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Pietsch B, Manske M, Hanewinkel R, Kaduszkiewicz H, Morgenstern M. Long-term effects of a lifestyle modification program for men with obesity delivered in German football clubs. Clin Obes 2024:e12696. [PMID: 39034636 DOI: 10.1111/cob.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/10/2024] [Accepted: 07/07/2024] [Indexed: 07/23/2024]
Abstract
This study examined the long-term effects of a lifestyle modification program delivered at German Bundesliga football clubs. Weekly 90-minute group sessions over 12 weeks combined health education and physical activity and were delivered by coaches affiliated with the football clubs. A total of 371 men (mean age 49.7 years [SD = 7.6]) attended 41 classes at 19 clubs in 2017 and 2018 and participated in the long-term follow-up. Primary outcome was weight-loss at follow-up with a mean observation period of 20.4 months after baseline. Measures were taken partly by research staff and partly by participants themselves. At baseline, the men had a mean weight of 111.3 kg (SD = 16.9). Three months after baseline (posttest), the men had lost a mean of 6.3 kg (95% CI: 5.7-6.9). From posttest to follow-up, growth curve model showed men lost an average of 0.8 kg (95% CI: 0.2-1.4). Weight regain from posttest to follow-up of at least 3% was observed in 75 participants (20.2%) and was associated with less improvement in vegetable consumption in an adjusted logistic regression model. The data suggest that participation in a male-only lifestyle modification program offered by German football clubs may lead to sustained weight loss, but lack of a randomized control group and drop-outs prevent generalization of the results.
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Affiliation(s)
- Benjamin Pietsch
- Department Research and Prevention, Institute for Therapy and Health Research, Kiel, Germany
| | - Michelle Manske
- Institute of General Practice, Kiel University, Kiel, Germany
| | - Reiner Hanewinkel
- Department Research and Prevention, Institute for Therapy and Health Research, Kiel, Germany
| | | | - Matthis Morgenstern
- Department Research and Prevention, Institute for Therapy and Health Research, Kiel, Germany
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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] [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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Pietsch B, Hanewinkel R, Morgenstern M. Football fans' emotional attachment to their clubs as a predictor of weight loss in a prevention programme for men with obesity. Clin Obes 2022; 12:e12540. [PMID: 35686379 DOI: 10.1111/cob.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
Data about which factors in lifestyle interventions facilitate weight loss (WL) success in men is still scarce. The Football Fans in Training (FFIT) programme in Germany attracts men with overweight and facilitates meaningful weight reduction. The goal of this study was to evaluate the possible impact of the fans' emotional attachment to their favourite football clubs on achieving at least 5% WL among the male-only participants. All 791 FFIT intervention participants of 2017 and 2018 were included in the study. We performed two separate logistic regression analyses: (a) baseline values of several participant characteristics as predictors of a 5% WL and (b) change scores of participants' health behaviour characteristics from the course start to end as predictors of the 5% WL. In addition, both models included the Emotional Attachment to a Sports Team (EAST). Analyses were based on the intention-to-treat principle. Higher EAST at baseline was associated with WL success, as was higher WL self-efficacy, lower score in vegetable intake and higher score in food high on carbohydrates. In the second analysis, EAST, an increase in fruit intake, vegetable intake, whole-grain intake and steps per day, as well as a reduction of fatty food intake, were associated with 5% WL success. The predictors are mostly explorative and limited to correlations. The results indicate that EAST was an independent predictor of WL success in the participating football fans. This understanding might be used for tailoring future interventions in sports or similar settings.
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George ES, El Masri A, Kwasnicka D, Romeo A, Cavallin S, Bennie A, Kolt GS, Guagliano JM. Effectiveness of Adult Health Promotion Interventions Delivered Through Professional Sport: Systematic Review and Meta-Analysis. Sports Med 2022; 52:2637-2655. [PMID: 35708886 PMCID: PMC9585012 DOI: 10.1007/s40279-022-01705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Researchers are capitalising on the strong connections that sport fans have with their teams for health promotion programmes, yet no existing systematic reviews have evaluated the effectiveness of interventions delivered through professional sport. OBJECTIVE The aim of this study was to systematically collate, evaluate, and synthesise the evidence on health promotion interventions implemented in professional sport settings. METHODS Randomised controlled trials reporting on adult health promotion initiatives delivered in professional sport settings were identified through electronic database searches in CINAHL, MEDLINE, SPORTDiscus, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. Data on health-related outcomes (e.g., weight, physical activity, dietary intake) were extracted and synthesised, and random effects meta-analyses were conducted to examine effects for weight and waist circumference. Risk of bias was examined using the Cochrane risk-of-bias tool for randomised controlled trials (RoB 2). RESULTS Six studies reporting on five unique interventions met the inclusion criteria, and all included studies were gender-sensitised and exclusively targeted men. Intervention effects were observed for several health outcomes, including physical activity, dietary intake, and psychosocial health. All studies aimed to reduce weight, and for most studies (n = 4), weight was a primary outcome, either of the included study or to inform a future definitive trial. Findings from the meta-analysis revealed an overall significant difference in change in weight of - 3.2 kg (95% confidence interval [CI] - 4.6 to - 1.8) and waist circumference of - 3.9 cm (95% CI - 4.9 to - 2.8), both in favour of the intervention group at 12 weeks. Intervention effects were also reported for several other health outcomes (e.g., physical activity, dietary intake, psychosocial health); however, they were not consistently measured across the studies and thus were not meta-analysed. CONCLUSION Health promotion interventions delivered through professional sporting organisations can significantly improve weight- and lifestyle-related health outcomes. Representation across the socioeconomic spectrum and across culturally and linguistically diverse groups was limited. As only a limited number of studies met the inclusion criteria for this review, a need exists for rigorously designed interventions, standardised intervention approaches, with long-term follow-up, and the potential for scalability. PROSPERO REGISTRATION NUMBER CRD42019123295.
