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Is a community pharmacy led weight management service effective? A mixed methods service evaluation
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Abstracts/Appetite 87 (2015) 371–403
Healthy eating and lifestyle in pregnancy. The HELP trial S. SIMPSON a , E. JOHN a , D. CASSIDY a , R. PLAYLE a , K. JEWELL, D. COHEN, M. LONGO. a SEWTU, Cardiff University, 7th floor Neudd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. [email protected] Maternal obesity is associated with pregnancy and birth complications. Excess weight gain during pregnancy can lead to longterm maternal obesity and is linked with child obesity. This study aims to test a theory based weight management intervention for obese pregnant women, which targets physical activity and healthy eating. This cluster RCT recruited 598 pregnant women across 20 maternity units. Women in the intervention group were invited to attend a weekly weight management group. Control participants received usual care. Women were followed up at 36 weeks gestation and 6 weeks, 6 months and 1 year postpartum. The primary outcome is BMI at 1 year postpartum. Secondary outcomes include pregnancy weight gain, quality of life, mental health, waist–hip ratio, child weight, diet, physical activity, pregnancy and birth complications, breast feeding, social support, self-regulation and selfefficacy. A health economic and process evaluation were also conducted. Baseline characteristics were similar between groups. Most women thought that controlling their weight was important and around half were confident that they could control their weight during the pregnancy. Over a third of the women weighed themselves daily or weekly. Follow-up data are currently being analysed and results for all outcomes will be completed by May 2014 and presented at the conference. This trial is in an under-researched area and is highly topical. If successful, this intervention could reduce health risks and lead to reduced healthcare costs, as well as potentially impacting on the wider family. http://dx.doi.org/10.1016/j.appet.2014.12.177
Weight management in pregnancy. Participants’ experiences of ‘Healthy Eating and Lifestyle in Pregnancy (HELP)’ trial S. SIMPSON a, D. CASSIDY a, L. COPELAND a, E. JOHN a, H. STANTON a, K. JEWELL. a SEWTU, Cardiff University, 7th floor Neudd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. [email protected] Around 1 in 5 pregnant women in the UK are obese. Obesity is linked to poor health and pregnancy complications. We developed and tested in a cluster RCT a theory-driven group-based intervention for obese pregnant women that was facilitated by midwives and Slimming World consultants. It was designed to support women during pregnancy to moderate weight gain and reduce BMI one year after birth, in addition to targeting secondary health and wellbeing outcomes. This paper aims to explore participants’ experiences of engaging in the ‘HELP’ trial and provide insight into receipt of the intervention and study processes. Sixty-two women took part in semi-structured telephone interviews. Participants were sampled across 20 centres; by treatment, weight change and group attendance. Data were collected at two time-points; 6 months and 1 year post-birth, and analysed using thematic analysis. Accounts offered insights into the group environment, the importance of social
support and the value of facilitators’ involvement. Reasons for compliance were highlighted, with discussion on aspects that encouraged women to change diet and activity behaviours, barriers to engaging with the intervention, and researcher influence in control sites. Participants emphasised the benefits of attending the group sessions where they obtained knowledge, support and skills in relation to weight and pregnancy. Engaging in the intervention appeared to help women to adopt healthier habits leading to avoidance of excess weight gain during pregnancy and better outcomes for mother, baby and the wider family. Participants’ accounts will facilitate interpretation of the main study findings. http://dx.doi.org/10.1016/j.appet.2014.12.178
Is a community pharmacy led weight management service effective? A mixed methods service evaluation S. SMITH, A. TODD, S. WHISSON, C. SUMMERBELL. Durham University, Queen’s Campus, Stockton on Tees, UK. [email protected] There are over 10,500 community pharmacies in England distributed across urban and rural areas, and therefore, given this wide and equitable accessibility, community pharmacists have the potential to impact on public health priorities including nutrition education and weight management. Several small-scale studies have demonstrated the effectiveness of community pharmacy weight management interventions, but a recent systematic review by Gordon et al. (2011) was not able to make an overall judgement about the efficacy of these interventions, primarily because the evidence base they included in their reviews was limited, or of poor quality, or both. This project proposes to contribute to this evidence base by evaluating a high-quality community pharmacy weight management service already in existence in Stockton-on-Tees, UK. The service is delivered by pharmacists in 10 pharmacies across the locality over a 12 week period, targeting 100 overweight individuals (Body Mass Index (BMI) of 25 or more). The evaluation will explore the implementation and delivery of the service, and ascertain views of service commissioners, deliverers and users through one-to-one interviews. Analysis of anthropometric and wellbeing data will determine the effectiveness of the service at reducing BMI and improving wellbeing in participants. Final data collection is scheduled for June 2014 and these data will be presented at the conference. Potentially, community pharmacies are ideal venues to deliver weight management services, and may be effective at improving BMI and wellbeing in overweight individuals. The findings from this project will be used to design a pilot RCT of pharmacy led weight management services. Funding: Stockton Council, UK.
