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Settings-based approaches: sports clubs

Last updated 03-04-2025

Settings-based interventions are an attractive setting to support delivery of health interventions and create supportive environment that promote the reduction of health risks. Over 17 million Australians aged 15 years and over engage in non-elite community sports undertaken in sporting organisations and clubs and many more watch professional sporting codes on television or in clubs. As such this is an important setting to deliver interventions to improve population diets and physical activity. The existing research in this setting however has largely targeted men.

A systematic review of randomised controlled trials on adult health promotion initiatives delivered in professional sports settings identified five unique interventions, all targeting men. These interventions resulted in a significant reduction in weight and waist circumference. Additionally, a realist review examining the impact of interventions delivered via sports clubs for men reported positive significant outcomes on a range of outcomes, including weight, diet, physical activity1 and clinical indicators. The review also highlighted that key factors in engaging men included recruiting them through familiar settings (such as sporting clubs), tailoring messaging, redefining certain aspects of health promotion (to avoid perceptions of being ‘feminine’), and incorporating elements like monitoring, competition, and coach involvement.

Football fans in training

A weight loss and management program targeted at men and delivered through professional football (soccer) clubs in Scotland resulted in sustained weight loss at 3.5 years and significant improvements in clinical, behavioural and psychological outcomes.2 As part of the ‘Football Fans in Training’ program, men aged 35 to 65 years were invited to join a 12-week weight management program delivered free of charge by community coaching staff at professional football clubs. Weekly sessions combined advice on healthy eating and behaviour change tips with a group physical activity session. The 12-week active phase was followed by a weight maintenance phase over the next nine months, including six email prompts from coaches and an invitation to a group reunion. Gender-sensitive features of the program included the football club setting, use of football insignia on program materials and style of delivery focused on participative and peer-supported learning.

A randomised controlled trial found the program to be effective at 12 months, with a mean difference in weight loss of 4.94 kilograms in favour of the intervention group. The intervention group also showed significant improvements in other outcomes including clinical (blood pressure and waist circumference), behavioural (physical activity, diet, alcohol) and psychological (self-esteem) outcomes.3 Follow-up research showed that at 3.5 years, men who had received the intervention sustained a mean weight loss of 2.9 kilograms from baseline and maintained improvements in clinical, behavioural and psychological outcomes.2 Considering the health benefits gained, the program was found to be highly cost-effective, both over 3.5 years and participants’ lifetime.

The success of the model has led to the expansion of the program, which as of 2018 had been delivered to 4500 men in 33 professional football clubs in Scotland2 and picked up by football clubs in England, the Netherlands, Norway and Portugal.4 In Germany, short-term results show that men in the intervention group lost an average 6.24 kilograms compared to men in the control group losing an average 0.5 kilograms after 12 weeks.5 The program has expanded to other sports, such as the Australian Football League (through the Fremantle Dockers and West Coast Eagles football clubs), rugby in New Zealand and ice hockey in Canada.6 A Scottish study has shown that the program demonstrated potential as a weight loss intervention for women.7 Another randomised controlled trial of the program (EuroFIT) was delivered in the United Kingdom, the Netherlands, Norway and Portugal found the program improved diet, weight and wellbeing in men.8

Changes in food service retail outlets in sport and recreation settings

There has also been some research targeting the provision of food in community sporting clubs via their food service retail outlets. In Australia, a multi-component intervention delivered over 2.5 winter seasons at community football clubs in New South Wales improved the availability and promotion of fruit and vegetables and non-sugar-sweetened drinks at canteens subject to the intervention, compared to a control group.9 Research staff supported the clubs to implement various strategies as part of the intervention, including improved availability and promotion of healthier options, education for club members on the benefits of healthy eating, and harnessing support for the changes by club coaches and committee members. There was no evidence of reduced club income resulting from the introduction of healthy options. This has also been trialled in junior leagues however the evidence of effectiveness has been mixed.10

A review examining the use of ‘choice architecture’ in these settings11 identified four cross cutting principles to support healthier food choices including: availability, pricing and placement favouring healthy options, promotional messages and sporting clubs’ commitment to supportive healthy eating and healthier food environments.

In Victoria, the Healthy Choice in Sport and Recreation is a framework for improving availability and promotion of healthier food and drinks in community settings.

