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Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study.

ABSTRACT: OBJECTIVE:Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional's perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities. DESIGN:A phenomenological-hermeneutical qualitative study was performed using semistructured interviews. SETTING:Thirty-two Danish municipalities were weight loss programmes are developed and conducted. PARTICIPANTS:Thirty-five health professionals with experience conducting weight loss programmes. RESULTS:Three themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life. CONCLUSION:Future municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.

SUBMITTER: Jessen-Winge C

PROVIDER: S-EPMC7677371 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study.

Jessen-Winge Christina C Ilvig Pia Marie PM Thilsing Trine T Lee Kim K Fritz Heather H Christensen Jeanette Reffstrup JR

BMJ open 20201118 11

<h4>Objective</h4>Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting wei ...[more]

PMID: 33208329

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Project description:INTRODUCTION:Given the prevalence of mental health problems globally, there is an increasing need for the police and other non-mental health trained professionals to identify and manage situations involving individuals with mental health problems. The review aimed to identify and explore qualitative evidence on views and experiences of non-mental health professionals receiving mental health training and the barriers and facilitators to training delivery and implementation. METHODS:A meta-synthesis of qualitative evidence on the barriers, facilitators and perceived impact of mental health training programmes for non-mental health trained professionals. Systematic literature searches were undertaken of the following databases: Criminal Justice Abstracts (CJA); MEDLINE; Embase; PsycINFO; ASSIA; CENTRAL; SSCI; ERIC; Campbell Library; Social Care Online and EPOC from 1995 to 2016. Records were independently screened for eligibility by two researchers, data extraction and quality appraisal of studies was also undertaken independently by two researchers. The CASP tool was used to quality appraise included studies. Included studies were synthesised using a meta-ethnographic approach as outlined by Noblit and Hare. RESULTS:10,282 records were identified and eight qualitative studies were included. A range of barriers and facilitators to training were identified and related to the delivery and content of training; the use of additional resources; and staff willingness to engage with training and organisational factors. The perceived impact of training was also discussed in terms of how it affects trainees; perceptions of mental health; self-perception; responses to situations involving mental health and the potential of training to reduce injury or physical harm in situations involving mental health. The value of training and how to measure its impact were also discussed. CONCLUSION:Findings from this review have implications for those designing, implementing and evaluating mental health training programmes. It is recommended that research evaluating mental health training includes a qualitative component to ensure that the barriers and facilitators to training and its impact on trainees' perceptions of mental health are understood. PROTOCOL REGISTRATION NUMBER:PROSPERO: CRD42015015981.

Project description:BackgroundObesity is a cardiovascular disease risk factor. Conventional weight loss (CWL) programmes focus on weight loss, however 'health, not weight loss, focused' (HNWL) programmes concentrate on improved health and well-being, irrespective of weight loss. What are the differences in CVD risk outcomes between these programmes?AimTo conduct a systematic review and meta-analysis to compare the effects of HNWL with CWL programmes on cardiovascular disease risk factors.MethodsWe searched CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, clinical trial registers, commercial websites and reference lists for randomised controlled trials comparing the two programmes (initially searched up to August 2015 and searched updated to 5 April 2019). We used the Mantel-Haneszel fixed-effect model to pool results. Sub-group and sensitivity analyses that accounted for variations in length of follow-up, enhanced programmes and risk of bias dealt with heterogeneity.ResultsEight randomised controlled trials of 20,242 potential studies were included. Improvements in total cholesterol-HDL ratio (mean difference - 0.21 mmol/L, 95% confidence interval [- 3.91, 3.50]) and weight loss (- 0.28 kg [- 2.00, 1.44]) favoured HNWL compared to CWL programmes in the long term (53-104 week follow-up), whereas improvements in systolic (- 1.14 mmHg, [- 5.84, 3.56]) and diastolic (- 0.15 mmHg, [- 3.64, 3.34]) blood pressure favoured CWL programmes. These differences did not reach statistical significance. Statistically significant improvements in body satisfaction (- 4.30 [- 8.32, - 0.28]) and restrained eating behaviour (- 4.30 [- 6.77, - 1.83]) favoured HNWL over CWL programmes.ConclusionsWe found no long-term significant differences in improved CVD risk factors; however, body satisfaction and restrained eating behaviour improved more with HNWL compared to CWL programmes. Yet firm conclusions cannot be drawn from small studies with high losses to follow-up and data sometimes arising from a single small study.Systematic review registrationPROSPERO CRD42015019505.

