Table 3.

Challenges identified and suggested tailoring for lifestyle interventions for socio-economically deprived populations

	Themes identified	Suggestions for tailoring (data)	Further suggestions for tailoring
Managing diversity	Meeting diverse needs	• Focus on education and no pressure to engage with tools for those with limited knowledge and difficult to engage.	• Separate groups for first time attendees with focus on education, and then on-going weigh-in and support groups for those who have previously attended.
	Language and literacy barriers	• Visual aids e.g. fats, sugars and salt pots, traffic light card.	• More visually presented information rather than reliance on written materials.
	Cultural diversity	• Target specific groups e.g. ethnicity, religion, to allow for tailoring of content and building relationships.	• More community development and linking with social housing. • Ensure service deliverers are suitably trained to deliver culturally sensitive information.
Working against the environment	Affordability; attendance and adherence	• Use health professional referrals to add value to free course. • Provide cost appropriate suggestions e.g. local deals, cheap recipes. • Linking with leisure facilities for special offers.	• Additional commitment element to course. • Considerations for policy level e.g. food vouchers.
	Access and availability	• Recommend frozen and tinned fruit and vegetables. • Suggest best options for fast food e.g. tomato rather than cream based curries. • Signposting. • Free leisure pass.	• Consideration for policy level e.g. planning. • Include strategies for replacing fast food e.g. cooking own healthier versions. • Interagency communication to identify gaps in provision.
	Life gets in the way	• Planning meals. • Damage limitation strategies e.g. knowing what not to eat at parties.	• Ensure easy to implement/ realistic goals. • Strategies to encouraging partners and families to support/ adopt changes.