Wyke, S. et al. (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, 16(2), e1002736. (doi: 10.1371/journal.pmed.1002736) (PMID:30721231) (PMCID:PMC6363143)
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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 inter- vention or a 12-month waiting list comparison group. Follow-up measurement was post-pro- gramme 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 ses- sions 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. Pri- mary 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 biomark- ers 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 bio- markers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analy- sis 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.
| Item Type: | Articles |
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| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Gray, Professor Cindy and Wyke, Professor Sally and McConnachie, Professor Alex and Hunt, Professor Kathryn and Macaulay, Dr Lisa and Gill, Professor Jason and Mcskimming, Mrs Paula and Kean, Ms Sharon and Bunn, Dr Christopher and Sattar, Professor Naveed |
| Creator Roles: | Wyke, S.Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review and editing Bunn, C.Data curation, Investigation, Methodology, Project administration, Writing – review and editing McSkimming, P.Formal analysis, Validation, Visualization, Writing – review and editing Gill, J. M.R.Data curation, Funding acquisition, Investigation, Methodology, Resources, Supervision, Writing – review and editing Gray, C. M.Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing – review and editing Hunt, K.Conceptualization, Funding acquisition, Investigation, Methodology, Supervision, Writing – review and editing Kean, S.Data curation, Resources, Writing – review and editing Macaulay, L.Data curation, Investigation, Methodology, Project administration, Writing – review and editing McConnachie, A.Conceptualization, Data curation, Formal analysis, Methodology, Validation, Visualization, Writing – original draft, Writing – review and editing Sattar, N.Funding acquisition, Methodology, Writing – review and editing |
| Authors: | Wyke, S., Bunn, C., Andersen, E., Silva, M. N., van Nassau, F., McSkimming, P., Kolovos, S., Gill, J. M.R., Gray, C. M., Hunt, K., Anderson, A. S., Bosmans, J., Jelsma, J. G.M., Kean, S., Lemyre, N., Loudon, D. W., Macaulay, L., Maxwell, D. J., McConnachie, A., Mutrie, N., Nijhuis-van der Sanden, M., Pereira, H. V., Philpott, M., Roberts, G. C., Rooksby, J., Røynesdal, Ø. B., Sattar, N., Sørensen, M., Teixeira, P. J., Treweek, S., van Achterberg, T., van de Glind, I., van Mechelen, W., and van der Ploeg, H. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing College of Social Sciences > School of Social and Political Sciences |
| Journal Name: | PLoS Medicine |
| Publisher: | Public Library of Science |
| ISSN: | 1549-1277 |
| ISSN (Online): | 1549-1676 |
| Copyright Holders: | Copyright © 2019 Wyke et al. |
| First Published: | First published in PLoS Medicine 16(2): e1002736 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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