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

Christopher Bunn* (Corresponding Author), Victoria Palmer, Nai Rui Chng, Eivind Andersen, Cindy M Gray, Kate Hunt, Judith G.M. Jelsma, Heather Morgan, Maria Nijhuis-van der Sanden, Hugo V. Pereira, Matthew Philpott, Matthew Philpott, Glyn C Roberts, John Rooksby, Øystein B Røynesdal, Marlene N. Silva, Marit Sørensen, Pedro J Teixeira, Theo van Achterberg, Irene van de GlindWillem van Mechelen, Femke Van Nassau, Hidde P. van der Ploeg, Sally Wyke

*Corresponding author for this work

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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, clubbased 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.
Original languageEnglish
Article number526
Number of pages24
JournalBMC Public Health
Volume23
Early online date20 Mar 2023
DOIs
Publication statusPublished - 20 Mar 2023

Bibliographical note

Funding
This project has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement number 602170. The Health Services Research Unit, University of Aberdeen, receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Acknowledgements
We are grateful to participants who took part in the research, coaches and club managers at fifteen football clubs and UEFA’s Football and Social Responsibility department for supporting the proposal at bidding stage. Ciaran Clissman of Pintail Ltd managed the project and provided invaluable editorial input into the funding application and delivery of the program. Prof Nanette Mutrie was substantially involved in the development of the EuroFIT program. Dr Lisa
Macauley administered the UK data collection in the UK and Alan Pollok supported some UK data collection. Dr Mattias Rost and Prof Mathew Chalmers were substantially involved in the development of MatchFIT and Drs Douglas Maxwell and Nikos Mourselas of PAL Technologies in the technical development of the SitFIT. Views and opinions expressed are those of the authors and do not necessarily reflect those of the European Union.

Keywords

  • Process evaluation
  • Physical Activity
  • Sedentary Time
  • Football
  • Intervention
  • Mixed methods

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