Hockey FIT Research

Publications

Petrella RJ, Gill DP, Boa Sorte Silva NC, Riggin B, Blunt WM, Kfrerer M, Majoni M, Marsh J, Irwin JD, Stranges S, Zwarenstein M, Zou G. The hockey fans in training intervention for men with overweight or obesity: a pragmatic cluster randomised trial. eClinicalMedicine 2024 Nov; 77: 102911. https://doi.org/10.1016/j.eclinm.2024.102911.

Petrella RJ, Gill DP, Kfrerer M, Riggin, B, Majoni M, Blunt W, Bliss B, Boa Sorte Silva NC, Aspinall PS, Adekoya P, DiNunzio M, Marsh J, Zou GY, Irwin JD. Hockey Fans in Training (Hockey FIT): Rationale, Design, and Baseline Characteristics from a Cluster Randomized Controlled Trial in Men with Overweight or Obesity. Contemporary Clinical Trials. 2023 Jun; 129: 107178. DOI: 10.1016/j.cct.2023.107178. 

Social Impact of a Corporate Social Responsibility Initiative – 2019

Optimization of the Hockey Fans in Training (Hockey FIT) Weight Loss and Healthy Lifestyle Program for Male Hockey Fans – 2017

Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial – 2017

Men’s Experiences with the Hockey Fans in Training Weight Loss and Healthy Lifestyle Program – 2016 

Engaging Men in Chronic Disease Prevention and Management Programs: A Scoping Review – 2016

Barriers to Recruiting Men Into Chronic Disease Prevention and Management Programs in Rural Areas: Perspectives of Program Delivery Staff – 2016

Hockey Fans in Training (Hockey FIT) Pilot Study Protocol: A Gender-sensitized Weight Loss and Healthy Lifestyle Program for Overweight and Obese Male Hockey Fans – 2016

The Physical Activity–Related Barriers and Facilitators Perceived by Men Living in Rural Communities – 2015

Conferences & Presentations

North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023

Petrella RJ, Gill DP, Boa Sorte Silva NC, Majoni M, Riggin B, Bliss B, Kfrerer M, Aspinall PS, Blunt W, Irwin JD, Zou GY. Can the power of sport help men with overweight/obesity improve their health through a tailored healthy lifestyle program? North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023. (Oral Presentation) 

Gill DP, Kfrerer M, Riggin, B, Majoni M, Blunt W, Bliss B, Boa Sorte Silva NC, Aspinall PS, Adekoya P, DiNunzio M, Marsh J, Zou GY, Irwin JD, Petrella RJ. Recruitment and characteristics of men with overweight/obesity from a trial of a gender-sensitized healthy lifestyle program. North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023. (Oral Presentation) 

Blunt WRiggin B, Gill DP, Boa Sorte Silva NC, Majoni M, Bliss B, Kfrerer M, Aspinall PS, Shillington KS, Irwin JD, Zou GY, Petrella RJ. Stakeholder Acceptability of the Hockey Fans In Training Healthy Lifestyle Intervention. North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023. (Oral Presentation) 

Kfrerer M, Blunt W, Riggin B, Gill DP, Majoni M, Bliss B, Aspinall PS, Crozier O, Adekoya P, Petrella RJ. Hockey FIT for Women (HFIT for Women): Evaluating reach and implementation of a gender-sensitized healthy lifestyle program. North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023. (Oral Presentation) 

Bliss BGill DP, Kfrerer M, Riggin, B, Majoni M, Blunt W, , Aspinall PS, Adekoya P, Crozier O, Petrella RJ. Hockey Fans In Training Graduate Program (HFIT Grad): Process Evaluation of an Add-on Fitness Program for HFIT Participants. North American Primary Care Research Group (NAPCRG) 51st Annual Meeting. San Francisco, CA. Oct 30-Nov 3, 2023. (Poster Presentation) 

8thInternational Society for Physical Activity and Health (ISPAH) Congress. Virtual Conference

Petrella RJ (Hockey FIT, UBC), Wilson R (Chair), Vanderloo L (Participaction), Mitchell D (Sportforlife), Cameron, C (CFLRI) . The current and evolving state of physical activity promotion in Canada. Invited Speaker for Symposium. 8thInternational Society for Physical Activity and Health (ISPAH) Congress. Virtual Conference. Oct 14, 2021.

7th Annual Canadian Obesity Summit (COS) – June 2021

Hockey Fans in Training (Hockey FIT) is a 12-month (3-month active phase and 9-month minimally-supported phase) weight loss and healthy lifestyle program for middle-aged, overweight/obese male hockey fans, delivered by trained coaches in collaboration with major junior or professional hockey teams and implementation partners (e.g., YMCAs, local fitness facilities, and universities) in Canada.

In the proposed study, a minimum of 32 sites (affiliated with hockey teams and local implementation partners) will be randomly assigned to either immediate delivery (Hockey FIT program) or delayed delivery (wait-list control). At each site, a minimum of 10 male hockey fans at risk for chronic diseases will be recruited to take part in the study (note: the goal is to recruit approximately 40 men/site). Sites assigned to the delayed delivery group will offer the Hockey FIT program to their enrolled participants after 12 months.

Through the Hockey FIT program, our team aims to promote weight loss, increase physical activity levels, and improve other health measures through a cost-effective solution that is acceptable and appealing to men who are overweight or obese.

