Digital physical activity health tool and culturally tailored weight management programmes are promoting healthy lifestyles in patients in obesity services
Nearly two thirds of adults in England are currently living with overweight or obesity.
People from ethnic minority backgrounds are disproportionately affected, and physical inactivity is currently the fourth leading risk factor for mortality (death) globally.
Clinical obesity is managed through specialist weight management services. However, these services often lack adequate provision of physical activity or tailoring for ethnic minority cultures.
Two targeted interventions developed by Leicester researchers are now having beneficial results for patients after being used within weight management services. These services provide specialist non-surgical support for individuals with severe and complex obesity.
Reducing physical inactivity plays a fundamental role in the overall health and wellbeing of individuals living with obesity.
The benefits of increasing day-to-day physical activity levels are multifaceted and include optimising body composition, functional ability, psychological wellbeing, cardiometabolic health and longevity.
Research undertaken within the lifestyle theme at NIHR Leicester BRC has changed international guidance on physical activity and long-term conditions. This work led to the development of the Steps4Health web-based app which was embedded within a tier 3 weight management service as part of routine care.
The Steps4Health web-based app monitors the user’s 24-hour physical behaviours focusing on the 5 Ss: Sitting, Stepping, Sweating, Strengthening and Sleeping.
The app generates personalised targets including a walking programme, and offers users continual feedback alongside educational material, and enables linkage to wearable activity devices and smart mobile phones.
Of 559 tier-3 service users 307 were eligible for referral to Steps4health and 290 completed registration. The most popular features of Steps4Health were educational resources providing information on physical activity and chronic conditions.
Over the first 6 weeks, an average clinically meaningful increase of 974 steps per day was observed, with the greatest increase seen in those with the highest risk of inactivity.
If commissioned nationally, Steps4Health could contribute to a reduction in the risk of cardiovascular disease in those living with clinical obesity.
NIHR’s Infrastructure funding through the Leicester BRC provided the resources necessary for research translation, stakeholder engagement, and digital development for Steps4Health. Without it the app would not have been developed or integrated into clinical care, and its potential to impact national policy and reduce cardiovascular risk in people with clinical obesity would not have been realised.
Tackling ethnic health inequalities through widening access to weight management services is a further focus of the Leicester team.
Up! Up! Living lighter the African and Caribbean way, is a tier 2 weight management service that is tailored for people of Black, Caribbean or African heritage.
Professor Goff worked in partnership with Lewisham community organisations and King’s Health Partner’s Diabetes, Endocrinology and Obesity (DEO) to develop and test the effectiveness of the culturally tailored programme which focuses on nutrition coaching, physical activity classes and cooking workshops.
After observing weight loss of 4.5% and reductions in waist circumference of 5cm on average in its attendees, the 12-week programme has now been commissioned as a tier 2 weight management programme by Lewisham Council.
Since being commissioned, to date Up!Up! has made a difference to around 400 people