Fit Fans: Football Health and Older Men

Fit Fans:
Understanding the Effectiveness of an
Intervention to Promote Positive
Behaviour Change in Older Men

Daniel Parnell, University of Derby
Daniel Bingham, Liverpool John Moores University; Roger Jones, Age
UK & Dave Richardson, 12 January 2011 John Moores University
Evaluation of Extra Time | Wednesday
Liverpool

The plan for today

• Background of Football in the Community
• Setting the Scene: The Partnership
• Overview of Methods
• The Project
• Reflections
• Ways Forward

Evaluation of Extra Time | Wednesday 12Congress2011
Fit Fans | Friday 17th August 2012, World January on Active Ageing

Historical Development

• Football in Community programmes started in 1986 to build
greater links between clubs and communities
(Brown, Crabbe and Mellor, 2006).
• Initially focused on traditional football coaching with young
children
(Mellor, 2008)
• However, FitC schemes are beginning to tackle major social
agendas (i.e., social inclusion, obesity, mental health)
(Watson, 2000; Parnell, 2013)


Why have community programmes been
linked to Professional Football Clubs?
• Sport has often been heralded as a way to create social change.

• Sport and specifically Football, can be utilised to help reach the
most ‘at risk’ people/children through community interventions,
tackling issues including health, social inclusion, and social
regeneration. (DOH, 2004).


The Power of Football as a Vehicle for Social
Change
‘Football for Health’ (FIFA, 2008) stated that not only can playing
football help tackle obesity, diabetes and hypertension it states:

‘And why not tap the full potential of this unique tool to spread
simple but effective messages on how to protect oneself from the
most devastating infectious diseases such as HIV, tuberculosis
and malaria? Because these 'big three' are responsible for about
three million deaths in Africa every year, the FIFA World Cup 2010
South Africa will be an invaluable opportunity to reach those most
heavily threatened by them’.


The Power of Football as a Vehicle for Social
Change

• 20 Premier League FitC schemes
(often independent organisations i.e., charities)

Premier League Health is a £1.63 million project funded
by the New Football Pools aimed specifically at men.

http://www.premierleague.com/page/CommunityPL

•84m invested in community projects
•2,431 community projects funded
•316 educational projects funded
(2011)

http://www.footballfoundation.org.uk/

Fit Fans | Friday 17th August 2012, World Congress on Active Ageing

Culture of Liverpool:

What images do you visualise
when you think about the city of
Liverpool?


Everton F.C

Health related issues Liverpool houses some
tend to be most of the most deprived
people and areas in
prevalent in areas England
(typically) described
‘deprived’

Evaluation of Extra Time | Wednesday 12 January 2011

Everton FC & Community Engagement

Vision:
“To motivate, educate
and inspire by
harnessing the power
of football and sport to
change lives within our
community”

Most deprived local authority in England 2004-2007 (LCC, 2007).


Everton Active Family Centre (EAFC)

In 2008, the joint venture between Everton in the Community and
Liverpool John Moores University, School of Sport and Exercise
Sciences, saw the development of the Everton Active Family Centre
(EAFC) which is a unique fitness facility based within the grounds of
Goodison Park.

Evaluation of Extra Time | Wednesday 12 January 2011

The birth of Fit Fans

Fit as a Fiddle (FaaF) is part of Age UK and funded by the Big
Lottery.

Their work has been presented by Roger Jones during the
conference, who leads the strand for older men.

At the time we had work in place for men 18-34, but no provision for
older men – we wanted to change this!

Therefore work began with FaaF, Age UK and local Age Concerns to
help develop Fit Fans.


Overview of methods

• 7 men aged 45>

• 1 hr weekly sessions

• Betwen Oct 2011 – May
2012 (8 months)

• Personalised programme

• Physiological
measurement’s included
(BMI, RBP & AG)


Results: how did ‘we pick the men up’?

EAFC Seminar:
• Engagement with all local stakeholders
• Grassroots and strategic
• Platform to disseminate, share (and
plenty of food!)

• Referrals through NHS &
word of mouth


Results

Unexpectedly the cohort
exhibited a range of serious
diagnosed illnesses that
challenged the
practitioner’s skill base and
experience in delivery on
the health agenda.


Results: health demographics

Robert, 63 Mick, 56
•Physical Disability/chronic pain (spinal •Depression (M); Anxiety (M); Obesity
injury); Obesity; Hypertension (M); High
Cholesterol (M); Osteoarthritis Lee, 47
•Depression (M); Anxiety (M); Addiction (Alcohol
Ant, 62 and Substance)
•Obesity; Gout; Hypertension (M); High
Cholesterol (M); Osteoarthritis Ryan, 62
•Bowl Cancer (within 12 month remission)
Nigel, 64
•Diabetes Mellitus (Type II) ; Obesity; Ben, 59
Hypertension (M); Osteoarthritis •Post-polio syndrome (M)

Mick, 56
•Depression (M); Anxiety (M); Obesity


Results: physiological measures

• The results show no significant changes within the physiological
measures; however results evidence positive BMI changes in 3 men and
weight management across the cohort.


