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Football Fans In Training

Football Fans in Training (FFIT) is a physical activity, healthy eating and weight management programme for overweight/obese men aged 35-65 years. Delivered by coaches at all Scottish Premier League (SPL) football clubs over the last two years, FFIT has successfully attracted men (a traditionally-hard-to reach group) from all sectors of society. Participants describe how FFIT has given them a ‘kick up the backside’ and helped them make positive changes to their lifestyles; they feel better, have more energy and say the football club setting was crucial in motivating them to join, become more active and improve their health and lifestyles.

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How It Started

Scottish men die 4-5 years earlier than Scottish women, but remain reluctant to engage in existing health promotion initiatives that encourage people to become more active and lead healthier lifestyles. Recently professional sport clubs have been recognised as vehicles for healthy lifestyle interventions aimed at men. Sporting settings have great potential for reducing health inequalities; they maximise engagement across the socioeconomic spectrum by capitalising on the traditional male sporting environment and the powerful social and psychological connections to the team (e.g. loyalty, identity and a sense of belonging) that ‘being a fan' creates.

FFIT was launched in 2010 with the aim of helping men to reduce their risk of ill health and premature mortality by achieving long term changes to their physical activity, eating habits and weight. It was hoped that providing an opportunity for men-only peer support from like-minded individuals (i.e. fans of the same club), the programme would encourage participants to continue to meet up following the initial 12 weekly sessions at their club to provide ongoing motivation to remain more active and maintain their healthier lifestyles.

Partners Involved

The success of the FFIT project depended on close partnership working between the Scottish Premier League Trust (the charitable arm of the SPL, which aims to help SPL clubs deliver positive social change for the benefit of their local communities), researchers from Scotland’s leading universities, the Medical Research Council (MRC), NHS clinicians, and commercial and governmental organisations namely:

Programme development:
Universities of Glasgow, Strathclyde, Dundee, MRC/CSO Social and Public Health Sciences Unit (MRC/CSO SPHSU), NHS Scotland.

Programme delivery:
Funders – Scottish Government, The Football Pools.
Administration – SPL Trust
Coach training – Universities of Glasgow, Strathclyde, MRC/CSO SPHSU, NHS Scotland
Session delivery – Football clubs: Aberdeen, Celtic, Dundee United, Dumferline Athletic, Hamilton Academical, Heart of Midlothian, Hibernian, Inverness Caledonian Thistle, Kilmarnock, Motherwell, Rangers, St Mirren, St Johnstone

Evaluation:
Funders – National Institute of Health Research, Chief Scientist Office, SPL Trust
Research – University of Glasgow, MRC/CSO SPHSU, Universities of Dundee, Strathclyde, Leeds Metropolitan, NHS Scotland

Process

FFIT is a gender-sensitised, physical activity, healthy eating and weight management programme delivered in 12, weekly, 90 minute sessions at the 12 football clubs in the SPL (and the club relegated to Division 1 the previous season).

FFIT is delivered to groups of men by club community coaches who are trained over 2 days and given written materials to support delivery. The participants receive: notes summarising the key physical activity and dietary information; pedometers; and club t-shirts to foster a ‘team spirit’. The sessions are delivered at the clubs’ home grounds and involve a combination of ‘pitch-side’ activity and ‘classroom' information and discussion.

Physical activity: FFIT aims to help men achieve 150 minutes of moderate physical activity a week and reduce sedentary behaviour. There are two physical activity components: an incremental pedometer-based walking programme shown to increase physical activity and reduce sedentary behaviour over 12 months; and ‘pitch-side’ activity sessions.

Diet: The ‘classroom' sessions are adapted from an effective men’s weight management programme that is delivered in a limited number of NHS clinics in central Scotland. Participants receive personalisable dietary advice, and are encouraged adopt a healthy, balanced diet with more fruit, vegetables and wholemeal/wholegrain foods, and to reduce portion sizes.

Behaviour change techniques: FFIT uses techniques that are effective in increasing physical activity and improving diet, including: self-monitoring, goal setting and review, and feedback.

Post-programme support: Participants receive 6-weekly e-mail prompts and a ‘reunion' session at the club 9 months after starting FFIT. They are also encouraged to meet up regularly to exercise together.

Marketing and recruitment: Most participants respond to adverts on football-related websites or at home matches. FFIT is also promoted through local employers and community venues.

