Identification of relevant mental health indicators for European community-based health enhancing physical activity initiatives: An adapted Delphi study

Health enhancing physical activity (HEPA) initiatives can improve mental health; however there is a lack of standardised measures to evaluate mental health impact. This study aimed to identify the relevant indicators of mental health and well-being in community-based HEPA initiatives in Europe as determined by specialists and practitioners in the field, and understand assessment methods commonly used.

An adapted, two round, Delphi method was conducted with N = 20 specialists (practitioners and academics) in the field of mental health and physical activity from Denmark, the Netherlands, the UK, and Ireland. Specialists selected the most important indicators and agreed consensus on definitions and operationalisation, where consensus ≥50% signified important indicators.

Specialists compiled 66 (n = 21 outcome, n = 45 determinant) indicators. Top rated indicators for the evaluation of HEPA initiatives were self-rated mental health (69.2%), physical activity (69.2%) life satisfaction (53.8%), stress (53.8%), loneliness (53.8%), social participation, network, connection and support (53.8%). Consensus on definition and application of the nine indicators varied (44.4%–100%), with no consensus on a standardised measurement tool reached, although specialists pointed to the need for culturally sensitive measurement tools.

While this study highlights a lack of conformity for evaluating mental health and wellbeing outcomes, it suggests utility in an agreed definition and application of nine indicators for the evaluation of HEPA initiatives, with social determinants of particularly high importance across the relevant contexts. Further research is recommended to develop guidance on pragmatic measurement tools that can be utilised across other (European) countries and their implementation tested.