Reference Gordon, J. I., et al. (2011). Obesity Reviews, 12, 897–911. http://dx.doi.org/10.1016/j.appet.2014.12.179
Abstracts/Appetite 87 (2015) 371–403
Healthy eating and lifestyle in pregnancy. The HELP trial S. SIMPSON a , E. JOHN a , D. CASSIDY a , R. PLAYLE a , K. JEWELL, D. COHEN, M. LONGO. a SEWTU, Cardiff University, 7th floor Neudd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. [email protected] Maternal obesity is associated with pregnancy and birth complications. Excess weight gain during pregnancy can lead to longterm maternal obesity and is linked with child obesity. This study aims to test a theory based weight management intervention for obese pregnant women, which targets physical activity and healthy eating. This cluster RCT recruited 598 pregnant women across 20 maternity units. Women in the intervention group were invited to attend a weekly weight management group. Control participants received usual care. Women were followed up at 36 weeks gestation and 6 weeks, 6 months and 1 year postpartum. The primary outcome is BMI at 1 year postpartum. Secondary outcomes include pregnancy weight gain, quality of life, mental health, waist–hip ratio, child weight, diet, physical activity, pregnancy and birth complications, breast feeding, social support, self-regulation and selfefficacy. A health economic and process evaluation were also conducted. Baseline characteristics were similar between groups. Most women thought that controlling their weight was important and around half were confident that they could control their weight during the pregnancy. Over a third of the women weighed themselves daily or weekly. Follow-up data are currently being analysed and results for all outcomes will be completed by May 2014 and presented at the conference. This trial is in an under-researched area and is highly topical. If successful, this intervention could reduce health risks and lead to reduced healthcare costs, as well as potentially impacting on the wider family. http://dx.doi.org/10.1016/j.appet.2014.12.177
Weight management in pregnancy. Participants’ experiences of ‘Healthy Eating and Lifestyle in Pregnancy (HELP)’ trial S. SIMPSON a, D. CASSIDY a, L. COPELAND a, E. JOHN a, H. STANTON a, K. JEWELL. a SEWTU, Cardiff University, 7th floor Neudd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. [email protected] Around 1 in 5 pregnant women in the UK are obese. Obesity is linked to poor health and pregnancy complications. We developed and tested in a cluster RCT a theory-driven group-based intervention for obese pregnant women that was facilitated by midwives and Slimming World consultants. It was designed to support women during pregnancy to moderate weight gain and reduce BMI one year after birth, in addition to targeting secondary health and wellbeing outcomes. This paper aims to explore participants’ experiences of engaging in the ‘HELP’ trial and provide insight into receipt of the intervention and study processes. Sixty-two women took part in semi-structured telephone interviews. Participants were sampled across 20 centres; by treatment, weight change and group attendance. Data were collected at two time-points; 6 months and 1 year post-birth, and analysed using thematic analysis. Accounts offered insights into the group environment, the importance of social
support and the value of facilitators’ involvement. Reasons for compliance were highlighted, with discussion on aspects that encouraged women to change diet and activity behaviours, barriers to engaging with the intervention, and researcher influence in control sites. Participants emphasised the benefits of attending the group sessions where they obtained knowledge, support and skills in relation to weight and pregnancy. Engaging in the intervention appeared to help women to adopt healthier habits leading to avoidance of excess weight gain during pregnancy and better outcomes for mother, baby and the wider family. Participants’ accounts will facilitate interpretation of the main study findings. http://dx.doi.org/10.1016/j.appet.2014.12.178
Is a community pharmacy led weight management service effective? A mixed methods service evaluation S. SMITH, A. TODD, S. WHISSON, C. SUMMERBELL. Durham University, Queen’s Campus, Stockton on Tees, UK. [email protected] There are over 10,500 community pharmacies in England distributed across urban and rural areas, and therefore, given this wide and equitable accessibility, community pharmacists have the potential to impact on public health priorities including nutrition education and weight management. Several small-scale studies have demonstrated the effectiveness of community pharmacy weight management interventions, but a recent systematic review by Gordon et al. (2011) was not able to make an overall judgement about the efficacy of these interventions, primarily because the evidence base they included in their reviews was limited, or of poor quality, or both. This project proposes to contribute to this evidence base by evaluating a high-quality community pharmacy weight management service already in existence in Stockton-on-Tees, UK. The service is delivered by pharmacists in 10 pharmacies across the locality over a 12 week period, targeting 100 overweight individuals (Body Mass Index (BMI) of 25 or more). The evaluation will explore the implementation and delivery of the service, and ascertain views of service commissioners, deliverers and users through one-to-one interviews. Analysis of anthropometric and wellbeing data will determine the effectiveness of the service at reducing BMI and improving wellbeing in participants. Final data collection is scheduled for June 2014 and these data will be presented at the conference. Potentially, community pharmacies are ideal venues to deliver weight management services, and may be effective at improving BMI and wellbeing in overweight individuals. The findings from this project will be used to design a pilot RCT of pharmacy led weight management services. Funding: Stockton Council, UK.
Reference Gordon, J. I., et al. (2011). Obesity Reviews, 12, 897–911. http://dx.doi.org/10.1016/j.appet.2014.12.179