North American Society for Sport Management (NASSM) San Diego, CA – 2020

Riggin B, Gill DP, Blunt W, & Petrella RJ (2020). The Impact of Participation in a Corporate Social Responsibility Program: Examining Fans’ Attitudes and Behaviour. Paper presented at the North American Society for Sport Management (NASSM) Conference. San Diego, CA

https://www.nassm.com/files/conf_abstracts/2020-195.pdf

North American Primary Care Research Group (NAPCRG) Chicago, IL – 2018

Petrella RJ, Blunt W, Gill DP, Sibbald S, Scott R, & Riggin B. (2018). Exploring the Role of External Social Supports in Creating and Maintaining Health Behaviour Changes in At-Risk Men Involved in the Gender-Sensitized Hockey Fans In Training (Hockey FIT) Program. Paper presented at the North American Primary Care Research Group (NAPCRG) Annual Meeting. Chicago, IL

European Association for Sport Management (EASM) Bern, Switzerland – 2017

Riggin B, Gill D, Petrella RJ, & Danylchuk K (2017). Better Health and Better Business: The Shared Value of Hockey Fans in Training (Hockey FIT). Paper presented at the European Association for Sport Management (EASM) Conference. Bern, Switzerland

5th Canadian Obesity Summit (COS) – 2017 

Objective: To examine the feasibility of recruiting and retaining overweight/obese men into a gender-sensitized weight loss and healthy lifestyle program using the power of sport affiliation.

Methods: Hockey Fans in Training (Hockey FIT) includes a 12-week active (group coaching) phase and a 40-week maintenance (self-directed) phase. We conducted a pilot pragmatic randomized controlled trial with an integrated process evaluation. Male hockey fans (aged 35-65 years; BMI ≥28 kg/m2) of 2 Ontario Hockey League teams were recruited. Eligible and consenting men were randomized to intervention (Hockey FIT) or comparator (Wait-list Control). Coaches monitored attendance weekly; men allocated to intervention, who attended <50% of sessions (including none in the final 6 weeks), were classified as ‘program non-completers’.

Results: Email blasts from hockey teams (35%) and word of mouth (25%) were the most successful methods for recruiting participants. In <6 weeks, 105 men heard about the study; 24 men were excluded [did not meet eligibility criteria (n=17); unavailable on scheduled day/time slot for program (n=7)] and 1 eligible individual did not enroll. The remaining 80 men were randomized and enrolled. In total, 10/40 (25%) of men in the intervention group were ‘program non-completers’. Of ‘program completers’, the mean (SD) percentage of sessions attended was 81.7 (13.7)%.

Conclusion: It was feasible to recruit and retain overweight/obese men to Hockey FIT. Recruitment methods were easy to implement and had no added costs. The majority of men were ‘program completers’ with high average attendance over 12 weeks; nonetheless, program optimization is warranted to further improve retention.

Dr. Petrella was an invited speaker at the 5th Canadian Obesity Summit, hosted by the Canadian Obesity Network (Canada’s largest obesity association of researchers, policy makers, and healthcare professionals) which has over 12000 professional members who are working towards improving Canadian lives affected by chronic disease.  Dr. Petrella’s presentation highlighted physical activity benefits beyond weight loss discussing our results from the Hockey Fans in Training pilot program and impact gender-sensitized programs can have on improving men’s health.

International Society for Behavioural Nutrition and Physical Activity (ISBNPA) – 2017 

Objective: To examine the feasibility of recruiting and retaining overweight/obese men into a gender-sensitized weight loss and healthy lifestyle program using the power of sport affiliation.

Methods: Hockey Fans in Training (Hockey FIT) includes a 12-week active (group coaching) phase and a 40-week maintenance (self-directed) phase. We conducted a pilot pragmatic randomized controlled trial with an integrated process evaluation. Male hockey fans (aged 35-65 years; BMI ≥28 kg/m2) of 2 Ontario Hockey League teams were recruited. Eligible and consenting men were randomized to intervention (Hockey FIT) or comparator (Wait-list Control). Coaches monitored attendance weekly; men allocated to intervention, who attended <50% of sessions (including none in the final 6 weeks), were classified as ‘program non-completers’.

Results: Email blasts from hockey teams (35%) and word of mouth (25%) were the most successful methods for recruiting participants. In <6 weeks, 105 men heard about the study; 24 men were excluded [did not meet eligibility criteria (n=17); unavailable on scheduled day/time slot for program (n=7)] and 1 eligible individual did not enroll. The remaining 80 men were randomized and enrolled. In total, 10/40 (25%) of men in the intervention group were ‘program non-completers’. Of ‘program completers’, the mean (SD) percentage of sessions attended was 81.7 (13.7)%.

Conclusion: It was feasible to recruit and retain overweight/obese men to Hockey FIT. Recruitment methods were easy to implement and had no added costs. The majority of men were ‘program completers’ with high average attendance over 12 weeks; nonetheless, program optimization is warranted to further improve retention.

Purpose: To examine whether Hockey Fans in Training (Hockey FIT), a gender-sensitized weight loss and healthy lifestyle program, can lead to long-term changes in healthy eating behaviours in overweight and obese men.

