Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial.

INTRODUCTION: Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months. METHODS: Male fans of two ice hockey teams (35-65 yr; body mass index ≥28 kg·m) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health. RESULTS: Eighty men were recruited in 4 wk; trial retention was >80% at 12 wk and >75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, -5.26 to -1.90 kg) more than the comparator group (P < 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months. CONCLUSIONS: Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial.

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics.

BACKGROUND: Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. HealtheSteps™ participants are provided with in-person lifestyle coaching and access to eHealth technologies delivered in community-based primary care clinics and health care organizations. METHOD/DESIGN: To determine the effectiveness of Healthesteps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of HealtheSteps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site) to either the intervention (HealtheSteps™ program) or comparator (Wait-list control). There are 3 phases of the HealtheSteps™ program, lasting 6 months each. The active phase consists of bi-monthly in-person coaching with access to a full suite of eHealth technology supports. During the maintenance phase I, the in-person coaching will be removed, but participants will still have access to the full suite of eHealth technology supports. In the final stage, maintenance phase II, access to the full suite of eHealth technology supports is removed and participants only have access to publicly available resources and tools. DISCUSSION: This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the HealtheSteps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program at the different community sites. These results will inform future optimization and scaling up of the program into additional community-based primary care sites. TRIAL REGISTRATION: NCT02413385 (Clinicaltrials.gov). Date Registered: April 6, 2015.

Effects of isometric handgrip training dose on resting blood pressure and resistance vessel endothelial function in normotensive women.

Isometric handgrip (IHG) training lowers resting blood pressure (BP) in both hypertensives and normotensives, yet the effect of training dose on the magnitude of reduction and the mechanisms associated with the hypotensive response are elusive. We investigated, in normotensive women, the effects of two different doses of IHG training on resting BP, and explored improved resistance vessel endothelial function and heart rate variability (HRV) as potential mechanisms of BP reduction. Resting BP, HRV, and resistance vessel endothelial function (venous strain-gauge plethysmography with reactive hyperemia) were assessed in 32 women before and after 4 and 8 weeks of 3×/week (n = 12) or 5×/week (n = 11) IHG training (four, 2-min unilateral contractions at 30 % maximal voluntary contraction), or 0×/week control (n = 9). IHG training decreased systolic BP in the 3×/week (94 ± 6 to 91 ± 6 to 88 ± 5 mmHg, pre- to mid- to post-training; P < 0.01) and 5×/week (97 ± 11 to 90 ± 9 to 91 ± 9 mmHg, P < 0.01) groups, concomitant with increased forearm reactive hyperemic blood flow (26 ± 7 to 30 ± 8 to 36 ± 9 mL/min/100 mL tissue, P < 0.01; and 26 ± 7 to 29 ± 7 to 38 ± 13 mL/min/100 mL tissue, P < 0.01, respectively), yet both remained unchanged in the control group. No changes were observed in diastolic BP, mean arterial BP, or any indices of HRV in any group (all P > 0.05). In conclusion, IHG training lowers resting systolic BP and improves resistance vessel endothelial function independent of training dose in normotensive women.