Innovative Approaches to Implement Chronic Disease Prevention Programs in Community Settings

Abstract Evidence-based programs relying on multidomain lifestyle interventions to prevent chronic disease are well-established, but their implementation in real-world settings remains limited. Community settings such as schools, social service organizations, municipal institutions, workplaces, and recreational sport organizations are promising options for implementing preventive programs because they are highly influential settings in the daily lives of most individuals. From a health equity perspective, focusing prevention efforts in community settings has the potential to reach populations with disproportionately higher chronic disease risk who are not able to access health improvement opportunities because of systemic societal factors. We will present the experience of the Hockey Fans In Training (Hockey FIT) program in Canada. This is a gender-sensitized lifestyle intervention that uses the power of sport fandom to engage hard-to-reach populations, such as men. The underrepresentation of men in lifestyle interventions, combined with men being less likely to seek preventive health care services but more likely to engage in high-risk behaviours compared with women, requires innovative approaches specifically designed for men, such sport fandom as suggested by previous studies. This program suggests that participants who received the Hockey FIT intervention had a significant reduction in weight and demonstrated greater improvements in other health indicators than control participants after 3 months, and improvements were maintained at 12 months. It is plausible that improved health status as a result of participation in Hockey FIT could also contribute to a difference in healthcare resource use and costs, thus representing a cost-effective strategy to mitigate the substantial obesity burden on healthcare systems and society.