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McDonald MD, Brickley B, Pavey T, Smith JA, Maiorana A, McCaffrey T, Hillis G, Bonson J, Chih HJ, Gupta H, Holmes S, Hunt K, Kerr DA, Kwaśnicka D, Makate M, McVeigh J, Moullin JC, Smith BJ, Wharton L, Wharton N, Quested E. Scale-up of the Australian Fans in Training (Aussie-FIT) men's health behaviour change program: a protocol for a randomised controlled hybrid effectiveness-implementation trial. BMJ Open 2023; 13:e078302. [PMID: 37879681 PMCID: PMC10603488 DOI: 10.1136/bmjopen-2023-078302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/23/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Improving physical activity (PA) and healthy eating is critical for primary and secondary prevention of cardiovascular disease (CVD). Behaviour change programmes delivered in sporting clubs can engage men in health behaviour change, but are rarely sustained or scaled-up post trial. Following the success of pilot studies of the Australian Fans in Training (Aussie-FIT) programme, a hybrid effectiveness-implementation trial protocol was developed. This protocol outlines methods to: (1) establish if Aussie-FIT is effective at supporting men with or at risk of CVD to sustain improvements in moderate-to-vigorous PA (primary outcome), diet and physical and psychological health and (2) examine the feasibility and utility of implementation strategies to support programme adoption, implementation and sustainment. METHODS AND ANALYSIS A pragmatic multistate/territory hybrid type 2 effectiveness-implementation parallel group randomised controlled trial with a 6-month wait list control arm in Australia. 320 men aged 35-75 years with or at risk of CVD will be recruited. Aussie-FIT involves 12 weekly face-to-face sessions including coach-led interactive education workshops and PA delivered in Australian Football League (Western Australia, Northern Territory) and rugby (Queensland) sports club settings. Follow-up measures will be at 3 and 6 months (both groups) and at 12 months to assess maintenance (intervention group only). Implementation outcomes will be reported using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. ETHICS AND DISSEMINATION This multisite study has been approved by the lead ethics committees in the lead site's jurisdiction, the South Metropolitan Health Service Human Research Ethics Committee (Reference RGS4254) and the West Australian Aboriginal Health Ethics Committee (HREC1221). Findings will be disseminated at academic conferences, peer-reviewed journals and via presentations and reports to stakeholders, including consumers. Findings will inform a blueprint to support the sustainment and scale-up of Aussie-FIT across diverse Australian settings and populations to benefit men's health. TRIAL REGISTRATION NUMBER This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000437662).
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Affiliation(s)
- Matthew David McDonald
- Physical Activity and Well-being Research Group, Enable Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Bryce Brickley
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Toby Pavey
- Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James A Smith
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Andrew Maiorana
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Exercise Physiology Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Tracy McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Graham Hillis
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia
| | - Jason Bonson
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Hui Jun Chih
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Himanshu Gupta
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Scarlett Holmes
- Physical Activity and Well-being Research Group, Enable Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Dominika Kwaśnicka
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Marshall Makate
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Joanne McVeigh
- Physical Activity and Well-being Research Group, Enable Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Joanna C Moullin
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Brendan J Smith
- Physical Activity and Well-being Research Group, Enable Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Lee Wharton
- Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Neil Wharton
- Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, Enable Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
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Hernández-Hernández JA, Londoño-Pineda A, Cano JA, Gómez-Montoya R. Stakeholder governance and sustainability in football: A bibliometric analysis. Heliyon 2023; 9:e18942. [PMID: 37600398 PMCID: PMC10432707 DOI: 10.1016/j.heliyon.2023.e18942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
This study presents a bibliometric analysis of stakeholder governance and sustainability in football. The PRISMA statement and the main techniques from the existing bibliometric analysis toolbox are applied to guide the research. The analysis includes 127 documents from Scopus and WoS, covering the period from 2007 to mid-2023, to examine the performance analysis and science mapping of the subject over time. The study's key findings highlight publication-related metrics, citation-and-publication-related metrics, co-authorship analysis, and co-word analysis. The analysis also identifies research gaps, including the need to explore barriers to stakeholder governance in football, the application of stakeholder pressure frameworks in football clubs, the examination of mimetic and normative pressures in the context of sustainability and governance in football, and the involvement of stakeholders and football institutions in collaborative efforts to enhance the effectiveness and impact of sustainability initiatives.
