Health promotion in elite Para sport: bridging knowledge gaps and addressing individual needs—a qualitative evaluation of the Safe and Healthy Para sport (SHAPE) intervention

Objective To qualitatively explore the perceptions of Para athletes, coaches and stakeholders of the implementation, use and effects of the health promotion intervention ‘Safe and Healthy Para sport’ (SHAPE). A secondary aim was to explore participants’ perceptions of how safety and health in Para sport could be further developed. Methods As part of a process evaluation, this qualitative, descriptive study applied a thematic analysis approach. In total, 18 participants (athletes, coaches and staff) from Sweden and South Africa participated in three focus groups. Results Three themes were generated from the focus groups: ‘how to reach every Para athlete in implementation and use’, ‘proactive athlete growth and support’, and ‘opportunities for sustainable Para sport’. Participants perceived that the SHAPE intervention was end-user friendly and that it was difficult to find health promotion material for Para athletes elsewhere. Athletes had used the health information to recover from injuries, and their awareness of mental health conditions had increased. Athletes also identified a need for more individualised content, but some athletes were not aware of the health platform. It was suggested that health promotion in Para sport could be better facilitated by peer support. The weekly athlete health monitoring fostered a sense of accountability both among athletes and within the sports organisation, but participants still perceived that medical evaluations are mostly neglected in Para sport and voiced a need to strengthen medical and economic support structures. Conclusion Health promotion can be used to improve health and well-being among Para athletes. However, it was challenging to reach out to the individual athlete, suggesting that health promotion should be implemented in each layer of the socioecological model within Para sport. Data are available upon reasonable request.