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Affiliation(s)
- Emma S. George
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW Australia
| | - Aymen El Masri
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Dominika Kwasnicka
- grid.433893.60000 0001 2184 0541SWPS University of Social Sciences and Humanities, Wroclaw, Poland ,grid.1008.90000 0001 2179 088XNHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
| | - Alannah Romeo
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Sarah Cavallin
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Andrew Bennie
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Gregory S. Kolt
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Justin M. Guagliano
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
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Exploring the provision and motives behind the adoption of health-promotion programmes in professional football clubs across four European countries. PLoS One 2021; 16:e0259458. [PMID: 34797842 PMCID: PMC8604315 DOI: 10.1371/journal.pone.0259458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022] Open
Abstract
This study mapped existing health-promotion provisions targeting adults in professional football clubs across England, the Netherlands, Norway, and Portugal, and explored motives behind the clubs’ adoption of the European Fans in Training (EuroFIT) programme. We surveyed top-tier football clubs in the four countries and interviewed representatives from football clubs and the clubs’ charitable foundation who delivered EuroFIT. The findings showed large between-country differences, with football clubs in England reporting far greater healthy lifestyle provision than other countries. Relatively few health-promotion programmes targeted adults, particularly in the Netherlands, Portugal, and Norway. Club representatives reported that the motives for adopting the EuroFIT programme often involved adhering to both the social objectives of the football club or club’s foundation and business-related objectives. They viewed the scientific evidence and evaluation underpinning EuroFIT as helpful in demonstrating the value and potential future impact of both the programme and the clubs’ wider corporate social responsibility provision.
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Müssig K, Adamek HE. Fußball – neue Wege in der Prävention und Behandlung des Typ-2-Diabetes. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1310-2685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungÜber die Hälfte der Bevölkerung in westlichen Ländern ist übergewichtig, und nahezu jeder Vierte ist adipös. In den nächsten Jahren wird es deshalb zu einem enormen Anstieg der Zahl an nicht übertragbaren Erkrankungen wie Diabetes, kardiovaskuläre Erkrankungen und Krebs kommen. Eine ausgewogene Ernährung, begleitet von regelmäßiger Bewegung, ist entscheidend bei der Prävention der Entwicklung und des Fortschreitens nicht übertragbarer Erkrankungen. Gesundheitsfördernde Programme besitzen eine große Bedeutung bei der langfristigen Verbesserung des Gesundheitsstatus unserer Bevölkerung, jedoch nehmen insbesondere Männer selten an gesundheitsfördernden Programmen teil. Deshalb gilt es nach neuen Wegen zu suchen, um effizienter Menschen mit einem erhöhten Risiko zu erreichen. Fußball verfügt über ein großes Potenzial, Menschen und vor allem Männer mit einem erhöhten Risiko für nicht übertragbare Erkrankungen, die üblichen gesundheitsfördernden Maßnahmen ablehnend gegenüberstehen, für die Teilnahme an Gesundheitsprogrammen zu gewinnen. Für ältere Spieler ist Walking Football eine neue Fußball-Variante mit einem geringeren Risiko für Verletzungen und eine körperliche Überlastung. Die vorliegende Arbeit gibt einen Überblick über die metabolischen Auswirkungen von Freizeitfußball und insbesondere Walking Football sowie Maßnahmen zur Gesundheitsförderung, die von professionellen Fußballvereinen angeboten werden, bei Menschen mit einem erhöhten Risiko für oder mit bereits bestehenden nicht übertragbaren Erkrankungen, wie insbesondere Typ-2-Diabetes.
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Affiliation(s)
- Karsten Müssig
- Klinik für Innere Medizin und Gastroenterologie, Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany
| | - Henning E. Adamek
- Medizinische Klinik 2 (Gastroenterologie, Hepatologie, Diabetologie), Klinikum Leverkusen gGmbH, Leverkusen, Germany
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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). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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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