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McDonald MD, Hunt K, Moullin J, Kerr D, Ntoumanis N, Quested E. 'A Different Ball Game': Adaptation of a men's health program for implementation in rural Australia. BMC Public Health 2023; 23:1387. [PMID: 37468854 DOI: 10.1186/s12889-023-16247-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Men residing in rural areas are less likely to participate in weight management interventions than women, and few men-specific programs target rural areas. Aussie-Fans in Training (Aussie-FIT) is an evidence-based weight management intervention that uses professional Australian Football club affiliations and settings as a 'hook' to engage urban-residing men. The aim of this study is to report on how findings from rural stakeholder focus groups were used to inform the adaptation of Aussie-FIT for implementation in rural areas. METHODS Seven focus groups with stakeholders (n = 24) in three rural towns explored existing weight management and physical activity provisions, barriers and facilitators to engaging men, and considerations for adapting Aussie-FIT for implementation in rural contexts. Qualitative data were analysed using the framework approach. Adaptations made to the Aussie-FIT program and strategies to implement the program in rural contexts were reported using a structured framework. RESULTS Themes generated from our analysis include limited appealing services for men, Australian Football as a 'common language', the influence of the 'smaller fishpond'(population), considerations for program inclusivity, and the importance of local partner organisations for sustainability. We adapted the recruitment and marketing strategies, delivery settings, football program theme and partnerships for rural implementation. Stakeholders advised that an Australian Football program theme without specific local club affiliations would be important to avoid alienating men with differing club allegiances or non-sporting backgrounds. A multi-component recruitment strategy utilising local trusted sources, and program marketing that aligns with masculine ideals were considered important by stakeholders in small communities where 'people talk'. CONCLUSIONS Rural areas were described as 'a different ball game' due to limited local services and resources in comparison to metropolitan areas. Study findings have synergies with previous studies undertaken in rural contexts including in relation to the power of word of mouth, the importance of trust, and local partner organisations. Findings have implications for engaging rural men in health interventions in rural contexts where professional sporting contexts are not available. Assessing the extent to which the adapted Aussie-FIT program can reach and engage men in rural Australia, and exploring the barriers and facilitators to delivering the program in rural contexts is required.
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Affiliation(s)
- Matthew D McDonald
- Curtin School of Population Health, Curtin University, Perth, Australia.
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Australia.
| | - Kate Hunt
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Joanna Moullin
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Deborah Kerr
- Curtin School of Population Health, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | - Nikos Ntoumanis
- Danish Centre for Motivation and Behaviour Change, University of Southern Denmark, Odense, Denmark
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Eleanor Quested
- Curtin School of Population Health, Curtin University, Perth, Australia
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Australia
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Bunn C, Palmer V, Chng NR, Andersen E, Gray CM, Hunt K, Jelsma JGM, Morgan H, der Sanden MNV, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Silva MN, Sørensen M, Teixeira PJ, van Achterberg T, van de Glind I, van Mechelen W, van Nassau F, van der Ploeg HP, Wyke S. How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial. BMC Public Health 2023; 23:526. [PMID: 36941552 PMCID: PMC10026416 DOI: 10.1186/s12889-023-15419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/10/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND A randomised trial of European Fans in Training (EuroFIT), a 12-week healthy lifestyle program delivered in 15 professional football clubs in the Netherlands, Norway, Portugal, and the United Kingdom, successfully increased physical activity and improved diet but did not reduce sedentary time. To guide future implementation, this paper investigates how those effects were achieved. We ask: 1) how was EuroFIT implemented? 2) what were the processes through which outcomes were achieved? METHODS We analysed qualitative data implementation notes, observations of 29 of 180 weekly EuroFIT deliveries, semi-structured interviews with 16 coaches and 15 club representatives, and 30 focus group discussions with participants (15 post-program and 15 after 12 months). We descriptively analysed quantitative data on recruitment, attendance at sessions and logs of use of the technologies and survey data on the views of participants at baseline, post program and after 12 months. We used a triangulation protocol to investigate agreement between data from difference sources, organised around meeting 15 objectives within the two research questions. RESULTS We successfully recruited clubs, coaches and men to EuroFIT though the draw of the football club seemed stronger in the UK and Portugal. Advertising that emphasized getting fitter, club-based deliveries, and not 'standing out' worked and attendance and fidelity were good, so that coaches in all countries were able to deliver EuroFIT flexibly as intended. Coaches in all 15 clubs facilitated the use of behaviour change techniques and interaction between men, which together enhanced motivation. Participants found it harder to change sedentary time than physical activity and diet. Fitting changes into daily routines, planning for setbacks and recognising the personal benefit of behaviour change were important to maintain changes. Bespoke technologies were valued, but technological hitches frustrated participants. CONCLUSION EuroFIT was delivered as planned by trained club coaches working flexibly in all countries. It worked as expected to attract men and support initiation and maintenance of changes in physical activity and diet but the use of bespoke, unstable, technologies was frustrating. Future deliveries should eliminate the focus on sedentary time and should use only proven technologies to support self-monitoring and social interaction. TRIAL REGISTRATION ISRCTN81935608, registered 16/06/2015.
