Development of person-centred obesity management support during disruption: The REJOIN project

ABSTRACT

Introduction: Motivational interviewing (MI) is a well-evidenced person- centred approach to helping people with behavioural change, but has not been adapted to help with weight-related behaviour change during times of significant disruption (e.g. COVID-19). The project aimed to co-develop with stakeholders (e.g. people living with obesity) an adapted MI intervention to support individuals during disruption. Methods: UK-based adults with lived experience of obesity were recruited to take part in 3 virtual co-development meetings. These stakeholder-led meetings involved (1) familiarisation with an existing MI intervention, (2) mapping out manual content and preferred delivery methods, and (3) reviewing and revising manual drafts. Co-development methodology was employed to translate discussions to a jointly developed intervention manual. Results: Twelve stakeholders attended co-development meetings in January and February 2021 which resulted in a four-phase adapted MI intervention comprising (1) Intensive professional support, (2) Continued professional support, (3) Community MI support, and (4) an Open-door hub. Key adaptations to a general MI intervention included (1) a focusing chart comprising a 'menu of options' prompting discussion of known weight management barriers during disruption, (2) explicit facilitation of a 'shared world view' discussion, and (3) integration of three techniques (attention to the present moment, if-then planning, & environmental prompt/cues) to address 'moments of vulnerability'. Intervention content and delivery is reported in line with the TIDieR checklist (Template for Intervention Description and Replication) and established taxonomies of behaviour change techniques. Conclusion: Stakeholder meetings led to the development of an adapted MI intervention which health-care practitioners could use to support people living with obesity during times of significant physical and social disruption. Future trials of the intervention will be conducted to determine its feasibility and acceptability to stakeholders.