UC San Diego

BACKGROUND: 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. METHODS: 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. RESULTS: Themes fell into the following categories: (i) motivations for joining Hockey FIT; (ii) effective program components; and (iii) adaptations and suggested improvements. CONCLUSIONS: 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. CLINICAL TRIAL INFORMATION: ClinicalTrials.gov. ID: NCT03636282.