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Affiliation(s)
- Christopher Bunn
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK.
| | - Victoria Palmer
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Nai Rui Chng
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Eivind Andersen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Cindy M Gray
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
- Institute for Social Marketing and Health, Faculty of Health and Sports Sciences, University of Stirling, Scotland, UK
| | - Judith G M Jelsma
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Heather Morgan
- Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK
| | - Maria Nijhuis-van der Sanden
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Hugo V Pereira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | | | - Glyn C Roberts
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Øystein B Røynesdal
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Marlene N Silva
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
- Direcção-Geral da Saúde, Programa Nacional Para a Promoção da Atividade Física, Lisbon, Portugal
| | - Marit Sørensen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | - Theo van Achterberg
- Department of Public Health and Primary Care, KU Louvain, Academic Centre for Nursing and Midwifery, Louvain, Belgium
| | - Irene van de Glind
- FWG, Department of Researchesearch and Development, Utrecht, The Netherlands
| | - Willem van Mechelen
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Femke van Nassau
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Hidde P van der Ploeg
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Sally Wyke
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
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Petrella AR, Sabiston CM, O’Rourke RH, Santa Mina D, Hamilton RJ, Matthew AG. Process Evaluation of a Sport-Based Supportive Care Intervention for Testicular Cancer Survivors: A Mixed Methods Study. Cancers (Basel) 2022; 14:cancers14112800. [PMID: 35681779 PMCID: PMC9179291 DOI: 10.3390/cancers14112800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023] Open
Abstract
Testicular cancer survivors report unmet supportive care needs that are associated with poorer physical and mental health, yet engagement in traditional supportive care is low. The Ball’s in Your Court intervention was designed to engage testicular cancer survivors in supportive care by leveraging a community-based sport and exercise model. Age-appropriate, gender-sensitized, and disease specific elements were reflected in the intervention design, setting, content, and delivery. The intervention included five weekly health promotion sessions among a group of testicular cancer survivors. The purpose of this study was to explore the intervention’s (i) feasibility and acceptability, (ii) effects on testicular cancer survivors’ perceived health, and (iii) gain feedback for intervention refinement. A total of 10 testicular cancer survivors participated in the pilot and completed questionnaires on demographics, cancer history, perceived health, and physical activity behavior at baseline (pre-intervention) and perceived health and satisfaction with intervention components (post-intervention). Open-ended feedback surveys were collected after each weekly session and researcher field notes were recorded by three members of the study team. One month following the intervention, a focus group was conducted with intervention participants. All participants were satisfied with the intervention. Content analysis of the qualitative data supported intervention acceptability. Visual analysis conducted at the individual level indicated that perceived health either remained stable or improved from pre- to post-intervention. The Ball’s in Your Court intervention provides a feasible and acceptable approach for the delivery of supportive care aimed at improving testicular cancer survivors’ health and wellness. Recommendations for intervention refinement were provided and require future examination.
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Affiliation(s)
- Anika R. Petrella
- Cancer Division, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK;
| | - Catherine M. Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada; (R.H.O.); (D.S.M.)
- Correspondence:
| | - Roxy H. O’Rourke
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada; (R.H.O.); (D.S.M.)
