Background
Methods
Study aims
Aim 1: Adaptation and integration of FFIT and HealtheSteps™ to create Hockey FIT
Aim 2: Potential for Hockey FIT to positively impact health outcomes
Study design
Location
Sample size
Recruitment & participants
Screening
Randomization, allocation & blinding
Hockey FIT program
Classroom education component | Exercise component |
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Week 1: Introduction to Hockey FIT & Physical Activity Prescription | |
70 min: • Introductions, program overview, ground rules • Discuss eating habits, exercise and activity levels • Introduction to lifestyle prescriptions (Rx), goal-setting, and tracking • Set Physical Activity Rx | 20 min: • Group walk |
Week 2: Healthy Eating Overview & Healthy Eating Prescription | |
65 min: • Review healthy living goals and tracking forms • Set new Physical Activity Rx • Food groups & eating a healthy diet • Formal introduction to SMART goal setting • Set Healthy Eating Rx | 25 min: • Group walk |
Week 3: Meal Planning & Weight Loss | |
60 min: • Review healthy living goals • Set new Physical Activity Rx • Avoiding compensation/trade-off behaviour • Healthy eating planning • Health benefits of losing weight • Calculating 5–10 % weight loss • Importance of support from others | 30 min: • Introduction to principles of fitness (10 min) • Warm up exercises (8 min) • Flexibility exercises (2 min) • Walk (10 min) |
Week 4: Becoming Fit & Exercise Prescription | |
65 min: • Review healthy living goals • Set new Physical Activity Rx • Health benefits of exercise • Overcoming barriers to exercise • Heart rate and Rating of Perceived Exertion • Simple fitness test (STEP test) • Local amenities • Set Exercise Rx | 25 min: • Warm up (5 min) • Aerobic exercise (15 min) • Cool down (5 min) |
Week 5: Alcohol & Weight Gain | |
50 min: • Review healthy living goals • Set new Physical Activity Rx • Alcohol and weight gain • Alcohol units • Planning your drinking • Cutting down on sugary drinks | 40 min: • Warm up (5 min) • Aerobic exercise (30 min) • Cool down (5 min) |
Week 6: Stages of Change | |
45 min: • Review healthy living goals • Set new Physical Activity Rx • Stages of change • Setbacks and strategies for dealing with them • Shared experiences • Weight taken (to review progress at Week 7) | 45 min: • Warm up (5 min) • Strength/muscular endurance exercise (with principles of strength training using body weight) (35 min) • Cool down (5 min) |
Week 7: Weight Loss | |
45 min: • Review healthy living goals • Set new Physical Activity Rx • Understanding food labels and healthier foods • Hints for better eating including eating breakfast | 45 min: • Warm up (5 min) • Strength/muscular endurance exercise (15 min) • Aerobic exercise (15 min) • Cool down (5 min) • Flexibility exercises (5 min) |
Week 9: Eating Out | |
45 min: • Review healthy living goals • Set new Physical Activity Rx • Making favourite meals healthier • Eating out sensibly • Nutrition in common fast foods & suggestions for making takeout meals ‘less’ unhealthy | 45 min: • Warm up (5 min) • Strength/muscular endurance exercise (15 min) • Aerobic exercise (15 min) • Cool down (5 min) • Flexibility exercises (5 min) |
Week 10: Avoiding Setbacks & New Exercise Prescription | |
55 min: • Review healthy living goals • Set new Physical Activity Rx • Exploring myths about healthy living • Triggers for setbacks and how to avoid them • Re-do simple fitness test (Step Test) & set new Exercise Rx | 35 min: • Warm up (5 min) • Strength/muscular endurance exercise (10 min) • Aerobic exercise (10 min) • Cool down (5 min) • Flexibility exercises (5 min) |
Week 11: Energy Balance & New Healthy Eating Prescription | |
45 min: • Review healthy living goals • Set new Physical Activity Rx • Planning your eating • The energy balance • Locus of control revisited • Set new Healthy Eating Rx | 45 min: • Warm up (5 min) • Strength/muscular endurance exercise (25 min) • Cool down (5 min) • Flexibility exercises (10 min) |
Week 12: Celebrating Achievements & Next Steps | |
60 min: • Celebrating achievement! • Review healthy living goals & set new Rx if necessary (Physical Activity, Healthy Eating & Exercise) • Next steps – includes introduction to suite of eHealth technology support options • Program feedback • Wrap-up | 30 min: • Warm up (5 min) • Strength/muscular endurance exercise (20 min) • Cool down (5 min) |
Outcome evaluation
Outcome | Equipment or instrument | Description |
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Objectively Measured Clinical Characteristics | ||
Weight (kg and % of baseline weight) | Digital weight scale (Tanita HD-351) | • Light clothing, no shoes and empty pockets • Blinded assessor post-baseline in private area |
Body mass index (kg/m2) | Digital weight scale (Tanita HD‐351) Portable stadiometer (seca 213) | • BMI calculated using the participant’s objectively measured height and weight • Height measured without shoes |
Waist circumference (cm) | Tape measure | • Follows protocol outlined by the Heart and Stroke Foundation of Canada • Two measurements taken to record an average; if measurements differ by more than 5 mm, a third measurement is taken and used in the average |
Resting systolic blood pressure (BP) (mmHg) | Digital BP monitor (BP Tru BPM-100) | • Participants sit quietly for 5 min prior to the first measurement; 3 measurements will be taken, 2 min apart. The first one is discarded, and the average of the last two is recorded • Feet flat on the floor, arm free of clothing, cuff at the level of heart and arm resting, same arm used (left arm preferred), no talking |
Resting diastolic BP (mmHg) | ||
Self-Reported Physical Activity | ||
