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Family Practice Advance Access published online on November 27, 2008
Family Practice, doi:10.1093/fampra/cmn081
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Engaging patients, clinicians and health funders in weight management: the Counterweight Programme

The Counterweight Project Team, Maria McQuigga, Jenny E Browna, J Iain Broomb, Rachel A Lawsa, John P D Recklessb, Paula A Noblea, Sudhesh Kumarb, E Louise McCombiea,*, Mike E J Leanb, G Felicity Lyonsa, Sarika Mongiaa, Gary S Frostb,*, Marney F Quinna, Julian H Barthb, Sarah M Haynesa, Nick Finerb, David W Haslamd, Hazel M Rosse,*, David J Holef and Steven Radziwonikf

* Have written the paper with contribution from other authors
a Weight Management Adviser (WMA)
b Principal Investigator (PI)
c ClinicalNurse Specialist (CNS)
d General Practitioner (GP)
e Counterweight Project Co-ordinator
f Data and Statistical Analysts

Correspondence to Professor Gary Frost, Head of Nutrition and Dietetic Research Group, Imperial College, Hammersmith Campus, London, UK; Email: g.frost{at}imperial.ac.uk

Received 27 May 2008; Revised 26 September 2008; Accepted 2 October 2008.


  Abstract

Background. The Counterweight Programme provides an evidence based and effective approach for weight management in routine primary care. Uptake of the programme has been variable for practices and patients.

Aim. To explore key barriers and facilitators of practice and patient engagement in the Counterweight Programme and to describe key strategies used to address barriers in the wider implementation of this weight management programme in UK primary care.

Methods. All seven weight management advisers participated in a focus group. In-depth interviews were conducted with purposeful samples of GPs (n = 7) and practice nurses (n = 15) from 11 practices out of the 65 participating in the programme. A total of 37 patients participated through a mixture of in-depth interviews (n = 18) and three focus groups. Interviews and focus groups were analysed for key themes that emerged.

Results. Engagement of practice staff was influenced by clinicians’ beliefs and attitudes, factors relating to the way the programme was initiated and implemented, the programme content and organizational/contextual factors. Patient engagement was influenced by practice endorsement of the programme, clear understanding of programme goals, structured proactive follow-up and perception of positive outcomes.

Conclusions. Having a clear understanding of programme goals and expectations, enhancing self-efficacy in weight management and providing proactive follow-up is important for engaging both practices and patients. The widespread integration of weight management programmes into routine primary care is likely to require supportive public policy.

Keywords. Patient-professional engagement, obesity management.

Counterweight Project Team, McQuigg M, Brown JE, Broom JI, Laws RA, Reckless JPD, Noble PA, Kumar S, McCombie EL, Lean MEJ, Lyons GF, Mongia S, Frost GS, Quinn MF, Barth JH, Haynes SM, Finer N, Haslam DW, Ross HM, Hole DJ and Radziwonik S. Engaging patients, clinicians and health funders in weight management: the Counterweight Programme. Family Practice 2008; 25: i79–i86.


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