A Gender-Sensitized Weight Loss and Healthy Lifestyle Program for Overweight and Obese Male Hockey Fans: Effects on Dietary Behaviours

BACKGROUND: Male dietary behaviours have often been associated with overweightness and obesity. Although little research exists to help prevent the problem, this can somewhat be explained by the lack of men engaging in healthy eating and lifestyle change. A gender-sensitized intervention study using hockey as a draw to participate may positively change dietary behaviours and associated health outcomes. METHODS: A 12 week, 12 session, weight loss and healthy lifestyle intervention program was conducted in which overweight and obese male fans of a local hockey team were coached to adopt healthy eating and lifestyle behaviour changes in collaboration with their favorite hockey club. RESULTS: After 12 weeks of intervention sessions, intervention participants displayed healthier dietary behaviours in comparison to the control group (p=0.029). CONCLUSION: A weight loss and healthy lifestyle intervention program targeting the often under-represented overweight and obese male population group can help to promote positive dietary behaviours, especially when delivered in the context and environment of being a fan of local junior hockey

Men’s Experiences with the Hockey Fans in Training Weight Loss and Healthy Lifestyle Program

Background: Increasing rates of chronic disease, especially in men, have led to an increased effort to implement lifestyle interventions focusing on healthy eating and physical activity. Men are underrepresented in lifestyle programs and some studies have observed that males prefer men-only programs that occur in the context of sports. This paper reviews men’s feedback regarding motivation for joining and overall experience in a 12-week lifestyle intervention in the context of junior level ice hockey teams. Methods: Men age 35-65 with a BMI ?28 were recruited from local ice hockey team fan bases in London and Sarnia Ontario, Canada and randomized to the 12-week lifestyle intervention or control group. Those who attended at least 6 of the 12 weekly sessions, including at least one session in the final six weeks (n=30) were asked to complete an online questionnaire upon finishing the active phase of the intervention. The questionnaire elicited reasons for joining the program, changes seen following their participation, and the usefulness of specific components of the program. Results: For the 27 men who completed the questionnaire, weight loss and a desire to increase physical activity were the two main reasons cited for joining the program. After the intervention, 100% of the men reported eating a healthier diet and 78% increased their activity level. Program satisfaction was high and 96% of men believed both the classroom and exercise components were useful. Conclusion: Our results support previous research showing increased levels of satisfaction in men when lifestyle interventions are run in...

Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial

Introduction  Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.  Methods  Male fans of two ice hockey teams (35-65 yr; body mass index ≥28 kg·m-2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health.  Results  Eighty men were recruited in 4 wk; trial retention was >80% at 12 wk and >75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, -5.26 to -1.90 kg) more than the comparator group (P < 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months.  Conclusions  Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial

Hockey Fans in Training: A Pilot Pragmatic 1 Randomized Controlled Trial

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months. Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health. Results Eighty men were recruited in 4 wk; trial retention was \u3e80% at 12 wk and \u3e75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, −5.26 to −1.90 kg) more than the comparator group (P \u3c 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months. Conclusions Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial

Hockey Fans in Training (Hockey FIT) Pilot Study Protocol: A Gender-Sensitized Weight Loss and Healthy Lifestyle Program for Overweight and Obese Male Hockey Fans

Background: Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia. Methods: Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other outcomes by 12 weeks, and retain these improvements to 12 months; 3) Evaluate feasibility of recruiting and retaining overweight/obese men; 4) Evaluate acceptability of Hockey FIT; and 5) Conduct program optimization via a process evaluation. We conducted a two-arm pilot pragmatic randomized controlled trial (pRCT) whereby 80 overweight/obese male hockey fans (35–65 years; body-mass index ≥28 kg/m2 ) were recruited through their connection to two junior A hockey teams (London and Sarnia, ON) and randomized to Intervention (Hockey FIT) or Comparator (Wait-List Control). Hockey FIT includes a 12-week Active Phase (classroom instruction and exercise sessions delivered weekly by trained coaches) and a 40-week Maintenance Phase. Data collected at baseline and 12 weeks (both groups), and 12 months (Intervention only), will inform evaluation of the potential of Hockey FIT to help men lose weight and improve other health outcomes. Feasibility and acceptability will be assessed using data from self-reports at screening and baseline, program fidelity (program observations and coach reflections), participant focus group discussions, coach interviews, as well as program questionnaires and interviews with participants. This information will be analyzed to inform program optimization. Discussion: Hockey FIT is a gender-sensitive program designed to engage overweight/obese male hockey fans to improve physical activity and healthy eating choices, thereby leading to weight loss and other positive changes in health outcomes. We expect this study to provide evidence for a full-scale confirmatory pRCT. Trial registration: NCT02396524 (Clinicaltrials.gov). Date of registration: Feb 26, 2015

