Concerns about gender inequalities in longevity, particularly premature male mortality, have prompted a range of innovative approaches to health promotion work with men dating back to the 1980s. In developing such work, sport, and football in particular, has emerged as a gendered cultural field that has utility for engaging men in health initiatives. Evaluations of such work, whilst few in number, have shown that health initiatives using football settings, football based interventions, or even football club branding, can have positive impact on various health measures in the short and the longer term. However, little work to date has looked at the underlying mechanisms that generate success in such projects. This paper presents secondary analysis of data collected during the evaluation of the Premier League Health (PLH) programme specifically focusing on these underlying mechanisms and how/where gender (masculinities) appears in these processes. We draw on interview data with sixteen staff who had been involved in the delivery of the PLH initiative and fifty-eight men who took part. Thematic analysis highlighted two overarching (and underpinning) themes: 'Trust', what processes it was key to and how it was developed and sustained; 'Change', including what it was facilitated by and what impact it had. The paper adds to our understanding of how active listening, flexibility and sustained engagement are key to sports based projects generating success. Furthermore, it demonstrates how the physicality and sociability of involvement, rather than any direct focus on 'health' was important in acting as a spring-board for facilitating reflection and aiding lifestyle changes for the men in line with PLH programme desired outcomes.

66% of patients who had withdrawn from a phase IV CR programme remained in an advanced stage of PA readiness. Drop-out was due to a combination of financial, physical and lifestyle factors.

SummaryObjectives: To investigate the challenges that men from hard-to-reach (HTR) populations encounter when attempting to commit to regular participation in physical activity and health behaviours and to explore the psychological and social effects of participation in a twelve week football-led health improvement intervention.Study Design: A twelve week football specific physical activity intervention targeting men from HTR populations was delivered by Everton Football Clubs' Football in the Community (FitC) scheme as part of a national programme of men's health delivered in/by English Premier League (EPL) football clubs. Men living in homeless shelters and/or recovering from substance misuse were recruited over a period of three months. The programme consisted of a two hour football session, twice weekly, alongside the dissemination of healthy living messages. Football sessions were conducted by a qualified FitC coach.Methods: This research was conducted during a twelve week period of immersed practitioner-research. Ethnographic and observational methodologies were adopted. Psychosocial issues were discussed with participants through informal client-researcher interactions and data were logged via field notes. Records of attendance were logged. Participants who failed to attend a session were contacted and their reason(s) for nonattendance were recorded. Data were analysed using deductive and inductive reasoning.Results: Despite the apparent ambition of the participants to regularly participate in the FitC programme, adherence to the programme was poor. Economic, environmental and social barriers to engagement in the programme were apparent. Engagement in the programme resulted in positive psychosocial developments; the development of structure, social interaction and social capital. Conclusion:Community based football-led health improvement programmes endorsed by professional football clubs appear well positioned to connect with, and attract, men from HTR populations. The evidence suggests that such programmes can improve psychosocial health amongst these populations. However, a bottom-up programme design and management strategy is required in order to reduce the challenges facing HTR participants when attempting to regularly engage in physical activity and health behaviours.

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