This project utilized a Community-Based Participatory Research (CBPR) approach to conduct qualitative interviews with 30 transgender adults living in a rural state. Participants’ identities spanned from trans women and men to non-binary and Two-Spirit. The aim of this study was to better understand the experiences, needs, and priorities of the participants as well as to examine possible determinants of mental health, well-being, and suicidality for transgender individuals in Montana. These factors were investigated at individual, interpersonal, community, and societal levels using an ecological framework. Qualitative results indicate that participants experienced discrimination at all levels. Participants noted that discrimination contributed to mental health challenges and limited access to adequate general and transgender-specific healthcare services, both of which impacted overall well-being. This is reflected most notably in the elevated rate of past suicidal ideation attempts among the sample. Participants reported that the ability to transition, as well as other protective factors, played a role in reducing suicidality and improving mental and physical health. Our findings highlight the need to address transgender mental health through implementing changes at multiple ecological levels.

BackgroundResearchers and policy-makers have highlighted that the potential for organized sports to promote health has been underexploited. Sports clubs have limited capacity to promote health due to their voluntary nature and have called for support from their national sports federations. The present article provides guidelines, based on the theoretical principles of health promoting sports clubs and an analysis of practical tools and proven strategies, to support national sports federations to invest in health promotion (HP).MethodsA qualitative iterative study was undertaken, based on five 2-h meetings of a group of 15 international researchers in HP in sports clubs. Notes and minutes from meetings, as well as shared outputs were analyzed based on the health promoting sports club framework.ResultsGuidelines developed for national sports federations to promote health includes a definition of a health promoting sports federation (HPSF), a description of how the settings-based approach to HP adapts to national sports federations, as well as practical applications of health promoting sports club’s intervention strategies. The analysis of existing tools also demonstrated that most tools are centered on a single dimension of health (social, mental, physical, spiritual or community), and often on a specific health topic. Furthermore, they do not cover HP as a continuous long-lasting process, but are generally short-term programs. The HPSF clarifies theoretical concepts, their practical implementation via case studies and outlines intervention components and tools useful for sports federations in their implementation of HP.ConclusionThe guidelines developed in this study are intended to facilitate national sports federations to acknowledge/understand, reinforce/underpin and foster current and further investment in HP.

Background Sport is recognised as a potential public health intervention through its influence on physical activity (PA) levels and consequent health benefits. International policy actors such as the Council of Europe, the World Health Organisation and the International Society for Physical Activity and Health have recommended that sport for all is promoted both for public health and as a basic right. Purpose: This review aims to provide evidence to support the development of policies aimed at maximising the opportunity to participate in PA and sporting activity. Methods We systematically searched six electronic databases for quantitative, qualitative, and review studies investigating how public sport policy affects PA and sport participation outcomes”. The scientific literature was screened according to predetermined eligibility criteria. Following study selection and data extraction, the quality was assessed using modified versions of existing quality assessment tools. Results were synthesised narratively. Results Database searches identified 3705 unique articles. A total of 93 full-text articles were assessed, with 31 meeting our inclusion criteria. Fourteen unique policy actions were identified and were categorised into the policy areas Build Sport Facilities, Reduce Financial Barriers, Build Capacity and Establish Partnerships with Sport Sector, and Promote Public Interest in Sports. Conclusions Policy actions to promote physical activity and sport participation have demonstrated qualified success but there is limited evidence of success in reaching hard to reach groups. Therefore, policymakers utilising sport to increase physical activity should treat it as a complementary intervention alongside other policy actions based on a systems perspective.

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