Results of the ASO Small Grant for Evaluating Remote and Digital Weight Management Services Research
ASO are delighted to announce the following two applicants have been awarded an ASO Small Grant for Evaluating Remote and Digital Weight Management Services Research. Congratulations to both applicants. The applications received were of excellent quality and we would like to thank everyone who applied.
- Georgios Dimitriadis et al, King's College Hospital NHS Foundation Trust
Examining the use of Gro Health, a remote, self-directed, and culturally-sensitive digital health intervention addressing modifiable risk in patients within a Tier 3 and 4 obesity service – The AlleGro real-world study
- Wendy Nicholls et al, University of Wolverhampton
Patient Engagement in Remote weight management Services: An evaluation of acceptability, accessibility, and barriers, and development of a remote healthcare Screening Tool (PERSyST).
Dimitriadis et al. Examining the use of Gro Health, a remote, self-directed, and culturally-sensitive digital health intervention addressing modifiable risk in patients within a Tier 3 and 4 obesity service – The AlleGro real-world study
Sustainable weight loss is a key action to take to improve metabolic health. Reducing weight reduces the risk of many conditions including heart disease, stroke, high blood pressure, type 2 diabetes mellitus (T2DM), osteoarthritis, gout, breathing problems and severe COVID-19 infection. Adherence to weight loss interventions is crucial to successful outcomes. Research demonstrates that to establish long-term sustainable weight loss, interventions grounded in behaviour change theories (BCTs) and persuasive system design (PSD) principles applied in weight loss maintenance interventions compared with those of weight-loss interventions alone have been found to stimulate greater motivation and adherence.
COVID-19 has stretched global healthcare systems and impacted day-to-day delivery of healthcare. As people stay at home for purposes of shielding, self-isolation, self-quarantine or sickness with COVID-19, digital technologies are replacing face-to-face contact. The key to digital technologies is simple: engagement and outcomes. Digital platforms have been demonstrated to support weight loss. However, there are no digital platforms used in the UK obesity that are delivered in native-language.
Gro Health is a digital behaviour change intervention supporting sustainable weight loss which takes a complete approach to weight loss including four areas of interest such as mental wellbeing, sleep, activity, and nutrition. The app is available on web, mobile, smart-speaker and smart-assistants and delivered in English, Arabic, Hindi, Urdu, Bengai, Gujrati and Punjabi with culturally relevant and appropriate adaptations.
This study will assess the real-world efficacy of the Gro Health digital health platform for the management of obesity (as a digital weight management service).
- Evaluate the practicability of prescribing Gro Health as a specialist remote monitored obesity service
- Establish the requirements for training healthcare professionals in the use of remote monitoring technologies for obesity management
- Track the amount of support patients require at onboarding for effective use
- Establish uptake, engagement and completion
- Assess the acceptability of this program from patients and healthcare professionals
The primary measures of this study will be weight loss achieved from baseline, and user engagement defined by retention.
- Improved use of service provision and healthcare professional time
- Use of remote monitoring tools to support patient-centred, in-person care
- Culturally-sensitive education and support to support health and wellbeing
- Reducing the need to visit clinics whilst still feeling supported and monitored
- Reducing risk of COVID-19 infection and transmission
- Reduced cost of care
Nicholls et al. Patient Engagement in Remote weight management Services: An evaluation of acceptability, accessibility, and barriers, and development of a remote healthcare Screening Tool (PERSyST)
The COVID-19 pandemic meant that WMS moved to remote healthcare, in place of face-to-face. This presents an opportunity to examine how acceptable and accessible remote healthcare is for patients living with obesity. The Chief Allied Health Professions Officer’s team called for better use of technology in delivering healthcare. Both Trusts taking part in this evaluation agree that digital/remote delivery will be part of future service (likely combined with face-to-face options).
Whilst digital WMS presents exciting possibilities, switching to remote healthcare has not suited some patients. To provide accessible and acceptable remote healthcare to future patients living with obesity, we need to better understand who remote healthcare is most likely to help, how, and why – which is why we are proposing this evaluation. For example, the relationship between healthcare practitioners and patients is central in helping patients adopt healthy behaviours, so it is important to see whether remote WMS can develop and strengthen practitioner-patient relationships at least as well as face-to-face working.
- Conduct COVID-safe focus groups to explore patient uptake of, and engagement with remote WMS. This includes acceptability, user-experiences, and patient-practitioner relations.
- Work with patients to develop a short screening tool which can show us who would benefit from additional support to receive WMS remotely, and who is well suited to this already.
This evaluation will contribute new knowledge about which patients are likely to find remote WMS acceptable and accessible, and under which circumstances. The planned screening tool is an innovation that will make a difference to the lives of people living with obesity. It will help identify patients who may benefit from support to help them access remote and digital WMS. We will identify practical steps for practitioners to improve the acceptability of remote services for patients who are traditionally less likely to benefit; thereby improving access and reducing inequalities.
Even after COVID, Trusts recognise that remote healthcare could still help patients be seen more quickly and economically. Waiting lists are currently around 12-18 months. This delay increases patients’ risk of developing other obesity-related health conditions, increasing the complexity of treatment required, and reducing quality of life. Understanding how we can support the needs of patients, when combining existing services with the opportunities that remote and digital working offers, will help reduce waiting lists by meeting the needs of a broader range of patients, more quickly.