Table 1.
Recommendation | Determinants | Interventions | |
---|---|---|---|
1 | Determining degree of overweight and overweight | Acceptable ways to raise and discuss the issue with patients (patients’ values in relationship to professional values or those in the recommendation)a |
Training—presentation, followed by team discussion Model scripts on discussing weight with patients, e.g. ‘Mr X, could we talk about your weight? What are your thoughts about your weight right now?’ ‘Mrs X, I’m concerned about your weight because I think it is causing health problems for you.’ |
How to effectively measure waist circumference (The extent to which the targeted healthcare professionals have pre-existing knowledge or expertise about the targeted condition)a |
Training in waist measurement—information provided, demonstration followed by practise | ||
2 | Assessment of lifestyle and willingness to change | Ways to assess willingness to change (patient motivation)a |
Presentation, discussion, sample questions provided, e.g. ‘What are you goals concerning your weight?’ ‘What changes are you willing to make to your eating or physical activity habits right now?’ ‘What kind of help would you like from me regarding your weight?’ ‘On a scale of 1 to 10, 10 being 100 % ready to take action, how ready are you to lose weight?’ |
Resources to motivate and inform (patients’ beliefs or knowledge or ability to learn, or the targeted healthcare professionals’ ability or perceived ability to inform or teach patients necessary knowledge and skills)a |
Booklet for patients containing clear, proscriptive information (Weight Loss You Can See). Posters for practices to invite patients to discuss their weight with a member of the practice team | ||
3 | Management of overweight and obesity | Lack of prescriptive information (patients’ beliefs or knowledge or ability to learn, or the targeted healthcare professionals’ ability or perceived ability to inform or teach patients necessary knowledge and skills)a |
Presentation, provision of summary of the guidelines, and booklet for patients |
Lack of knowledge (the extent to which the targeted healthcare professionals have pre-existing knowledge or expertise about the targeted condition)a |
Discussion with practices on delegation and the role for practice nurses (an action plan) | ||
4 | Referral | Lack of information on referral pathways (the extent to which the resources that are needed to adhere are available)a |
We collected details on local weight loss and lifestyle services and provided this \]information to practice teams |
aDefinitions of identified determinants given in the checklist [16]