Assessing the impact of football-based health improvement programmes: stay onside, avoid own goals and score with the evaluation!

Health improvement is an important strand of the Premier League’s ‘Creating Chances’ strategy. Through community programmes, professional football clubs offer health-enhancing interventions for a number of different priority groups at risk from a range of lifestyle-related health conditions. However, while national guidance recommends evaluating health improvement interventions, concerns remain about how to do this most effectively. This study aims to investigate the popularity of football-based health improvement schemes and assess the challenges associated with their evaluation. Adapted from existing methodologies, a semi-structured questionnaire was administered to an ‘expert’ sample (n = 3) of football-led health evaluators. The sample was selected because of their experience and knowledge of performing evaluations of football-led health improvement programmes. Our ‘experts’ offered reasons for the popularity of football settings as channels for health improvement (including the reach of the club badge and the popularity of football), the justification for evaluating such schemes (including confirming effectiveness and efficiency) and the challenges of implementing evaluations (capacity, commitment and capability). Finally, a selection of key considerations for the evaluation of the impact of football-led health improvement programmes (obtaining expert guidance, building capacity and planning for evaluations) are discussed.

[1]  Susan Michie,et al.  Developing and Evaluating Complex Interventions , 2015 .

[2]  R. Califf,et al.  Evaluating the Impact of Public Health Notification: Duke Clopidogrel Experience , 2012, Circulation. Cardiovascular quality and outcomes.

[3]  Cindy M. Gray,et al.  "You've got to walk before you run": positive evaluations of a walking program as part of a gender-sensitized, weight-management program delivered to men through professional football clubs. , 2013, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[4]  Cindy M. Gray,et al.  Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits , 2013, BMC Public Health.

[5]  J. McKenna,et al.  Health improvement and professional football: players on the same side? , 2013 .

[6]  S. Wyke,et al.  Can the draw of professional football clubs help promote weight loss in overweight and obese men? A feasibility study of the Football Fans in Training programme delivered through the Scottish Premier League , 2011, Journal of Epidemiology & Community Health.

[7]  D. Chenoweth.  THE ECONOMIC COSTS OF PHYSICAL INACTIVITY, OBESITY, AND OVERWEIGHT IN CALIFORNIA ADULTS: Health Care, Workers' Compensation, and Lost Productivity , 2005 .

[8]  J. McKenna,et al.  The pre-adoption demographic and health profiles of men participating in a programme of men's health delivered in English Premier League football clubs. , 2011, Public health.

[9]  A. Yancey,et al.  Dissemination of physical activity promotion interventions in underserved populations. , 2006, American journal of preventive medicine.

[10]  P. Sayers,et al.  It’s a Goal!: basing a community psychiatric nursing service in a local football stadium , 2004, The journal of the Royal Society for the Promotion of Health.

[11]  I Hutton,et al.  Kicking the habit. , 1985, Nursing mirror.

[12]  J. McKenna,et al.  Optimizing lifestyles for men regarded as 'hard-to-reach' through top-flight football/soccer clubs. , 2013, Health education research.

[13]  M. Moseley.  The beautiful game , 1999, The Lancet.

[14]  Charlie Foster,et al.  Perceived barriers to walking in the neighbourhood environment and change in physical activity levels over 12 months , 2007, British Journal of Sports Medicine.

[15]  Richard Kahn,et al.  The Impact of Prevention on Reducing the Burden of Cardiovascular Disease , 2008, Diabetes Care.

[16]  N. Black.  Can England's NHS survive? , 2013, The New England journal of medicine.

[17]  J. McKenna,et al.  Health improvement for men and hard-to-engage-men delivered in English Premier League football clubs. , 2014, Health education research.

[18]  K. Marsh,et al.  Cost-effectiveness of interventions to improve moderate physical activity: A study in nine UK sites , 2010 .

[19]  J. South,et al.  Perceptions of research and evaluation in health promotion practice and influences on activity. , 2000, Health education research.

[20]  R. Callister,et al.  12‐Month Outcomes and Process Evaluation of the SHED‐IT RCT: An Internet‐Based Weight Loss Program Targeting Men , 2011, Obesity.

[21]  W. Gesler,et al.  Approaches to sampling and case selection in qualitative research: examples in the geography of health. , 2000, Social science & medicine.

[22]  J McKenna,et al.  Effect of a national programme of men's health delivered in English Premier League football clubs. , 2013, Public health.

[23]  Peter Scarborough,et al.  The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006-07 NHS costs. , 2011, Journal of public health.

[24]  Chih-Ping Chou,et al.  Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial , 2011, Journal of Epidemiology & Community Health.

[25]  Daniel Parnell,et al.  Football in the community schemes: exploring the effectiveness of an intervention in promoting healthful behaviour change , 2013 .

[26]  A. Sheikh,et al.  Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2 , 2008, BMJ : British Medical Journal.

[27]  Robert Luben,et al.  Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study , 2008, PLoS medicine.

[28]  Vj. Janesick.  The choreography of qualitative research design , 2000 .

[29]  Cindy M. Gray,et al.  A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial , 2014, The Lancet.

[30]  N. Cavill,et al.  Standard Evaluation Framework for Physical Activity Interventions , 2012 .

[31]  J. McKenna,et al.  Delivering men's health interventions in English Premier League football clubs: key design characteristics. , 2013, Public health.

[32]  Ian R White,et al.  Comparison of imputation and modelling methods in the analysis of a physical activity trial with missing outcomes. , 2004, International journal of epidemiology.

[33]  J. Faugier,et al.  Sampling hard to reach populations. , 1997, Journal of advanced nursing.

[34]  S. Gortmaker,et al.  Health and economic burden of the projected obesity trends in the USA and the UK , 2011, The Lancet.

[35]  D. Murdoch,et al.  Sustained benefits of a health project for middle-aged football supporters, at Glasgow Celtic and Glasgow Rangers Football Clubs. , 2010, European heart journal.

[36]  L. Stratton G. Dugdill.  Evaluating Sport and Physical Activity Interventions: A guide for practitioners , 2007 .

[37]  H. Alexander,et al.  Using outreach to involve the hard-to-reach in a health check: what difference does it make? , 2012, Public health.

[38]  R. Glasgow,et al.  Evaluating the public health impact of health promotion interventions: the RE-AIM framework. , 1999, American journal of public health.

[39]  A. White,et al.  ‘It is fun, fitness and football really’: a process evaluation of a football-based health intervention for men , 2013 .

[40]  J. McKenna,et al.  An even more beautiful game. , 2013, Public health.

[41]  K. Fox,et al.  Why some do but most don't. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study , 2011, BMC public health.