A “start to swim” program for health-enhancement purpose: a Delphi study

Introduction
Popularity of “start to run” or “start to cycle” programs increases with the evidence that regular physical activity contributes to the prevention and management of a wide range of chronic diseases (Rippe and Angelopoulos, 2010). Nevertheless, start to swim programs could lead to even more health-enhancing outcomes (Chase et al., 2008). The aim of this study was to obtain a “start to swim” model program by means of a two-round Delphi study.
Methods
In the first round, 10 key-experts in sport physiology (n=4) or in swimming coaching (n=6) outlined possible relevant components of the “start to swim” program in a semi-structured interview. Initial exclusion criterion, program set-up, program key principles, program progression and final goals were interrogated. Then, a facilitator provided an anonymous summary of the experts’ suggestions from the previous round as well as the arguments they provided for their choice. In the second round, experts were asked to comment on this summary before providing a final form to this program.
Results
After two rounds, the experts agreed on a collective and coached intervention with 2 sessions per week and a progressive replacing of the coach by a group leader during a 4 months program. People without medical contraindication and able to swim 25 meters could take part to this program. The final goal-setting is personal and based on each individual progression and motivation. Sessions are endurance-oriented and divided between traditional swimming sessions and diversified aquatic activities. In order to support this active lifestyle in a long-term basis, referring to swimming clubs or other aquatic activities associations are performed by the coach at the end of the program.
Discussion
The start to swim program take into consideration behavioural and social aspects necessary for a successful adoption and maintenance of physical activity (Khan et al, 2002). Consistent with previous findings, a group-based program (Cox et al., 2008) with individually adapted-goals (Marcus and Forsyth, 2003) could lead to a long-term adherence to exercise. Future studies should include systematic evaluation of the “start to swim” program before translation into the community.