Social and Organizational Value in Sport: A Shared Value Perspective of a Men’s Health Initiative

One of the primary criticisms of corporate social responsibility (CSR) is that any resources allocated to social programming may detract from an organization’s economic returns. Porter and Kramer (2011) argue that social and organizational returns do not have to be mutually exclusive, and that a shared value approach can effectively improve the environment and social conditions in which a company operates, while simultaneously enhancing the firm’s long-term business. The purpose of this dissertation was to examine a health initiative, aimed at male ice hockey fans and implemented within a Canadian Major Junior hockey context, through the lens of shared value. This dissertation follows the integrated article format, which consists of three separate, but related studies conducted in order to achieve this purpose. Specifically, the three studies examine: (a) how shared value can be created within a non-professional sport context, (b) the initiative’s social impact, and (c) the various means of optimizing a program to meet stakeholder needs. In Study 1, the purpose was to examine how shared value can be generated by incorporating social concerns into an organization’s business operations and interaction with stakeholders. Those that participated in the men’s health initiative were invited to take part in two focus groups following the completion of the program, of which 15 volunteered to participate (Site 1, n = 5; Site 2, n = 10). To enrich the data and further explore their perspectives, those who participated in the focus groups were also interviewed as well as an additional 13 program participants (n = 28) and other stakeholders, including the program designer (n = 1), session instructors (n = 4), representatives from the associate hockey organizations (n = 3), and a representative from the associated fitness facility (n = 1). The qualitative data were analyzed using Porter and Kramer’s (2011) concept of shared value and the Shared Value Strategy and Measurement Process (SVSMP) (Porter, Hills, Pfitzer, Patscheke & Hawkins, 2012). The findings from Study 1 revealed themes that were related to the creation of shared value in sport, including: (a) the initiative’s area of focus, (b) the initiative’s goals, (c) motives for collaboration, (d) co-creation of an initiative, (e) shared value evaluation, (f) moral ownership, and (g) program outcomes. A defining component of a shared value initiative is that, in addition to providing organizational benefits, it must also generate social returns. Therefore, the assessment of an initiative’s social impact is warranted. The purpose of Study 2 was to examine the social impact of the men’s health initiative and was guided using Inoue and Kent’s (2013) integrative framework of CSR impact. Objective health measures and physical activity levels of the program’s participants (n = 80) were assessed at baseline, and follow-up assessments occurred at 12 weeks and 12 months to determine the intermediate and long-term impact. At 12 months, qualitative data were collected through one-on-one interviews with the program’s participants (n = 28). The findings revealed that the program had a positive social impact on those who participated in the program, as well as other members of the community who were not directly involved. Specifically, the intermediate impact on the program’s participants included a reduction in their weight, body mass index, waist circumference, systolic blood pressure, and improvements in physical activity, diet, and self-rated health. The long-term impact at 12 months indicated that the participants maintained a reduction in their weight, waist circumference, blood pressure, and improvements in diet. The changes to the community were reported as improvements in family bonding time, diet, physical activity levels, and awareness of health programs and components. Although many sport organizations offer social initiatives, few undertake any formal program evaluation to determine whether stakeholder needs are being met and whether resources are being used in a strategic manner. Thus, the purpose of Study 3 was to evaluate the design and implementation of the men’s health initiative from the perspective of its stakeholders. One-on- one interviews were conducted with each stakeholder (n = 37) and was guided using Chen’s (2015) program theory. The findings identified several themes that either facilitated or impeded the design and delivery of the program including the managing of partnerships, psychological and social supports/barriers, delivery agents, hockey content, and capacity building. Sport is often positioned as a vehicle for achieving social change. This dissertation supports this notion and reflects how organizations are capable of creating shared value by addressing social needs and developing business returns, benefiting both the organization and community alike. By understanding how shared value can be created, managers are able to rationalize current social programming to stakeholders and make the necessary adjustments to contribute to meaningful social change. Through the assessment of an initiative’s social impact, we can examine whether programs are truly benefiting the constituents and communities for whom they were intended. Lastly, the use of program evaluation allows managers to ensure that stakeholder needs are being met and feedback can be used to optimize future programming

Process Evaluation Of The HealtheSteps™ Lifestyle Prescription Program

Background: Physical inactivity, sedentary behaviour, and poor diet are contributing to the rise in chronic disease rates throughout the world. HealtheSteps™ is a lifestyle prescription program focused on reducing risk factors for chronic disease through in-person coaching sessions, goal setting and tracking, and technology supports. Purpose:A process evaluation was conducted alongside a pragmatic randomized controlled trial to: a) explore the acceptability of HealtheSteps™ program from coach and participant perspectives; and b) identify where the program can be improved. Methods:Participants at risk or diagnosed with a chronic disease were recruited from five primary care/health services organizations into HealtheSteps™. Participants met with a trained coach bi-monthly for six months and set goals for physical activity (step counts), exercise (moderate to vigorous activity), and healthy eating. Coaches were interviewed at 6 months and participants at 12 months (6 months post-program). All coach interviews (n=12) were analyzed along with a purposeful sample of participant interviews (n=13). Results:Coaches found HealtheSteps™ was easy to deliver and recommendations for exercise and healthy eating were helpful. Including discussions on participant readiness to change, along with group sessions and more in-depth healthy eating resources were suggested by coaches to improve the program. Participants described the multiple avenues of accountability provided in the program as helpful. However, more feedback and interaction during and post-program from coaches was suggested by participants. Conclusions:HealtheSteps™ is an acceptable program from the perspectives of both coaches and participants with suggested improvements not requiring significant changes to the core program design

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

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: 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 (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

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