Adapted Physical Activity Programs in the Swiss Social Security System

Background: Regular physical activity mitigates the adverse health effects of sedentary behaviour, promoting physical, mental, and social well-being. In Switzerland (CH), physical inactivity is most prevalent among populations with lower education levels and precarious social

status. Globally, there is a growing need for stronger policies to reduce physical activity

inequalities. My PhD research addresses this by investigating the integration of Adapted Physical Activity (APA) programs into the Social Insurance System (SIS) to support the reintegration of vulnerable populations.

Objectives: Using a transdisciplinary research framework, four studies will be conducted with

the following aims: 1) provide an overview of the state of the art in this scientific field; 2) provide

an overview of the current APA programs (APA-p) in the Swiss SIS; 3) exploring the different types of governance in SIS and their effects on APA-p in CH; and 4) measuring global health impacts of a specific APA-p in the SIS. While this PhD research may not be able to provide definitive guidance on the most effective governance model for reaching vulnerable groups in CH through APA-p, it

may help understand tendencies, obstacles, facilitators and benefits of the proposed approach.

Methods: This exploratory PhD research adopts a mixed-methods approach, combining qualitative and quantitative data. To identify knowledge gaps and propose solutions regarding

unequal access to physical activity in CH, four articles will be published: (1) a systematic review on APA use within social insurance systems; (2) a mapping review identifying existing APA-p in

Swiss SIS via gray literature and snowballing; (3) a comparative study analysing how different SIS governance models affect APA-p through knowledge co-creation; and (4) an evaluation of a

participatory APA-p’s direct impacts via pre-/post-tests and interviews.

Expected Outcome: This research aims to challenge the prevailing paradigm within the SIS, which tends to frame beneficiaries in need of support as a burden. By offering an alternative

perspective, it highlights how recognising the vulnerabilities of insured individuals can inform and inspire the development of more inclusive and effective interventions.