Tagged / Obesity

Congratulations to Denyse King

Congratulations to Denyse King, who is currently attending the Future Technologies Conference, FTC 2018; Vancouver, BC; Canada (15-16 November).  Her conference paper ‘NoObesity apps – From approach to finished app’ has been published in Advances in Intelligent Systems and Computing [1].  Denyse is part of the Centre for Midwifery, Maternal & Perinatal Health (CMMHP) where she is a Lecturer (Academic) in Midwifery based at BU’s campus in Portsmouth ,

Obesity is still a growing public health problem in the UK and many healthcare workers find it challenging to have a discussion with service users about this sensitive topic. They also feel they are not competent to provide the relevant heath advice and are seeking easily accessible, evidence-based, mobile health learning (mHealth). mHealth applications (apps) such as the Professional NoObesity and Family NoObesity (due for release late 2018), have been designed to: support families with making sustainable positive behaviour changes to their health and well-being, ease pressure on practitioners’ overweight and obesity care related workloads, as well as to support the education of professionals, students and service users. This paper describes the process of designing the apps from the inception of the idea, through the stages of research, app builds and testing. The processes of collaborative working to design and develop the apps to meet the needs of both service users and health professionals will also be reflected upon. Childhood obesity is an complex problem and whilst it is recognised that the NoObesity apps cannot singlehandedly resolve this health crisis, it is proposed that they can support families to identify and reduce the barriers that prevent them from living healthier, happier lives. 

Reference:

King D., Rahman E., Potter A., van Teijlingen E. (2019) NoObesity Apps – From Approach to Finished App. In: Arai K., Bhatia R., Kapoor S. (eds) Proceedings of the Future Technologies Conference (FTC) 2018. FTC 2018. Advances in Intelligent Systems and Computing, vol 881. Springer, Cham, pp. 1145-1157.

Denyse King’s Health Education England project ‘NoObesity’

NoObesity

The government’s key priority of reducing childhood obesity through adult education (as announced by Jeremy Hunt in Sept 2015), prompted BU’s Denyse King to write a proposal to Health Education England. Denyse is a Midwifery Lecturer / Public Health Practitioner in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) at Bournemouth University. The proposal outlined her wish to develop a stand-alone mobile learning resource for health workers who care for families of overweight or obese children, and for families who need to identify individual needs to facilitate behavioural changes.

Afbeeldingsresultaat voor childhood obesity statistics uk, 2016

The development of this project pivoted on putting patients and the public in the centre of the process. Patients and the public were engaged through focus groups where insights were gathered to identify the challenges and issues to the problem. A series of online focus groups were undertaken with service users and professionals to understand the key challenges and issues respondents came across when trying to prevent/manage overweight and obesity. Key themes from the focus groups were:

  • Empowering – the solution needs to recognise the experiences people bring and therefore the tools need to be empowering in supporting families to address obesity.
  • Parenting tips – to address challenges with encouraging positive health behaviours with children.
  • Responding to barriers – from parent/carers who are being supported by health professionals.
  • Obesity isn’t a quick fix – recognising that sustained behaviour change takes time and support to overcoming barriers is vital.
  • Healthy snacks and activities – provide easy and simple ideas to support parents/carers and professionals to identify quick ways to support healthier eating and increase activity.
  • Portion size – understanding that portion size is important in addition to eating healthily.

Topic experts were identified and invited to join the project steering group where they provided the governance and steer of the overall development of this project whilst Denyse King wrote the content. The following Apps have been developed as a result and will be available to all as free download in IOS and Android platforms from late September 2017:

  • NoObesity Family Focused App – After consultation with a healthcare worker, families set health goals, identify potential barriers and strategies to overcome them, record their progress towards their goals, earning points and awards as they go. Families are encouraged to link accounts to healthcare professional accounts (see below). The tool also includes parenting tips, games and useful links.
  • NoObesity Professional Focused App– Healthcare professionals can see the goals, barriers, strategies, progress, points and awards of linked families, making them better able to provide tailored advice to the families, to help them achieve their goals. This is based on research findings that ‘one-size- fits-all’ health advice simply doesn’t work for most families. The tool also includes the Wessex MECC-based guidance on how to best support families, how to handle common objections, games and useful links.