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics

Abstract Background Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. HealtheSteps™ participants are provided with in-person lifestyle coaching and access to eHealth technologies delivered in community-based primary care clinics and health care organizations. Method/Design To determine the effectiveness of Healthesteps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of HealtheSteps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site) to either the intervention (HealtheSteps™ program) or comparator (Wait-list control). There are 3 phases of the HealtheSteps™ program, lasting 6 months each. The active phase consists of bi-monthly in-person coaching with access to a full suite of eHealth technology supports. During the maintenance phase I, the in-person coaching will be removed, but participants will still have access to the full suite of eHealth technology supports. In the final stage, maintenance phase II, access to the full suite of eHealth technology supports is removed and participants only have access to publicly available resources and tools. Discussion This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the HealtheSteps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program at the different community sites. These results will inform future optimization and scaling up of the program into additional community-based primary care sites. Trial registration NCT02413385 (Clinicaltrials.gov). Date Registered: April 6, 2015

Impact of Hockey Fans in Training Program on Steps and Self-rated Health in Overweight Men

Football Fans in Training (FFIT) is an effective, gender-sensitized, weight loss and healthy living program for overweight/obese men, delivered via professional football clubs. Hockey Fans in Training (Hockey FIT) is a new program adapted from FFIT for Canadian hockey. PURPOSE: To examine the impact of Hockey FIT on steps, self-esteem, mood, and self-rated health, 12 weeks after baseline (post program). METHODS: 80 male fans [35-65 years; body mass index (BMI) ≥ 28 kg/m2] of 2 Ontario Junior A hockey clubs were randomized to either intervention (Hockey FIT) or comparator (wait-list control), within a pilot, pragmatic randomized controlled trial (RCT). Hockey FIT involved 12 weekly, 90-minute group sessions delivered by trained coaches using club facilities. Each session combined classroom material, including evidence- based behaviour change techniques (e.g., self-monitoring, goal setting) and healthy eating advice (e.g., reducing portion size), with physical activity sessions. Prescriptive exercise (e.g., individualized target heart rates and pedometer-based incremental step targets) was incorporated throughout. We examined between-group differences in mean steps/day (7-day pedometer monitoring), self-esteem (Rosenberg scale), positive and negative affect (I-PANAS-SF scale), and self-rated health (EQ-5D-3L VAS score) using linear mixed effects regression models that accounted for club and age. RESULTS: Groups were similar at baseline [median (interquartile range): age: 48.0 (17.0) years; BMI: 35.1 (6.3) kg/m2]. 75% of men in the intervention group attended ≥ 6 sessions. At 12 weeks, the intervention group increased their daily steps to a greater extent than the comparator [difference between groups in mean change: 3127 (95% confidence interval: 1882 to 4372) steps/day, p <0.001]. The intervention group also improved their self-rated health (scale 0 to 100; 100 = best) to a greater extent than the comparator [difference between groups in mean change: 7.0 (2.1 to 11.9) points, p = 0.005]. There were no differences between groups in self-esteem or positive/negative affect post program. CONCLUSION: Hockey FIT has the potential to help overweight/obese men increase their physical activity levels and improve their self-rated health. Long-term follow-up and a full-scale pragmatic RCT is warranted

Can a Sports Team-based Lifestyle Program (Hockey Fans In Training) Improve Weight In Overweight Men?