Average steps/day | Pedometer (Yamax Digiwalker SW-200 with security strap) | • Participants wear pedometers during waking hours for a 7-day period (putting pedometer on upon waking and removing immediately before sleeping), but not during showering/ bathing • Participants are asked to wear the pedometer at the waist, centered over their most dominant foot • Participants record the number of steps completed each day on a paper-based tracking form |
Total physical activity (MET-min/weeka) | International Physical Activity Questionnaire (IPAQ) – Short Form | • Self-completed paper‐based questionnaire • Participants recall information on vigorous activities, moderate activities, walking, and sitting • Sedentary time is measured with a single question (minutes spent sitting on a typical week day) • The IPAQ provides guidelines for data processing and score creation |
Time spent in sedentary activity (min/day) | ||
Self-Reported Eating and Alcohol | ||
Total healthful eating score | Starting the Conversation (STC) | • Self-completed paper-based questionnaire • Designed for dietary assessment and intervention in a clinical setting • Participants recall eating habits over the past few months (on average) on 8 different items • A total healthful eating score (possible range 0–16) is calculated, whereby a lower score indicates a more healthful diet |
Fatty food score | Modified version of the Dietary Instrument for Nutrition Education (DINE) | • Self-completed paper-based questionnaire • Participants recall eating habits over the last 7 days • Fruit and vegetable consumption is measured with a single question • Methods published by FFIT will be followed to calculate a fatty food score (possible range 8–68) and sugary food score (possible range 3–16), with higher scores indicative of higher consumption |
Sugary food score | ||
Sugary food score | ||
Total alcohol Consumption (units/week) | 7-day recall diary | • Self-completed paper-based diary • Participants recall alcohol consumption (beer, cider/cooler, wine, distilled alcohol, and other) over the last 7 days • Total alcohol consumption is calculated by summing the number of drinks across the categories for each day and then summing the total number of drinks/day |
Psychological and Health-Related Quality of Life | ||
Self-esteem score | Rosenberg Self Esteem Scale (RSES) | • Self-completed paper-based questionnaire • Consists of 10 items assessing global self- esteem; 5 items have positively worded statements and 5 are negatively worded • Participants are asked to reflect on their current feelings (i.e., the extent to which they agree or disagree with each statement) • A summary score (possible range 0‐30) is calculated to provide a measure of self-esteem, where higher scores indicate higher self- esteem |
Positive Affect Score | International Positive and Negative Affect Schedule Short Form (I‐PANAS‐SF) | • Self-completed paper-based questionnaire • Consists of 10 words that describe different feelings or emotions (half positive, half negative) • Participants rate how they normally feel, from 1 = never to 5 = always • Positive and negative affect sub‐scale scores are calculated (both range 5‐25), where higher scores indicate higher levels of positive affect, and negative affect, respectively |
Negative Affect Score | ||
Self-Rated Health [visual analog scale (VAS) score] | European Quality of Life 5 Dimensions Questionnaire - 3 Level Version (EQ‐5D- 3 L) | • Self-completed paper-based questionnaire • For purposes of this study, the VAS score will be used to assess current state of health on a scale from 0 (worst imaginable state of health) to 100 (best imaginable state of health) |
Participant appreciation
Time point | Description |
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During program sessions | • GoodLife Fitness water bottles • GoodLife Fitness duffle bags • Hockey team t-shirt or track jacket |
Attendance raffle | • Signed hockey jerseys • Signed hockey sticks • Cookbook • Water bottles • Gift cards • Baseball caps • Cereal • Umbrella |
9-month reunion & booster session | • Hockey FIT t-shirts • Hockey FIT pucks • Gift bags from sponsor (Bank of Montreal) • Healthy lunch • Hockey game ticket (London Knights vs. Sarnia Sting) |
12-month measurement session (Intervention Group) | • $20 gift cards to a local sports store |
Statistical analysis for outcome evaluation
Aims 3–5: Feasibility of recruiting and retaining overweight or obese men, acceptability of Hockey FIT program and research procedures, and Hockey FIT program optimization
Process evaluation data sources
Process evaluation & program optimization
Process measures | Data sources |
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Program Reach | Participant Self-Reports at Screening and Information from Baseline Sessions 12-Month Participant Program Questionnaire 12-Month Participant Interview |
Reasons Participants Stayed With/Opted Out of the Program | 12-Week Participant Focus Groups Weekly Attendance Records 12-Week Non-Completer Telephone Interviews 12-Month Participant Program Questionnaire 12 month Participant Interview |
Extent to which Coaches Delivered Hockey FIT as Designed | Fidelity (Program Observations and Post Session Coach Reflections) Weekly Attendance Records 12-Week Coaches Interviews |
Participants’ Experience of Taking Part in Hockey FIT | 12-Week Participant Focus Groups 12-Week Participant Program Questionnaire 12-Month Participant Program Questionnaire 12-Month Participant Interview |
Coaches’ Experience of Delivering Hockey FIT | 12-Week Coaches Interviews Fidelity (Program Observations and Post Session Coach Reflections) |
Participants’ Experience Maintaining Lifestyle Changes | 12-Month Participant Program Questionnaire 12-Month Participant Interview |