Dietetic Support in the Community
Research type
Research Study
Full title
Dietetic Support in the Community – the DiSCo Study: An Exploratory Study at a Primary Care Facility of Attitudes towards and Perceptions of Weight Management Services
IRAS ID
183551
Contact name
Simon Dobson
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
0 years, 3 months, 31 days
Research summary
A UK Government report (Foresight, 2007) examined how society might deliver a sustainable response to the steadily rising obesity epidemic over the next 40 years. The impact of obesity through its recognised co-morbidities places a significant and increasing burden on the health service both now and in the future. Over half of the adult population of North Wales are classified as overweight or obese; results in the Welsh Health Survey (WHS, Welsh Government, 2014) found that around 3 in 5 adults (59%) are overweight, of which 1 in 4 adults (23%) are classified as obese, as defined by the WHO’s criterion of a body mass index of 30 or above (WHO, 2011). Adults living in more deprived areas have greater levels of obesity and consume less fruit and vegetables (WHS, Welsh Government, 2014). The Welsh Government published The Obesity Pathway (Welsh Government, 2010) is a tool for Health Boards, local authorities and key stakeholders to map activity for both adults and children against the 4 tiers, and then identify gaps. A North Wales business case was submitted at a strategic level in 2014 to support the development of a Tier 3 adult service, which is an identified priority for BCUHB. To maximise efficiency, a sustainable and effective service is required at Level 1 and 2 for long term prevention and support. Whilst there is growing activity at Level 1 across BCUHB, including nutrition skills training and practical cookery training delivered by the Public Health Dietetic Team, there has been limited activity at Tier 2 within the primary care setting; current activity has focused on an Orthopaedic Lifestyle programme, as well as NERS delivered by the local authority leisure services. Clinical Guidelines from NICE for Tier 2 (2006, modified in 2015, CG 43) recommend that ‘managers and health professionals in primary care settings ensure that preventing and managing obesity is prioritised at both strategic and delivery levels. Dedicated resources should be allocated for action’ (p9). In North Wales there is a lack of community based weight management programmes for referral from primary care. Few options exist for effective treatment within the traditional service. Previous research in obesity weight management has cited a need for studies to explore different dietetic interventions and their influences on outcomes (BDA, 2011)5. Additionally, high rates of non attendance are characteristic of obesity management (Honas et al, 2003) which has been confirmed by local practitioners.
This proposal presents a timely opportunity to examine the current service. The study will perform a qualitative exploration of the patients’ experiences of dietary assessment and approaches to treatment that they have received as part of the primary care service. The results of the study will be influential in redefining services and treatment for weight management in adults for BCUHB dietetic service as well as implications for the greater primary care service. It will inform the local health board's agenda to deliver genuine patient – centred care in future. The patient's opinion and input in service design and delivery will aim to lead to improved quality, reduced waste, better patient experience and better use of resources (1000 lives plus, 2012) whilst fulfilling essential elements of the Prudent Healthcare agenda.REC name
Wales REC 5
REC reference
16/WA/0040
Date of REC Opinion
19 Feb 2016
REC opinion
Favourable Opinion