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, Christopher Bunn, Eivind Anderson, 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

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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 findingsA 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-programmeand 12 months after baseline. EuroFIT is a 12-week, group-based programmedelivered 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-totreatanalyses 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.
ConclusionParticipation 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.
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
Waiting Lists
Portugal
Arthralgia
Norway
Self Concept
Social Support
England
Netherlands
Cost-Benefit Analysis
Body Mass Index

Keywords

  • Adult
  • Aged
  • Europe/epidemiology
  • Exercise/physiology
  • Health Promotion/methods
  • Humans
  • Male
  • Middle Aged
  • Physical Fitness/physiology
  • Program Evaluation/methods
  • Sedentary Behavior
  • Soccer/physiology

Cite this

Wyke, Sally ; Bunn, Christopher ; Anderson, 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.
@article{6ad84cfbce0f4bb3bbfc1807c8d1121c,
title = "The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial",
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 findingsA 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-programmeand 12 months after baseline. EuroFIT is a 12-week, group-based programmedelivered 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-totreatanalyses 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.ConclusionParticipation 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.",
keywords = "Adult, Aged, Europe/epidemiology, Exercise/physiology, Health Promotion/methods, Humans, Male, Middle Aged, Physical Fitness/physiology, Program Evaluation/methods, Sedentary Behavior, Soccer/physiology",
author = "Sally Wyke and Christopher Bunn and Eivind Anderson 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 = "Acceptance from webpage OA article",
year = "2019",
month = "2",
day = "5",
doi = "10.1371/journal.pmed.1002736",
language = "English",
volume = "16",
journal = "PLOS Medicine",
issn = "1549-1676",
publisher = "PLOS",
number = "2",

}

Wyke, S, Bunn, C, Anderson, 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

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; Bunn, Christopher; Anderson, 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

TY - JOUR

T1 - The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial

AU - Wyke, Sally

AU - Bunn, Christopher

AU - Anderson, 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 - Acceptance from webpage OA article

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 findingsA 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-programmeand 12 months after baseline. EuroFIT is a 12-week, group-based programmedelivered 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-totreatanalyses 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.ConclusionParticipation 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.

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 findingsA 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-programmeand 12 months after baseline. EuroFIT is a 12-week, group-based programmedelivered 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-totreatanalyses 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.ConclusionParticipation 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.

KW - Adult

KW - Aged

KW - Europe/epidemiology

KW - Exercise/physiology

KW - Health Promotion/methods

KW - Humans

KW - Male

KW - Middle Aged

KW - Physical Fitness/physiology

KW - Program Evaluation/methods

KW - Sedentary Behavior

KW - Soccer/physiology

UR - http://doi.org/10.1371/journal.pmed.1002772

U2 - 10.1371/journal.pmed.1002736

DO - 10.1371/journal.pmed.1002736

M3 - Article

C2 - 30721231

VL - 16

JO - PLOS Medicine

JF - PLOS Medicine

SN - 1549-1676

IS - 2

M1 - 1002736

ER -