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 (Lead / Corresponding author), Christopher Bunn, Eivind Andersen, Marlene N. Silva, Femke van Nassau, Paula McSkimming, Sypros Kolovos, Jason M. R. Gill, Cindy M. Gray, Kate Hunt, Annie Anderson, Judith E. Bosmans, Judith G. Jelsma, Sharon Kean, Nicolas Lemyre, David W. Loudon, Lisa Macaulay, Douglas J. Maxwell, Alex McConnachie, Nanette Mutrie & 14 others Maria 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 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 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. CONCLUSION: Participation 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. TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

Original languageEnglish
Article numbere1002736
Number of pages25
JournalPLoS Medicine
Volume16
Issue number2
Early online date5 Feb 2019
DOIs
Publication statusPublished - 5 Feb 2019

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Randomized Controlled Trials
Exercise
Football
Quality-Adjusted Life Years
Diet
Costs and Cost Analysis
Health
Biomarkers
Quality of Life
Confidence Intervals
Intention to Treat Analysis
Waiting Lists
Portugal
Arthralgia
Norway
Self Concept
Social Support
England
Netherlands
Cost-Benefit Analysis

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Wyke, Sally ; Bunn, Christopher ; Andersen, Eivind ; Silva, Marlene N. ; van Nassau, Femke ; McSkimming, Paula ; Kolovos, Sypros ; Gill, Jason M. R. ; Gray, Cindy M. ; Hunt, Kate ; Anderson, Annie ; Bosmans, Judith E. ; Jelsma, Judith G. ; 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.
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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 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. CONCLUSION: Participation 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. TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.",
author = "Sally Wyke and Christopher Bunn and Eivind Andersen and Silva, {Marlene N.} and {van Nassau}, Femke and Paula McSkimming and Sypros Kolovos and Gill, {Jason M. R.} and Gray, {Cindy M.} and Kate Hunt and Annie Anderson and Bosmans, {Judith E.} and Jelsma, {Judith G.} 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 = "Funding: This project has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement number 602170. The Health Services Research Unit, University of Aberdeen, receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.",
year = "2019",
month = "2",
day = "5",
doi = "10.1371/journal.pmed.1002736",
language = "English",
volume = "16",
journal = "PLoS Medicine",
issn = "1549-1277",
publisher = "Public Library of Science",
number = "2",

}

Wyke, S, Bunn, C, Andersen, E, Silva, MN, van Nassau, F, McSkimming, P, Kolovos, S, Gill, JMR, Gray, CM, Hunt, K, Anderson, A, Bosmans, JE, Jelsma, JG, 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, e1002736. 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 (Lead / Corresponding author); Bunn, Christopher; Andersen, Eivind; Silva, Marlene N.; van Nassau, Femke; McSkimming, Paula; Kolovos, Sypros; Gill, Jason M. R.; Gray, Cindy M.; Hunt, Kate; Anderson, Annie; Bosmans, Judith E.; Jelsma, Judith G.; 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, e1002736, 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

T2 - The European Fans in Training (EuroFIT) randomised controlled trial

AU - Wyke, Sally

AU - Bunn, Christopher

AU - Andersen, Eivind

AU - Silva, Marlene N.

AU - van Nassau, Femke

AU - McSkimming, Paula

AU - Kolovos, Sypros

AU - Gill, Jason M. R.

AU - Gray, Cindy M.

AU - Hunt, Kate

AU - Anderson, Annie

AU - Bosmans, Judith E.

AU - Jelsma, Judith G.

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 - Funding: This project has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement number 602170. The Health Services Research Unit, University of Aberdeen, receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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 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 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. CONCLUSION: Participation 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. TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

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 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 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. CONCLUSION: Participation 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. TRIAL REGISTRATION: International Standard Randomised Controlled Trials, ISRCTN-81935608.

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U2 - 10.1371/journal.pmed.1002736

DO - 10.1371/journal.pmed.1002736

M3 - Article

VL - 16

JO - PLoS Medicine

JF - PLoS Medicine

SN - 1549-1277

IS - 2

M1 - e1002736

ER -