Impact case study database

The impact from this case study is through three key areas: influence on societal understanding and acceptance of alterative versions of masculinity in a sport setting; influence on sport-related subjects teaching in UK HE; and influence on public debate into the safety for children playing contact sport.

• Influence on societal understanding and acceptance of alterative versions of masculinity in a sport setting

Anderson’s work on inclusive masculinity has received substantial scholarly attention and he is widely cited in the media, for instance recently in the New York Times (5.1). The widespread media coverage of this topic has helped increase society’s acceptance of homosexuality and understanding of alternative masculinities. Anderson has also written a series of articles for The Conversation on changing masculinities that have engaged the public on topics such as mental health awareness, paternity leave and domestic violence. These articles have been viewed by over 20,000 unique readers in the UK, India, the USA and Australia. Anderson has consulted with Sport England and with government officials in Catalonia to develop an understanding of alternative versions of masculinity at governmental and regulatory levels. He has also led a series of industry engagement activities involving a mixture of academics and sports organisations such as the English Football Association. Recently, Anderson (with members of the UoA) has been instrumental in setting up a LGBT+ Research in Sport Network with Sport England. He has also delivered professional development sessions for several professional sports clubs to educate their players on inclusivity in sport.

In addition, Parry (working with colleagues at Western Sydney University in Australia) extended the focus on inclusion for sexual minorities to supporters’ clubs, working with Cricket Victoria (the governing body of cricket in the Australian state of Victoria) and the Melbourne Stars and Melbourne Renegades Big Bash cricket teams, to study the development of inclusive supporters’ groups in the Big Bash League. This project’s recommendations were implemented by the clubs and cricket association to provide inclusive, welcoming and safe environments for LGBT+ supporters at Big Bash games in the state of Victoria (5.2). These findings have subsequently been adopted in the neighbouring state of New South Wales, with the Sydney Sixers also developing an LGBT strategy to create a more inclusive environment.

• Influence on the teaching of sport-related subjects in UK higher education institutions and beyond

Anderson’s work on inclusive masculinities has also impacted teaching. His textbooks have been adopted by universities in the UK (Bournemouth University, Liverpool John Moores University), and the United States (California State University Chico and University of Oregon). He has supervised 22 doctoral students, of which 11 have gone on to teach at higher education institutions in Australia, the USA and the UK. These students have also incorporated Anderson’s research into their teaching, therefore influencing the next generation of scholars and helping shape higher education practice. At institutions such as Oxford Brookes, Wolverhampton, Durham and Southampton Solent, inclusive masculinity now features on sport-related and gender/sexuality-related courses. In addition, the research of Anderson and colleagues (e.g., McCormack) is used as a model answer in the OCR A-Level Sociology paper discussing the part of sexuality in exploring how identity is changing. Furthermore, Anderson has shown that his teaching on masculinities has been linked with decreasing levels of homophobia among undergraduate students (5.3). In this study, student attitudes towards homosexuals were also seen to be significantly more positive after the twelve-week course being taught by an openly gay lecturer.

• Influence on public debate into the safety of contact sport and the need for greater protection to be afforded to children.

Anderson is one of the founders of the Sport Collision Injury Collective (SCIS), a multidisciplinary collective of academics who are highlighting the injuries sustained in youth sport participation. This group published an open letter “Preventing injuries in children playing school rugby” penned by Professors Allyson Pollock (Professor of Public Health Research and Policy, Newcastle University) and Eric Anderson with 71 additional signatories sent to UK and Ireland Chief Medical Officers (CMOs), Children’s Commissioners and responsible ministers of state for health, education and sport. In response, the Ombudsman for Children in Ireland took this matter up with the Minister for Education and Skills, the Minister for Transport, Tourism and Sport and the Minister for Health to make recommendations (5.4). The Children’s Commissioner for Wales also responded to both the media attention and the open letter to indicate that participation in potentially dangerous sports such as rugby union should not be compulsory. Anderson has been invited to present the findings of this research to the Royal Society of Medicine, the Minister for Health, and two Members of Parliament. In addition, he has met with Association for Physical Education, the PE Subject Association, to shape the future of school sport in the UK.

The SCIC’s website has received over 900 million hits and the letter itself was published by major print and online newspapers such as The Guardian, The Telegraph, and The Independent. Anderson was interviewed by BBC News (3^rd August 2016 and 27^th September 2017) and Sky News (15^th October 2017). There was substantial social media coverage of the letter with over 500 unique tweets on the topic. Overall, this work has contributed to a vigorous public debate on safety in school sport, and a move to change policy to enhance safety. For example, while the initial response to this call on social media was vitriolic, there has been a softening over time and Anderson was invited to present the plenary session within the 24th Annual Congress of the European College of Sport Science, indicating that there is growing acceptance of the significance of head injuries in sport. Recently, public debates have occurred concerning tackling in children’s rugby, and announcements made concerning heading in football training being banned for children under 12, and debates on tackling in children’s rugby. While debate and policy change comes from a variety of influences, the work (5.5) and lobbying of Anderson and colleagues (5.6) has very likely contributed to these positive changes concerning safety in children’s sport.