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada; (R.H.O.); (D.S.M.)
| | - Robert J. Hamilton
- The Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (R.J.H.); (A.G.M.)
| | - Andrew G. Matthew
- The Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (R.J.H.); (A.G.M.)
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Kwasnicka D, Donnachie C, Thøgersen-Ntoumani C, Hunt K, Gray CM, Ntoumanis N, McBride H, McDonald MD, Newton RU, Gucciardi DF, Olson JL, Wyke S, Morgan PJ, Kerr DA, Robinson S, Quested E. The Aussie-FIT process evaluation: feasibility and acceptability of a weight loss intervention for men, delivered in Australian Football League settings. Psychol Health 2022; 37:470-489. [PMID: 33719789 DOI: 10.1080/08870446.2021.1890730] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This process evaluation aimed to evaluate the feasibility and acceptability of Aussie-FIT, a group-based weight loss intervention for men with overweight and obesity in Australia. DESIGN Process data and data collected from: (1) six-participant focus groups (n= 24), (2) coach interviews (n = 4), (3) audio recordings of Aussie-FIT sessions and (4) post-program participant surveys (n= 93) were analysed. MAIN OUTCOME MEASURES We explored the feasibility and acceptability of program setting and context, recruitment strategies, factors impacting implementation and mechanisms of impact. RESULTS Recruitment via Australian Football League (AFL) clubs was highly effective; 426 men expressed interest within 3 days of advertising, 130 men took part. Program attendance was not consistently recorded by coaches. Coach interviews indicated a 'core group of men' participated in each session (typically 10-12 of 15 men). Program delivery proved feasible in the AFL context. Program acceptability and satisfaction were high. Internalisation of autonomous motives was identified as driving behaviour change. Behaviour change to support maintained weight loss was facilitated through habit formation, goal setting and effective management of multiple goals. CONCLUSION Aussie-FIT sets a blueprint for future weight loss interventions that utilise behaviour change strategies and principles of self-determined motivation to support men to lose weight. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12617000515392. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
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Affiliation(s)
- Dominika Kwasnicka
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia.,Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Craig Donnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Kate Hunt
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nikos Ntoumanis
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Hannah McBride
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Matthew D McDonald
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Daniel F Gucciardi
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Jenny L Olson
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
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Bromley PA, Müller FO, Malan J, Torres J, Vanderbeke O. An Intervention Mapping Study: Developing the Choosing Health digital weight loss and maintenance intervention (Preprint). J Med Internet Res 2021; 24:e34089. [PMID: 362568 PMCID: PMC9627465 DOI: 10.2196/34089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/10/2022] [Accepted: 05/29/2022] [Indexed: 12/01/2022] Open
Abstract
Background Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are widely accessible, personalized, and theory- and evidence-based are still limited. Objective This study aimed to develop a digital behavior change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and use these to provide tailored support. Methods We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of a logic model of the problem, a model of change, intervention design and intervention production, the implementation plan, and the evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research—including 4 focus groups (n=40), expert consultations (n=12), and interviews (n=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from a variety of relevant backgrounds (including nutrition, physical activity, and the health care sector). Results Following a structured process, we developed a tailored intervention that has the potential to reduce excess body weight and support behavior changes in people with overweight and obesity. The Choosing Health intervention consists of tailored, personalized text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. The intervention content includes behavior change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support, and addressing physical and psychological resources. Conclusions The use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of the general public, we were able to map out program facilitators and barriers while increasing the ecological validity of the program to ensure that we build an intervention that is useful, user-friendly, and informative. We also summarized the lessons learned for the Choosing Health intervention development and for other health promotion programs. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-040183
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Cagas JY, Biddle SJH, Vergeer I. Yoga not a (physical) culture for men? Understanding the barriers for yoga participation among men. Complement Ther Clin Pract 2020; 42:101262. [PMID: 33276223 DOI: 10.1016/j.ctcp.2020.101262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 12/13/2022]
Abstract
Yoga offers an integrated approach to health and well-being that could potentially benefit men. This qualitative descriptive study examined men's perceptions of yoga, and identified barriers and possible facilitators for participation. Twenty-one non-yoga participant men, 18-60 years old, and living in Queensland, Australia, were interviewed. Two major barriers were identified using thematic analysis: (1) preference for other forms of physical activity, and (2) gender-related perceptions and pressures (i.e., perception of yoga as feminine, and presence of "bloke" culture and masculine ideals in society). Potential facilitators included: (1) acceptability of yoga among men, (2) providing brief information sessions, and (3) men-only classes. The non-competitive nature of yoga, in addition to being predominantly undertaken by women, makes it less appealing for men living in Australia. These barriers need to be considered if yoga is to be promoted as an option for men, particularly those not drawn to traditional sports or exercise.
