Modifying and evaluating the feasibility of a web-based weight loss intervention for Royal Navy personnel

Abstract

A range of resources exist to support overweight and obese personnel with their weight management efforts in the Royal Navy (RN). However, the high prevalence of personnel with excess weight in the RN suggests that these resources may be insufficient. Web-based weight loss interventions may be particularly well-suited for addressing the problem of overweight and obesity in the RN, as they may provide flexible and easily accessible support that can be accessed in users’ own time.
This thesis presents an evaluation of the first web-based weight loss intervention for overweight and obese RN personnel. A systematic review and meta-synthesis of 17 studies was conducted to explore overweight and obese adults’ perceptions and experiences of behavioural weight management interventions. The review indicated several factors that overweight and obese people perceived as affecting their weight management efforts, which if addressed, could improve the credibility of weight management interventions. A survey study with 1030 RN personnel identified there was some interest in using a web-based weight loss intervention in the RN, particularly among obese personnel and female personnel. A qualitative study with 21 overweight and obese RN personnel identified participants’ perceived barriers and facilitators within the Naval environment that were related to their weight management efforts. These findings were used to inform modifications to an existing web-based weight loss intervention. A second qualitative study explored 14 overweight and obese personnel’s perceptions and experiences of using the modified web-based weight loss intervention. Further modifications to the intervention were undertaken in light of the results from this study. A final feasibility study aimed to evaluate the possibility of trialling and implementing the modified web-based weight loss intervention among 43 overweight and obese RN personnel according to the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. It was estimated that the uptake of the intervention was 6% and it had a moderate effect on weight loss among users, despite not being implemented as intended.
This thesis identified a number of suggestions for improving overweight and obese RN personnel’s engagement with web-based weight management interventions. These include the need for interventions to promote autonomous motivation among overweight and obese personnel to manage their weight, and interventions at the organisational level to change perceptions around weight management in the RN.

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Identifiers

ORCID for Lucy Yardley: orcid.org/0000-0002-3853-883X

ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

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