Date: 01 June 2016
Category: Obesity in men
Recently, the Public Health team at Southampton City Council brought Football Fans in Training (FFIT) programme to Southampton. This was the first iteration of the 12-week FFIT programme in an English Premier League Football Club, and so working as part of the Public Health team, I conducted an evaluation to compare whether FFIT could be generalised effectively into a new setting.
Working in collaboration with the charitable wing of Southampton FC (known as the Saints Foundation) and in conjunction with the Scottish Premier Football League (SPFL) Trust, the agreement was to pilot the programme with approximately 15 suitable participants and to conduct the evaluation using a mixture of quantitative and qualitative methods.
The Saints Foundation selected a suitable coach to run the programme in Southampton and attended a two-day SPFL Trust FFIT coach training. An emphasis was placed on fidelity to the original FFIT programme, which was enhanced by using detailed FFIT delivery manuals. The SPFL Trust also supplied participant programme booklets and an equipment kit containing weighing scales, height stadiometer, blood pressure machine and ‘Eat well Plate’ demonstration kit.
The programme was promoted during the last match of the 2014/15 football season, using adverts in toilets and in food halls. Eighteen eligible men, all overweight or obese, enrolled on a first come, first served basis. Fifteen completed the first 12-week FFIT delivery, which began at the end of March 2015.
At 12 weeks men had lost an average of 6.9kg, or more than 6% of their initial weight - a similar result to the original FFIT trial. Furthermore, two thirds of participants achieved 5% weight loss – enough to lead to health benefits such as a reduced risk of diabetes.
The 12-week FFIT programme cost per participant (based on 15 participants) was as low as £87.28, mainly due to The Saints Foundation not passing on coach salary or facility rental to the FFIT Southampton programme. This weight-loss programme is therefore cost-effective if participants maintain 1Kg of weight loss for a lifetime, according to the usual boundaries set by the National Institute for Health and Care Excellence (NICE).
Shortly after the delivery of the 12-week programme, a coach interview, a focus group (five participants), and a participant questionnaire (11 of the 15 programme completers) were conducted as part of the evaluation. All participants who completed the questionnaire believed their involvement to have been successful, a success driven mainly by the trio of ‘football’, ‘team’ and the nature of the ‘programme’. Although not cited as a primary reason for success, the characteristics of the coach were believed to be ‘important’ or ‘extremely important’ in the success of the programme. The coach created an atmosphere that was safe, fun and encouraging, underpinned by a respect for the participants. They in turn respected his professionalism.
Participants believed that the continuation of some form of weekly activity sessions after the 12-week programme had finished was vital to the continuation of their success. These sessions would maintain the integrity of the ‘team’, which was a powerful form of support in maintaining the physical activity and healthy eating changes they had made. Twelve of the original fifteen men completing the programme continue to meet up for weekly physical activity sessions.
The power that the participants drew from the union of ‘football’ and ‘team’ and the lack of belief in their individual, intrinsic, abilities to maintain the changes without them, suggest that long term weight maintenance and behaviour change is going to be a challenge for some of these individuals. The men did not believe that the FFIT programme itself could be adapted to protect against this problem.
Longer-term success may be possible if the participants are able to continue to maintain their involvement with the ‘team’, although it is not sustainable for the FFIT Southampton programme to continue to fund weekly sessions of physical activity ad infinitum. Additionally this reliance on ‘team’ expressed by this cohort of football supporters who have successfully engaged with the FFIT programme, and reached impressive weight loss goals, may suggest that this may not generalise to men who are less connected with the idea of a ‘team’ and/or football, but this would need to be evaluated.
In conclusion, the first Southampton FFIT programme delivery appears to have been a success. A second cohort has recently completed the programme and a third cohort is underway. Future commissioning decisions will be made after reviewing subsequent outcomes from these and future cohorts. It is also hoped that further data will be collected on the first cohort at 12 months so that further comparisons with the original FFIT trial can be made and the cost-effectiveness of the programme can be further reviewed.
What happened when Southampton City Council brought Football Fans in Training to Southampton FC?
Specialty Registrar in Public Health