Denyse would like to thank Dr. Joanne Newton project proposal support, Felicity Hargreaves and Helen Bingham for approval of the final project proposall. Thanks to all those who contributed to answering the research questions, as well as those who tested and fed back on the prototype, and also to Bournemouth University, University of Southampton, and NHS England for their support of this project.

 

List of the members of the steering group

Name Job Title Organisation Steering Group Role
Em Rahman Head of Public Health Workforce Development Programmes Health Education England (Wessex) Steering Group Chair
Alison Potter Technology Enhanced Learning Lead (South) Health Education England (South) Deputy-Chair
Dr. Jenny Godson (MBE) National Lead for Oral Health Improvement Public Health England Dental and dental aspects of nutrition
Prof. Edwin van Teijingen Professor – Centre for Midwifery, Maternal & Perinatal Health Bournemouth University Research supervision and education governance
Dr. Juliet McGrattan General Practitioner Cumbria Medical Chambers GP role governance
Kate King-Hicks Health and Wellbeing Programme Lead Public Health England (South East) Obesity governance
Tony Hewett Intervention Manager and behaviour change specialist Miltoncross Academy School staff role governance
Dr. Jo Walker Consultant Paediatrician Portsmouth Hospitals Trust Consultant doctors role governance
Dr. Wendy Marsh Lead Midwife for Safeguarding Portsmouth Hospitals Trust Safeguarding governance
Kate Lees Consultant in Public Health and Dietitian Lees & Latouze Nutrition governance
Denyse King Lecturer in Midwifery and Public Health Practitioner Bournemouth University Content author and governance

“New” FHSS paper on obesity published July 2017


The American Journal of Men’s Health published our latest paper on obesity prevention in men.  The paper ‘Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)’ originates from a collaboration between BU and various universities in Scotland, led by the University of Aberdeen [1].

This systematic review paper found that reducing diets produced better weight loss than physical activity alone. The most effective interventions combined reducing diets, exercise, and behaviour change techniques . Group interventions produced favourable weight loss results. The paper reports that once engaged, men remained committed to a weight loss intervention.

The paper concludes that weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behaviour change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.  This paper is the thirteenth paper from a large NIHR grant [2-13].

The American Journal of Men’s Health is an open access, peer-reviewed resource for cutting-edge information regarding men’s health and illness. It is, however worth noting that although our paper is formally published in July 2017 it has been online for two years!  The journal’s website states clearly that the article was first published online on June 30, 2015 BUT the issue in which it appears is published is July 1, 2017!

