1 School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
2 The Bone and Joint Institute, Western University, London, ON, Canada.
3 Department of Health, Kinesiology, and Applied Physiology, Faculty of Arts and Science, Concordia University, Montréal, QC, Canada.
4 Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
5 Department of Recreation and Leisure Studies, Faculty of Health, University of Waterloo, Waterloo, ON, Canada.
6 Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
7 Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
8 Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
9 The Bone and Joint Institute, Western University, London, ON, Canada. robert.petrella@ubc.ca.
10 Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada. robert.petrella@ubc.ca.
11 Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. robert.petrella@ubc.ca.
12 School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada. robert.petrella@ubc.ca.

Background/objectives: To describe the program-related costs and estimate the cost-effectiveness of Hockey Fans In Training (Hockey FIT), a gender-sensitized lifestyle intervention, over a 1-year period.

Subjects/methods: We conducted a pragmatic, cluster randomized trial among men aged 35-65 years with a body mass index =27 kg/m², in 39 community-based Canadian sites, allocated to either Hockey FIT or a wait-list control group. We estimated the cost-effectiveness of Hockey FIT in terms of both weight loss and quality adjusted life years (QALY) from both a healthcare payer and societal perspective.

Results: There were 657 participants included in this analysis (360 control; 297 Hockey FIT). Baseline characteristics were similar between groups. The total intervention cost was $6832.20 CAD per site or $341.61 CAD per participant. The total mean cost for participants in the Hockey FIT group over the 12-month study period were slightly greater than the control group from the healthcare payer perspective (mean difference = $72.94 CAD; 95% CI: $531.17-$677.06, corresponding to a percentage difference of +7.4%) and from the societal perspective (mean difference = $395.31 CAD; 95% CI: -$1247.40-$2038.02, percentage difference of +13.2%), however differences were not statistically significant. Participants in the Hockey FIT group had significantly greater weight loss at 12 months compared to the control group (mean difference = 1.51 kg (95% CI: -2.42- -0.59) resulting in an incremental cost of $48.30 CAD per kilogram weight loss from the healthcare payer perspective, and $261.79 CAD per kilogram weight loss from the societal perspective. There were no significant differences in quality adjusted life years, resulting in incremental ratios of $36,470 CAD/QALY gained (payer) and $197,655 CAD/QALY (societal).

Conclusion: A lifestyle intervention that engaged men through the power of sport fandom (Hockey FIT) resulted in greater weight loss, with minimal additional costs, and no significant differences in healthcare resource use over one year in middle-aged men with overweight or obesity.