The body of evidence on structural prevention is scarce and needs further development. This study contributes to international research by analysing 10-year outcomes of a multicomponent programme promoting a healthy sports setting in Switzerland. Data were collected in 2007, 2011 and 2015, enabling a longitudinal perspective on outcomes. Telephone interviews, case studies, online-surveys and analysis of key documents and data were conducted. The programme «cool and clean» is well known and accepted by key partners. Partnering between the health and the sports sector has improved visibly and cantonal ambassadors are well established. Imparting knowledge among coaches and staff works well and the training for a responsible serving of alcohol has improved. However, the implementation of tied funding by cantonal authorities and the codification by sports organisations of «cool and clean» principles in rules and regulations proceeds slowly. Little progress has been made in implementing smoke-free outdoor areas at sport facilities, even on public premises. The study provides some evidence that the multilevel structural approach works. However, the findings suggest that it takes time to implement structural change on every level.
Market Integration: Case Studies of Structural Change