Using sport to reduce health risk behaviors Sport can be an effective way to reach out to people, especially youth, and to encourage healthy lifestyle behaviors that will help protect them against HIV and other diseases.
Sport can be used to empower children and youth by conveying appropriate prevention messages, teaching the skills necessary to establish and sustain healthy behavior patterns, and increasing their resilience in the face of life challenges. Prominent athletes and local coaches can be powerful role models in this respect, exerting a strong positive influence on the children and youth they reach.
Research has shown that regular interaction with a caring, non-related adult can help to protect youth against risk factors that might otherwise negatively influence their health and their future. 118 This is particularly important in communities where war, disease, or the need for parents to leave to find work, have left few positive adult role models in place. Caring, well-trained coaches can help fill a critical gap in this respect. Well-designed sport programs that educate, support and empower youth can also encourage positive behavior change by enhancing self-perception, imparting self-esteem, 119 and promoting more conscious care and respect among youth for their own bodies.
These critical dimensions of properly designed sport programs with health education components can help reduce the vulnerability of young people to substance abuse; premature, unprotected, or unwanted sexual activity; and the transmission of infectious disease through these activities. For more than ten years, the Center for Communication Programs at Johns Hopkins Bloom berg School of Public Health has designed, implemented, and evaluated behavior change interventions centred around soccer programs, first under the Caring Understanding Partners (CUP) initiative and now under the Sports for Life program. 121 Sports for Life has been implemented in various communities in Ethiopia, Namibia, Lesotho, and the Ivory Coast with exciting outcomes. Program administrators report success in breaking down barriers between generations, enhancing youth self-efficacy with regard to safe sex, developing leadership among youth, and challenging social norms. For instance, while soccer was once considered “boys’ business,” girls are also now participating — even in more traditional communities in rural Africa where girls are expected to remain in the home. While empirical research pertaining to behavior change is limited, in general, youth who are active in sports are less susceptible to the consumption of legal and illegal drugs, although this varies by sport activity. 123 US research on the links between sport participation and adolescent sexual activity and pregnancy shows that adolescent girls who participate in sport are less likely than their non-athletic peers to participate in sexual activity and/or report a pregnancy.
In a broader study of health risk behaviors of adolescents in organized sports, athletes and non-athletes differed in specific health risk behaviors. 125 While athletes were more likely to put themselves at risk for accidental injuries, they were less likely to smoke cigarettes or marijuana, more likely to eat a healthy diet, and less likely to feel bored or hopeless.
At a psychological level, young people’s confidence levels and their tendency to behave in more sexually responsible 43 ways are closely linked. Sport may, therefore, be used as a tool to build confidence, thereby helping to reduce sexual risk behavior. 126 These results cannot automatically be generalized across cultures and development contexts, but they do indicate the potential for sport to have a positive effect in reducing youth health risk behavior. This is important because there is strong evidence to suggest that, where the spread of HIV and AIDS is subsiding or even declining, it is primarily because young people are becoming equipped with the information and skills they need to adopt safer behaviors. 127 In designing programs and interventions to maximize sport’s potential in this respect, governments can draw on more general lessons from the broader research literature on health behavior change and building resilience in youth.
Resilience is the inner strength, responsiveness, and flexibility that individuals possess that enables them to withstand stress and to recover quickly to a healthy level of functioning after a traumatic event. 128 Research on resilience has identified key protective factors that help to reduce the effects of risk factors in the lives of children and youth. These protective factors include: 129 • Community support in the form of caring interactions between adults and children who are not related; • Unconditional acceptance of a young person by an older person; • The development and promotion of healthy peer relationships; and • Youth opportunities to help others and make a contribution to their community. Organizations using sport to advance child and youth health should seek ways to build these dimensions into their programs to further reduce health risk behavior. This can be done through the coach-child relationship, peer-to-peer teaching and support, youth leadership and coach training, and child-centred approaches that place the development needs of participating children and youth ahead of winning.
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