.org/10.1007/978-3-030-95856-5_2.