Can you see me? Participant experience of accessing a weight management programme via group videoconference to overcome barriers to engagement

Abstract

Background Engagement with conventional weight management group programmes is low. Objective To understand participant experience of accessing an adapted programme via videoconference. Participants Adults with obesity (BMI ≥ 35kg/m 2 ), referred to an NHS Dietetics service in Wales, were offered a group videoconference weight management programme as an optional alternative to in‐person groups. Thirteen participants (mean age 48.5 ± 20.2 years, 8 female) recruited to two videoconference groups were interviewed. Study design A Registered Dietitian delivered a behavioural programme using Skype for Business in 10 sessions over 6 months. Participants joined the groups from any Internet‐connected device with a webcam. Participant perspectives were audiorecorded in one‐to‐one, semi‐structured interviews. Interviews were transcribed verbatim and thematically analysed using self‐determination theory as a theoretical framework. Results Ten themes were identified, three relating to service engagement and seven relating to behaviour change facilitation. Key themes in engagement included ‘reduced burden’, described as saving time and travel and ‘reduced threat’ as participants perceived joining a group from home as less daunting compared to attending in‐person. Despite reporting some initial technical difficulties with establishing video and audio connection, participants described beneficial peer support although not physically with other group members. Conclusion Accessing a group weight management programme via videoconference may be the preferred option for some participants, overcoming some of the barriers to access to standard in‐person programmes, particularly in rural areas. Participants are able to experience peer support via videoconference. During the COVID‐19 pandemic, weight management programmes could utilize videoconference groups to continue to provide support.

Rapid conversion to virtual obesity care in COVID‐19: Impact on patient care, interdisciplinary collaboration, and training

“… 20 Similarly, patients in a videoconference weight loss program reported fewer barriers to program engagement, especially in rural areas. 21 This may also explain why some patients said they would prefer telephone or video care, even after the shelter‐in‐place orders are lifted. Telehealth care may increase access to services for patients with geographic, transportation, medical, or personal/work limitations.…”

Public perspectives on health improvement within a remote‐rural island community

“…Rural health outcomes are often worse than their urban counterparts, especially concerning mental health, with life expectancy in ‘developed’ countries being lower in rural communities 1 . While rurality per se is not considered to negatively affect health outcomes, the intrinsic geographical isolation of rural communities exacerbates other overarching conditions 2,3 . In response, a multifaceted approach to addressing societal conditions of ‘poverty, discrimination, inequality, [and] inequalities of resource allocation’ 1 is proposed to improve health outcomes in rural communities.…”

Remote Treatment Successfully Delivers a Usual Care Weight Loss and Lifestyle Intervention in Adults with Morbid Obesity

“…Data presented here clearly suggest that remote treatment can work well in real-world weight loss treatment settings. A temporary transition to remote delivery can be easily integrated into regular treatment and may help combine the benefits of both formats [4, 20]. Even though patients in the present study initially signed up for in-person treatment, they successfully transitioned into the remote part.…”

“…Small decreases in the therapeutic alliance and group cohesion have been associated with remote treatment [5]. Alternatively, lowered attendance could reflect an increased burden due to other COVID-19-associated obligations such as child care and working from home [20, 21].…”