Reasons for dropout and low attendance of participants of the SALEEM exercise and sport intervention in the Koutsochero refugee camp (Larissa, Greece): A qualitative study

Introduction:
Because of violence, hunger and misery, people are forced to flee from their home countries. Refugees experience severe traumatic events during their flight. There is a significantly higher risk of suffering from psychiatric disorders, such as post- traumatic stress disorder (PTSD) and major depression among refugees. There is thus a need for greater efforts towards refugees’ wellbeing. The aim of this study was to examine reasons for dropping out and low attendance of an exercise and sport intervention.
Methodology:
The present qualitative study is carried out within a large pragmatic randomized control trial (SALEEM-study), which took place in a Greek refugee camp. After the first 3-month intervention phase, semi-structured interviews were conducted with the dropouts and low attenders (attendance of zero to less than once per week) of the intervention group (IG). Eleven interviews were carried out and further analyzed by qualitative content data-analysis.
Results:
A system of categorization was developed. Six main categories developed from the data: Social aspects, Physical and Mental Health, Rumination, Emotions and Feelings, Project and its perception and Contextual/Structural Barriers. Additionally, within each main category, subcategories were presented.
Conclusion:
Several important implications can be drawn from this thesis. The results presented here suggest possibilities to overcome dropout and low attendance, in particular motivational strategies, sustainability of carrying out the sport activities, doing the activities away from the camp and including the participants more in the entire process. Moreover, the social interactions acquired through the sport activities appeared to be important for the refugees and should be paid attention to. The results from this study may contribute to adapt and/or reconsider future sport programs within refugee camp settings.