Ffit secure project team matt slides 15th jan 2015

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.
FFIT Secure Project
Feasibility and overview of
measurements

Overview of measurements
The phase two and three measurements at Perth and Kilmarnock address the
following research questions:
RQ5. What objective and subjective measurements are feasible and
acceptable to the prisoners, intervention delivery staff and relevant
authorities?
RQ9. Does taking part in Perth FFIT lead to weight loss, increased PA,
decreased sedentary time, and other improvements in health behaviours and
physical and mental health post-programme and at 6, 9 and 12 months?
RQ10. In the event of a future RCT of the effectiveness of Perth FFIT, which
outcomes are most important as primary and secondary outcomes [e.g.
weight loss, increased PA, decreased sedentary time, improvements in
mental health, reduction in BP, reduction in CHD/diabetes risk as assessed by
blood/urinary biomarkers, changes in medication use (sleeping pills,
anxiolytics etc)], and what sample size would be required?

Overview of measurements – Phase two (Perth)
•Phase two consisted of programme delivery with data collection at:
• Baseline
• Post-programme
• 6, 9 and 12 months was conducted at HMP Perth.
The measures include: Objective: weight; waist circumference; BMI; height;
resting blood pressure; respiratory function; grip strength; PA and sedentary
time over 7 days (using activPAL accelerometers). Self-reported: PA and
sitting time; wellbeing; sleep; affect; aggression; diet and portion size;
smoking; motivation for exercise; self-efficacy for behavioural change,
medication provision; perception of health, long term health conditions, current
injuries and joint pain.
We also collected blood and urine samples at baseline, post-programme, and
at 12 months to investigate changes in biomarkers.

Overview of measurements – Phase three (Perth and
Kilmarnock)
Phase three data collection was undertaken at both HMP Perth and Kilmarnock.
Taking place at:
• Baseline
• Post-programme
• 6 months
The measures include: Objective: weight; waist circumference; BMI; height;
resting blood pressure; respiratory function; grip strength; PA and sedentary time
over 7 days (using actiGraph accelerometers). Self-reported: PA and sitting time;
wellbeing; sleep; affect; aggression; diet and portion size; smoking; motivation for
exercise; self-efficacy for behavioural change, medication provision; perception of
health, long term health conditions, current injuries and joint pain.
We also collected blood and urine samples at baseline, post-programme, and will at
6 months to investigate changes in biomarkers.

HMP Perth Phase Two Measurement Overview
0
2
4
6
8
10
12
14
16
18
20
10/10/13 06/02/14 14/05/14 15/07/14 07/10/14
Baseline 3 month 6 month 9 month 12 month

Attrition
5
4
9
HMP Perth Phase Two -
Participant Location at 12
month measure
Perth
Moved to
another prison
Released

What can we do about the high rates of attrition?
• Follow the participants up in other prisons
• Write to the participant upon release
• Write to a third party the participant identified at baseline
• Other ideas?

HMP Perth – Phase two findings: Weight
90
100110120
Weight(kg)
Baseline 15 Weeks 12 Months
Participant weights over the three time points
8090
100110120
Baseline 15 Weeks
Participant weights over the two time points

HMP Perth – Phase two findings: Sitting time
0
500
10001500
Time(minutes)
Baseline 15 Weeks 12 Months
Time spent sitting on a weekday over the three time points
0
500
10001500
Baseline 15 Weeks
Time spent sitting on a weekday over the two time points

HMP Perth – Phase two findings: Sleep
Very Bad
Fairly Bad
Fairly Good
Very Good
20001D 20006P 20011N
Quality of Sleep over the
Three Time Points
Baseline 15 Week 12 Month
Very Bad
Fairly Bad
Fairly Good
Very Good
Quality of Sleep from
Baseline to 15 Weeks
Baseline 15 Weeks

Participant feedback on the measures
•The girls broke the, ken they spoke to us, ken they werenae rigid. Even the nurses that
were taking the blood, they were all friendly, and I think that way, because you dinnae get
a lot of friendliness in a prison. I thought the measurements were great, and I thought the
girls were brilliant. They done it well, and they made you feel at ease. (HMP A, P11)
•I’m fine wi’ giving oot all of that, aye. I didnae see a problem wi’ that at all. You know,
they’re gie’ing you your blood type, and gie’ing like your full details if you really wanted,
eh? (HMP A, P5)
•I found that quite interesting actually, aye. Just to get a bit o’ the medical background
and just getting them talking at the end, just keep you kinda on the right path. (HMP A,
P1)
• as you ken nothing really phases me, ken whit I mean? But I was quite happy tae dae it,
eh. Was quite happy tae dae it. (And having stuff like this or… (overtalk) It’s no’ that,
ken, like I’ve never met her before, so it was good to get a conversation wi’ somebody
that I didnae ken, ken whit I mean? (HMP A – P2)