A number of Victoria based studies have been undertaken. An initiative by YMCA Victoria to remove all sugar-sweetened beverages (SSBs) and increase healthier drink availability over a year at 16 aquatic and recreation centres reduced sales of the unhealthiest ‘red’ (limit intake) drinks.12 The initiative involved the complete removal of some types of ‘red’ SSBs (e.g. non-diet carbonated beverages) and reduced the availability of others (e.g. sports drinks), together with complementary strategies such as promotional posters and placing the healthier drinks at eye level. The initiative led to a substantial decrease in sales of ‘red’ drinks, while sales of the healthiest ‘green’ drinks did not change and sales of all drinks decreased.

Content for this page was updated by Melanie Lum, Research Fellow and Serene Yoong, Associate Professor at the Global Centre for Preventive Health and Nutrition at Deakin University. For more information about the approach to content on the site please see About | Obesity Evidence Hub.

References

1. Timm A, van Hoye A, Sharp P, Helms Andersen T, Hansen L, Nautrup Østergaard J, Krustrup P, Cortsen K, Iversen PB, Rod MH, Demant Klinker C. Promoting men's health through sports clubs: A systematic rapid realist review. J Sport Health Sci. 2024 Aug 30;14:100969. doi: 10.1016/j.jshs.2024.100969. Epub ahead of print. PMID: 39209022.
2. Gray CM, Wyke S, et al. (2018). Long-term weight loss trajectories following participation in a randomised controlled trial of a weight management programme for men delivered through professional football clubs: a longitudinal cohort study and economic evaluation. The International Journal of Behavioral Nutrition and Physical Activity 15(1): 60-60.
3. Hunt K, Wyke S, et al. (2014). A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet (London, England) 383(9924): 1211-21.
4. Wyke S, Bunn C, Andersen E, Silva MN, Van Nassau F, McSkimming P, Kolovos S, Gill JM, Gray CM, Hunt K. The effect of a programme to improve men’s sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial. PLoS Med. 2019;16(2):e1002736. doi: 10.1371/journal.pmed.1002736
5. Pietsch B, Weisser B, et al. (2019). Short term effects of a weight loss and healthy lifestyle programme for overweight and obese men delivered by German football clubs. European Journal of Sport Science: 1-10.
6. Curtin University (2018). Media release - Footy fans the new recruits in WA-first project to tackle obesity. Available from: https://news.curtin.edu.au/
7. Bunn C, Donnachie C, et al. (2018). Can professional football clubs deliver a weight management programme for women: a feasibility study. BMC Public Health 18(1): 1330.
8. Bunn C, Palmer V, Chng NR, Andersen E, Gray CM, Hunt K, Jelsma JGM, Morgan H, der Sanden MN, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Silva MN, Sørensen M, Teixeira PJ, van Achterberg T, van de Glind I, van Mechelen W, van Nassau F, van der Ploeg HP, Wyke S. How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial. BMC Public Health. 2023 Mar 20;23(1):526. doi: 10.1186/s12889-023-15419-y. PMID: 36941552; PMCID: PMC10026416.
9. Wolfenden L, Kingsland M, et al. (2015). Improving availability, promotion and purchase of fruit and vegetable and non sugar-sweetened drink products at community sporting clubs: a randomised trial. International Journal of Behavioral Nutrition and Physical Activity 12(1): 35.
10. Clinton-McHarg T, Gonzalez S, Milner S, Sherker S, Kingsland M, Lecathelinais C, Hall A, Doran C, Wiggers J, Wolfenden L. Implementing health policies in Australian junior sports clubs: an RCT. BMC Public Health. 2019 May 14;19(1):556. doi: 10.1186/s12889-019-6873-3. PMID: 31088417; PMCID: PMC6515613.
11. Prowse R, Lawlor N, Powell R, Neumann EM. Creating healthy food environments in recreation and sport settings using choice architecture: a scoping review. Health Promot Int. 2023 Oct 1;38(5):daad098. doi: 10.1093/heapro/daad098. Erratum in: Health Promot Int. 2023 Dec 1;38(6):daad178. doi: 10.1093/heapro/daad178. PMID: 37705493; PMCID: PMC10500220.
12. Boelsen-Robinson T, Orellana L, Backholer K, Kurzeme A, Jerebine A, Gilham B, Chung A and Peeters A (2020). Change in drink purchases in 16 Australian recreation centres following a sugar-sweetened beverage reduction initiative: an observational study. BMJ Open 10(3): e029492.