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. (2017) Clinical effectiveness of weight loss & weight maintenance interventions for men: a systematic review of men-only randomised controlled trials (ROMEO Project), American Journal of Men’s Health 11(4): 1096-1123.  http://journals.sagepub.com/doi/full/10.1177/1557988315587550
  2. Robertson, C, Archibald, D, Avenell, A, Douglas, F., Hoddinott, P., van Teijlingen E, Boyers, D., Stewart, F, Boachie, C, Fioratou E., Wilkins, D, Street, T., Carroll, P., Fowler, C. (2014) Systematic reviews of & integrated report on quantitative, qualitative & economic evidence base for the management of obesity in men. Health Technology Assessment 18(35): 1-424. http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/118180/FullReport-hta18350.pdf
  3. Stewart, F., Fraser, C., Robertson, C., Avenell, A., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. (2014) Are men difficult to find? Identifying male-specific studies in MEDLINE and Embase, Systematics Reviews 3,78.
  4. Archibald, D, Douglas, F, Hoddinott, P, van Teijlingen, E, Stewart, F., Robertson, C., Boyers, D., Avenell, A. (2015) A qualitative evidence synthesis on management of male obesity. BMJ Open 5: e008372. doi:10.1136/bmjopen-2015-008372 http://bmjopen.bmj.com/content/5/10/e008372.full.pdf+html
  5. Boyers, D, Stewart, F, Fraser, C, Robertson, C, Avenell, A, Archibald, D, Douglas, F, Hoddinott P, van Teijlingen E. (2015). A systematic review of the cost-effectiveness of non-surgical obesity interventions in men, Obesity Research & Clinical Practice 9(4), 310-327.
  6. Robertson, C, Avenell, A, Boachie, C., Stewart, F., Archibald D., Hoddinott, P, Douglas, F, van Teijlingen E, Boyers D. (2016) Should weight loss and maintenance programmes be designed differently for men? Systematic review of long-term RCTs presenting data for men & women: The ROMEO Project, Obesity Research & Clinical Practice 10: 70-84.
  7. Robertson, C., Avenell, A., Boachie, C., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. (2015) Should weight loss programmes be designed differently for men and women? The ROMEO Project, Appetite 87: 374.
  8. Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. (2015) A systematic review of long-term weight management randomized controlled trials for obese men. The ROMEO Project, Appetite 87: 374.
  9. Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. (2015) A systematic review of weight loss interventions in the UK. The ROMEO Project, Appetite 87: 375.
  10. Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., (2015) A systematic review of the cost-effectiveness of non-surgical obesity interventions in men, Appetite 87: 375.
  11. Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D., Avenell, A., Stewart, F., Robertson, C., (2015) A qualitative evidence synthesis on the management of male obesity. The ROMEO Project, Appetite 87: 381.
  12. Avenell, A., Robertson, C., Boachie, C., Stewart, F Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. (2016) Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses BMJ 355:i5826 http://www.bmj.com/content/355/bmj.i5826/rapid-responses
  13. Avenell, A., Robertson, C., Stewart, F., Boyers, D., Douglas, F., Archibald, D., van Teijlingen, E., Hoddinott, P., Boachie, C. (2016) Sex can affect participation, engagement, and adherence in trials, BMJ 355:i6754 http://www.bmj.com/content/bmj/355/bmj.i6754.full.pdf

Management of male obesity: The qualitative evidence (BMJ Open)

BMJ Open 2015Yesterday BMJ Open published our latest article on the weight management in obese men, under the title A qualitative evidence synthesis on the management of male obesity.[1]  To the best of our knowledge, this is the first synthesis of qualitative studies investigating men’s perceptions and experiences of weight management services.  The interdisciplinary study was conducted between the three research centres at the University of Aberdeen, namely the Health Services Research Unit (HSRU), the Health Economics Research Unit (HERU) and the Rowett Institute of Health & Nutrition, the University of Stirling’s NMAHP Research Unit, the University of Edinburgh’s Scottish Collaboration for Public Health Research & Policy (SCPHRP) and Bournemouth University.

Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m2 in all settings. In total 22 studies were identified.

Health concerns and the perception that certain programmes had ‘worked’ for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematizing their weight until labelled ‘obese’; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design.

The paper concluded that men’s perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition.  This paper grew out of the larger ROMEO study which was published in our full HTA (Health Technology Assessment) report, which is also freely available on line, click here! [2]

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Stewart, F., Robertson, C., Boyers, D., Avenell, A. (2015) A qualitative evidence synthesis on the management of male obesity. BMJ Open 5: e008372. doi:10.1136/bmjopen-2015-008372 http://bmjopen.bmj.com/content/5/10/e008372.full.pdf+html
  2. Robertson, C., Archibald, D., Avenell, A., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D., Stewart, F., Boachie, C., Fioratou, E., Wilkins, D., Street, T., Carroll, P., Fowler, C. (2014) Systematic reviews of & integrated report on the quantitative, qualitative & economic evidence base for the management of obesity in men. Health Technology Assessment 18(35): 1-424.  http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/118180/FullReport-hta18350.pdf

New paper on obesity research

Colleagues associated with the Health Economics Research Unit (HERU), Health Services Research Unit (HSRU) and the Rowett Institute of Nutrition and Health (all based at the University of Aberdeen), the Nursing, Midwifery & Allied Health Professional Research Unit (University of Stirling), the Scottish Collaboration for Public Health Research & Policy (SCPHRP) based at the University of Edinburgh and the Centre for Midwifery, Maternal and Perinatal Health (CMMPH) at Bournemouth University published their latest paper on obesity research.  The paper ‘A systematic review of the cost-effectiveness of non-surgical obesity interventions in men’ is published in the journal: Obesity Research & Clinical Practice.  This systematic review summarises the literature reporting the cost-effectiveness of non-surgical weight-management interventions for men. Studies were quality assessed against a checklist for appraising decision modelling studies.  This research is part of the larger ROMEO study.

