BackgroundOver 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients’ perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies.MethodsQualitative study employing semi-structured interviews and thematic analysis, with a sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices in Alberta.ResultsFour illustrative themes emerged: (1) the patient-physician relationship plays an important role in the adequacy of obesity management; (2) patients have clear expectations of substantive conversations with their primary care team; (3) complex conditions affect weight and patients require assistance tailored to individual obesity drivers; (4) current services provide support in important ways (accessibility, availability, accountability, affordability, consistency of messaging), but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities.ConclusionsPatients have clear expectations that their primary care physician asks them about weight within a supportive therapeutic relationship. They see obesity as a complex phenomenon with multiple drivers. They want their healthcare providers to assess and address their root causes - not simplistic advice to “eat less, move more”. Patients felt that the current services were positive resources, but expressed needs for tailored weight management plans, and longer-term follow-up.

Background: Medical education researchers increasingly use qualitative methods, such as ethnography to understand shared practices and beliefs in groups. Focused ethnography (FE) is gaining popularity as a method that examines sub-cultures and familiar settings in a short time. However, the literature on how FE is conducted in medical education is limited. Aim: This paper provides 10 practical tips for conducting FE in medical education research. Methods: The tips were developed based on our expertise in ethnographic research and existing literature. Results: The 10 tips include: (1) Know the difference, (2) Build relationships before you start, (3) Have shared purpose and knowledge translation strategies with your stakeholders (4) Practice being reflexive, (5) Align research question with methodology, (6) Prepare your fieldwork, (7) Use a variety of methods for data collection, (8) Consider context on micro, meso, and macro levels, (9) Use triangulation, and (10) Provide a 'thick description', Conclusions: These 10 tips give practical guidance to medical educators in thinking about how and when to conduct FE.

Background:The implementation of interventions to support practice change in primary care settings is complex. Pragmatic strategies, grounded in empiric data, are needed to navigate real-world challenges and unanticipated interactions with context that can impact implementation and outcomes.Objective: This article uses the example of the "5As Team" randomized control trial to explore implementation strategies to promote knowledge transfer, capacity building, and practice integration, and their interaction within the context of an interdisciplinary primary care team.Methods: We performed a qualitative evaluation of the implementation process of the 5As Team intervention study, a randomized control trial of a complex intervention in primary care. We conducted thematic analysis of field notes of intervention sessions, log books of the practice facilitation team members, and semistructured interviews with 29 interdisciplinary clinician participants. We used and further developed the Interactive Systems Framework for dissemination and implementation to interpret and structure findings. Trial registration: Results: Three themes emerged that illuminate interactions between implementation processes, context, and outcomes: (1) facilitating team communication supported collective and individual sense-making and adoption of the innovation, (2) iterative evaluation of the implementation process and real-time

People living with obesity suffer from multiple health issues, including diabetes and mental health problems. Misinformation about the complex nature of this condition greatly affects the way one manages obesity. This results in unrealistic expectations by both healthcare providers and patients. Effective obesity management must be individually tailored for each patient. The objective of this project was to improve four communication tools by co-designing them with patients. A co-design approach was used to improve the efficacy and applicability of the tools through a working collaboration between patients, care providers, and researchers. While most articles describe processes to create shared-decision making (SDM) tools which compare alternative diagnosis and treatment options, few papers describe models to create SDM tools which go beyond showing benefits and risks. In this paper, we describe our process and approach to the re-design of four of the 5As obesity tools. We hope this study provides a valuable model for other teams.