The importance of service‐users’ perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes

Sutcliffe, Katy; Melendez‐Torres, G. J.; Burchett, Helen; Richardson, Michelle; Rees, Rebecca; Thomas, James

doi:10.1111/hex.12657

Cited by 25 publications

(31 citation statements)

References 55 publications

(298 reference statements)

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“…Both the positive receipt of feedback by most participants in our study and the emphasis on communication, leading to the establishment of a reciprocal, therapeutic relationship with the project worker, underline the importance of an intervention lasting some time. The importance of supportive relationships in engagement with behaviour change interventions has also been reported in younger populations (Sutcliffe et al, ).…”

Section: Discussionmentioning

confidence: 86%

Health promotion for mild frailty based on behaviour change: Perceptions of older people and service providers

Avgerinou

Gardner

Frost

et al. 2019

Health Soc Care Community

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Mild frailty is common among older people, but it is potentially reversible with health promotion interventions. Behaviour change may be a key to preventing progression of frailty; however, we know little about what interventions work best and how a behaviour change approach would be perceived by this group. The aim of this study was to explore how mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach. We conducted semi‐structured interviews with 16 older people with mild frailty who received a pilot home‐based behaviour change health promotion service, including a dyad of older person/family carer, and two service providers delivering the service in two diverse areas of South England. Interviews were audio‐recorded, transcribed and thematically analysed. The concept of goal setting was acceptable to most participants, though the process of goal setting needed time and consideration. Goals on maintaining independence, monitoring of progress and receiving feedback were reported to increase motivation. Physical/mental capability and knowledge/perception of own needs were main determinants of the type of goals chosen by participants as well as the approach used by the project workers. Older people with complex needs benefited from care coordination, with a combination of goal setting and elements of social, practical and emotional support in varying proportions. Mildly frail older people responded well to a behaviour change approach to promote health and well‐being. Further consideration is needed of the most effective strategies based on complexity of needs, and how to overcome barriers among people with cognitive impairment.

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Section: Discussionmentioning

confidence: 86%

Health promotion for mild frailty based on behaviour change: Perceptions of older people and service providers

Avgerinou

Gardner

Frost

et al. 2019

Health Soc Care Community

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“…Themes identified at this stage included perceptions of ( a ) the relative importance and utility of different features of WMPs, ( b ) the best approaches for delivering each of the features, and ( c ) the mechanisms through which the different features influence behavior change. Findings from our views synthesis are reported in depth elsewhere . To develop the QCA of intervention effectiveness, we examined trials included in the NICE 2013 review on the primary outcome of mean kilogram difference in weight loss between intervention and control arm.…”

Section: Background To Our Reviewsmentioning

confidence: 99%

“…Findings from our views synthesis are reported in depth elsewhere. 11 To develop the QCA of intervention effectiveness, we examined trials included in the NICE 2013 review on the primary outcome of mean kilogram difference in weight loss between intervention and control arm. We selected the 10 most effective and the 10 least effective interventions and used these as the basis for our QCA models.…”

Section: Background To Our Reviewsmentioning

confidence: 99%

“…Because the use of QCA in intervention synthesis is still in its infancy, we offer here a rationale and a framework for using a systematic review and synthesis of qualitative studies that explore service users' views (what we call hereafter a views synthesis ) to structure the use of QCA in analyzing intervention effectiveness throughout the life cycle of the analysis. We demonstrate this framework throughout with our recent views synthesis and QCA on tier 2 weight management programs (WMPs) for overweight and obese adults. Both the views synthesis and the QCA have been published elsewhere; here, we provide an account of the methods we used to integrate these two syntheses.…”

Section: Introductionmentioning

confidence: 99%

“…We demonstrate this framework throughout with our recent views synthesis and QCA on tier 2 weight management programs (WMPs) for overweight and obese adults. Both the views synthesis and the QCA have been published elsewhere; here, we provide an account of the methods we used to integrate these two syntheses.…”

Section: Introductionmentioning

confidence: 99%

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Developing and testing intervention theory by incorporating a views synthesis into a qualitative comparative analysis of intervention effectiveness

Melendez‐Torres

Sutcliffe²,

Burchett

et al. 2019

Research Synthesis Methods

Self Cite

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Qualitative comparative analysis (QCA) was originally developed as a tool for cross‐national comparisons in macrosociology, but its use in evaluation and evidence synthesis of complex interventions is rapidly developing. QCA is theory‐driven and relies on Boolean logic to identify pathways to an outcome (eg, is the intervention effective or not?). We use the example of two linked systematic reviews on weight management programs (WMPs) for adults—one focusing on user views (a “views synthesis”) and one focusing on the effectiveness of WMPs incorporating dietary and physical activity—to demonstrate how a synthesis of user views can supply a working theory to structure a QCA. We discuss how a views synthesis is especially apt to supply this working theory because user views can (a) represent a “middle‐range theory” of the intervention; (b) bring a participatory, democratic perspective; and (c) provide an idiographic understanding of how the intervention works that external taxonomies may not be able to furnish. We then discuss the practical role that the views synthesis played in our QCA examining pathways to effectiveness: (a) by suggesting specific intervention features and sharpening the focus on the most salient features to be examined, (b) by supporting interpretation of findings, and (c) by bounding data analysis to prevent data dredging.

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Disparities in Healthcare Utilization Among Adults with Obesity in the United States, Findings from the NHIS: 2006–2015

Weissman

Russell

Ansah

et al. 2019

Popul Res Policy Rev

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Few studies of disparities consider logistical hurdles faced by adults with obesity in obtaining needed healthcare. This study compared adults with obesity to adults without obesity on self-reported practical aspects of receiving healthcare including ease of seeing a doctor and wait times for appointments. Serious psychological distress and chronic health conditions are prevalent in adults with obesity. Because serious psychological distress and number of chronic health conditions can act as confounders in any observed differences between the adults with and without obesity in their use of healthcare, we have examined these differences independent of serious psychological distress and chronic health conditions. Adults 18 to 64 years sampled from the 2006-2015 National Health Interview Survey (NHIS) (n = 74,598) were examined on five self-reported indicators: does not need a doctor, waited too long in the doctor's office, and to get an appointment, year since having seen a doctor, and saw a doctor ten times or more in the last 12 months. Multivariable models adjusted for serious psychological distress, chronic health conditions, gender, age, race/ethnicity, income, health coverage, and survey year demonstrated that adults with obesity were more likely to wait too long to get an appointment, and in the waiting room. Adults with obesity report not needing doctors despite seeing doctors frequently. Greater attention is needed to understand barriers to health care utilization in adults with obesity.

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The importance of service‐users’ perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes

Cited by 25 publications

References 55 publications

Health promotion for mild frailty based on behaviour change: Perceptions of older people and service providers

Health promotion for mild frailty based on behaviour change: Perceptions of older people and service providers

Developing and testing intervention theory by incorporating a views synthesis into a qualitative comparative analysis of intervention effectiveness

Disparities in Healthcare Utilization Among Adults with Obesity in the United States, Findings from the NHIS: 2006–2015

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