Fieldworker feedback on the measures
• “Working with the participants on a one-to-one basis gave them an opportunity
to meet and chat with external visitors, and ask questions re diet and health as
the questionnaire/measurements were completed. The importance of being non-
judgemental is pivotal in carrying out our professional tasks, but the preparatory
training equipped us should any potential incidents arise.” (fieldworker 1)
• “I always enjoy the day and enjoy meeting and encouraging our participants in a
humanistic and non-judgemental way in the hope that our visits offer a change
from the mundane routine and helps them cope with what must be very difficult
for them and their families on the outside.” (fieldworker 4)
•“In terms of physical measurements, asking for blood and urine samples seemed
like a problem for some prisoners. In terms of the questionnaire, questions about
depression or anxiety often provoked a strong reaction, mostly a strong denial of
these feelings. Also questions about anger and losing your temper seemed to
make some of the prisoners visibly uncomfortable.” (fieldworker 2)

Conclusions
In relation to research questions 5, 9 and 10, we have learnt:
• The self-reported and objective measures we have taken are feasible and
acceptable to the prisoners, intervention delivery staff and relevant
authorities (including blood and urine samples).
• We have some evidence that taking part in FFIT has a range of health
benefits, although the high rates of attrition are problematic.
• We are beginning to explore the quantative data from HMP Perth phase
two, and will soon have phase three before and after data from both HMP
Kilmarnock and Perth. This data will inform what primary and secondary
outcomes will be the most important in any future study.

Dissemination – Presentations
Completed
• Gray, C M, Maycock, M, Mutrie, N,. (2014) Health promoting sports clubs, BASES Symposium, St
Georges Park (part of this symposium focused on FFIT-Prisons).
• Gray, CM, and Singh, B, on behalf of the FFIT team (2014) Football Fans in Training: Weight loss,
physical activity and healthy lifestyle for men, Healthy Stadia, Geneva
• Hunt K, on behalf on the FFIT team (2014) Can we adapt a football-based healthy living
programme to deliver and evaluate in prisons? The story of Football Fans in Training. Scottish
Prison Service National Prison Health Improvement Group. Better Health, Better Lives: Successes
and Challenges, Edinburgh, 8th December 2014
• Hunt K, on behalf on the FFIT team. Football Fans in Training (FFIT). Head of Offender Outcomes
meeting, Scottish Prison Service, Calton House, Edinburgh, 29th April 2014
• Hunt K, Gray C. Can we use successful experience of healthy living programmes for men
delivered via professional football clubs to improve health and well-being of prison staff and
inmates? SPS Prisons Forum, June 2013
• Maycock, M. (2014). Can a football-based gender-sensitised group healthy living programme be
adapted to attract men to positive lifestyle changes in a Prison? . Men, health and wellbeing:
Critical insights Conference, Leeds Metropolitan University.
• Maycock, M. (2014). What can ethnography contribute to studies of masculinity within prison
settings? Dislocating Masculinities Conference, University of Sussex, Brighton.
• Maycock, M., (2014). What are the implications for performances of masculinity of taking part in a
football-based gender-sensitised group healthy living programme in a male Prison? Medical
Sociology Group 46th Annual Conference 2014 Aston University.

Dissemination – Presentations
Future
• Maycock, M. (2015) The acceptability of a football-based healthy lifestyle programme
delivered to inmates in two Scottish prisons 8th Correctional Health Conference, Boston,
March.
Proposed
• Matt has convened a proposed panel focusing on Prison Masculinities at the Men and
Masculinities conference in New York in March. Maycock, M. (2015) Paper 5: The
emergence of multiple masculinities during a gender-sensitised healthy living programme
(FFIT-Prisons), delivered to inmates in two male prisons in Scotland.
• Maycock, M. (2015) "When I first started, I couldn't get up those stairs without having
breathing problems": can a football club based weight management model engage male
prisoners in positive lifestyle change? ISBNPA, Edinburgh

Dissemination – Papers
We are proposing two papers:
1) Masculinities within the context of the FFIT-prisons context
Proposed journals:
• Men and masculinities
• SHI
• ?
2) Programme development
Proposed journals:
• BMC Public Health
• ?

Ffit secure project team matt slides 15th jan 2015

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