Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

Abstract

BackgroundThe prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part.MethodsA mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme.ResultsObjectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club.ConclusionsThe delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.

“If We Want to Get Men in, Then We Need to Ask Men What They Want”: Pathways to Effective Health Programing for Men

“…Specifically, men might distance themselves from discussions because of the presumed "touchy-feely" or "feminine" environment, and service providers might choose a different or more structured/orderly format based on stereotypes that men are rational or logical (Carroll et al, 2014;Galdas et al, 2014). Findings from this study along with boarder literature suggest that men often benefit from having the opportunity to engage in a more spontaneous or laid-back environment (Carroll et al, 2014;Galdas et al, 2014;Hunt et al, 2014). Bringing men together in a group environment challenges them to confront the notion that sitting and talking is for women (Coles et al, 2010).…”

“…Some research indicates that proactive engagement with health (either health services, or health-promoting practices) is not part of Irish culture or social norms for men (Carroll et al, 2014;Institute of Public Health in Ireland, 2011). Men are often socialized to embrace risk taking or unhealthy practices in an effort to prove their masculinity rather than engage in health-promoting practices, which are often discursively situated as feminine (Galdas et al, 2014;Hunt et al, 2014;Richardson, 2004). Based on their limited health-promoting or help-seeking practices, men are often deprioritized within health promotion, and often viewed as "the problem" because their health practices and attitudes are seen as antithetical to "good health" (Kirwan, Lambe, & Carroll, 2013).…”

“. . . If You’re Not Part of the Institution You Fall by the Wayside”: Service Providers’ Perspectives on Moving Young Men From Disconnection and Isolation to Connection and Belonging

“…Previous studies (Hunt et al, 2014;Lefkowich, Richardson, & Robertson, 2015;Pringle et al, 2013Pringle et al, , 2014Robertson et al, 2015) have identified sport as offering much potential for gender-specific and strengths-based approaches to engaging men in more holistic ways on mental health. Sport and physical activity based interventions can improve general well-being, increase mood and selfesteem, and can act as a hook to engage so-called "hard to reach" men.…”

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

“…Nevertheless, men also reported a number of barriers to ongoing weight control after the programme, including injury, illness and stressful life events, such as bereavement, which hampered their ability to make long-lasting changes. 44 Similar to other RCTs, 48,49 11.3% of men in the comparison group succeeded in losing ≥ 5% weight (as measured at 12 months) before starting the programme. This pre-intervention weight loss may reflect a number of potentially interacting factors.…”