title: A local consensus process making use of focus groups to enhance the implementation of a national integrated health care standard on obesity care.
abstract: BACKGROUND
  Recent guidelines on obesity management promote integrated care. There is little knowledge about local opportunities and barriers, faced by health care professionals and patients, that affect implementation of an integrated national health care standard in a local setting. Our aim is to understand experiences and expectations of health care professionals and patients as part of the local implementation process.
  
  
  METHODS
  Eight focus groups and two interviews have been conducted among 24 patients (60+) and 29 professionals from seven different care disciplines.
  
  
  RESULTS
  Both patients and professionals have identified serious barriers to implement the national standard: older adults do not feel taken seriously and experience lacking support from professionals. Professionals give contradictory advice and recommendations do not match needs of older adults. Professionals actually feel reluctant to discuss weight-related topics due to several reasons: they do not consider obesity being a chronic disease, lack of qualifications to support self-management and perceived lack of awareness and motivation among patients.
  
  
  CONCLUSIONS
  Focus groups have proven their value to ascertain the opportunities and barriers older adults and professionals foresee while improving obesity care in order to meet the standards as required in a national guideline. Our research provides an emerging picture of health care professionals and patients having contradictory views and expectations about 'the others' role and their notions on the capability to intervene on patient's weight problems. Without this emerging picture, we would have missed important information on barriers to overcome. The likelihood of successful implementation would then have been small.
authors.affiliation: Research Centre for the Prevention of Overweight, VU University Amsterdam/Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands. elze.derksen@gmail.com
authors.forename: R E
authors.initials: RE
authors.lastname: Derksen
authors.forename: W J
authors.initials: WJ
authors.lastname: Brink-Melis
authors.forename: M J
authors.initials: MJ
authors.lastname: Westerman
authors.forename: J J M Ten
authors.initials: JJ
authors.lastname: Dam
authors.forename: J C
authors.initials: JC
authors.lastname: Seidell
authors.forename: T L S
authors.initials: TL
authors.lastname: Visscher
mesh_terms: D000328:Adult; D032921:Consensus; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D011320:Primary Health Care / Q000592:standards*; D036301:Qualitative Research