# Process evaluation of the Hockey Fans in Training lifestyle intervention (for men with overweight or obesity)

## TL;DR

This study evaluated a lifestyle program called Hockey FIT that uses hockey fandom to help men with overweight or obesity adopt healthier habits.

## Contribution

The study introduces a novel approach to engaging middle-aged men in lifestyle change by leveraging their interest in hockey.

## Key findings

- Hockey FIT successfully engaged men in lifestyle change through group dynamics and shared interests.
- Program components like competition and user-friendly supports were key to behavioral change.
- Adaptations and feedback from participants and coaches helped refine the intervention.

## Abstract

Despite the proven relationship between lifestyle and morbidity and mortality, rates of chronic disease (e.g. obesity) continue to rise in paradox to the myriad of studies supporting lifestyle behaviour change. Men have been less likely to seek out preventative care or lifestyle programs, putting them at risk. In response, Hockey Fans In Training (Hockey FIT) was developed as a group-based, lifestyle intervention leveraging the draw of hockey fandom to engage middle-aged men with overweight or obesity in lifestyle change. Encouraging pilot study results informed the optimization and delivery of the intervention through a cluster randomized controlled trial in 42 sites in Canada and the USA.

A process evaluation was conducted to evaluate intervention acceptability and fidelity and adaptations. Community-based sites were randomly allocated to Hockey FIT intervention (immediate program start) or wait-list control (12-month delay). Qualitative process evaluation data were collected from intervention sites and included seven virtual participant focus groups and one interview (n = 35 participants), open-ended participant feedback questionnaires (n = 316), interviews with program coaches (n = 22), post-session coach reflections (n = 233), and interviews with implementation partners (n = 16). A process of content analysis by question was performed and data saturation was reached.

Themes fell into the following categories: (i) motivations for joining Hockey FIT; (ii) effective program components; and (iii) adaptations and suggested improvements.

The process evaluation detailed success engaging men in lifestyle change using sport fandom, and the importance of capitalizing further on competition within groups to drive behavioural change through user-friendly supports and greater engagement with hockey.

ClinicalTrials.gov. ID: NCT03636282

Group dynamics in pursuit of cohesiveness are a pivotal part in creating health behaviour change. Working within groups or communities with similar interests (such as hockey fans) could be a strong foundation for creating and maintaining behaviour change.