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

Abstract

BackgroundReducing 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-programme 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 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-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 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...

Five-year cost-effectiveness analysis of the European Fans in Training (EuroFIT) physical activity intervention for men versus no intervention

“…Details of the EuroFIT RCT can be found in Van Nassau et al [19] and Wyke et al [20]. In summary, 15 professional football clubs in England, the Netherlands, Norway, and Portugal recruited 1113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 into the trial using any of social media posting, email invitations to club members, and local press coverage.…”

“…Table 1 presents the parameters used in the Markov model. As a first line strategy to retrieve information on the association between physical activity levels and individuals' health, we used the 2018 Physical Activity EuroFIT RCT [20] Health conditions (transition probabilities at the end of each cycle of 12 months)…”

“…Inactive to colorectal cancer 0.015 Fixed COSM study [30,31] Inactive to heart diseases 0.011 Fixed Meta-analysis; SALLS study [30,[32][33][34] Inactive to Type 2 diabetes 0.005 Fixed EPIC-Interact study and epidemiological study [33,35,36] Inactive to stroke 0.0046 Fixed ARIC study [37] Inactive to depression [33,35,36] Recommended activity to stroke 0.0029 Fixed ARIC study [37] Guidelines Advisory Committee Scientific Report [6]. The report includes the broadest systematic literature review available on the association between physical activity and adverse outcomes, including risk of EuroFIT RCT [20] cardiovascular disease, cancers and all-cause mortality.…”

“…EuroFIT was rigorously evaluated in a 4-country RCT [19]. While the EuroFIT program successfully increased the number of daily steps at 12 months, there was no difference in sedentary time between the two groups [20]. However, improvements were observed in secondary outcomes, including body weight, the proportion of participants with a BMI less than 30 kg/m 2 , waist circumference, well-being, self-esteem and vitality, and biomarkers of cardiovascular health (i.e.…”

“…systolic and diastolic blood pressure, fasting insulin and fasting triglycerides). The within-trial cost-effectiveness analysis showed that EuroFIT was not cost-effective compared to a waitlist condition at 12 months follow-up for quality adjusted life years (QALYs) [20]. However, if the observed improvements in physical activity are sustained over time, it is possible that EuroFIT is cost-effective with regard to QALYs in the long term.…”