Methods: We conducted a pilot pragmatic randomized controlled trial (RCT) in two sites in Ontario, Canada where 80 male fans of local junior hockey (35-65 years; BMI ≥28 kg/m2) were randomized (1:1) to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT consisted of a 12-week active phase (weekly 90-minute sessions including education on behaviour change techniques, physical activity (PA), and healthy eating, plus group-based dry-land exercise) and a 40-week minimally supported maintenance phase (smartphone app for sustaining PA; private social network for group members only; standardized emails; booster session/reunion). Measurements at baseline (T0), 12 weeks (T1) and 12 months (T2; intervention only) included self-administered diet questionnaires (Starting the Conversation [STC]; Modified Dietary Instrument for Nutrition Education [DINE]). Linear mixed models for repeated measurements adjusted by age and site were used for continuous outcomes to examine mean changes within the intervention group. McNemar’s test was used for dichotomous outcomes to examine change in proportions.

Results: 82.5% of the intervention group completed T1 measurements and 75.0% completed T2 measurements. Within the intervention group, mean changes (95% confidence interval, CI) were as follows – (1) STC healthful eating score (range 0-16; lower=more healthful eating), T0 to T1: -3.12 (-3.89, -2.35) and T0 to T2: -2.47 (-3.34, -1.60); and (2) DINE fatty food score (range 8-68; lower= less fatty food consumption), T0 to T1: -3.05 (-5.07, -1.02) and T0 to T2: -2.31 (-4.48, -0.14). The proportion of men within the intervention group consuming fruit and vegetables ≥3 times/day was 27.5% at T0 compared to 72.7% at T1 (p<0.001) and 63.3% at T2 (p=0.006).

Conclusions: Hockey FIT is a novel weight loss and healthy lifestyle program designed to engage hard-to-reach men at high risk of chronic disease through the power of sport affiliation. Findings from this pilot RCT suggest that Hockey FIT can lead to long-term maintenance of healthy eating behaviours in overweight and obese men.

Purpose: To examine the extent to which the Hockey Fans In Training (Hockey FIT) program was delivered as designed.

Methods: We conducted a pilot pragmatic randomized controlled trial recruiting overweight and obese male hockey fans (35-65 years; BMI≥ 28 kg/m2) from two local junior hockey teams (London Knights and Sarnia Sting) into a weekly, 90-minute classroom education and physical activity program for 12 weeks. A fidelity assessor observed all sessions at both sites, tracked delivery of key program tasks as per protocol, detailed factors influencing delivery of these tasks (content, timing, location, and style and methods of delivery), and interviewed Hockey FIT coaches after each session. This provided the ability to: a) determine the percentage of key program tasks delivered by coaches; and b) explore factors affecting delivery of key program tasks.

Results: Of the 51 key program tasks to be delivered by the coaches, 46 tasks (84%) in London and 49 tasks (96%) in Sarnia were delivered as designed. Introductions to the Hockey FIT research team and tours of the hockey arena (by hockey team personnel) were missed at both sites (week 1). Introductions may have been missed as coaches were still becoming familiar with program protocol. Tours were missed because of a lack of available personnel. Coaches perceived time constraints (especially at the London site) and repetition of content affected delivery of tasks. Certain topics stimulated more participant discussion than expected requiring coaches to rush to stay on time. Other topics were exhausted in previous sessions, and may not have been fully explored again as per protocol. The assessor noted participants enjoyed sessions at the arena location, but cited difficulties with classroom setup and rooms being double booked at the fitness facility (Sarnia Site). The style and methods of delivering program content by coaches were consistent across both sites. The assessor noted as the program progressed, participants and coaches felt more comfortable with each other, making it easier to effectively deliver the program tasks.

Conclusions: Hockey FIT was largely delivered as intended. Fidelity data will be used to inform further program optimization and scale up.

North American Society for Sport Management (NASSM) – 2017 

Organizations seeking to differentiate themselves from competitors are utilizing corporate social responsibility (CSR) as a strategy to do so by incorporating social and environmental concerns into their business operations and interactions with stakeholders. Both researchers and practitioners alike have identified the sport industry as an advantageous field to engage in CSR due to the unique characteristics inherent within sport (Babiak & Wolfe, 2006). However, insufficient funding and resource constraints, such as human resources, knowledge, and expertise are significant obstacles to overcome for the successful implementation of CSR-related programs (Anagnostopoulos & Shilbury, 2013). Consequently, researchers are calling for a more strategic approach to CSR (Breitbarth & Harris, 2008) and have encouraged engaging in cross-sector partnerships to address important social needs within the community (Hess, Rogovsky, & Dunfee, 2002). While previous research has shown CSR is becoming much more common within professional sport leagues (Babiak & Wolfe, 2006), limited research has examined the use within amateur leagues, where resource constraints are often intensified.

A particular component of CSR is strategic corporate community involvement (CCI), which typically involves aligning an organization’s social initiatives with their core competencies and long-term strategies (Hess et al., 2002). Many of the social needs these programs aim to address are present, and even exacerbated, in smaller communities where professional teams do not exist (e.g., rural community health issues). To date, the assessment of CCI programs has received minimal attention both in the literature and in practice (Kihl, Babiak & Tainsky, 2014). Chen (2005) recommends the use of theory driven evaluation, where the needs of various stakeholders can be taken into consideration, to determine whether the program has been successfully implemented as planned, thus identifying any shortcomings in the process and ensuring resources are being used in a strategic manner. Research conducted by Kihl et al. (2014) suggests that Chen’s (2005) program theory evaluation is one means in which a CCI program can be assessed. However, a shortfall of the theory lies in the fact that a feedback loop, which identifies problems and provides recommendations to the implementing organizations, is implied and is not explicit. There is a dearth of research that has utilized program theory to evaluate a CCI program and none has explored one that is situated within a non-professional sport league setting. The present research aimed to fill this gap by evaluating the design and implementation of a CCI program and its various partnerships within an amateur sport league setting. Chen’s (2005) program theory model was adapted to include an explicit feedback loop, thus recommendations could be directly reported to the various stakeholders.

