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Globally, over 80 million people currently live in a context of forced displacement.1 This includes people displaced within the border of their own country as well as refugees and asylum seekers. The overwhelming majority (85%) reside in low-resourced environments with compromised health systems2 3 that are simultaneously experiencing a rapidly increasing burden of non-communicable disease.4 Restricted access to education or gainful employment can create additional disadvantage, while both premigration and postmigration stressors increase the risk of poor health, including poor mental health.5
Sport (and physical activity more broadly) is increasingly recognised as a cross-cutting strategy for delivering a range of health and psychosocial interventions. The International Society for Physical Activity and Health identified 8 of the 17 United Nations Sustainable Development Goals (SDGs) towards which physical activity can contribute, including SDG3 (good health and well-being), SDG4 (quality education), SDG5 (gender equity), SDG10 (reduced inequalities) and SDG16 (peace and justice).6 7 Therefore, in situations of forced displacement, sport and physical activity programmes may have impact across humanitarian, development and peace outcomes, the intersection of which is commonly referred to as the triple nexus.8 However, facilitating access to safe sport within contexts of displacement spans numerous sectors including protection, education and health. This can result in a siloed and ad hoc approach to programming, research and evaluation, which limits the efficacy and effectiveness of efforts to ensure access to sport for all individuals living in situations of forced displacement.9 10 Further, with the COVID-19 pandemic having restricted participation in sport at all levels, interdisciplinary efforts promoting its benefits as part of a holistic response meeting the needs of displaced people are required.
The ORF supports the protection, inclusion and empowerment of young people affected by displacement (including displaced people and their host communities). It was founded by the International Olympic Committee (IOC) in 2017. The vision of the ORF is a society where everyone belongs, through sport. Its aim is for 1 million young people (aged 10–24) affected by displacement to access safe sport by 2024.11 The Foundation applies the principles outlined in the 2018 Sport for Protection Toolkit, launched in collaboration with the United Nations Refugee Agency, United Nations High Commissioner for Refugees, the IOC and Terre des Hommes. The toolkit provides a practical resource for interdisciplinary practitioners working with sport to improve outcomes for young displaced people, including both theoretical and step-by-step practical guidance.12
The Olympic Refuge Foundation Think Tank was launched in 2020 to promote understanding and uptake of sport to support positive outcomes for young people affected by displacement, including protection, psychosocial well-being and mental health and to foster inclusion. The Think Tank includes academics, practitioners, people with lived experience from international development and emergency contexts, and clinicians (psychiatry, psychology, physiotherapy and exercise physiology), child protection advocates, educators and postconflict intervention coordinators. This diversity of expertise provides substantive opportunity to break down sectoral silos to use sport more effectively within situations of forced displacement through a shared understanding of the barriers to, and opportunities to enhance, programming fostering collaboration between disciplines and sectors, and generating evidence to guide implementation.
In June 2021, members of the Think Tank participated in brief recorded interviews. They were invited to share their vision of the potential role of sport in humanitarian settings and to reflect on the lessons learnt and implications for sport promotion in contexts of forced displacement. Interviews were recorded and transcribed verbatim and analysed using a condensed version of thematic analysis.13 Nineteen members of the Think Tank participated in interviews, and five core, yet overlapping themes were identified: (1) sport as a mechanism for holistic and inclusive humanitarian intervention; (2) the vital role of cultural context; (3) sport structures, from grassroots organisations to policy; (4) rigour and generating an evidence base; and (5) addressing microconnections, meso-connections and macro-connections.
Foster sport as a mechanism for holistic and inclusive humanitarian intervention
Members of the Think Tank often referred to the power and potential of sport to contribute to wider social outcomes and general health and well-being. Because different aspects of well-being were mentioned, the theme references holistic to encompass the variety of outcomes that can be achieved by sport programmes when they are appropriately designed and implemented. The negative effect sport can have on participants was also noted,14 as was the importance of mitigating risks in order to ensure positive outcomes. Providing an opportunity for positive engagement, provision of safe environments, fostering connections and relationships between host and displaced communities, and the contribution of sport to mental health and psychosocial outcomes were also noted as underused strategies in situations of forced displacement.
Adapt to—and draw on—cultural context
One of the most cited considerations from Think Tank members was the importance of the cultural context and including stakeholders from grassroots and community levels of the target population. Prioritising cultural sensitivity is critical, especially in the context of sports programmes targeting mental health and psychosocial outcomes. Considering the unique history, context and culture of the target community and avoiding ‘one-size-fits all’ approaches to sport promotion were particularly emphasised. Similarly, securing access by tackling the specific barriers to participation in contexts of forced displacement (such as legal status, movement restrictions, gender and inclusion, and safety issues in communities and families) is vital.
