The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial

Sally Wyke (Corresponding Author), Christopher Bunn, Eivind Andersen, Marlene N Silva, Femke van Nassau, Paula McSkimming, Spyros Kolovos, Jason M R Gill, Cindy M Gray, Kate Hunt, Annie S Anderson, Judith Bosmans, Judith G M Jelsma, Sharon Kean, Nicolas Lemyre, David W Loudon, Lisa Macaulay, Douglas J Maxwell, Alex McConnachie, Nanette MutrieMaria Nijhuis-van der Sanden, Hugo V Pereira, Matthew Philpott, Glyn C Roberts, John Rooksby, Øystein B Røynesdal, Naveed Sattar, Marit Sørensen, Pedro J Teixeira, Shaun Treweek, Theo van Achterberg, Irene van de Glind, Willem van Mechelen, Hidde P van der Ploeg

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.

METHODS AND FINDINGS: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs.

CONCLUSION: Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment.

TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

Original languageEnglish
Article number1002736
Number of pages25
JournalPLoS Medicine
Volume16
Issue number2
DOIs
Publication statusPublished - 5 Feb 2019

Fingerprint

Randomized Controlled Trials
Exercise
Football
Quality-Adjusted Life Years
Diet
Costs and Cost Analysis
Health
Biomarkers
Quality of Life
Confidence Intervals
Intention to Treat Analysis
Waiting Lists
Portugal
Arthralgia
Norway
Self Concept
Social Support
England
Netherlands
Cost-Benefit Analysis

Keywords

  • ACTIVITY MONITOR
  • FOOTBALL
  • HEALTHY LIVING PROGRAM
  • INTERVENTIONS
  • MANAGEMENT
  • METAANALYSIS
  • PRIMARY-CARE
  • RELIABILITY
  • SENSITIZED WEIGHT-LOSS
  • VALIDATION

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The effect of a programme to improve men's sedentary time and physical activity : The European Fans in Training (EuroFIT) randomised controlled trial. / Wyke, Sally (Corresponding Author); Bunn, Christopher; Andersen, Eivind; Silva, Marlene N; van Nassau, Femke; McSkimming, Paula; Kolovos, Spyros; Gill, Jason M R; Gray, Cindy M; Hunt, Kate; Anderson, Annie S; Bosmans, Judith; Jelsma, Judith G M; Kean, Sharon; Lemyre, Nicolas; Loudon, David W; Macaulay, Lisa; Maxwell, Douglas J; McConnachie, Alex; Mutrie, Nanette; Nijhuis-van der Sanden, Maria; Pereira, Hugo V; Philpott, Matthew; Roberts, Glyn C; Rooksby, John; Røynesdal, Øystein B; Sattar, Naveed; Sørensen, Marit; Teixeira, Pedro J; Treweek, Shaun; van Achterberg, Theo; van de Glind, Irene; van Mechelen, Willem; van der Ploeg, Hidde P.

In: PLoS Medicine, Vol. 16, No. 2, 1002736, 05.02.2019.

