'Shape-Up', a Modified Cognitive-Behavioural Community Programme for Weight Management: Real-World Evaluation as an Approach for Delivering Public Health Goals.

Amber Soni,Helen Croker,Laura Mcgowan,Rebecca J Beeken,Paul Chadwick,Victoria Lawson

doi:10.3390/nu13082807

Abstract

Obesity is widespread, with serious health consequences; addressing it requires considerable effort at a public health level, incorporating prevention and management along with policies to support implementation. Behavioural weight-management programmes are widely used by public health bodies to address overweight and obesity. Shape-Up is an evidence-based programme combining a structured behavioural intervention (targeting nutrition and physical activity behaviours) within a peer-learning framework. This study was a service-evaluation of Shape-Up, as delivered in Rotherham by a local leisure provider, and included a secondary analysis of data collected in the community by service providers. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to explore programme effectiveness, implementation, and whom it reached. A total of 141 participants were included. Compared to local demographics, participants were older, at 48.9 (SD 14.47) years, with a lower employment rate (41% employed) and greater proportion female (67% female). Mean BMI was 38.0 (SD 7.54) kg/m2. Mean weight-change between baseline and endpoint (12 weeks, 10 group sessions) was −4.4 (SD 3.38) kg, and degree of weight change was associated with session attendance (F (9, 131) = 6.356, p < 0.0005). There were positive effects on participants’ weight, health-related behaviours, and quality of life. The intervention content (including the focus of nutritional recommendations) and structure were adapted during implementation to better suit national guidelines and local population needs. RE-AIM was found to be a useful framework for evaluating and adapting an existing evidence-based weight management programme in line with local population needs. This could be a more cost-effective approach, compared to developing new programmes, for delivering public health goals relating to obesity, nutrition, and physical activity.

Highlights

IntroductionObesity is widespread and costly economically and for health; 63% of adults in England were living with overweight (body mass index, Body Mass Index (BMI) > 25 kg/m2 ) or obesity (BMI > 30 kg/m2 ) in 2018 [1]
Obesity is widespread and costly economically and for health; 63% of adults in England were living with overweight or obesity (BMI > 30 kg/m2 ) in 2018 [1]
The majority of weight-management support is provided in the community; one study found that of 91,000 individuals living with overweight and obesity in the United Kingdom (UK), 30% were offered advice, 20% referred to a weightmanagement programmes (WMPs), and 14% given weight-loss medication [8], an earlier UK study found lower rates: 20%, 4%, and 2%, respectively [9]

Summary

Introduction

Obesity is widespread and costly economically and for health; 63% of adults in England were living with overweight (body mass index, BMI > 25 kg/m2 ) or obesity (BMI > 30 kg/m2 ) in 2018 [1]. Public health policy typically targets individuals either through weight-loss advice (for example, during a General Practitioner appointment), weightmanagement programmes (WMPs), weight-loss medication, or surgery. Which of these is indicated depends on an individual’s BMI status and existing co-morbidities [7]. The majority of weight-management support is provided in the community; one study found that of 91,000 individuals living with overweight and obesity in the United Kingdom (UK), 30% were offered advice, 20% referred to a WMP, and 14% given weight-loss medication [8], an earlier UK study found lower rates: 20%, 4%, and 2%, respectively [9]. Mid-way review of progress and review of physical activity (Rotherham session)

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