Results and Impact

The first (Autumn 2010) delivery of FFIT was monitored across all clubs, and an objective evaluation (including a pilot randomised trial, participant focus groups, and interviews with men who dropped out) conducted at two clubs.

Results:
355 men (mean age 45.1) enrolled across all clubs. This was a high risk group: mean BMI was 34.5 kg/m2, and 68% of men in the pilot trial had high blood pressure. Attendance was high(78.2%) and 75.0% completed the 12 week course. Reasons for dropping out included work commitments, illness and moving away, and many non-completers continued to follow FFIT at home.

In the pilot trial, self-reported physical activity increased significantly in men following the 12-week programme (participants) compared to a comparison group who had not taken part in FFIT. Mean daily step counts also increased, from 5590-9250 steps,and self-reported sedentary behaviour decreased. For many participants, these changes persisted to 12 months.

Their more active, healthier lifestyles helped participants lose 4.56% of their body weight over the 12 week programme (c.f. a small weight gain in the comparison group); and at 12 months, participants’ mean weight remained significantly below their baseline weight. Lasting psychological improvements (e.g. self-esteem, mood) were also reported: “I know within myself it’s different, just getting back into being active again…I’ve a different mindset and that’s been a huge thing for me.”

Impact:
FFIT has received national and international recognition, and was featured in a BBC TV documentary in February 2012. A motion commending FFIT’s potential for helping overweight/obese men improve their health by taking more exercise and losing weight was lodged in the Scottish Parliament earlier this year.

Lessons Learned

Key learning points:
1) During the ‘classroom’ sessions participants are encouraged to interact, exchange tips and ideas, and indulge in general ‘banter’. This happens very successfully in most clubs, but observations and coach feedback suggested this interaction meant that on occasion coaches struggled to deliver all the materials within the time allocated.
Response: The programme notes were redesigned to highlight the key delivery points for each session to facilitate timely delivery of the ‘classroom’ material whilst encouraging participant interaction, and to maximise the time available for ‘pitch-side’ training.

2) Observations and participant feedback suggested that although for some men walking remains the preferred form of exercise throughout the programme, others are keen to progress to other forms of activity (e.g. swimming, cycling, attending a gym) between the weekly sessions.
Response: Information was added about how these other activities could contribute to the weekly step count to encourage men to progress at their own pace.

3) The pilot trial suggested that although men were continuing to do well at 6 months, a number were beginning to struggle to maintain some of their physical activity and dietary changes at 12 months.
Response: Post-programme email prompts and a 9-month ‘reunion’ session at the club were added. The emails reinforce the key learning points of the programme, and the reunion allows the men to discuss their progress with the coaches and set new, ongoing goals.

What's next for the project?

The evaluation results are being used to secure ongoing and future funding for the project as they become available. The results of the objective evaluation of FFIT in August 2010 were fed back to the programme delivery funders, the Scottish Government and The Football Pools, in Spring 2011 to secure funding for the three programmes that are being run at clubs across Scotland in 2011/2012.

These programmes are being used to conduct a ‘gold-standard’ evaluation [a randomised controlled trial (RCT), cost-effectiveness analysis and process evaluation] involving 748 men at 13 clubs. This RCT will report on the 12 month outcomes achieved by men on the programme and on the project’s potential for long term impact on public health. The main findings will become available in August 2013 and full findings in December 2013.

Next steps:
1) The RCT results will be used to make the case to secure funding for future deliveries of FFIT in Scottish Premier League clubs.
2) The RCT will also provide evidence to support the rollout of the FFIT model to other football leagues, both nationally and internationally.
3) Work is currently being undertaken to explore whether the FFIT model can be transferred to improve men’s health through increased physical activity and healthier eating habits in other settings; both sporting (e.g. professional rugby clubs in the UK and New Zealand) and non-sporting (e.g. prisons).

What is this?

What is it about?

Where is this relevant?

When was this published?

12/5/2012

Lead Contact Name

Dr Cindy Gray

Designation

Research Fellow

Organisation

Institute of Health and Wellbeing, University of Glasgow

Address

Gartnavel Royal Hospital 1055 Great Western Road Glasgow G12 0XH

Phone Number

0141 330 6274

Email Address

cindy.gray@glasgow.ac.uk

Address

Gartnavel Royal Hospital 1055 Great Western Road Glasgow G12 0XH

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