This study developed a CCI initiative called Hockey Fans in Training (Hockey FIT), a weight-loss program designed for overweight male ice hockey fans in collaboration with their local Major Junior ice hockey organizations. Forty fans from two organizations, for a total of eighty, volunteered to participate in 12 weekly sessions hosted in the local hockey club facilities. The program involved a collaboration of cross-sector partners including the educational institution engaged in this research project, a non-profit charity organization that provided research support, a for-profit fitness organization that provided access to their facilities, a community sponsoring organization that provided financial support, and two amateur sport organizations. Following the completion of the program, each stakeholder’s perspective was explored through a qualitative approach. Two focus groups were conducted, one per team, which consisted of fans who completed Hockey FIT. Eight fans volunteered to participate in the first focus group and ten fans participated in the second. Questions pertained to why they decided to join Hockey FIT, what motivated them to continue to attend, aspects of the program that they found effective, and what areas required refinement. Ten people, who were involved in the delivery of Hockey FIT, will be interviewed to achieve an understanding of how the CCI initiative was designed and executed, as well as the communication strategies among delivery agents, program effectiveness, motives for each partner’s involvement, and whether the program that was carried out was congruent with the initially planned program. Through the use of program theory, the researchers aimed to determine whether the intervention was successful, as well as how and why. Interviews with the remaining stakeholder groups are presently being conducted and thematic analysis is in progress.

Preliminary findings from this research suggest that amateur sport organizations possess the desire to engage in CSR and to give back to their fans, but they lack the available resources to do so. Cross-sector partnerships allowed Hockey FIT to overcome this crucial constraint to the benefit of partners involved as well as the broader community alike. Interestingly, the program had little influence on the fan’s overall perception of the club, as many were already highly identified with their respective team, but fans acknowledged it as a means of protecting the brand’s image during organizational staff turnover. The community sponsoring organization saw the initiative as an opportunity to engage in cobranding with a significant community sport organization and one that aligned with their own CSR agenda.

This research has practical and theoretical implications. It demonstrates the efficacy of amateur sport organizations contributing to social change, as they are more prevalent within communities than their professional counterparts. This research also explores the unique opportunity for local organizations to sponsor a CCI program as a way of exhibiting their CSR within the community through partnerships with local sport organizations. Finally, this research answers the need identified by Kihl et al. (2014) to determine the generalizability of using program theory in different contexts and the efficacy of including a feedback loop within Chen’s (2005) model.

Anagnostopoulos, C., & Shilbury, D. (2013). Implementing corporate social responsibility in English football: Towards multi-theoretical integration. Sport, Business and Management: An International Journal3(4), 268-284.

Babiak, K., & Wolfe, R. (2006). More than just a game? Corporate social responsibility and Super Bowl XL. Sport Marketing Quarterly15(4), 214-222.

Breitbarth, T., & Harris, P. (2008). The role of corporate social responsibility in the football business: Towards the development of a conceptual model. European Sport Management Quarterly8(2), 179-206.

Chen, H. T. (2005). Practical program evaluation: Assessing and improving planning, implementation, and effectiveness. Sage.

Hess, D., Rogovsky, N., & Dunfee, T. (2002). The next wave of corporate community involvement: Corporate social initiatives. California Management Review,44(2),110-125.

Kihl, L., Babiak, K., & Tainsky, S. (2014). Evaluating the Implementation of a Professional Sport Team’s Corporate Community Involvement Initiative. Journal of Sport Management28(3), 324-337.

Canadian Urological Association Men’s Health Summit – 2017 

Dr. Petrella was selected as a keynote speaker at this event focused on bringing awareness to men’s health issues. At this presentation Dr. Petrella detailed the current state of chronic disease in men and the impact of the Hockey Fans in Training pilot program in reducing men’s risk for chronic disease.

London Health Research Day – 2017 

Introduction: In 2014, 20% of Canadians aged 18 and older were classified as obese and 60% of males were at an increased health risk because of excess weight (Statistics Canada, 2014). Specifically, male sports fans tend to weigh more, eat higher fat foods, and have worse general health habits than non-sports fans (Sweeney & Quimby, 2012). Research has found weight-loss programs that are based in a sporting context, where participants had a strong sense of affiliation, showed lower dropout rates and higher rates of satisfaction than traditional programs (Robertson, 2014). In Canada, hockey is a core cultural component with two-thirds of adults following the sport (Environics, 2012). Therefore, Hockey Fans in Training (Hockey FIT) was created, where male fans from two major Junior hockey organizations participated in 12 weekly physical activity, healthy eating and health promotion sessions hosted in local hockey club facilities.

Objective: The purpose of the current study was to assess the Hockey FIT program using Inoue and Kent’s (2013) corporate social responsibility impact framework, which consists of the following impacts: intermediate individual, long-term individual, intermediate community, and long-term community.