Research output: Contribution to journalArticle

Wyke, S, Bunn, C, Andersen, E, Silva, MN, van Nassau, F, McSkimming, P, Kolovos, S, Gill, JMR, Gray, CM, Hunt, K, Anderson, AS, Bosmans, J, Jelsma, JGM, Kean, S, Lemyre, N, Loudon, DW, Macaulay, L, Maxwell, DJ, McConnachie, A, Mutrie, N, Nijhuis-van der Sanden, M, Pereira, HV, Philpott, M, Roberts, GC, Rooksby, J, Røynesdal, ØB, Sattar, N, Sørensen, M, Teixeira, PJ, Treweek, S, van Achterberg, T, van de Glind, I, van Mechelen, W & van der Ploeg, HP 2019, 'The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial', PLoS Medicine, vol. 16, no. 2, 1002736. https://doi.org/10.1371/journal.pmed.1002736
Wyke, Sally ; Bunn, Christopher ; Andersen, Eivind ; Silva, Marlene N ; van Nassau, Femke ; McSkimming, Paula ; Kolovos, Spyros ; Gill, Jason M R ; Gray, Cindy M ; Hunt, Kate ; Anderson, Annie S ; Bosmans, Judith ; Jelsma, Judith G M ; Kean, Sharon ; Lemyre, Nicolas ; Loudon, David W ; Macaulay, Lisa ; Maxwell, Douglas J ; McConnachie, Alex ; Mutrie, Nanette ; Nijhuis-van der Sanden, Maria ; Pereira, Hugo V ; Philpott, Matthew ; Roberts, Glyn C ; Rooksby, John ; Røynesdal, Øystein B ; Sattar, Naveed ; Sørensen, Marit ; Teixeira, Pedro J ; Treweek, Shaun ; van Achterberg, Theo ; van de Glind, Irene ; van Mechelen, Willem ; van der Ploeg, Hidde P. / The effect of a programme to improve men's sedentary time and physical activity : The European Fans in Training (EuroFIT) randomised controlled trial. In: PLoS Medicine. 2019 ; Vol. 16, No. 2.
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abstract = "BACKGROUND: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.METHODS AND FINDINGS: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83{\%} and 85{\%} of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5{\%} confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5{\%} CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs.CONCLUSION: Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment.TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.",
keywords = "ACTIVITY MONITOR, FOOTBALL, HEALTHY LIVING PROGRAM, INTERVENTIONS, MANAGEMENT, METAANALYSIS, PRIMARY-CARE, RELIABILITY, SENSITIZED WEIGHT-LOSS, VALIDATION",
author = "Sally Wyke and Christopher Bunn and Eivind Andersen and Silva, {Marlene N} and {van Nassau}, Femke and Paula McSkimming and Spyros Kolovos and Gill, {Jason M R} and Gray, {Cindy M} and Kate Hunt and Anderson, {Annie S} and Judith Bosmans and Jelsma, {Judith G M} and Sharon Kean and Nicolas Lemyre and Loudon, {David W} and Lisa Macaulay and Maxwell, {Douglas J} and Alex McConnachie and Nanette Mutrie and {Nijhuis-van der Sanden}, Maria and Pereira, {Hugo V} and Matthew Philpott and Roberts, {Glyn C} and John Rooksby and R{\o}ynesdal, {{\O}ystein B} and Naveed Sattar and Marit S{\o}rensen and Teixeira, {Pedro J} and Shaun Treweek and {van Achterberg}, Theo and {van de Glind}, Irene and {van Mechelen}, Willem and {van der Ploeg}, {Hidde P}",
note = "Data from the study are available for secondary analysis. Applications to access the data can be made by contacting Professor John Cleland, Director of the Robertson Centre for Biostatistics and Glasgow Clinical Trials Unit (John.Cleland@glasgow.ac.uk). Applicants are required to submit a brief proposal outlining their intended use of the data, but no genuine application from an appropriately qualified researcher will be refused. Access to the data will be given via a secure analytical platform.",
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TY - JOUR

T1 - The effect of a programme to improve men's sedentary time and physical activity

T2 - The European Fans in Training (EuroFIT) randomised controlled trial

AU - Wyke, Sally

AU - Bunn, Christopher

AU - Andersen, Eivind

AU - Silva, Marlene N

AU - van Nassau, Femke

AU - McSkimming, Paula

AU - Kolovos, Spyros

AU - Gill, Jason M R

AU - Gray, Cindy M

AU - Hunt, Kate

AU - Anderson, Annie S

AU - Bosmans, Judith

AU - Jelsma, Judith G M

AU - Kean, Sharon

AU - Lemyre, Nicolas

AU - Loudon, David W

AU - Macaulay, Lisa

AU - Maxwell, Douglas J

AU - McConnachie, Alex

AU - Mutrie, Nanette

AU - Nijhuis-van der Sanden, Maria

AU - Pereira, Hugo V

AU - Philpott, Matthew

AU - Roberts, Glyn C

AU - Rooksby, John

AU - Røynesdal, Øystein B

AU - Sattar, Naveed

AU - Sørensen, Marit

AU - Teixeira, Pedro J

AU - Treweek, Shaun

AU - van Achterberg, Theo

AU - van de Glind, Irene

AU - van Mechelen, Willem

AU - van der Ploeg, Hidde P

N1 - Data from the study are available for secondary analysis. Applications to access the data can be made by contacting Professor John Cleland, Director of the Robertson Centre for Biostatistics and Glasgow Clinical Trials Unit (John.Cleland@glasgow.ac.uk). Applicants are required to submit a brief proposal outlining their intended use of the data, but no genuine application from an appropriately qualified researcher will be refused. Access to the data will be given via a secure analytical platform.

PY - 2019/2/5

Y1 - 2019/2/5

N2 - BACKGROUND: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.METHODS AND FINDINGS: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs.CONCLUSION: Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment.TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

AB - BACKGROUND: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.METHODS AND FINDINGS: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs.CONCLUSION: Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment.TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

KW - ACTIVITY MONITOR

KW - FOOTBALL

KW - HEALTHY LIVING PROGRAM

KW - INTERVENTIONS

KW - MANAGEMENT

KW - METAANALYSIS

KW - PRIMARY-CARE

KW - RELIABILITY

KW - SENSITIZED WEIGHT-LOSS

KW - VALIDATION

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UR - http://www.mendeley.com/research/effect-programme-improve-mens-sedentary-time-physical-activity-european-fans-training-eurofit-random

UR - https://doi.org/10.1371/journal.pmed.1002736

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DO - 10.1371/journal.pmed.1002736

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VL - 16

JO - PLoS Medicine

JF - PLoS Medicine

SN - 1549-1277

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