Co-Designing and Refining a Home-Based Exercise Programme for Adults Living with Overweight and Obesity: Insight from People with Lived Experience
Abstract
:1. Introduction
2. Materials and Methods
3. Results and Discussion
3.1. Priority One—Individualisation
“You’re talking about people living their lives. That’s the whole point isn’t it, it’s person centred, good things and bad things happen so you’ve got to have that flexibility is the key to it really.”(P5,I)
“The right fit for you might not be someone like, I’ve said it as well, it’s not necessarily someone that’s the same as you.”(P1,I)
“I know what it’s like developing these things, that the the list of um your wants and what can be delivered straight away is two different things.”(P3,I)
“It’s very specific to you rather than having a general um um general outcomes because exercise and health is very individual and very you know uh idiosyncratic, and what you like and what you don’t like and what’s important to you.”(P5,I)
3.2. Priority Two—Motivation
“So the motivations in this room will be different.”(P1,I)
“It could be the first step someone is taking in trying to lose weight or anything of the kind and they need to have motivation to carry on, that structure and that plan in place.”(P4,V)
“So sometimes when I have like oh I’ve got a birthday coming up, you know, and I would hang out one of my clothes that I’d want to wear and that would be an inspiration for me.”(P2,V)
“You decide you want to do the class at seven o’clock on a Tuesday and an email comes through at six o’clock saying… it might not necessarily work but it might help some people you know saying your your class is coming up, so it’s your own self-imposed dead self-imposed goal.”(P3,V)
“After a class, if I’ve completed it, it depends again not everyone wants emails coming in all the time but well some something for me it might be nice to get an email saying well done it’s great that you attended.”(P3,V)
“Somebody else on the programme who was specifically your buddy who you could support. And by you know that if you have a naff week then you know you can say to them yeah I’ve had a naff week or they can say to you I’ve had a naff week and you can say oh that’s ok because I did last week but look I’m back on it.”(P2,I)
“I’m not then just focusing on my on myself. And then if I don’t necessarily do it one week, it’s not a problem because someone else might pick up the mantle in terms of the contributing.”(P1,I)
3.3. Priority Three—More Than Just Weight Loss
“My overwhelming aim is to get healthier, because then other things will follow…If I had to pick one word why I would be willing to give this a go, it’s for the benefit of my health.”(P4,I)
“Could you um not use regression…because it sounds like a definite failure word… if you’re having a bad day like…say with whatever condition, you’re already having a bad day so to then thinking oh I’ve regressed, can’t do as opposed to, these are the alternatives.”(P2,I)
“Be aware of it (emotional wellbeing) as it goes along… at the end of the 12 weeks is probably when they’re more likely to say something than you know on day one.”(P6,I)
“For me when I do these exercises, I feel more radiant…how do I measure that?”(P2,V)
“I think you’ve raised a really good point. Signposting to professional services is is a must.”(P3,I)
3.4. Strengths and Limitations
3.5. Future Development and Practical Application
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participant Discussion Point | Supporting Quote | Corresponding Programme Response |
---|---|---|
Programme facilitators/deliverers should be people with lived experience. | “You can’t have somebody then saying I understand, when they’re slim, they’re fit and they’re healthy and they go to the gym ten times a week…so actually to have somebody who it who is the same, I think is a real win.” (P2,I) | The programme materials (videos and images used) will be representative of adults living with overweight and obesity. |
Exercises should have adaptations/alternatives, not ‘regressions’, to accommodate individual circumstances and abilities, avoiding demotivation from finding some exercises ‘too hard’. | “You’re already having a bad day so to then thinking oh I’ve regressed, can’t do, as opposed to these are the alternatives.” (P2,I) | Terminology used throughout the programme will be carefully considered, ensuring it is sensitive to the population group. |
Desire to receive optional prompts/reminders throughout the week, concern about forgetting and reaching the end of the week with sessions to catch up on. | “Maybe you could set or at some point the system could set some form of notification.” (P3,V) | Dependent on the platform, sending prompts/reminders may be feasible, and we would aim to do so. |
Desire to receive optional rewards/congratulations upon session and goal completion to increase motivation and adherence. | “Something for me, it might be nice to get an email saying well done it’s great that you attended.” (P3,V) | Dependent on the platform, we will aim to send rewards/congratulations upon session completion. |
Creation of an ethos where participants do not have to start over if their engagement does not go ‘perfectly’. minimising one missed session snowballing into complete ‘programme failure’. | “If you’re a little bit sensitive or you know you’ve had a few failures in previous lives then you know you would get to that stage and think, I’ve blown it again, and not actually go back.” (P3,V) | To consider and integrate into the programme materials, emphasising participants tailoring the programme to themselves. |
Flexibility to alter the online platform features to suit them best and maintain desired privacy. | “So that it’s a very personably built rather than a generic platform.” (P2,I) | Whilst it may not be feasible to alter the features per participant, we can make help participants choose the features that work best for them. |