Methods: Forty fans from each organization (N = 80) participated. Quantitative data was obtained through weight-loss measurements and physical activity levels (steps/day) of fans at baseline, 12-weeks, and 12-months. Qualitative data was obtained through focus groups conducted at 12-weeks and interviews conducted at 12-months.

Results: The intermediate individual impact was assessed by comparing the participant’s body weight and physical activity at baseline and 12-weeks. Participants receiving the Hockey FIT program lost, on average, 4.4kg and increased their physical activity by 3600 steps/day. Follow-up assessments at 12-months were then compared to baseline measurements and were used to assess the long-term individual impact. The data is currently under analysis, however, preliminary results suggest participants were able to maintain a partial weight-loss and increase in physical activityInoue and Kent (2013) describe the intermediate community impact as “an aggregate of the intermediate individual impact of a program on the community where it is implemented” (p. 302) and can be evaluated using the product of the intermediate individual impact and the number of participants in the program. Therefore, the intermediate community impact was an estimated . The long-term community impact was explored using focus groups and interviews with the participants. Results showed that Hockey FIT had a positive impact on members of the community who were not directly involved in the program including positive dietary changes to family and friends, increased activity levels of family members, more bonding time with family, and positive changes to family education and motivation on healthy active living.

Discussion: Overall, Hockey FIT improved the health of male fans and demonstrated an innovative method of combating obesity. Furthermore, participants appear to have maintained their positive lifestyle changes one year after the program. Finally, the positive results provided an indirect benefit to members within the community and offers a promising opportunity to transform a passive spectator into an active sport participator.

10th Health & Rehabilitation Sciences Graduate Research Conference, Western University – 2017 

Background: Although obesity in men has increased in recent years, men are less likely than women to enrol in weight management programs. There has been success in engaging men in evidence-based weight management programs through their interest in sports. Hockey Fans in Training (Hockey FIT) was developed to engage overweight male hockey fans and provide a program that introduces them to the knowledge, skills, support, and opportunity to eat healthier, become more active, and lose weight.

Hypotheses/Objectives: This study aimed to explore the social support given and received by men while involved in the Hockey FIT program.

Methods: Overweight or obese men (age 35-65, body-mass index >28kg/m2) who were fans of their local Ontario Hockey League team (London Knights or Sarnia Sting) participated in 12 weekly 90-minute sessions that combined physical activity with classroom sessions about healthy living and weight loss. Participant focus groups and Hockey FIT coach interviews were conducted after 12 weeks. Transcripts were coded using open, axial, and selective coding in Excel to reveal key themes.

Results/Implications: Seven themes emerged: motivation, external factors, challenges and barriers, program impact, competition & accountability, ideas for improvement, and program elements. These themes showed that men enjoyed being in the company of other men like them and pushing each other to succeed. Support from family members also contributed to success. These results support the importance of social support and group dynamics in the success of men’s weight management and healthy lifestyle programs.

American College of Sports Medicine (ACSM) – 2016 

Football Fans in Training (FFIT) is an effective, gender-sensitized, weight loss and healthy living program for overweight/obese men, delivered via professional football clubs. Hockey Fans in Training (Hockey FIT) is a new program adapted from FFIT for Canadian hockey.

Purpose: To examine the impact of Hockey FIT on steps, self-esteem, mood, and self-rated health, 12 weeks after baseline (post program).

Methods: 80 male fans [35-65 years; body mass index (BMI) ≥ 28 kg/m2] of 2 Ontario Junior A hockey clubs were randomized to either intervention (Hockey FIT) or comparator (wait-list control), within a pilot, pragmatic randomized controlled trial (RCT). Hockey FIT involved 12 weekly, 90-minute group sessions delivered by trained coaches using club facilities. Each session combined classroom material, including evidence-based behaviour change techniques (e.g., self-monitoring, goal setting) and healthy eating advice (e.g., reducing portion size), with physical activity sessions. Prescriptive exercise (e.g., individualized target heart rates and pedometer-based incremental step targets) was incorporated throughout. We examined between-group differences in mean steps/day (7-day pedometer monitoring), self-esteem (Rosenberg scale), positive and negative affect (I-PANAS-SF scale), and self-rated health (EQ-5D-3L VAS score) using linear mixed effects regression models that accounted for club and age.

Results: Groups were similar at baseline [median (interquartile range): age: 48.0 (17.0) years; BMI: 35.1 (6.3) kg/m2]. 75% of men in the intervention group attended ≥ 6 sessions. At 12 weeks, the intervention group increased their daily steps to a greater extent than the comparator [difference between groups in mean change: 3127 (95% confidence interval: 1882 to 4372) steps/day, p <0.001]. The intervention group also improved their self-rated health (scale 0 to 100; 100 = best) to a greater extent than the comparator [difference between groups in mean change: 7.0 (2.1 to 11.9) points, p = 0.005]. There were no differences between groups in self-esteem or positive/negative affect post program.

Conclusion: Hockey FIT has the potential to help overweight/obese men increase their physical activity levels and improve their self-rated health. Long-term follow-up and a full-scale pragmatic RCT is warranted.

The issue of gender is often neglected when planning and implementing chronic disease prevention and management strategies. Football Fans in Training (FFIT) – a gender-sensitized, weight loss and healthy living program for men delivered via professional football clubs – has been shown to be highly effective in helping overweight/obese men lose weight and improve their health risk.