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Affiliation(s)
- Jonathan Y Cagas
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia; Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Quezon City, Philippines.
| | - Stuart J H Biddle
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Ineke Vergeer
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
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McDonald MD, Dombrowski SU, Skinner R, Calveley E, Carroll P, Elders A, Gray CM, Grindle M, Harris FM, Jones C, Hoddinott P. Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial. BMC Med Res Methodol 2020; 20:249. [PMID: 33023501 PMCID: PMC7542377 DOI: 10.1186/s12874-020-01136-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Men, particularly those living in disadvantaged areas, are less likely to participate in weight management programmes than women despite similar levels of excess weight. Little is known about how best to recruit men to weight management interventions. This paper describes patient and public involvement in pre-trial decisions relevant to recruitment and aims to report on recruitment to the subsequent men-only weight management feasibility trial, including the: i) acceptability and feasibility of recruitment; and ii) baseline sample characteristics by recruitment strategy. Methods Men with BMI ≥30 kg/m2 and/or waist circumference ≥ 40 in. were recruited to the feasibility trial via two strategies; community outreach (venue information stands and word of mouth) and GP letters, targeting disadvantaged areas. Recruitment activities (e.g. letters sent, researcher venue hours) were recorded systematically, and baseline characteristics questionnaire data collated. Qualitative interviews (n = 50) were conducted three months post-recruitment. Analyses and reporting followed a complementary mixed methods approach. Results 105 men were recruited within four months (community n = 60, GP letter n = 45). Community outreach took 2.3 recruiter hours per participant and GP letters had an opt-in rate of 10.2% (n = 90/879). More men were interested than could be accommodated. Most participants (60%) lived in more disadvantaged areas. Compared to community outreach, men recruited via GP letters were older (mean = 57 vs 48 years); more likely to report an obesity-related co-morbidity (87% vs 44%); and less educated (no formal qualifications, 32% vs 10%, degree educated 11% vs 41%). Recruitment strategies were acceptable, a sensitive approach and trusting relationships with recruiters valued, and the ‘catchy’ study name drew attention. Conclusions Targeted community outreach and GP letters were acceptable strategies that successfully recruited participants to a men-only weight management feasibility trial. Both strategies engaged men from disadvantaged areas, a typically underserved population. Using two recruitment strategies produced samples with different health risk profiles, which could add value to research where either primary or secondary prevention is of interest. Further work is required to examine how these strategies could be implemented and sustained in practice. Trial registration ClinicalTrials.gov: NCT03040518, 2nd February 2017.
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Affiliation(s)
- Matthew D McDonald
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK. .,Physical Activity and Wellbeing Research Group, Curtin University, Perth, Australia. .,School of Psychology, Curtin University, Perth, Australia.
| | - Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada.,Division of Psychology, University of Stirling, Stirling, UK
| | - Rebecca Skinner
- Division of Psychology, University of Stirling, Stirling, UK
| | - Eileen Calveley
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Cindy M Gray
- School of Social and Political Sciences, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Grindle
- Institute for Health Research and Innovation, University of the Highlands and Islands, Inverness, UK
| | - Fiona M Harris
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
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10
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Shoneye CL, Mullan B, Begley A, Pollard CM, Jancey J, Kerr DA. Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e17919. [PMID: 32641284 PMCID: PMC7511863 DOI: 10.2196/17919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/15/2020] [Accepted: 07/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. OBJECTIVE The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. METHODS This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. RESULTS Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. CONCLUSIONS This study explores users' capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/12782.
