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...

Optimization Of The Hockey Fans In Training (Hockey FIT) Weight Loss And Healthy Lifestyle Program For Male Hockey Fans

BACKGROUND: The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits. METHODS: Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting who were overweight or obese into a weekly, 90-minute classroom education and group exercise program held over 12 weeks; a 40-week minimally-supported phase followed. A process evaluation of the Hockey FIT program was completed alongside a pragmatic randomized controlled trial and outcome evaluation in order to fully explore the acceptability of the Hockey FIT program from the perspectives of coaches delivering and participants engaged in the program. Data sources included attendance records, participant focus groups, coach interviews, assessment of fidelity (program observations and post-session coach reflections), and 12-month participant interviews. RESULTS: Coaches enjoyed delivering the program and found it simple to deliver. Men valued being among others of similar body shape and similar weight loss goals, and found the knowledge they gained through the program helped them to make and maintain health behaviour changes. Suggested improvements include having more hockey-related information and activities, greater flexibility with timing of program delivery, and greater promotion of technology support tools. CONCLUSIONS: We confirmed Hockey FIT was an acceptable gender-sensitized health promotion program for male hockey fans who were overweight or obese. Minor changes were required for optimization, which will be evaluated in a future definitive trial

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

Heart failure management insights from primary care physicians and allied health care providers in Southwestern Ontario

Background: It remains to be determined whether collaborative strategies to improve and sustain overall health in patients with heart failure (HF) are currently being adopted by health care professionals. We surveyed primary care physicians, nurses and allied health care professionals in Southwestern Ontario regarding how they currently manage HF patients and how they perceive limitations, barriers and challenges in achieving optimal management in these patients. Methods: We developed an online survey based on field expertise and a review of pertinent literature in HF management. We analyzed quantitative data collected via an online questionnaire powered by Qualtrics®. The survey included 87 items, including multiple choice and free text questions. We collected participant demographic and educational background, and information relating to general clinical practice and specific to HF management. The survey was 25 min long and was administered in October and November of 2018. Results: We included 118 health care professionals from network lists of affiliated physicians and clinics of the department of Family Medicine at Western University; 88.1% (n = 104) were physicians while 11.9% (n = 14) were identified as other health care professionals. Two-thirds of our respondents were females (n = 72) and nearly one-third were males (n = 38). The survey included mostly family physicians (n = 74) and family medicine residents (n = 25). Most respondents indicated co-managing their HF patients with other health care professionals, including cardiologists and internists. The vast majority of respondents reported preferring to manage their HF patients as part of a team rather than alone. As well, the majority respondents (n = 47) indicated being satisfied with the way they currently manage their HF patients; however, some indicated that practice set up and communication resources, followed by experience and education relating to HF guidelines, current drug therapy and medical management were important barriers to optimal management of HF patients. Conclusions: Most respondents indicated HF management was satisfactory, however, a minority did identify some areas for improvement (communication systems, work more collaborative as a team, education resources and access to specialists). Future research should consider these factors in developing strategies to enhance primary care involvement in co-management of HF patients, within collaborative and multidisciplinary systems of care.Medicine, Faculty ofNon UBCFamily Practice, Department ofReviewedFacult

A Three-Year Diary-Longitudinal Study of University Students’ Depressive Symptoms

By investigating university students’ trajectories of depressive symptoms based on multiple weekly or monthly time points, researchers can identify temporal effects such as high stress periods during the academic year and provide valuable information for planning interventions when students are most in need. Also, the higher prevalence of depression among women than men invites further investigation of gender differences over time. Our presentation is based on a longitudinal study on the relations between alcohol use, depression, and interpersonal conflict in a sample of university students in their first three academic years. We focus on depressive symptoms (Beck Depression Inventory-II; BDI-II) to identify specific temporal patterns and time points that may influence depression levels. A sample of 848 first years students (64.1% female) at a large university in Southwestern Ontario, Canada, completed an online baseline questionnaire one week after the beginning of classes in September 2006. Subsequently, a subset of 415 respondents participated in the second phase, consisting of 26 consecutive online weekly questionnaires from October 2006 to April 2007. A subset of 358 students participated in the third phase consisting of 24 consecutive months from May 2007 to April 2009. These weekly and monthly online assessments included the Beck Depression Inventory-II (BDI-II). We describe the BDI-II score trajectories over the three-year period of the weekly and monthly assessments. We also report on the latent growth modelling analyses of the depressive symptom trajectories, including gender-based trajectories. The strongest trend was an initial decrease in reported depressive symptoms in the first part of the first semester. Gender difference analyses revealed similar trajectory shapes for men and women but with women scoring about 2 points higher than men at each time point. Implications of these results are discussed in reference to the empirical literature on depression. More information about this study can be obtained from the lead author. Paul F. Tremblay, PhD, received his doctorate in psychology (measurement) from the University of Western Ontario, Canada, in 1998. He is a scientist in the Social, Prevention, and Health Policy Research Department at the Centre for Addiction and Mental Health, an adjunct research professor in the Psychology Department at the University of Western Ontario, and an academic research associate at the Centre for Research and Education on Violence Against Women and Children in London, Ontario. He conducts research on the experiences of conflict and aggression and their relations to drinking patterns, depressive symptoms, and personality dimensions

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

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

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