Purpose: To examine the potential for new male-friendly, physical activity and healthy living program – Hockey Fans in Training (Hockey FIT) – to help overweight/obese men decrease their weight, waist circumference (WC), and body mass index (BMI), after 12 weeks.

Methods: A pilot, pragmatic randomized controlled trial (RCT) whereby male fans (35-65 years; BMI≥ 28 kg/m2) of 2 Junior A hockey clubs (Ontario, Canada) were randomized to either the intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT involved 12 weekly, 90-minute group sessions delivered by trained coaches using club facilities. Each session combined classroom activities, including evidence-based behaviour change techniques (e.g., self-monitoring, goal setting) and healthy eating advice (e.g., reducing portions), with physical activity training. Lifestyle prescriptions, including incremental step count targets, were also prescribed each week.  We examined between-group differences in mean weight loss, WC, and BMI using linear mixed effects regression models that accounted for club and age.

Results: Baseline characteristics were similar between groups [total N = 80, median (interquartile range) – i) age: 48.0 (17.0) years; ii) weight: 112.2 (23.2) kg; iii) WC: 119.3 (13.5) cm; iv) BMI: 35.1 (6.3) kg/m2]. Of the 40 men in the Hockey FIT group, 30 (75%) attended at least 6 sessions. At 12 weeks, the Hockey FIT group lost more weight than the control group [difference between groups in mean weight change (control is reference): -3.6 (95% confidence interval: -1.9 to -5.2) kg, p<0.001]. The Hockey FIT group also saw greater reductions in WC and BMI, when compared to the control group [difference between groups in mean i) WC: -2.8 (-0.6 to -5.0) cm, p=0.01; ii) BMI: -0.9 (-0.4 to -1.4) kg/m2, p<0.001].

Conclusion: Hockey FIT has the potential to help overweight/obese men lose weight and improve health risk. A definite RCT is warranted with long-term follow-up.

Increasing rates of chronic disease (CD) have led to an increased effort to implement lifestyle interventions aimed at healthy eating, healthy weight and physical activity. While male CD risk exceeds that of women, men are often highly underrepresented in lifestyle programs. This may in part be due to the fact that men consider programs inherently feminine, serving as a barrier for participation. Some studies have observed that men prefer lifestyle programs that incorporate an element of competition and occur in the company of other men. Additionally, programs situated in the context of sports may have lower drop-out rates and higher levels of satisfaction due to feelings of affiliation.

Purpose: To review men’s feedback regarding their motivation for joining and their experience in a 12-week lifestyle intervention in the context of professional hockey clubs, in London and Sarnia, Ontario, Canada.

Methods: Participants who completed at least 6 of the 12 weekly sessions (n=30) were asked to fill out an online questionnaire after their completion of the intervention. The questionnaire was designed to elicit why they joined the program, what changes they saw following their participation, as well as what program components they found useful and not useful in helping them make those changes.

Results: A total of 27 men completed the questionnaire. Weight loss and a desire to increase physical activity were the two main reasons cited for joining the program. After the 12-week intervention, 100% of the men reported eating a healthier diet and 78% reported having increased their activity level. Satisfaction with the program elements was high with 96% of men believing both the classroom and exercise components were useful. Most suggestions for improvement involved decreasing the repetition of classroom material and increasing the proportion of physical activity during each session.

Conclusion: Our results support previous research showing increased levels of satisfaction in men when lifestyle interventions are run in a sporting context and incorporate both an educational component (with a large focus on healthy eating and physical activity) and an exercise component. This information will be used to support the refinement of the Hockey FIT program prior to conducting future studies.

Family Medicine Grand Rounds – Schulich School of Medicine and Dentistry, Western University – 2016
LARASA World Leisure Conference – 2016

Global healthcare spending has dramatically increased for the treatment of chronic diseases such as type 2 diabetes and cardiovascular disease (Deloitte, 2015). The prevention of such diseases can be improved with modified lifestyle behaviour, such as increased physical activity, which can also help to reduce the upward trend in obesity rates (worldobesity.org, 2012). In Canada, for example, more than half (58%) of annual healthcare spending is for the treatment of chronic diseases (Public Health Agency of Canada, 2011). In particular, males tend to suffer from poorer health when compared to females with 40% of Canadian men overweight and 27% classified as obese (Statistics Canada, 2014). Additionally, sports fans, who tend to be male, weigh more, eat higher fat foods, and have worse general health habits than their non-sports fan counterparts (Health.com, 2008). Previous research has shown that weight-loss programs that are based in a sporting context, where participants had a strong sense of affiliation, showed lower dropout rates and higher reported rates of satisfaction among participants than traditional weight-loss programs (Robertson, 2014).

In an attempt to utilize this knowledge, researchers in the UK developed Football Fans in Training (FFIT), a weight-loss and healthy living program developed specifically for male fans and delivered through their local Scottish professional football clubs. In Canada, hockey is a core leisure activity and cultural component with two-thirds of adults following the sport as fans, and 80% identifying hockey as a key part of what it means to be Canadian (Environics, 2012). Therefore, in collaboration with the researchers involved in FFIT, Hockey Fans in Training (HockeyFIT) was created, where 40 male fans from two Major Junior hockey organizations (N = 80) participated in 12 weekly physical activity, healthy eating and health promotion sessions led by trained instructors and hosted in local hockey club facilities. In addition to improving participants’ health, this program offered two hockey organizations the opportunity to demonstrate their corporate social responsibility (CSR) and commitment to the health of their community. The purpose of the current study was to examine the impact of this HockeyFIT health initiative through the lens of CSR. The research was guided using Inoue and Kent’s (2013) framework with objective health measurements and physical activity levels of fans measured at baseline, and follow-up assessments at 12-weeks and 12-months to determine the immediate and long-term impact of the program. Additionally, focus groups and interviews were conducted with key stakeholders to further explore the fans’ experiences. Quantitative and qualitative findings are currently under analysis and will be provided during the presentation.