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Affiliation(s)
- Charlene L Shoneye
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Barbara Mullan
- Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Christina M Pollard
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence Research & Impact in Public Health, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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11
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Kwasnicka D, Ntoumanis N, Hunt K, Gray CM, Newton RU, Gucciardi DF, Thøgersen-Ntoumani C, Olson JL, McVeigh J, Kerr DA, Wyke S, Morgan PJ, Robinson S, Makate M, Quested E. A gender-sensitised weight-loss and healthy living program for men with overweight and obesity in Australian Football League settings (Aussie-FIT): A pilot randomised controlled trial. PLoS Med 2020; 17:e1003136. [PMID: 32760144 PMCID: PMC7410214 DOI: 10.1371/journal.pmed.1003136] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 06/16/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Recent evidence shows that sport settings can act as a powerful draw to engage men in weight loss. The primary objective of this pilot study was to test the feasibility of delivering and to evaluate preliminary efficacy of Aussie-FIT, a weight-loss program for men with overweight/obesity delivered in Australian Football League (AFL) settings, in preparation for a future definitive trial. METHODS AND FINDINGS This 6-month pilot trial took place in Perth, Australia. Participants were overweight/obese (Body Mass Index [BMI] ≥ 28 kg/m2), middle-aged (35-65 years old) men. Participants were recruited in May 2018, and the intervention took place between June and December 2018. The intervention involved 12 weekly 90-min face-to-face sessions, incorporating physical activity, nutrition, and behaviour change information and practical activities delivered by coaches at 2 clubs. Data were collected at baseline and immediately postintervention. For trial feasibility purposes, 6-month follow-ups were completed. Outcomes were differences in weight loss (primary outcome) and recruitment and retention rates, self-reported measures (for example, psychological well-being), device-measured physical activity, waist size, and blood pressure at 3 months. Within 3 days of advertising at each club, 426 men registered interest; 306 (72%) were eligible. Men were selected on a first-come first-served basis (n = 130; M age = 45.8, SD = 8; M BMI = 34.48 kg/m2, SD = 4.87) and randomised by a blinded researcher. Trial retention was 86% and 63% at 3- and 6-month follow-ups (respectively). No adverse events were reported. At 3 months, mean difference in weight between groups, adjusted for baseline weight and group, was 3.3 kg (95% CI 1.9, 4.8) in favour of the intervention group (p < 0.001). The intervention group's moderate-to-vigorous physical activity (MVPA) was higher than the control group by 8.54 min/day (95% CI 1.37, 15.71, p = 0.02). MVPA among men attracted to Aussie-FIT was high at baseline (intervention arm 35.61 min/day, control arm 38.38 min/day), which may have limited the scope for improvement. CONCLUSIONS Aussie-FIT was feasible to deliver; participants increased physical activity, decreased weight, and reported improvements in other outcomes. Issues with retention were a limitation of this trial. In a future, fully powered randomised controlled trial (RCT), retention could be improved by conducting assessments outside of holiday seasons. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12617000515392.
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Affiliation(s)
- Dominika Kwasnicka
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
- SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Nikos Ntoumanis
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
| | - Kate Hunt
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Robert U. Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Daniel F. Gucciardi
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
| | - Jenny L. Olson
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
| | - Joanne McVeigh
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Occupational Therapy, Speech Therapy & Social Work, Curtin University, Perth, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Deborah A. Kerr
- School of Public Health, Curtin University, Perth, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Philip J. Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | | | - Marshall Makate
- School of Public Health, Curtin University, Perth, Australia
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
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12
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Maddison R, Hargreaves EA, Jiang Y, Calder AJ, Wyke S, Gray CM, Hunt K, Lubans D, Eyles H, Draper N, Heke I, Kara S, Sundborn G, Arandjus C, Jenkins M, Marsh S. Rugby Fans in Training New Zealand (RUFIT-NZ): protocol for a randomized controlled trial to assess the effectiveness and cost-effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand. Trials 2020; 21:139. [PMID: 32019609 PMCID: PMC7001306 DOI: 10.1186/s13063-019-4038-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/29/2019] [Indexed: 11/18/2022] Open
Abstract