Project description:BackgroundMental health professionals (MHP) working in court-mandated treatment settings face ethical dilemmas due to their dual role in assuring their patient's well-being while guaranteeing the security of the population. Clear practical guidelines to support these MHPs' decision-making are lacking, amongst others, due to the ethical conflicts within this field. This qualitative interview study contributes to the much-needed empirical research on how MHPs resolve these ethical conflicts in daily clinical practice.Methods31 MHPs working in court-mandated treatment settings were interviewed. The interviews were semi-structured and our in-depth analysis followed the thematic analysis approach.ResultsWe first outline how mental health professionals perceive their dual loyalty conflict and how they describe their affiliations with the medical and the justice system. Our findings indicate that this positioning was influenced by situational factors, drawing the MHPs at times closer to the caring or controlling poles. Second, our results illustrate how participating MHPs solve their dual loyalty conflict. Participants considered central to motivate the patient, to see the benefits of treatment and its goals. Further, transparent communication with patients and representatives of the justice system was highlighted as key to develop a trustful relationship with the patient and to manage the influences from the different players involved.ConclusionsEven though individual positioning and opinions towards dealing with the influences of the justice system varied, the results of our research show that, in spite of varying positions, the underlying practice is not very different across participating MHPs. Several techniques that allow developing a high-quality therapeutic alliance with the patient are key elements of general psychotherapy. Transparency appears as the crucial factor when communicating with the patient and with representatives of the justice system. More specifically, patients need to be informed since the beginning of therapy about the limits of medical confidentiality. It is also recommended to develop guidelines that define the level of detailed information that should be disclosed when communicating with the authorities of the justice system.

Project description:BackgroundImmigrant health professionals are a particularly vulnerable group in a host country's labour market, as they face several barriers when re-entering their occupations. International studies indicate that early interventions can increase the employability of immigrants. Qualification programmes are one of these early interventions that can support the re-integration of these health professionals into the labour market. The purpose of this review is to identify international qualification programmes for immigrant health professionals, analyse their content and evaluate their effectiveness.MethodsSix international databases (PubMed, Web of Science, CINAHL, PsychInfo, EBSCO and ProQuest Social Sciences) were systematically searched. The search terms were identified using the PICOS-framework. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were screened independently by two authors and discussed. Studies included in the final synthesis were assessed with the Mixed Methods Appraisal Tool (MMAT) and Kirkpatrick's Training Evaluation Model.ResultsOut of 10,371 findings, 31 articles were included in the final synthesis. The majority of them were addressed to international health care professionals and doctors. Two of them were addressed to refugee doctors. Three types of programme elements were identified: teaching, clinical practise and social support. The programmes' length ranged from 2 days to up to 2.5 years. Despite recommendations in its favour, pre- and post-programme support was scarce. Results also indicate a lack of transparency and quality in terms of evaluation. Effectiveness was mostly observed in the area of language improvement and an increase in self-confidence.ConclusionThis review points out the lack of systematically evaluated qualification programmes for immigrant health professionals. Programme providers should focus on implementing programmes for all health professionals as well as for underrepresented groups, such as refugees. In order to generate best practises it is necessary to evaluate these programmes. This requires the development of appropriate instruments when working with immigrant population in the context of educational programmes.

Project description:BackgroundThe shortage of healthcare professionals (HCP) negatively affects health services in rural areas in many parts of the world, as is the case in South Africa. Innovative programs designed to improve the recruitment strategies for health system in a rural area are essential. They need support with a scholarship and mentorship programme for young people from rural areas to study for health science degrees, with the aim that they would take up a post at the hospital in their community, once qualified. This paper reports the perceptions and experiences of the students and graduates sponsored by the foundation, and those of managers from the facilities where the students were ultimately placed, in order to gauge whether such a programme can make a sustainable contribution to address the shortage of health personnel in rural areas and to what extent this is happening.MethodsThe authors used qualitative methods, combining semi-structured in-depth interviews and focus groups and the data were analyzed thematically.ResultsThe results provide information on students interviewed who appreciated the financial and socio-emotional support that they received. On the other hand, graduates value the availability of jobs in their home community on completion of their studies. The managers reported the success of the programme in increasing the number of healthcare personnel at the hospitals, and the increased range of available medical services. Since the graduates are familiar with the language and culture of their patients the managers considered that they are better able to assist them.ConclusionsThe system was well thought-out and achieved its goal of improving health services in an underdeveloped rural area of South Africa. More could be achieved if other government services in the area were simultaneously improved and if the system were replicated elsewhere. The students and graduates from rural areas are involved on sustaining health services in rural areas while rural managers support the programme and make suggestions for improvement and to promote the program in other regions.

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Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study.

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Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study.

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