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Social innovation to improve physical activity and sedentary behaviour through elite European football clubs:  European Fans in Training

Social innovation to improve physical activity and sedentary behaviour through elite European football clubs: European Fans in Training

Periodic Report Summary 3 - EUROFIT (Social innovation to improve physical activity and sedentary behaviour through elite European football clubs: European Fans in Training)

Project Context and Objectives:
Low levels of physical activity, sedentary lifestyles and poor diets can increase the risk of developing diseases, such as cardiovascular disease and diabetes. People can improve their health and reduce their risk of disease by adopting healthier lifestyles. However, men are less likely to engage in programmes to support lifestyle changes. For example, only 10-30% of participants in current weight management programmes across Europe are men. New and innovative ideas are needed to engage and support men in improving their health.

EuroFIT is building new social partnerships between football clubs, fans and researchers to improve men’s health by addressing physical inactivity, sedentary behaviour and poor diet. EuroFIT builds on the success of the UK-based Football Fans in Training (FFIT) project, in which men participate in a weight management and healthy living programme delivered in over 30 of Scotland’s professional football clubs.

EuroFIT brings together health researchers, football clubs and fans to build and deliver a programme that men find attractive and engaging. The goal of EuroFIT is for participants to achieve measurable improvements in physical activity, sedentary time and eating habits/diet, and to sustain these changes over time. EuroFIT researchers have designed the intervention programme using a combination of theory, evidence, experience and participatory intervention design, incorporating the latest evidence-based behavioural change techniques and informed by self-determination, goal-action and sociological theories about interaction. Coaches and fans have contributed to the design of the programme to ensure that it meets their needs.

The programme has been delivered in 15 clubs in Portugal, Norway, the Netherlands and the UK and has been evaluated in a randomised controlled trial in over 1,100 men. Participants learned techniques to change their behaviour through interacting with each other and with coaches and participate in physical activity sessions designed to increase their fitness over time. The programme was delivered during 12 weekly sessions. The information and techniques delivered in the ‘classroom’ part of the session were designed specifically with the male audience in mind. Delivery of the EuroFIT programme in the club stadia by coaches associated with the club has been a key driver of engagement for the participating fans.

Men in the programme also received a wearable device (SitFIT) that enabled them to monitor their own physical activity and sedentary behaviour, as well as enjoying access to a game-based app developed for the project (MatchFIT). Researchers measured body weight, eating habits, blood pressure, risk of cardiovascular disease, mental health and other quality of life outcomes when men started the EuroFIT programme and again after 12 months to assess if there were positive lifestyle changes, and if the changes were sustained over time.

During the project, the EuroFIT team is also examining how to replicate the programme in new clubs in the future. Specifically, implementation plans are being developed, based on research results from the project. As a real world test, six new clubs tested the implementation plans by funding and delivering the EuroFIT programme without further support from the EuroFIT team. In addition, ways to expand the programme to other target groups, such as women and children, were explored through taster sessions run in one club in the UK, Netherlands, Portugal and Norway.


Project Results:
To date, the project has developed the EuroFIT programme and key technologies used in programme delivery (SitFIT and MatchFIT). In order to develop a robust, evidence-based programme, EuroFIT researchers incorporated the findings of a systematic review of existing ways to reduce sedentary behaviour and the latest research about interventions that are effective in helping people to increase their physical activity and sustain behaviour changes in the long-term. The team also tailored the programme for local cultures, where needed, and sought input from key stakeholders (representatives from football clubs, funding agencies and sports associations) to learn about their previous experiences with delivering health promotion programmes in club settings. Learnings from the clubs and coaches have greatly enriched the programme.

The EuroFIT programme includes two technologies, which were developed in parallel with the programme. Men involved in the programme were given a pocket-worn device (SitFIT) that would let them monitor their own physical activity and sedentary behaviour. A new, low cost version of the SitFIT device, the SitFIT ‘Activator’, has also been developed. It allows people to easily track their step count and see how much time they spend standing using their mobile phone. The ‘Activator’ is the recommended technology for future replications of the programme.

A game-based app (MatchFIT) has also been developed specifically for the project. Men were given the option of using MatchFIT to join in a team-based game with other men in the programme, as well as to track their own activity over the course of a week. This was attractive and engaging for many, though not all, users.

