Implementation of an Australian football themed men's health program in rural Australia: a mixed-methods study

Rural men face a greater risk of ill-health than their urban counterparts but often lack access to appealing health programs. Aussie Fans in Training (Aussie-FIT) is an engaging men's health program delivered in urban professional sports contexts. This study examines the feasibility of implementing an adapted version of Aussie-FIT in rural Western Australia, focussing on the recruitment and retention of program coaches and participants. Men (aged 35-65) with overweight or obesity were recruited via Facebook, word of mouth, and local media for the 12-session Aussie-FIT program in 3 rural towns. Coaches were recruited via local stakeholder networks. A mixed-methods approach included process data relating to the number of coaches expressing interest and delivering programs, program reach, attendance registers, and five post-program participant focus groups (total n = 25). Qualitative data exploring barriers and facilitators to engaging men were analysed using reflexive thematic analysis. Eighty-three of 124 men (67%) expressing interest enrolled, with most residing in low-to-middle socioeconomic areas (n = 77; 96%) and not university educated (n = 60; 74%). Half (n = 40) were recruited via Facebook and a third by word of mouth. Average attendance was 8.2 of 12 sessions, with 57 (69%) completers. Retention varied by site (59-79%), partly due to Covid-19. An inclusive and supportive environment, the football theme and setting, and intragroup connectedness supported engagement. Findings suggest that it is feasible to implement Aussie-FIT in rural Western Australia without a professional club affiliation or setting, and that popular local sporting codes and community sports settings can be utilized to engage rural men in behavioural health programs.