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A prospective mixed method study of person-centred care in a community weight management programme

Why is this research needed?

Obesity has become one of the biggest health concerns in the UK – it has multiple origins, is strongly associated with deprivation, and the extent of obesity-related multi-morbidity is often not fully recognised.

There is strong evidence that most medical and psychosocial conditions caused by obesity can be substantially improved by weight loss but due to the complexities of obesity, treatment has posed a considerable challenged in societies and health systems.

Traditional approaches to obesity treatment have usually been “one size fits all” but it is widely recognised that a multidisciplinary approach to obesity treatment is appropriate. This includes some diets (1), physical activity (2), surgery (3) and pharmacotherapy - this however is currently problematic as safety concerns have led to the withdrawal of several drugs (4).

Method

Using Plymouth’s weight management clinic (WMC) as a case study, we will examine whether person-centred models of care could maximise engagement, retention in and outcomes from weight management interventions in a sustainable, effective long-term approach to obesity-related ill health.

The programme at Plymouth WMC works on an opt-in basis, and offers a two year programme of treatment using a combination of one-to-one and group interventions. While it was not explicitly designed to be person-centred, many person-centred features have been intentionally incorporated so that the clinic offers a multicomponent intervention that is responsive to the needs of individuals and the community.

The project will use a mixed-methods approach including fieldwork, narrative interviews with patients, self-report questionnaires, and semi-structured interviews. The qualitative and quantitative methods will be equally weighted. A patient and public involvement group will be set up at an early stage and consulted throughout to provide advice for various aspects of the research project.

Project aims and objectives

Aims:

  1. To contribute a rich narrative understanding of how personal, familial, socio-cultural and environmental factors contribute to obesity and perceptions towards the weight management clinic and care.
  2. To identify principles of person-centred care in weight management based on WMC practice that can be generalised.

Objectives:

  1. Provide a review of the national literature on person-centred care in weight management to contextualise WMC practice.
  2. Provide a rapid ethnographic analysis of the local WMC to explore person-centred practice.
  3. Describe the social, cultural and clinical frameworks for individuals with obesity and explore how these factors relate to perceptions of health and identity or facilitate access to help with weight control and investigate how these barriers could be overcome.
  4. Undertake qualitative semi-structured interviews focusing on the experience of WMC care and employ these findings to contextualise outcomes by typology response type.
  5. To develop a set of testable, generalizable and practical principles for person-centred weight management that will be partly informed by working with a PPI group and practitioners.

Publications

Marshall D, Quinn C, Child S, Shenton D, Pooler J, Forber S, Byng R (2015). What IAPT services can learn from those who do not attend. Journal of Mental Health

Find out more

If you’d like to learn more, please download a copy of the current project proposal (pdf).

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