 

Prof. Edwin van Teijlingen

Faculty of Health & Social Sciences

 

Reference:

Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., A systematic review of the cost-effectiveness of non-surgical obesity interventions in men, Obesity Research & Clinical Practice (online first)

Changing diet and exercise, offering men-only groups, and humour may be the recipe for tackling male obesity

Fewer men join weight loss programmes but are more likely than women to stick with them, according to analysis of international obesity studies by researchers from the Universities of Aberdeen, Bournemouth and Stirling.

Men also prefer the use of simple ‘business-like’ language, welcome humour used sensitively, and benefit from the moral support of other men in strategies to tackle obesity. The researchers suggest that obese men might be helped better if weight loss programmes were specifically designed for men.

Researchers from the Universities of Aberdeen, Bournemouth and Stirling analysed evidence from around the world, gathered from weight loss trials and studies that have also taken men’s views. The team particularly investigated what would make services more appealing for men.

From their systematic review (see: http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/118180/FullReport-hta18350.pdf ) of the evidence on obesity management published by the NHS National Institute for Health Research Health Technology Assessment Programme, researchers also found:

 

  • Cutting calories together with exercise and following advice on changing behaviour are the best way for obese men to shed pounds. This can also help reduce the risk of type 2 diabetes and can help improve erectile dysfunction for some men.
  • Obese men who eat less lose more weight than those who take more exercise but don’t eat less.
  • In the long term, one calorie-reducing diet has not yet been found to better than another for weight loss for men.
  • Middle-aged men are motivated to lose weight once they perceive they have a health problem they want to tackle.
  • A desire to improve personal appearance without looking too thin is also a motivator for weight loss in men.
  • Men are likely to prefer weight-loss programmes delivered by the NHS rather than those run commercially.
  • Group-based weight management programmes run only for men provide moral support.
  • Obesity interventions in sports clubs, such as football clubs, have been very effective, with low dropout rates and very positive responses from men.

 

Chief investigator Professor Alison Avenell, based at the University of Aberdeen, said: “More men than women are overweight or obese in the UK, but men are less likely to see their weight as a problem and engage with weight-loss services, even though obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. This could be because dieting and weight-loss programmes are perceived as being feminine activities.”

“We looked at the outcomes of obesity management trials and interventions as well as interviews with men in order to find out more about how to design services and inform health policy. While more research is needed into the effectiveness of new approaches to engage men with weight-loss, our findings suggest that men should be offered the opportunity to attend weight loss programmes that are different to programmes which are mainly attended by women.”

 

Dr Flora Douglas, from the Rowett Institute of Nutrition and Health, said: “Men prefer more factual information on how to lose weight and more emphasis on physical activity in weight loss programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings.   Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice helped men.  Programmes which were situated in a sporting venue, where participants had a strong sense of affiliation, showed low drop-out rates and high satisfaction.”

University of Stirling Professor Pat Hoddinott said: “Men are much less likely to enrol in commercial weight loss schemes. Some men preferred weight loss programmes delivered in an NHS context. The difference between weight loss for men from NHS and commercial programmes is presently unclear”.

 

Professor Edwin van Teijlingen from Bournemouth University added: “This research project has benefited throughout from the input and insights offered by the Men’s Health Forum in Ireland, the Men’s Health Forum Scotland and the Men’s Health Forum England and Wales.”

This project was funded by the National Institute for Health Research, Health Technology Assessment Programme (NIHR HTA Project 09/127/01; Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men http://www.nets.nihr.ac.uk/projects/hta/0912701).  The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health.

 

Prof. Edwin van Teijlingen

CMMPH