Abstract
BackgroundThe Well Now health and weight course teaches body respect and health gain for all. The course validates peoples’ lived experiences and knowledge through group activities and discussion with the aim of helping people to better understand their food and body stories. Well Now explores different ways of knowing, including the use and limits of body signals, like energy levels, hunger, taste and emotions and helps people keep food and behaviours in perspective by drawing attention to other factors that impact on health and wellbeing. This study undertook a service evaluation of the Well Now course to understand its acceptability for participants and its impact on diet quality, food preoccupation, physical activity and mental wellbeing.MethodsThis service evaluation combined quantitative pre- and post-course measures with telephone interviews with previous attendees. Paired t-tests were used to determine if there were statistically significant differences in the intended outcomes. Semi-structured qualitative telephone interviews were undertaken with previous attendees 6–12 months after attendance to understand how participants experienced the Well Now course.ResultsSignificant improvements were demonstrated in diet quality, food preoccupation, physical activity and mental wellbeing outcomes. Medium effect sizes are demonstrated for mental wellbeing and diet quality, with smaller effect sizes shown for physical activity and food preoccupation. The weight and Body Mass Index (BMI) of attendees remained stable in this timeframe. The qualitative data corroborates and extends elements of the quantitative outcomes and highlights areas of the course that may benefit from further development and improvement. The findings further indicate that the Well Now approach is largely acceptable for attendees.ConclusionsWell Now’s non-judgemental holistic approach facilitates change for those who complete the course, and for those who do not. This health gain approach upholds non-maleficence and beneficence, and this is demonstrated with this service evaluation for both completers and partial completers.
Highlights
The Well health and weight course teaches body respect and health gain for all
Services across the United Kingdom (UK) have relied on a diet paradigm and this is reflected in one of the six Public Health priorities for Scotland [1] that of having a ‘healthy weight and enjoying being physically active’
This paper presents the findings from a service evaluation for this health gain approach when delivered in communities
Summary
The Well health and weight course teaches body respect and health gain for all. The course validates peoples’ lived experiences and knowledge through group activities and discussion with the aim of helping people to better understand their food and body stories. Services across the UK have relied on a diet paradigm and this is reflected in one of the six Public Health priorities for Scotland [1] that of having a ‘healthy weight and enjoying being physically active’ This paradigm shapes the Scottish Government’s 2018 document, A Healthier Future: Scotland’s Diet and Healthy Weight Delivery Plan [2], which details a vision for improving health across Scotland including via outcome three, ‘access to effective weight management services’. The diet approach can oversimplify the relationship between lifestyle, health and weight, and ignore the impact that non-lifestyle factors have on health It often equates following diet and activity guidelines with achieving a ‘healthy weight’. It presupposes that a strong evidence base exists to demonstrate the benefits of attempted weight loss are improved health, and that there are no adverse effects to this process
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