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Abstract
20% of adults in Tower Hamlets can be classed as clinically obese; the Weight 2 Go! Programme was commissioned as joint partnership between social action for health (SAfH) and the Centre for Sports and Exercise Medicine. A multidisciplinary team (MDT) designed and guided peer led sessions. Multidisciplinary working provides the opportunity to share knowledge and multi-component interventions have been shown to achieve weight loss. However problems may arise due to different approaches, power sharing etc. Qualitative assessment has not previously been done in this context as previous evaluations measure intervention success based on solely quantitative outcomes.
Methods Mixed methods: Quantitative and qualitative for data triangulation.
Quantitative Secondary data provided by delivery team. A variety of outcome measures, for example, weight, BMI, waist circumference, HADS, DINE.
Descriptive stats and repeat measures ANOVA (p=0.05)
Qualitative 16 semi-structured interviews conducted using purposive sampling.
Framework analysis involved: identification of a thematic framework→ Development of charts→ Identification of emerging concepts
Results Quantitative 108 people recruited; majority female (n=85) and Bangladeshi (n=88)
Average participant attendance 41.6%- drop out rate 12.8%
Over 6-month period: changes in weight (p=0.113), BMI (p=0.094), waist circumference (p= 0.061), percentage body fat (p= 0.973), 6MWT (p=0.179) were not significant. DINE scores for fat, and unsaturated fat consumption were not significant (p=0.177 and p=0.149 respectively) but DINE score for fibre consumption was significant (p=0.032). The HADS assessment for depression and anxiety were not significant (p=0.192 and p=0.093 respectively).
Qualitative
Delivery team
Successful factors in MDT collaboration included distinct roles and communication.
Challenges included minimal commissioner input and participant retention
Limitations lack of success targeting Non-Bangladeshi communities
Changes: positive- increased flexibility
Overall a unique, tailored and successful programme
Participants
Peer led delivery strongest aspect; hands off role of MDT appropriate
Group rapport produced supportive environment
Changes: positive, organisers open to feedback
Programme was successful Lifestyle modification; varied weight loss
Conclusions Although the outcome measures showed non-significant changes, participants reported success in achieving their personal aims. Therefore, the mixed method evaluation provided a global assessment of the experience and success of the programme. The qualitative findings are similar to those of other studies. They show that MDT interventions provide a holistic approach, however open communication is key to their success. Peer led and culturally appropriate programmes such as Weight 2 Go! have also been shown to improve adherence and outcome measures. This in addition to community/individually tailored programmes may improve outcome measures. Mixed methods assessment shows that a peer led community intervention supported by a MDT is a potentially effective intervention for weight management.