Table 1 The EuroFIT program details

Why (2)

Lifestyle interventions targeting physical activity, sedentary time and dietary behaviours have the potential to support behavioural change and result in attainment or maintenance of healthier weight and other public health gains. Although men have often been reluctant to engage in such lifestyle programs, many are at high risk of long-term mental and physical health problems, as a result of high amount of sedentary time and lack of physical activity, poor diet and excess weight. The aim of the EuroFIT program is to help men, aged 30–65 years, with self-reported BMI of 27 or above to become more physically active and less sedentary, improve their diet, and maintain these changes over the long term. EuroFIT is designed to attract men by drawing on multiple motivations to do something: their desire to (re)gain fitness and/or an interest in football or their football club.

What, materials (3)

EuroFIT draws explicitly on motivational theories (Self-Determination Theory [41] and Achievement Goal Theory [42]) to encourage men to develop an internalised self-relevant motivation for becoming more physically active, sitting less and eating a healthier diet. It is also informed by sociological theories, including how practices of masculinity in different contexts and gendered identities intersect with health related-behaviours [25]. Access to club facilities for weekly group discussion sessions and physical activity training are required. Coach delivery manuals include the rationale, content and suggestions of how to deliver each weekly session. Participants receive: a manual including information and self-monitoring forms; a novel device, the SitFIT to allow self-monitoring of daily steps and non-sedentary behaviours (time spent upright/walking); and access to a new app-based game (MatchFIT) to promote social support and interaction around physical activity outside EuroFIT sessions.

What, procedure (4)

Football clubs: Football clubs decide to offer the EuroFIT program. Training: Club community coaches are trained over two days to deliver the program. Training is experiential and interactive and focuses on the ethos of the EuroFIT program; the reasons for becoming more physically active and less sedentary; the importance of ‘healthy standing’; promoting the use of self-monitoring, goal-setting, problem-solving and action-planning; supporting men’s motivation to sustain behaviour changes; facilitating group discussions; providing an environment which values men and their efforts, supports autonomy and encourages social support and a sense of relatedness; providing safe and optimally challenging physical activity. Recruitment: Clubs recruit participants through any of: online publicity (e.g. advertising on club/fan websites), e-mail, newsletter or social media announcements (i.e. Twitter, Facebook), poster/flyers, match-day advertising, face-to-face recruitment at home matches (handing out leaflets and collecting contact details), local/national media coverage, active involvement of local supporters’ organisations and word of mouth. Content: The EuroFIT program focuses first on initiating and then on maintaining behaviour change. In the early weeks, participants’ identification with ‘men like me’ is promoted (e.g. everyone receives a EuroFIT T-shirt, similar interests are emphasised). The coaches provide the men with support to change their behaviours that may challenge their masculine identities, but is not in conflict with them (e.g. emphasising learning new skills based on evidence of how to take control of lifestyle). Peer interaction, sharing of experiences and enjoyment is promoted during each session. Men are taught interactively how to use a ‘toolbox’ of specific behaviour change techniques and encouraged to try and use what works and is likely to be sustainable, for them. The ‘toolbox’ includes information on health and lifestyle presented in a way that is personally relevant and accessible, behavioural and outcome goal-setting, problem-solving, action-planning and self-monitoring of behaviour and outcomes (using a novel self-monitoring device, sitFIT, which provides feedback in real time on sedentary time and step counts), as well as building social support within (including using social media) and beyond the group (e.g. family, friends, work colleagues). The sessions also include physical activity training using club facilities, where coaches encourage each participant to work at an intensity that is appropriate for his own fitness and ability. At a later stage in the programme, men are helped to maintain changes by integrating the behaviour change strategies that they felt useful and significant for them, into their daily lives (goal-setting, self-monitoring, action-planning) and by using relapse prevention techniques. Coaches encourage vicarious learning of strategies for maintaining changes through interaction among group members and promote a deepening sense of relatedness to the club, the coach and the other men (e.g. becoming a team within the club, using the game-based app MatchFIT). Personal meaning of the changes already made is also prompted, indeed, men are encouraged to find ways of performing a new behaviour that fits into their daily routines and that they enjoy and to recognise the personally relevant benefits of behaviour change (e.g. increased energy levels, wellbeing, able to do more of the things which they themselves value, such as increased quality time with their family).

Who provides (5); How (6); Where (7); How much (8)

Professional football club community coaches deliver 12 weekly, face-to-face 90-min sessions to groups of 15–20 men. One reunion session is held 6–9 months after baseline. The sessions are held in club stadia and/or the clubs training facilities to foster an ‘insider’ view, increased physical and symbolic proximity to the club, and hence an enhanced sense of relatedness to the club.