Translating hunger training research to primary health: a qualitative study of nurse attitudes towards a novel weight management intervention

Abstract

INTRODUCTIONPractice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose (‘hunger training’), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires understanding of key stakeholder perspectives. AIMThe aim of this study was to explore the perspectives of practice nurses on the suitability of using hunger training as a weight management intervention in general practice. METHODSTen nurses trialled hunger training for 1 week, followed by a semi-structured interview where they were asked about their experience; perceived patient interest; enablers and barriers; and suggested changes to hunger training. RESULTSAll nurses were positive about hunger training and wanted to use it with their patients. They thought it was a useful method for teaching patients about eating according to their appetite, and the impact of food choices on glucose. Motivation was seen to be both an important potential barrier and enabler for patients. Other anticipated patient enablers included the educational value of hunger training and ease of the programme. Other barriers included lack of time and cost of equipment and appointments. For most nurses, 1 week of following hunger training was sufficient training to deliver the intervention. Suggested refinements included adding nutrition advice to the booklet, incorporating other health goals and enabling social support. DISCUSSIONThese findings suggest that hunger training could be translated to primary care with minor modifications.

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“…One such CGM-based disease prevention intervention with great potential for scalable implementation is Glucose-Guided Eating (GGE), formerly known as Hunger Training ( 29–31 ). In contrast to comprehensive lifestyle interventions, GGE implements a low-contact, timed eating approach, previously shown to be practical for delivery in clinical care settings ( 32 ). Rooted in the principles of chrononutrition, which emphasizes the role of meal timing in disease risk ( 33 ), GGE offers a unique approach to timed-eating.…”

From the Editor: At the heart of the mission of general practice

“…We also have a report from the Southern region presenting quantitative findings relating to the first three years of Clinical Pharmacist Facilitators being employedwhat they did and what they foundproviding an important baseline for future measurement of the impact of this new group of primary care clinicians; 11 and a paper about nurses trialling a new intervention to manage weight loss. 12 As we go to press there has been no change for 6 days in the number of 5 cases of Covid-19 in New Zealand. Internationally, however, the situation is different and many new cases and new deaths from Covid-19 are reported daily.…”