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Title: Evaluating the impact of a sport-for-development intervention on the physical and mental health of young adolescents in Gulu, Uganda - a post-conflict setting within a low-income country
Author: Richards, Justin A.
ISNI:       0000 0004 2728 2714
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2011
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Introduction: Physical inactivity is thought to contribute to the emergence of non-communicable diseases in post-conflict settings of low-income countries. Sport-for-development (SfD) organisations in these regions claim to improve the health of programme participants. However, there is a paucity of supporting evidence. I assessed the impact of a voluntary community-based SfD intervention on the physical activity (PA), physical fitness (PF) and mental health (MH) of adolescents in Gulu, Uganda. Methods: The Acholi Psychosocial Assessment Instrument (APAI), standing broad jump (SBJ), multi-stage fitness test (MSFT) and BMI-for-age (BFA) were adapted to the local context. I tested their feasibility and reliability with a repeat-measures design (n=70). A cross-sectional analysis of a random sample was used to assess the local needs and establish the PF and MH of the adolescents reached by the intervention (n=1464). This was also the baseline assessment for the impact evaluation. It comprised a randomised control trial (n=144) nested within a cohort study (n=1400) and triangulated by cross-sectional assessment of PA using accelerometry (n=54). Results: The adapted PF and MH measures demonstrated good intra-tester reliability (ICC>0.75). Adolescents in Gulu predominantly had “healthy” BFA (>90%). They performed better than global norms for the SBJ (p<0.001), but worse for the MSFT (p<0.05). The girls who registered for the intervention had higher PF at baseline (p<0.05) and experienced no significant benefits when compared to the community. The aerobic capacity of the boys intervention group increased relative to the community (p<0.01), but was not significantly different to the trial control group whose PF also improved. The PA results concurred with this finding. Boys in the intervention group experienced a deterioration in MH relative to their peers (p<0.05). Implications: It is feasible to apply rigorous evaluation methods to SfD interventions. Although adolescents in Gulu have poor aerobic capacity, a voluntary programme may not reach those at risk. Interpreting the impact evaluation was limited by a lack of programme development theory, but suggested that opportunities for non-competitive play may confer PF benefit without harming MH. Further investigation is warranted.
Supervisor: Foster, Charlie Sponsor: Clarendon Scholarship ; Oxford-Australia Scholarship ; University College Scholarship
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Cardiovascular disease ; Disease prevention ; Anxiety disorders ; Evidence based mental health ; Conflict ; Health (refugees) ; Psychosocial issues (refugees) ; Public Health ; Children and youth ; sport ; sport-for-development ; physical activity ; physical fitness ; mental health ; health ; post-conflict ; low-income country ; developing country