The research of Faulkner and colleagues (3.1 to 3.6) has underpinned the creation of the HELP ( Health Enhancing Lifestyle Programme) Hampshire Stroke Clinic; an accessible, low-cost service to community-dwelling individuals living with stroke (5.1) which has had a substantial impact on: i) people, by improving health outcomes for stroke patients and facilitating greater opportunities for volunteers, ii) reconfiguring the pathway for stroke referrals within the NHS (HHFT), and iii) practice services (e.g., Hobbs rehabilitation processes and research focus).

Impact on patient beneficiaries

The HELP Hampshire Stroke Clinic is recognised as one of the top 100 University programmes that are ‘saving lives and keeping us healthy’ (5.2). The HELP Hampshire Stroke Clinic collects robust data on stroke outcomes. Substantial improvements in BP have been evidenced, with attendees to the clinic experiencing meaningful reductions in BP from when they start (146/82 mmHg) to when they complete the programme (135/79 mmHg) (5.3). This is impactful when considering that a BP ≤140/85 mmHg is associated with up to a 41% reduction in experiencing future strokes (Weiss et al., 2017, doi:10.7326/M16-1754). Engagement with the exercise programme has resulted in attendees showing improvements in their functional abilities (e.g., balance, walking), psychosocial outcomes (anxiety, depression, confidence) and quality of life have also been reported (5.3). In support of these positive impacts, the Stroke Association have reported that:

‘The programme is having a real impact on the lives of our service users and has both physical and psychosocial health outcomes. They feel that the support from ward to the clinic is 'seamless' and for service users whose strokes were a few years ago, this new programme has given a renewed boost to their recovery and a feeling that they can continue to make improvements.’ (5.4)

The impact of this clinic on the quality of life of service users and their families has also been significant, as evidenced through patient testimonials. For example, this patient highlighted numerous positive impacts:

‘When I first started attending, I was barely out of my wheelchair. Afraid to walk, as I was not at all confident to walk. But now with exercises for core muscles, co-ordination, agility, balance, strength, making us more aware, I'm able to walk with my own two legs with a lot more confidence’ (5.5)

Impact on referral configuration

Prior to the commencement of the HELP Hampshire Stroke Clinic, the referral of stroke patients to Winchester City Council’s Active Lifestyle’s Exercise Referral Scheme, primarily from GP practices, was limited, with approximately 20 patients being referred annually to community, leisure-centre based exercise programmes. The HELP Hampshire Stroke Clinic has instigated significant service reconfiguration for the referral of patients to community stroke rehabilitation programmes by developing a new pathway of secondary care via HHFT, and in particular the Hyper-acute stroke unit, TIA clinic and ESD team (5.6, 5.7). Although the Clinic also receives referrals from GP practices, with 16 GP practices referring patients to the clinic in the first year of the Clinic (March 2019 to March 2020), the programme quadrupled (n = 80 patients) the number of annual stroke survivors engaging in community exercise. As of June 2020, and due to COVID-19, the HELP Hampshire Stroke Clinic commenced the delivery of virtual online, practitioner led exercise classes. Accordingly, individuals newly diagnosed with stroke during COVID-19 are also able to access the services of the HELP Hampshire Stroke Clinic.

Impact on voluntary sector

Based on the success of recruiting local stroke patients to the HELP Hampshire Stroke Clinic, the Stroke Association approached the University of Winchester to create a new stroke support group (5.4). Accordingly, in November 2019, the HELP Hampshire Stroke Clinic and Stroke Association started to provide additional opportunities for community-dwelling stroke survivors (approx. 20-30 people) to help improve patients’ communication, rebuild confidence and independence, and help people rebuild their life after stroke. Students (Sports Science, Physiotherapy) from the University of Winchester and other Higher Education Institutions (Solent University; University of Portsmouth) are afforded opportunities to enhance their learning whilst supporting the HELP Hampshire Stroke Clinic. Their involvement provides an opportunity to foster the application of knowledge and aids in developing and applying their learned skills, whilst facilitating confidence-building and an opportunity to improve communication skills when dealing with members of the public (5.8). In addition to enhancing learning opportunities, this link is shaping the views of future generation allied health practitioners on after stroke care. Impacting upon the Physiological Society and Guild HE report on ‘Sport & Exercise Science Education: Impact on the UK Economy’ (5.9), the HELP Hampshire Stroke Clinic was one of only three (of 29) University case studies that was deemed to provide ‘benefits to the public purse’.

Impact on independent neuro-physiotherapy provider

Hobbs Rehabilitation is the largest independent rehabilitation provider in the UK. The HELP Hampshire Stroke Clinic has influenced Hobbs’ activity by: i) facilitating opportunities for them to deliver group-based exercise classes in the community as a part of a collaborative programme, and ii) encouraging them to engage in research activities to help further their knowledge, understanding and application of physical therapy for patients with neurological conditions (5.10).