Creation of a buddy system to share knowledge and experience and create accountability for increased motivation. Bridging the gap between participants’ high motivation for social exercise and low motivation for exercise that focuses on individual improvement. | “You’re doing it to help yourself but your main focus is somebody else.” (P6,I) | A potential feature that was highlighted prior and reinforced by the PPI. Pairings and logistics will need to be carefully considered. |
Peer support network, in addition to a buddy system, as a space where participants can share their progress, provide tips, and congratulate others if they wish. Potential for this to be in the form of a virtual call or an online platform. | “It’s important after three weeks everyone gets together, tells you how they’re feeling, brainstorming, negative, positive feedback, any tips and hints people have and can give each other to encourage each other to carry on with it.” (P4,V) | A suggestion that could be implemented easily, facilitated by the rise in use of virtual meetings and the forum facility already built on the online platform. |
Focus on the overall health benefits rather than just weight loss, with appropriate signposting to additional resources available to all. Being able to measure these changes alongside the physiological measures. | “My overwhelming aim is to get healthier, because then other things will follow.” (P4,I) | Reflects the programme’s aim for participants. Considerations to be made regarding measuring emotional well-being. |
Longer duration than 12 weeks. Expressed a desire to access the programme after 12 weeks to go back, continuing to build a habit. | “Twelve weeks is lovely except that it’s not a life changer.” (P2,I) | Continued access to programme materials and resources could be arranged for participants after the trial has finished. |
Current programmes focus on individuals that heavily promote their own success. Concern was presented regarding comparison of successes despite the variation of individual goals and how different goals could be catered for. | “People are gonna take a lot more notice of a ten stone weight loss than they are to the person that’s lost their first pound… those who shout the loudest get the most attention.” (P1,I) | Consideration required regarding the online platform privacy. A virtual reward system to focus on goal achievement rather than goal content or size. |
Concerns of safety within the home environment and precautions needed to restructure the environment to accommodate this. | “At that set up point, if if you’re gonna be doing weights or whatever you’re doing you know you need that sort of space” (P2,I) | Provision of information and reminders regarding safety considerations and minimising risk in their home environment. |
Questions regarding the provision of equipment: reliability, quality, and cost. Emphasis placed on capitalising on materials in the home environment because it is a home-based programme. | “If it’s home-based try and make the best use of what you’ve got in your house.” (P4,I) | Chosen equipment will be minimal and provided by the research team. Alternatives found in the home will also be suggested within the programme material. |
Education on exercise types and benefits. Participants wanted to know what type of exercise ‘counted’ and the benefit each exercise has. | “When I do a pilates class once a week and the instructor always tells us which bit of our body it’s helping with, and that actually is quite an interesting useful thing.” (P2,I) | Inclusion of educational components and justifications within the exercise videos and additional programme resources. |
Questions regarding accessibility include digital literacy, language barriers, neurodiversity, and socio-economic class. | “Would there be financial help to support internet costs (during the trial)? Would you have translation into other languages on the website?” (P5,V) | Whilst it was recognised that these considerations are very important, they are not feasible to facilitate within the scope of the current project due to time and resource constraints. However, these issues will be considered should the project be run on a larger scale. |
Requirement for at least some in-person contact throughout the duration of the programme to feel supported and reduce potential dropout. | “The fact that an actual person knows what their plans are, it might really motivate them.” (P3,V) | Baseline, midpoint, and endpoint data collection sessions will be in person. Additional to the researchers collecting data, it will allow for in-person interaction to increase feelings of support and connectedness. |
Further involvement in pilot testing—both for the programme itself and the delivery platform. | “Well that would be brilliant, yes I would like that.” (P3,V) | Volunteers at the PPI events will be offered to join the pilot. |
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Power, S.; Rowley, N.; Duncan, M.; Broom, D. Co-Designing and Refining a Home-Based Exercise Programme for Adults Living with Overweight and Obesity: Insight from People with Lived Experience. Obesities 2023, 3, 132-144. https://doi.org/10.3390/obesities3020011
Power S, Rowley N, Duncan M, Broom D. Co-Designing and Refining a Home-Based Exercise Programme for Adults Living with Overweight and Obesity: Insight from People with Lived Experience. Obesities. 2023; 3(2):132-144. https://doi.org/10.3390/obesities3020011
Chicago/Turabian StylePower, Sofie, Nikita Rowley, Michael Duncan, and David Broom. 2023. "Co-Designing and Refining a Home-Based Exercise Programme for Adults Living with Overweight and Obesity: Insight from People with Lived Experience" Obesities 3, no. 2: 132-144. https://doi.org/10.3390/obesities3020011