Overall, we anticipate the results of this CSR health initiative will benefit a variety of constituents. Participants of this study will benefit on an individual level through improved lifestyle behavior and continuing to engage in some form of leisure activity, with a snowball effect to friends and family. Both hockey organizations involved will benefit from the various advantages associated with CSR. Finally, we intend to demonstrate that a CSR health initiative may ultimately have long-term positive impact on the various stakeholders.

9th Health & Rehabilitation Sciences Graduate Research Conference, Western University – 2016

Background: Although obesity in men has increased in recent years, men are less likely than women to enrol in weight management programs. There has been success in engaging men in evidence-based weight management programs through their interest in sports.

Hypotheses and Objectives: It is hypothesized that Hockey Fans in Training (Hockey FIT) will engage overweight male hockey fans and provide a program that introduces to them the knowledge, skills, support, and opportunity to eat healthier, become more active, and lose weight. The objective of the qualitative aspect of this study is to optimize the Hockey FIT program through process evaluation and program redevelopment. Feedback will be obtained from coaches and participants regarding the strengths and weaknesses of the program, areas for improvement, and whether or not personal goals and expectations were met.

Proposed Methods/Methods: The pilot trial involved 80 overweight or obese men (age 35-65, body-mass index (BMI) >28kg/m2) who were hockey fans of two different Ontario Hockey League clubs (London Knights and Sarnia Sting). The Hockey FIT program involved trained Hockey FIT coaches delivering 12 weekly 90-minute sessions, combining both classroom learning and physical activity. Following program completion, participants completed a questionnaire and focus groups were held. In addition, fidelity notes were taken during each session and coaches were interviewed following each session and at the completion of the 12 sessions.

Future Applications/Directions: Qualitative data from the pilot study will be analyzed and used for process evaluation in order to optimize the Hockey FIT program. A larger, randomized controlled trial will follow.

Men’s Health Day Breakfast Symposium, St. Joseph’s Health Care Foundation – 2016 

Dr. Petrella was an invited speaker at the annual Men’s Health Day Breakfast Symposium. This symposium was open to the public and focused on raising awareness about men’s health and well-being. In this presentation, Dr. Petrella outlined the current state of men’s health in Canada and the impact the Hockey Fans in Training pilot program had on improving men’s health.

Kinesiology Graduate Student Association Symposium, Western University – 2016 

In Canada, more than half (58%) of annual healthcare spending is for the treatment of chronic diseases (Public Health Agency of Canada, 2011). In particular, males tend to suffer from poorer health when compared to females with 40% of Canadian men overweight and 27% classified as obese (Statistics Canada, 2014). Additionally, sports fans often weigh more, eat higher fat foods, and have worse general health habits than their non-sports fan counterparts (Health.com, 2008). Therefore, Hockey Fans in Training (HockeyFIT) was created, where 40 male fans from two Major Junior hockey organizations (N = 80) participated in 12 weekly physical activity, healthy eating and health promotion sessions led by trained instructors and hosted in local hockey club facilities. In addition to improving participants’ health, this program offered two hockey organizations the opportunity to demonstrate their corporate social responsibility (CSR). The purpose of the current study was to examine the impact of this HockeyFIT health initiative through the lens of CSR. The research was guided using Inoue and Kent’s (2013) framework with objective health measurements and physical activity levels of fans measured at baseline, and follow-up assessments at 12-weeks and 12-months to determine the immediate and long-term impact of the program.

Faculty of Health Sciences Research Day, Western University – 2016 

Background: Obesity levels in Canada are higher in men than in women, and men’s obesity levels have increased by 6% since 2003. Despite these facts, men are less likely than women to enroll in weight management programs. Success has been shown engaging men in weight management programs that incorporate sport and competition. We have adapted a Scottish program named Football Fans in Training to our Canadian culture in developing Hockey Fans in Training (Hockey FIT).

Objectives: Hockey FIT will engage overweight male hockey fans and provide a program that introduces to them the knowledge, skills, support, and opportunity to eat healthier, become more active, and lose weight. Through qualitative analysis of our pilot trials we will conduct program optimization via process evaluation and program redevelopment. Finally, qualitative data will be used to analyze how men’s social support affects their changes in behaviour towards a healthier lifestyle.

Methods: Men who are fans of their local Ontario Hockey League clubs (London Knights or Sarnia Sting) and who met our criteria (age 35-65, body-mass index > 28 kg/m2) were recruited into the Hockey FIT program. 40 men in each club were randomly assigned to an intervention group or a waitlist comparison group. The Hockey FIT intervention program involved trained Hockey FIT coaches delivering 12 weekly 90-minute sessions, combining both classroom learning and physical activity. A 40-week maintenance period followed the 12-week intervention phase. Physical measurements were taken throughout, and qualitative data in the form of focus groups and interviews was collected after 12 weeks.

