Study protocol of European Fans in Training (EuroFIT): a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs

Abstract

BackgroundLifestyle interventions targeting physical activity, sedentary time and dietary behaviours have the potential to initiate and support behavioural change and result in public health gain. Although men have often been reluctant to engage in such lifestyle programs, many are at high risk of several chronic conditions. We have developed an evidence and theory-based, gender sensitised, health and lifestyle program (European Fans in Training (EuroFIT)), which is designed to attract men through the loyalty they feel to the football club they support. This paper describes the study protocol to evaluate the effectiveness and cost-effectiveness of the EuroFIT program in supporting men to improve their level of physical activity and reduce sedentary behaviour over 12 months.MethodsThe EuroFIT study is a pragmatic, two-arm, randomised controlled trial conducted in 15 football clubs in the Netherlands, Norway, Portugal and the UK (England). One-thousand men, aged 30 to 65 years, with a self-reported Body Mass Index (BMI) ≥27 kg/m2 will be recruited and individually randomised. The primary outcomes are objectively-assessed changes in total physical activity (steps per day) and total sedentary time (minutes per day) at 12 months after baseline assessment. Secondary outcomes are weight, BMI, waist circumference, resting systolic and diastolic blood pressure, cardio-metabolic blood biomarkers, food intake, self-reported physical activity and sedentary time, wellbeing, self-esteem, vitality and quality of life. Cost-effectiveness will be assessed and a process evaluation conducted.The EuroFIT program will be delivered over 12 weekly, 90-minute sessions that combine classroom discussion with graded physical activity in the setting of the football club. Classroom sessions provide participants with a toolbox of behaviour change techniques to initiate and sustain long-term lifestyle changes. The coaches will receive two days of training to enable them to create a positive social environment that supports men in engaging in sustained behaviour change.DiscussionThe EuroFIT trial will provide evidence on the effectiveness and cost-effectiveness of the EuroFIT program delivered by football clubs to their male fans, and will offer insight into factors associated with success in making sustained changes to physical activity, sedentary behaviour, and secondary outcomes, such as diet.Trial registrationISRCTN: 81935608. Registered 16 June 2015.

Five-year cost-effectiveness analysis of the European Fans in Training (EuroFIT) physical activity intervention for men versus no intervention

“…We developed a Markov cohort model with a time horizon of 5 years to estimate the cost-effectiveness of the EuroFIT program from a societal perspective [19]. We chose to use a Markov model due to its flexibility and its ability to handle multiple possible outcomes [21].…”

“…The EuroFIT RCT was conducted during 2016 and 2017 in England, The Netherlands, Norway and Portugal. Ethics committees in each of the four countries have approved the study protocol [19]. The RCT was registered with ISRCTN number 81935608.…”

“…Details of the EuroFIT RCT can be found in Van Nassau et al [19] and Wyke et al [20]. In summary, 15 professional football clubs in England, the Netherlands, Norway, and Portugal recruited 1113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 into the trial using any of social media posting, email invitations to club members, and local press coverage.…”

“…The EuroFIT program built on the FFIT program, but shifted the focus of the program from weight loss to improving physical activity and reducing sedentary behaviour. EuroFIT was rigorously evaluated in a 4-country RCT [19]. While the EuroFIT program successfully increased the number of daily steps at 12 months, there was no difference in sedentary time between the two groups [20].…”

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

“…The EuroFIT programme has been evaluated in a RCT (2015-17) in 15 professional football clubs across four European countries (England, the Netherlands, Portugal and Norway), with outcomes, including objective PA, sedentary behaviour and weight, being measured to 12 months. 121 The high costs and participant burden of collecting bloods may compromise the accuracy of health economics models in community-based studies such as the FFIT programme. The development of alternative models that use less invasive variables (e.g.…”