title: Engaging patients, clinicians and health funders in weight management: the Counterweight Programme.
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.
authors.forename: Maria
authors.initials: M
authors.lastname: McQuigg
authors.forename: Jenny E
authors.initials: JE
authors.lastname: Brown
authors.forename: J Iain
authors.initials: JI
authors.lastname: Broom
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Laws
authors.forename: John P D
authors.initials: JP
authors.lastname: Reckless
authors.forename: Paula A
authors.initials: PA
authors.lastname: Noble
authors.forename: Sudhesh
authors.initials: S
authors.lastname: Kumar
authors.forename: E Louise
authors.initials: EL
authors.lastname: McCombie
authors.forename: Mike E J
authors.initials: ME
authors.lastname: Lean
authors.forename: G Felicity
authors.initials: GF
authors.lastname: Lyons
authors.forename: Sarika
authors.initials: S
authors.lastname: Mongia
authors.forename: Gary S
authors.initials: GS
authors.lastname: Frost
authors.forename: Marney F
authors.initials: MF
authors.lastname: Quinn
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Haynes
authors.forename: Nick
authors.initials: N
authors.lastname: Finer
authors.forename: David W
authors.initials: DW
authors.lastname: Haslam
authors.forename: Hazel M
authors.initials: HM
authors.lastname: Ross
authors.forename: David J
authors.initials: DJ
authors.lastname: Hole
authors.forename: Steven
authors.initials: S
authors.lastname: Radziwonik
mesh_terms: D001291:Attitude of Health Personnel; D001835:Body Weight; D019317:Evidence-Based Medicine; D017144:Focus Groups; D006801:Humans; D009313:National Health Programs; D009723:Nurse-Patient Relations; D009765:Obesity / Q000628:therapy*; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D020377:Self Efficacy; D006113:United Kingdom; D015431:Weight Loss