Weight management interventions for adults living with overweight or obesity and severe mental illness: a systematic review and meta-analysis.

When compared with the general population, people living with severe mental illness (SMI) are 1·8 times more likely to have obesity while in adult mental health secure units, rates of obesity are 20 % higher than the general population. In England, there are currently 490 000 people living with SMI. The aim of this systematic review was to collate and synthesise the available quantitative and qualitative evidence on a broad range of weight management interventions for adults living with SMI and overweight or obesity. Primary outcomes were reductions in BMI and body weight. Following sifting, eighteen papers were included in the final review, which detailed the results of nineteen different interventions; however, there was a lack of qualitative evidence. Pooled results for three studies (MD - 3·49, 95 % CI - 6·85, -0·13, P = 0·04) indicated a small effect in terms of body weight reduction but no effect on BMI for four studies (MD - 0·42, 95 % CI - 1·27, 0·44, P = 0·34). Key recommendations for future research included integration of qualitative methodology into experimental study design, a review of outcome measures and for study authors to follow standardised guidelines for reporting to facilitate complete and transparent reporting.

Exploring the Perceived Impact of the COVID-19 Pandemic Social Distancing Measures on Athlete Wellbeing: A Qualitative Study Utilising Photo-Elicitation.

Countries all over the globe have implemented mandatory social distancing measures in an attempt to suppress and control the spread of the Coronavirus disease (COVID-19). This enforced period of isolation, disruption to normal training routines and competition cancellation, could be having an adverse effect on the mental health and wellbeing of athletes. This study sought to explore the perceived impact of the COVID-19 social distancing measures on athlete wellbeing. Fourteen elite athletes who were unable to train or compete due to government imposed lockdown measures were recruited to participate in this qualitative study. Utilising the photo elicitation method, participants were asked to take a series of photographs that represented their experiences as athletes living in lockdown. These photographs were used to guide discussions in follow up unstructured interviews. Reflexive inductive thematic analysis identified three main themes that captured athletes' experience of social distancing measures and the implications for their wellbeing: (1) threats to wellbeing; (2) adapting routines and maintaining motivation; and (3) reflecting on participation in competitive elite sport. The initial sudden loss of sport in the athlete's lives posed a threat to their wellbeing, but over the duration of the lockdown period the athletes developed numerous strategies to protect their wellbeing. Furthermore, their time away from sport encouraged them to reflect on their athletic identity and to make life changes that would protect their wellbeing during the rest of the lockdown period and when they returned to sport. A number of immediate practical recommendations are offered for athlete support personnel working with athletes during the crisis, these include developing self-care strategies and social networks, adapting routines, setting new goals and encouraging the pursuit of dual-careers. Future research is encouraged to investigate how practitioners can deliver effective psychological support through tele-consulting, and to consider whether their support is best focused on therapeutic counselling or mental skills training during the pandemic.

The role of internet resources in health decision-making: a qualitative study.

OBJECTIVE: Internet resources remain important for health information and advice but their specific role in decision-making is understudied, often assumed and remains unclear. In this article, we examine the different ways in which internet resources play a role in health decision-making within the context of distributed decision-making. METHODS: We conducted semi-structured interviews with 37 people in the United Kingdom who reported using the internet in relation to decision-making, and representing a range of long- and short-term health conditions. The interviews focused on decision-making activities across different settings and in relation to different stakeholders to understand how internet resources play a role in these activities. We carried out a thematic analysis of the interviews. RESULTS: We identified three main ways in which internet resources played a role in health decision-making. A supportive role (as a decision crutch), a stimulating role (as a decision initiator), and an interactional role (impacting on the doctor-patient relationship). These three roles spanned different resources and illustrated how the decision-making process can be impacted by the encounters people have with technology - specifically internet based health resources - in different ways and at different time points. CONCLUSIONS: Examining health decisions with respect to internet resources highlights the complex and distributed nature of decision-making alongside the complexity of online health information sourcing. We discuss the role of internet resources in relation to the increasing importance of online personal experiences and their relevance within shared decision-making.

Changing hospitals, choosing chemotherapy and deciding you've made the right choice: Understanding the role of online support groups in different health decision-making activities.

OBJECTIVE: To investigate the ways in which people use online support groups (OSGs) in relation to their health decision-making and to identify the key features of the resource that support those activities. METHOD: Eighteen participants who used OSGs for a range of health conditions participated in qualitative study in which they were interviewed about their experiences of using OSGs in relation to decision-making. Exploration of their experiences was supported by discussion of illustrative quotes. RESULTS: Across the health conditions OSGs supported two main decision-making activities: (i) prompting decision making and (ii) evaluating and confirming decisions already made. Depending on the activity, participants valued information about the process, the experience and the outcome of patient narratives. The importance of forum interactivity was highlighted in relation to advice-seeking and the selection of relevant personal experiences. CONCLUSION: People use OSGs in different ways to support their health related decision-making valuing the different content types of the narratives and the interactivity provided by the resource. PRACTICE IMPLICATIONS: Engaging with OSGs helps people in a number of different ways in relation to decision-making. However, it only forms one part of people's decision-making strategies and appropriate resources should be signposted where possible.