One of the largest ever academic studies of men's health in England has found that Premier League football clubs have a powerful effect in changing the health of men, especially those regarded as hard-to-reach and whose lifestyle choices are leading to a substantial burden on NHS services.
A unique £1.63m three year programme, Premier League Health was the first national men's health promotion initiative delivered by Premier League football clubs. The joint report by the Centre for Men's Health and Centre for Active Lifestyles at Leeds Metropolitan University explored the power of professional football clubs to influence the health of men and found that three quarters of men made positive health changes.
This included: 25% reducing harmful lifestyle risk factors, over 40% improving their level of physical activity, a third moving to a healthier weight category and 30% reducing harmful levels of alcohol consumption through participating in Premier League Health.
The study noted how top level football can encourage positive lifestyle changes in working age men and can deliver effective health promotion campaigns.
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Simon Morgan, Head of Community Development at the Premier League, said: "The Premier League is the most watched and supported football league in the world and it plays an important role in embracing the local communities which are at the heart of our clubs. It's about delivering social intervention programmes that make a positive difference to those people, and Premier League Health has done that with 10,000 men.
"The research by Leeds Metropolitan University has shown that Premier League clubs can engage with men to improve their lifestyles and that local NHS and public bodies should commission football clubs to deliver health services. Through the power of the badge and the quality of initiatives put on by the clubs there are long term benefits for men's health in this country."
Professor Alan White of Leeds Metropolitan University, who conducted the research over the three years, commented: "Our findings suggest that a group of men who are traditionally seen as difficult to reach in health promoting activities will engage if it is done in a way that they can relate to, like football. The men really valued the opportunity to take part in activities that were not only fun but could also make them fitter and healthier. When we came to do the 12 week follow-up we were surprised at how many men had reduced their risk factors. This suggests that it is worth taking a more imaginative approach to public health."
Previous research by Professor White has found that harmful lifestyle behaviours and poor socio-economic circumstances contribute to European men of working age having a 64% higher death rate than women. However, efforts to influence men's ill-health are challenging and activities delivered through traditional channels often have limited effectiveness. It was this opportunity that Premier League Health explored.
Premier League Health began in the summer of 2009 when clubs submitted proposals to run men's health interventions that met local needs identified in conjunction with partner agencies. Sixteen clubs were awarded funding to run programmes delivered by health trainers, managers and health professionals who received education and training in behavioural change techniques and men's health promotion.
Premier League Health was adopted by men demonstrating multiple problematic lifestyle behaviours, however many of these participants did not view themselves as having poor health: over a third of participants never consulted their GP and over half never used health advice and information services such as NHS Direct.
The study found that Premier League Health has been effective in increasing a number of health-enhancing behaviours in men who completed the intervention. Those men who completed the research follow-up demonstrated an impressive array of statistically significant positive changes in health-enhancing behaviours. For the full pre and post intervention results see 'Note 1'.
The study identified a number of reasons for this:
· Combining the appeal of professional football clubs with the opportunity to develop health in a 'male friendly' way represented a unique opportunity for reaching men.
· Football-based awareness raising events and outreach activities were especially important for reaching men who were ambivalent towards orthodox health promotion activities.
· The informal approach of Premier League Health staff and familiar settings, such as club stadia, were essential for safeguarding regular involvement in physical activity and lifestyle sessions. These surroundings were seen as having substantial advantages over conventional NHS locations.
· The interventions incorporated socially supportive environments that facilitated a sense of belonging and a fun and enjoyable atmosphere. For many men, this experience supported maintaining newly acquired healthier behaviours.
Central to Premier League Health was engagement with public bodies. Clubs communicated key health messages to a wide audience via one-off events and regular sessions to raise awareness and signpost people to local services.
Premier League Health represented a major opportunity to understanding both the effects of football-based interventions and the most important active design characteristics for engaging, and keeping men involved in wider public health promotion interventions.
For Commissioning Agencies the study recommended that they commission men's health interventions delivered in and by professional football clubs: "These can be effective at reaching and facilitating the adoption of working age men, including those regarded as being hard to connect with conventional health promotion approaches. Once engaged, interventions can be effective at facilitating improvements in health-enhancing behaviours."
For Delivery and Evaluation Agencies the study recommended that they "develop men's health promotion interventions in partnership with a range of other organisations from higher education, health, physical activity and sports sectors who can provide resources, advice, knowledge and sustainable entry and exit routes for participants as well as evaluation expertise."
The study recognised hailed the impact that Premier League Health has had in identifying innovative new practices in male health provision: "Sustained, these changes can help moderate the substantial inequalities in mortality and morbidity rates that blight the futures of many such men. Moreover, these findings fill many of the gaps in the evidence about how these effects can be achieved." The study has outlined the key lessons for practitioners on how to assess needs, plan, implement and evaluate gender-specific health interventions implemented in and by football clubs.