The issue of gender is often neglected when planning and implementing chronic disease prevention and management strategies. Football Fans in Training (FFIT) — a gender-sensitized, weight loss and healthy living program for men delivered via professional football clubs — has been shown to be highly effective in helping overweight/obese men lose weight and improve their health risk. PURPOSE: To examine the potential for new male-friendly, physical activity and healthy living program — Hockey Fans in Training (Hockey FIT) — to help overweight/obese men decrease their weight, waist circumference (WC), and body mass index (BMI), after 12 weeks. METHODS: A pilot, pragmatic randomized controlled trial (RCT) whereby male fans (35-65 years; BMI ≥ 28 kg/m2) of 2 Junior A hockey clubs (Ontario, Canada) were randomized to either the intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT involved 12 weekly, 90-minute group sessions delivered by trained coaches using club facilities. Each session combined classroom activities, including evidence- based behaviour change techniques (e.g., self-monitoring, goal setting) and healthy eating advice (e.g., reducing portions), with physical activity training. Lifestyle prescriptions, including incremental step count targets, were also prescribed each week. We examined between-group differences in mean weight loss, WC, and BMI using linear mixed effects regression models that accounted for club and age. RESULTS: Baseline characteristics were similar between groups [total N = 80, median (interquartile range) — i) age: 48.0 (17.0) years; ii) weight: 112.2 (23.2) kg; iii) WC: 119.3 (13.5) cm; iv) BMI: 35.1 (6.3) kg/m2]. Of the 40 men in the Hockey FIT group, 30 (75%) attended at least 6 sessions. At 12 weeks, the Hockey FIT group lost more weight than the control group [difference between groups in mean weight change (control is reference): -3.6 (95% confidence interval: -5.2 to -1.9) kg, p<0.001]. The Hockey FIT group also saw greater reductions in WC and BMI, when compared to the control group [difference between groups in mean i) WC: -2.8 (-5.0 to -0.6) cm, p=0.01; ii) BMI: -0.9 (-1.4 to -0.4) kg/m2, p<0.001]. CONCLUSION: Hockey FIT has the potential to help overweight/obese men lose weight and improve health risk. A definite RCT is warranted with long-term follow-up

Can a Sports Team-based Lifestyle Program (Hockey Fans In Training) Improve Weight In Overweight Men?

The issue of gender is often neglected when planning and implementing chronic disease prevention and management strategies. Football Fans in Training (FFIT) — a gender-sensitized, weight loss and healthy living program for men delivered via professional football clubs — has been shown to be highly effective in helping overweight/obese men lose weight and improve their health risk. PURPOSE: To examine the potential for new male-friendly, physical activity and healthy living program — Hockey Fans in Training (Hockey FIT) — to help overweight/obese men decrease their weight, waist circumference (WC), and body mass index (BMI), after 12 weeks. METHODS: A pilot, pragmatic randomized controlled trial (RCT) whereby male fans (35-65 years; BMI ≥ 28 kg/m2) of 2 Junior A hockey clubs (Ontario, Canada) were randomized to either the intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT involved 12 weekly, 90-minute group sessions delivered by trained coaches using club facilities. Each session combined classroom activities, including evidence- based behaviour change techniques (e.g., self-monitoring, goal setting) and healthy eating advice (e.g., reducing portions), with physical activity training. Lifestyle prescriptions, including incremental step count targets, were also prescribed each week. We examined between-group differences in mean weight loss, WC, and BMI using linear mixed effects regression models that accounted for club and age. RESULTS: Baseline characteristics were similar between groups [total N = 80, median (interquartile range) — i) age: 48.0 (17.0) years; ii) weight: 112.2 (23.2) kg; iii) WC: 119.3 (13.5) cm; iv) BMI: 35.1 (6.3) kg/m2]. Of the 40 men in the Hockey FIT group, 30 (75%) attended at least 6 sessions. At 12 weeks, the Hockey FIT group lost more weight than the control group [difference between groups in mean weight change (control is reference): -3.6 (95% confidence interval: -5.2 to -1.9) kg, p<0.001]. The Hockey FIT group also saw greater reductions in WC and BMI, when compared to the control group [difference between groups in mean i) WC: -2.8 (-5.0 to -0.6) cm, p=0.01; ii) BMI: -0.9 (-1.4 to -0.4) kg/m2, p<0.001]. CONCLUSION: Hockey FIT has the potential to help overweight/obese men lose weight and improve health risk. A definite RCT is warranted with long-term follow-up

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics

Background: Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. HealtheSteps™ participants are provided with in-person lifestyle coaching and access to eHealth technologies delivered in community-based primary care clinics and health care organizations. Method/Design To determine the effectiveness of Healthesteps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of HealtheSteps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site) to either the intervention (HealtheSteps™ program) or comparator (Wait-list control). There are 3 phases of the HealtheSteps™ program, lasting 6 months each. The active phase consists of bi-monthly in-person coaching with access to a full suite of eHealth technology supports. During the maintenance phase I, the in-person coaching will be removed, but participants will still have access to the full suite of eHealth technology supports. In the final stage, maintenance phase II, access to the full suite of eHealth technology supports is removed and participants only have access to publicly available resources and tools. Discussion This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the HealtheSteps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program at the different community sites. These results will inform future optimization and scaling up of the program into additional community-based primary care sites. Trial registration NCT02413385 (Clinicaltrials.gov). Date Registered: April 6, 2015.Health and Social Development, Faculty of (Okanagan)Non UBCHealth and Exercise Sciences, School of (Okanagan)ReviewedFacult