Establish sport structures, from grassroots organisations to policy
Organising sports programming appropriately, including clearly defined aims and objectives and adequate monitoring and evaluation practices, is needed. This must happen at all levels from grassroots organisations to policy. Relevant stakeholders include coaches and programme staff, sporting organisations and clubs, players and members of the target community. Ensuring local access to required resources to effectively implement sports programmes that maximise participation and not solely competition is needed to maximise reach and impact. Trusted adult role models who are appropriately trained to provide access to and facilitate safe sports programmes, as well as mentorship to youth, were also identified as a key consideration.
Build an evidence base through rigorous research
Generating and translating academic evidence into meaningful programmes and policies were identified as critical to realising the utility of sport in situations of forced displacement. Prioritising cost–benefit evaluations, connecting the various health and well-being outcomes in response to interventions, as well as successfully communicating research findings to affected communities, donors and the entire humanitarian sector were also recognised. Knowledge translation in the form of policy briefs and evidence reviews that identify the specific benefits of sport, for whom and in what specific context should be made accessible to communities, donors and programme coordinators across sectors. Embedding sport in existing broader health and social programmes was also recommended to meaningfully impact policy and practice. Identifying gaps in the evidence base and mobilising academic efforts through participatory methodology should also be prioritised.
Address microconnections, meso-connections and macro-connections
The importance of multilevel connections to facilitate effective programming, including practitioners at the grassroots level, youth and persons with lived experience, and policymakers, was consistently highlighted. Leveraging microconnections, meso-connections and macro-connections amplifies the impact of sport programmes for displaced populations. A diversity of voices in programme design and implementation—combining expertise by training with expertise by lived experience—was noted as important for policy, advocacy and practice influence.
Avoid potholes and navigate the road towards implementation
Negative outcomes associated with sport, including exploitation and abuse, restricted access to sporting infrastructure, limited opportunity to participate, social exclusion, negative aspects of competition, harassment and bullying, were identified as considerations in the planning and implementation of sport programmes in situations of forced displacement. In addition, given that women and girls are most likely to be exposed to adversity and increased risks in contexts of displacement,15 appropriate consideration of gender with regard to culturally sensitive sport and physical activity promotion is paramount.
These themes define a roadmap to address the opportunities and challenges for the promotion of sport for people living in contexts of forced displacement. While sport can impact a diverse range of outcomes in situations of forced displacement, sport can cause harm if not delivered in a planned and considered manner by people with appropriate training and support, rooted in local context. Sport is often considered a luxury in humanitarian settings as opposed to an integrated and evidence-based component of psychosocial programming, with the COVID-19 pandemic having underlined the vital importance of social connection and physical activity. The five themes identified define a roadmap for the merging of sport and mental health and psychosocial support. Through synthesing the available evidence base, developing programme guidance and planning tools, fostering engagement with youth and communities, the Think Tank will continue working towards realising the cross-cutting potential of sport in humanitarian and displacement contexts as part of a coordinated intersectoral, interdisciplinary and interagency approach. We anticipate that the aforementioned insights will inform efforts to ensure all people affected by displacement have equitable access to sport for health and well-being.
Data availability statement
No data are available.
Patient consent for publication
Handling editor Seye Abimbola
Collaborators Olympic Refuge Foundation Think Tank: Alastair Ager, Institute of Global Health and Development; Maria Bray, Terre des Hommes; Michael Cacich, Education Above All - Educate A Child; Jadranka Stikovac Clark, Generations For Peace; Holly Collison, Loughborough University London; Oliver Dudfield, Sport for Development Coalition; Anna Farello, Loughborough University London; Paul Frisoli, Lego Foundation; Grace Gatera, Lived experience youth advocate; Sarah Harrison, International Federation of Red Cross Red Crescent Societies, Reference Centre for Psychosocial Support; Sabrina Hermosilla, University of Michigan; David Karorero, Lived experience youth advocate; Phiona Koyiet, World Vision International; Kathleen Latimer, Olympic Refuge Foundation; Patrick Onyango Mangen, Regional Psychosocial Support Initiative; Dicky C Pelupessy, Faculty of Psychology, Universitas Indonesia; Claudia L. Reardon, University of Wisconsin School of Medicine and Public Health; Simon Rosenbaum, UNSW Sydney, Discipline Psychiatry and Mental Health; Leslie Snider, Peace in Practice; Victor Ugo, Lived experience youth advocate; MHPSS Youth Engagement and Advocacy Advisor, MHPSS Collaborative; Chinwendu Ukachukwu, Lived experience youth advocate; Davy Vancampfort, KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences; Peter Ventevogel, UNHCR; Ajwang’ Warria, Faculty of Social Work, University of Calgary, Canada; Michael Wessells, Columbia University.
Contributors All authors provided data in the form of video interviews and participation in group meetings. A subset of authors conducted data analysis and drafted the manuscript. All authors reviewed and provided input into the final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.