Background A healthy lifestyle program that appeals to, and supports, obese New Zealand (NZ) European, Māori (indigenous) and Pasifika men to achieve weight loss is urgently needed. In Scotland, Football Fans in Training (FFIT), a weight management and healthy lifestyle program for overweight and obese men aged 35–65 years , delivered by community coaching staff at professional football clubs, has been shown to be beneficial and cost-effective. A pilot program inspired by FFIT but delivered by professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, improved physiological outcomes, and adherence to healthy lifestyle behaviors in overweight and obese men. The objective of this trial is to determine the effectiveness and cost-effectiveness of the Rugby Fans in Training New Zealand (RUFIT-NZ) program. Methods A pragmatic, two-arm, multi-center, randomized controlled trial involving 308 overweight and obese men aged 30–65 years, randomized to either an intervention group (n = 154) or a wait-list control group (n = 154). The intervention-group participated in the 12-week RUFIT-NZ program, a gender-sensitized, healthy lifestyle intervention adapted to the environment and cultural diversity of NZ and delivered through professional rugby clubs. Participants in the intervention group undergo physical training sessions, in addition to workshop-based sessions to learn about nutrition, physical activity, sleep, sedentary behavior, and a range of behavior-change strategies for sustaining a healthier lifestyle. The control group receives the program after 52 weeks. The primary outcome is change in body weight from baseline to 52 weeks. Secondary outcomes include change in body weight at 12 weeks; waist circumference, blood pressure, fitness, and lifestyle behaviors at 12 and 52 weeks; and cost-effectiveness. A process evaluation informed by the RE-AIM framework will evaluate potential implementation of RUFIT-NZ as an ongoing program in NZ after the trial. Discussion This trial will investigate the effectiveness and cost-effectiveness of the RUFIT-NZ program in overweight and obese NZ men. Trial registration Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered on 18 January 2019, according to the World Health Organization Trial Registration Data Set. Universal Trial Number, U1111-1245-0645.
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Affiliation(s)
- Ralph Maddison
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. .,Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia.
| | - Elaine Anne Hargreaves
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Amanda Jane Calder
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, Scotland
| | - Cindy M Gray
- Institute for Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, Scotland
| | - Kate Hunt
- Institute for Social Marketing, Faculty of Health and Sports Sciences, University of Stirling, Stirling, UK
| | - David Lubans
- School of Education, Priority Research Centre for Physical Activity and Nutrition University of Newcastle, Newcastle, NSW, Australia
| | - Helen Eyles
- National Institute for Health Innovation and Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Nick Draper
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | | | - Stephen Kara
- Axis Sport Medicine Clinic, Auckland, New Zealand
| | - Gerhard Sundborn
- Department of Pacific Health, University of Auckland, Auckland, New Zealand
| | - Claire Arandjus
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Matthew Jenkins
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Samantha Marsh
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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13
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Hunt K, Wyke S, Bunn C, Donnachie C, Reid N, Gray CM. Scale-Up and Scale-Out of a Gender-Sensitized Weight Management and Healthy Living Program Delivered to Overweight Men via Professional Sports Clubs: The Wider Implementation of Football Fans in Training (FFIT). Int J Environ Res Public Health 2020; 17:E584. [PMID: 31963224 PMCID: PMC7014345 DOI: 10.3390/ijerph17020584] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/11/2022]
Abstract
Increasing prevalence of obesity poses challenges for public health. Men have been under-served by weight management programs, highlighting a need for gender-sensitized programs that can be embedded into routine practice or adapted for new settings/populations, to accelerate the process of implementing programs that are successful and cost-effective under research conditions. To address gaps in examples of how to bridge the research to practice gap, we describe the scale-up and scale-out of Football Fans in Training (FFIT), a weight management and healthy living program in relation to two implementation frameworks. The paper presents: the development, evaluation and scale-up of FFIT, mapped onto the PRACTIS guide; outcomes in scale-up deliveries; and the scale-out of FFIT through programs delivered in other contexts (other countries, professional sports, target groups, public health focus). FFIT has been scaled-up through a single-license franchise model in over 40 UK professional football clubs to 2019 (and 30 more from 2020) and scaled-out into football and other sporting contexts in Australia, Canada, New Zealand, England and other European countries. The successful scale-up and scale-out of FFIT demonstrates that, with attention to cultural constructions of masculinity, public health interventions can appeal to men and support them in sustainable lifestyle change.