Results: goal setting

• The men did make a range of
more subtle bespoke goals that
impacted their day-to-day
existence significantly

For example:
- ability to walk short distances,
- reduction in alcohol intake

...which made them ‘feel better’.


Results: the role of the practitioner

• Men stated that the practitioners played a critical role n their continued
participation in the programme

“You always hear that runners get a high or something, but I just always
felt knackered lad. You know what I mean? But what I will say is, having a
bit of banter with Dan, and having him keep banging on about getting out
there and doing a little bit extra...well really he is right. I look back and I
felt knackered walking around, but now no problem, easy!” (Nigel)

“Coming here once a week and me starting to go the gym in my own time,
has really improved my confidence, I was putting weight on, but advice
given has really made me believe I can get rid of this weight and get back
into work.” (Mick)



I haven’t lost weight Dan (practitioner) but I tell you what I feel on top
of the world! After sweating it out on that treadmill. I mean...I get down
(emotionally) a fair bit especially living by myself, not working (i.e., not
in employment) no more and our kid (brother) being ill and living in
that care home. And just coming here talking to you about all this
health and fitness stuff - you just feel fitter and better just talking
about it (Nigel)


Results: the practitioners reflections
“As a health and exercise practitioner (with a degree in Sport and Exercise Science) I
was aiming to get these fellas, off the couch and out there. Walking more, going to the
gym, cycling, swimming all those types of activities. I believed that age was only a
number and when you are retired and have plenty of time to keep healthy and active.
There is no reason why you can’t reach 30 minutes of moderate exercise, or even an hour
!?

“The men looked at me in shock when I suggested that they jogged on the treadmill, or even
asking them to aim for the goal of walking 30 minutes every day “...what walk 30 minutes it
ain’t happening lad - simple”.

I asked Robert if could try and do an extra two reps on the chest press (he had only done 4).
He replied clearly without the slightest hesitation “I will do what I can do lad, have you forgot
I am not 21 like yourself”. I replied “well how about aiming higher it’s my job to try and
increase intensity in order to achieve your health goals, and its only two reps.”

Robert replied “Well two reps f*#king hurt lad.”



A caring, informed, multi-skilled practitioner (i.e., data collection,
health, exercise, psychology, counselling skill & knowledge of
special populations and behaviour change) was essential in:

•Maintaining engagement

•Providing a service in the heart of an area of multiple deprivation

•Deploying evidence based practice

•Collating evidence of impact


Results: the football clubs role

“You give me a choice of going to some boring shitty community
health club with people hogging the equipment, or coming here
having a gym at Goodinson Park to myself, with free health support
aint real, me mates laugh at me when I tell them”. (Nigel).

“Its local, its round the corner, and its Everton, it’s a top club so to
have stuff like this is surprising.” (Ryan).

“I still get excited coming here every week, coming to Everton to get
fit is as near to a kids dream of coming to Goodison to play football.
It’s just the best” (Mick).


Results: the football clubs role

All participants reported the FC playing a role in making the prospect of
engaging in behaviour change and exercise ‘more appealing’ than
mainstream National Health
Service support.

In essence coming to the football
club to train had a greater
‘pull’ than anything else available.


Discussion points

• Practitioners have to be accustomed of subjective subtle goal
setting that is appropriate to each individual and their daily life;
and not engaging in the typical nature of just following national
guidance.
• Whilst also be able to effectively deal with the complex needs of
older men (i.e., a range of serious illness's).
• The involvement of the FC appeared to contribute favourably to
maintenance in the intervention.


Thoughts moving forward

The notion of a caring practitioner is noted by Hillsdon (1998)… the
knowledge base of the practitioners was central in gaining trust
and co-operation. Furthermore, Bogdan-Lovis et al. (2006), noted
that co-operation and trust enhanced adherence and sustained life
changes.

The empathic nature of the practitioners and their ability to take on
the client’s personal challenges be they physical, emotional or
social in a fun, enjoyable, non-threatening and safe environment is
an essential component of their success…

(placement student’s consultancy report conclusion)


Engagement is more productive than
preaching…


Extended thank to all of the “Gents” that took part in the
program and also to all of the volunteers during the
intervention for their input, dedication and passion.

The authors would also like to acknowledge and
dedicate this work to Ray (“Ryan”) who sadly passed
away in the spring of 2012 to a reoccurrence of Cancer.
Such a brilliant and wonderful person and a joy to work
with and get to know.


0. Thank you for listening.
Dan Parnell
School of Science
University of Derby
t: 07538500348
e: d.parnell@derby.ac.uk
w: www.derby.ac.uk

twitter: @parnell_daniel
blog: TheCommunityFootballBlog

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