Managerial perceptions of factors affecting the design and delivery of sport for health programs for refugee populations

•Sport has great promise for delivering health outcomes for refugee populations.•Experts in Germany and Netherlands discuss sport for health programs for refugees.•Effective design and delivery of sport is shaped by social-ecological factors.•Programs should adopt both increasing participation and settings-based approaches.•A social-ecological model of sport for health programs for refugees is proposed.Millions of refugees from the Middle East and Africa have moved to mainland Europe in recent years, where they face boredom, physical and mental health issues, and lack of social relationships. Policy makers consider sport an effective way to address these issues, but researchers have not fully considered managerial considerations in designing and delivering sport to refugees. The purpose of this study is to understand how sport managers can design and deliver sport to refugee populations in order to maximize beneficial health outcomes. The authors theoretically grounded the study in a social-ecological model, recognizing that the design, delivery, and outcomes of sport are set within constraints at multiple levels. Data were collected using a Delphi approach with a group of experts from Germany and the Netherlands. The findings indicated that the experts attributed a number of health benefits to sport programs including physical activity, diversion, stress reduction, coping, and building friendships. Benefits were more likely to occur when the sport delivery approach moved from merely increasing participation to also affecting the sport for health settings. The experts also identified a number of intrapersonal, interpersonal, organizational, and societal level factors impacting the design, delivery, and outcomes of sport for health programs which are rich in implications for sport managers and policy makers.