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Affiliation(s)
- Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling FK9 4LA, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
- Department of Psychology, Curtin University, Bentley, WA 6102, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Christopher Bunn
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Craig Donnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Nicky Reid
- Scottish Professional League Trust (SPFL-T), Glasgow G42 9DE, UK;
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
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14
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Draper CE, Tomaz SA, Zihindula G, Bunn C, Gray CM, Hunt K, Micklesfield LK, Wyke S. Development, feasibility, acceptability and potential effectiveness of a healthy lifestyle programme delivered in churches in urban and rural South Africa. PLoS One 2019; 14:e0219787. [PMID: 31365557 PMCID: PMC6668772 DOI: 10.1371/journal.pone.0219787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
Rising levels of obesity in South Africa require innovation in community-level lifestyle change programmes. Our aim was to co-develop Impilo neZenkolo ('Health through Faith'), a healthy lifestyle programme for low-income, black South Africans delivered through churches, and evaluate its feasibility, acceptability and potential effectiveness. In the first phase we developed programme materials with church members. In the second phase we trained lay leaders to deliver the programme and assessed feasibility, acceptability (observation, focus groups and interviews) and potential effectiveness (pre and post measurement of weight, hip and waist circumferences, blood pressure, self-reported physical activity, dietary habits, health status, self-esteem, psychological distress). The study was conducted in four churches in urban and rural South Africa. The development workshops led to increased focus on positive benefits of participation, widening inclusion criteria to all adults and greater emphasis on Christian ethos. Challenges to feasibility included: recruitment of churches; scheduling of programme sessions (leading to one church not delivering the programme); attendance at the programme (63% attended more than half of the 12 weekly sessions); and poor programme fidelity (in particular in teaching behaviour change techniques). Aspects of the programme were acceptable, particularly the way in which the programme was aligned with a Christian ethos. There was some indication that amongst the 42/68 (62%) for whom we were obtained pre- and post-programme measurements the programme has potential to support weight loss. We conclude that a healthy lifestyle programme for low-income, black South Africans, delivered through churches, may be viable with extensive re-development of delivery strategies. These include finding external funding for the programme, endorsement from national level denominational organisations and the professionalization of programme leadership, including paid rather than volunteer leaders to ensure sufficient time can be spent in training.
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Affiliation(s)
- Catherine Elizabeth Draper
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simone Annabella Tomaz
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Ganzamungu Zihindula
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal, Durban, South Africa
| | - Christopher Bunn
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kate Hunt
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Institute for Social Marketing, Faculty of Health and Sports Sciences, University of Stirling, Stirling, United Kingdom
| | - Lisa Kim Micklesfield
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sally Wyke
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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15
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Wyke S, Bunn C, Andersen E, Silva MN, van Nassau F, McSkimming P, Kolovos S, Gill JMR, Gray CM, Hunt K, Anderson AS, Bosmans J, Jelsma JGM, Kean S, Lemyre N, Loudon DW, Macaulay L, Maxwell DJ, McConnachie A, Mutrie N, Nijhuis-van der Sanden M, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Sattar N, Sørensen M, Teixeira PJ, Treweek S, van Achterberg T, van de Glind I, van Mechelen W, van der Ploeg HP. The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial. PLoS Med 2019; 16:e1002736. [PMID: 30721231 PMCID: PMC6363143 DOI: 10.1371/journal.pmed.1002736] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting. METHODS AND FINDINGS A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs. CONCLUSION Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment. TRIAL REGISTRATION International Standard Randomised Controlled Trials, ISRCTN-81935608.
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Affiliation(s)
- Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Eivind Andersen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Marlene N Silva
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paula McSkimming
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Spyros Kolovos
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, United Kingdom
| | - Judith Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sharon Kean
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nicolas Lemyre
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | | | - Lisa Macaulay
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, the University of Edinburgh, Edinburgh, United Kingdom
| | - Maria Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Hugo V Pereira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Matthew Philpott
- European Healthy Stadia Network CIC Ltd., Liverpool, United Kingdom
| | - Glyn C Roberts
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Øystein B Røynesdal
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marit Sørensen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Irene van de Glind
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Leijon M, Åsberg K, Karlsson N, Skagerström J, Dannapfel P, Arvidsson D. A Weight-Loss and Healthy Living Program for Men Delivered in Swedish Football and Ice-Hockey Clubs (ViSiT): Results from the ViSiT Feasibility Study. Health (London) 2019. [DOI: 10.4236/health.2019.1110110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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