Study protocol of European Fans in Training (EuroFIT): a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs.

BACKGROUND: Lifestyle interventions targeting physical activity, sedentary time and dietary behaviours have the potential to initiate and support behavioural change and result in public health gain. Although men have often been reluctant to engage in such lifestyle programs, many are at high risk of several chronic conditions. We have developed an evidence and theory-based, gender sensitised, health and lifestyle program (European Fans in Training (EuroFIT)), which is designed to attract men through the loyalty they feel to the football club they support. This paper describes the study protocol to evaluate the effectiveness and cost-effectiveness of the EuroFIT program in supporting men to improve their level of physical activity and reduce sedentary behaviour over 12 months. METHODS: The EuroFIT study is a pragmatic, two-arm, randomised controlled trial conducted in 15 football clubs in the Netherlands, Norway, Portugal and the UK (England). One-thousand men, aged 30 to 65 years, with a self-reported Body Mass Index (BMI) ≥27 kg/m(2) will be recruited and individually randomised. The primary outcomes are objectively-assessed changes in total physical activity (steps per day) and total sedentary time (minutes per day) at 12 months after baseline assessment. Secondary outcomes are weight, BMI, waist circumference, resting systolic and diastolic blood pressure, cardio-metabolic blood biomarkers, food intake, self-reported physical activity and sedentary time, wellbeing, self-esteem, vitality and quality of life. Cost-effectiveness will be assessed and a process evaluation conducted. The EuroFIT program will be delivered over 12 weekly, 90-minute sessions that combine classroom discussion with graded physical activity in the setting of the football club. Classroom sessions provide participants with a toolbox of behaviour change techniques to initiate and sustain long-term lifestyle changes. The coaches will receive two days of training to enable them to create a positive social environment that supports men in engaging in sustained behaviour change. DISCUSSION: The EuroFIT trial will provide evidence on the effectiveness and cost-effectiveness of the EuroFIT program delivered by football clubs to their male fans, and will offer insight into factors associated with success in making sustained changes to physical activity, sedentary behaviour, and secondary outcomes, such as diet. ISRCTN: 81935608 . Registered 16 June 2015.

Matters of the heart: patients' adjustment to life following a cardiac crisis.

In a sample of patients who experienced a myocardial infarction, coronary artery bypass graft surgery or both within the past year, we examined the extent to which patients' attempts to intrapersonally inhibit their emotions about their cardiac event and their attempts to disclose their feelings about the event to their partner predicted their psychological health (depression, anxiety, post-traumatic stress) and relational functioning (closeness, satisfaction). The more patients inhibited their feelings about their cardiac event, the poorer their psychological and relational functioning. Greater disclosure was associated with greater closeness to their partner. However, frequency of disclosure was also an indicator of level of distress, such that the more frequently patients talked about their feelings regarding the cardiac event with their partner, the more they had anxiety and post-traumatic stress symptoms. Important interactions of inhibition by disclosure on outcomes as well as moderation by time since the cardiac event were found and are discussed in greater detail.

Interpersonal interactions on online forums addressing eating concerns.

OBJECTIVE: Although some research suggests that online eating disorder forums promote "pro-eating-disorder" lifestyles and discourage recovery, other research suggests that such forums are an important source of interpersonal support. The current study extends this research by exploring the positive and negative behaviors encouraged on these forums and by comparing forum members' perceptions of support received from online and offline relationships to support received in relationships of age-matched controls. METHOD: In a survey of 60 forum members, we assessed information exchanged and support provided on eating disorder forums. Further, we assessed perceptions of social support for general and specific life concerns in this group of forum members as well as 64 age-matched university controls. RESULTS: Results show that both adaptive and maladaptive behaviors are encouraged on the forums, and that this encouragement has some influence on forum members trying out these behaviors. Overall, forum members reported receiving less support for their eating concerns as compared to their general life stressors, and they perceived less support for both their general concerns and eating concerns in their offline relationships as compared to their online forum relationships. Moreover, forum members reported receiving less support from their offline relationships as compared to support received in relationships by age-matched controls. DISCUSSION: Forum members perceive less support in their important relationships than other peers do, and they seek out and participate in forums as a means of attaining greater social support. However, our research suggests that these forums also encourage dysregulated eating behaviors. Implications of online forum support and its impact on recovery are discussed further.

Why identities fluctuate: variability in traits as a function of situational variations in autonomy support.

Interest in intra-individual variation in trait expression across situations, contexts, and relationships, and the meaning of this variation for personal functioning has grown significantly. In this article we review this literature with an emphasis on (a) appropriate methods for identifying variations in trait expression and (b) the substantive meaning and sources of this variation. Self-determination theory suggests that people will express traits differently as a function of the degree of support for autonomy they experience in any given setting. Accordingly, autonomy support is shown to predict variations in Big Five trait expression and other stable individual differences such as attachment security and dependency. The discussion focuses on methodological issues in the study of variability and on why autonomy support may play a central role in explaining trait variability and its relation to well-being.

On the benefits of giving as well as receiving autonomy support: mutuality in close friendships.

Two studies examined autonomy support within close friendships. The first showed that receiving autonomy support from a friend predicted the recipient's need satisfaction within the relationship and relationship quality as indexed by emotional reliance, security of attachment, dyadic adjustment, and inclusion of friend in self and that there was significant mutuality of receiving autonomy support and of each other variable. The relations of perceived autonomy support to need satisfaction and relationship quality held for both female-female and male-male pairs across the two studies. The second study replicated and extended the first, showing that receiving autonomy support also predicted psychological health. Furthermore, giving autonomy support to a friend predicted the givers' experience of relationship quality over and above the effects of receiving autonomy support from the friend. When both receiving and giving autonomy support competed for variance in predicting well-being, giving, rather than receiving, autonomy support was the stronger predictor.