Future Directions: Interview and focus group transcripts will be coded to explore emerging themes that relate to social support that men received during the program. The program will be redeveloped and run with hockey clubs throughout the OHL.

European Association for Sport Management (EASM) Conference – 2016 

Participation in sport has been linked to a number of benefits including improvements in both physiological and psychological health (U.S. Department of Health and Human Services, 2010). Despite these benefits, the national sport participation rate of Canadians aged 15 years and older has been declining since 1992 (Canadian Heritage, 2013). In 2010, 26% of Canadians aged 15 years and older participated in sport, a decrease of 17% over the previous 18 years (Canadian Heritage, 2013). Moreover, lack of physical activity among Canadians is at an all-time high with the average adult depicting sedentary behaviour for over nine hours per day (Statistics Canada, 2013). These inactive lifestyles can have negative health implications, particularly for males who tend to suffer from poorer general health when compared to females (Statistics Canada, 2014). Specifically, males who are sports fans tend to weigh more, eat higher fat foods, and have worse general health habits than their non-sports fan counterparts (Health.com, 2008). Previous research has shown that other significant gender differences exist, such as motivation for engaging in sport whereby males are motivated by challenge, competition, social recognition, and strength and endurance (Kilpatrick, Hebert, & Bartholomew, 2005). Recent research has shown that weight-loss programs that are based in a sporting context, where participants had a strong sense of affiliation, resulted in lower dropout rates and higher rates of satisfaction among participants than traditional weight-loss programs (Stewart, Fraser, Robertson, Avenell, Archibald, Douglas, Hoddinott, Van Teijlingen, & Boyers, 2014). Through the use of self-determination theory (SDT) researchers can gain insights into what energizes people’s behaviour and moves them into action using human perceptions, cognitions, emotions, and needs as predictors of regulatory, behavioral, developmental, and experiential outcomes (Deci & Ryan, 2015).

In Canada, ice hockey remains a key component of the Canadian culture, with two-thirds of the adult population
following the sport, and one-quarter indicating that they love hockey and consider themselves to be “huge fans” (The Environics Institute, 2012). While many Canadians may enjoy following their national winter sport, only 4.4% of Canadians 15 years and older actually participate (CBC, 2013). Given the gender-specific motivational traits and the negative health implications due to inactivity particularly for males, the purpose of this study was to develop and implement an exercise program specifically for inactive males.

Hockey Fans in Training (Hockey FIT) was created as a gender-sensitized weight-loss and healthy living program
designed specifically for male ice hockey fans and delivered through their local Major Junior hockey organizations. Fans from two organizations (N = 80) volunteered to participate in 12 weekly physical activity, healthy eating, and health promotion sessions led by trained instructors and hosted in local hockey club facilities. Objective health measurements (i.e., participant’s weight-loss, waist circumference, body mass index, blood pressure, diet, and health-related quality of life) and physical activity levels of fans (i.e., step counts over 7 days and self-reported International Physical Activity Questionnaire) were measured at baseline, with follow-up assessments at 12-weeks and 12-months to evaluate program effectiveness. Additionally, the psychological benefits (i.e., self-esteem, positive/negative affect, self-reported quality of life) from participation in the program were examined. Finally, focus groups and interviews were conducted with the participants to further explore their motivation for joining the program and their satisfaction following its completion. SDT was used as the theoretical framework for the analysis.

Preliminary results suggest that through leveraging the participant’s emotions (i.e., their love for hockey and the use of competition), Hockey FIT was successful in increasing the participant’s physical activity levels and improving adherence to the changes following completion of the program. Qualitative data revealed that participant satisfaction was high because the program was delivered in a hockey environment and in a lighthearted manner, and was designed for ‘men like me’. The results also supported the gender-specific motivation findings of Kilpatrick, Hebert, and Bartholomew (2005).

Although many Canadian males enjoy following ice hockey, in general, they are quite sedentary and physically inactive. This present study found that exercise, which incorporates gender specific motivational attributes and is based in a hockey context, is successful in increasing sport participation rates of Canadian male hockey fans. By partnering with established sport organizations, this program can help combat a rise in sedentary rates and obesity levels within their local community and fan base. Future research could investigate whether the passion shared by fans of other sports is equally effective with similar satisfaction rates as the current study. Finally, the results from this study offer a promising opportunity for sport organizations to transform a passive spectator into an active sports participator.

References:
Deci, E., & Ryan, R. (2015). Self-Determination Theory. International Encyclopedia of the Social & Behavioral Sciences, 21(2), 486-491.

Health.com. (2008). Die-Hard Sports Fans Fatter, Less Healthy
Than Others. Retrieved from http://news.health.com/2008/12/23/sports-fans-not-as-healthy/

Kilpatrick, M., Hebert, E., & Bartholomew, J. (2005). College students’ motivation for physical activity: differentiating men’s and women’s motives for sport participation and exercise. Journal of American college health, 54(2), 87-94.

Stewart, F., Fraser, C., Robertson, C., Avenell, A., Archibald, D., Douglas, F., Hoddinott, P., Van Teijlingen, E., & Boyers, D. (2014). Are men difficult to find? Identifying male-specific studies in MEDLINE and Embase. Systematic reviews, 3(1), 1.

U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office, November 2000.

If you would like more information, please e-mail us at HFIT@uwo.ca.

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