title: Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.
abstract: BACKGROUND
  Referral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants' view of weight management as a lifestyle issue.
  
  
  OBJECTIVE
  To examine the ways in which participants' attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention.
  
  
  METHODS
  A qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June-September 2013.
  
  
  METHODS
  Twenty-nine participants (body mass index [BMI] ≥28 kg/m(2); age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach.
  
  
  RESULTS
  Although participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits.
  
  
  CONCLUSIONS
  Referral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects.
authors.affiliation: The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge.
authors.forename: Jodie T
authors.initials: JT
authors.lastname: Allen
authors.affiliation: Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, and senior lecturer, The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Cohn
authors.affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, Cambridge.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ahern
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000523:psychology; D009765:Obesity / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology; D011320:Primary Health Care / Q000379:methods*; D055818:Public-Private Sector Partnerships; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration; D040242:Risk Reduction Behavior; D006113:United Kingdom; D061217:Weight Reduction Programs / Q000379:methods*
keywords: general practice; obesity; primary health care; qualitative research; referral and consultation; weight loss
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