Evaluation trials to test lifestyle interventions like EuroFIT are complex. Once developed, the EuroFIT programme was delivered in 15 football clubs in four countries by local coaches as part of a randomised controlled trial. 1,113 men were recruited to take part in the trial, with half being offered the opportunity to take part in the programme at the start of the trial and the remainder after 12 months. Data was collected at the start of the trial (baseline), 3-4 months later, and finally after 12 months. In addition to collecting health data, a detailed process evaluation, including focus group discussions with participants and interviews with coaches and managers were conducted in all countries. A rigorous analysis of effectiveness and cost-effectiveness are now complete, leading to submission of the first major EuroFIT paper. Further analysis of the trial results continues, exploring in depth what worked (and what didn’t) for our difficult-to-reach audience.

We’ve also explored how to make the EuroFIT programme work for women and other groups. Through taster sessions, the team learned that the walking programme was appealing and that the club-based learning about healthy eating was useful for women also.

Making sure that the EuroFIT programme continues to help men across Europe into the future is an important part of the project. To see if clubs could successfully run the programme without support from the research team, we recruited five clubs to deliver EuroFIT as part of a replication study, without any funding from the project. The participants and clubs were delighted with the results. The clubs in the study want to continue delivering the programme, and there is strong demand from other clubs as well.

The team is now working on a strategy for roll-out of EuroFIT across Europe, including licensing, training, quality assurance and support for clubs. Importantly, the programme has also been well-received by key stakeholders in the public health and football communities. As football is central to the EuroFIT programme, the team is now working with UEFA to develop a strategy for Europe-wide replication.


Potential Impact:
EuroFIT is a true social innovation, bringing together actors from across society (professional sports clubs, fans, public health experts and technologists) to address a well-established but difficult problem – engaging inactive men in positive lifestyle change. EuroFIT exploits the potential of football related social networks and mutual peer support to encourage the maintenance of lifestyle changes. EuroFIT empowers each participant to take control in managing his own health. It demonstrates to men that change is possible and achievable, and that it is not “too late to do anything about it”.

Health promotion programmes, like EuroFIT, have great social impact if they are found to be effective, including reductions in health risk and improvements in well-being. Men that EuroFIT attracts are ‘difficult-to-reach’ through traditional public health programmes, yet they include those most at risk of future ill-health or premature death, and therefore are a high priority for improving individual and public health across Europe. By reaching this ‘difficult-to-reach’ group, EuroFIT has the potential to decrease inequalities because more men, especially those in low socio-economic status groups, will be attracted to lifestyle change.

During the project, the EuroFIT team has measured changes in lifestyle and health outcomes, and looked at whether these changes are sustained over the long term, building the evidence-base to support implementation of the EuroFIT programme in future.

EuroFIT has generated excellent research evidence on the use of social innovation for health. Research impact is being achieved through new understanding of the how health indicators respond to changes in sedentary behaviour and physical activity and through new knowledge about long-term maintenance of lifestyle changes. EuroFIT researchers from a broad range of disciplines have worked together to deliver an interdisciplinary solution for health promotion. The new data we have produced will fill current research gaps and offer generalisable, sustainable, solutions to improving public health.

The EuroFIT team is sharing what has been learned with other researchers through presentations at key academic conferences, publications in high impact, peer-reviewed journals and interactions with related projects in the area of health promotion programmes and innovation. The team has also engaged with public health stakeholders, and the programme has been well received. For example, in Portugal, EuroFIT was adopted as part of the national Programme for Physical Activity in April 2017.

Unhealthy lifestyles are costly. Physical inactivity, sedentary behaviour and poor diet are a major cause of disease, which leads to higher healthcare costs and other indirect costs. As a health promotion programme that supports sustained change, EuroFIT will deliver economic impact if effective. The EuroFIT programme is low cost, and is easy to replicate and implement after the project ends. Throughout the project, the team has focused on the cost of delivering the programme and the longer-term healthcare savings.

EuroFIT will also have an impact on policy. We are delivering this impact through the evidence we have produced that EuroFIT works and by developing clear implementation strategies to allow the programme to be easily replicated in new clubs. Led by partner Healthy Stadia, the team is finalising a model for the delivery of EuroFIT across Europe. A license agreement is nearly in place, which will maximise re-use while maintaining programme integrity, and so the health and well-being of the participants. A ‘Final Event’ is now being planned to launch the EuroFIT programme at the project end to encourage wider upatke to maximise health benefits for men, as well as societal and economic impacts.


List of Websites:
eurofitFP7.eu

Project information

Grant agreement ID: 602170

Status

Closed project

  • Start date

    1 November 2013

  • End date

    31 October 2018

Funded under:

FP7-HEALTH

  • Overall budget:

    € 7 771 992,42

  • EU contribution

    € 5 957 158

Coordinated by:

UNIVERSITY OF GLASGOW

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