Can you see me? Participant experience of accessing a weight management programme via group videoconference to overcome barriers to engagement.

BACKGROUND: Engagement with conventional weight management group programmes is low. OBJECTIVE: To understand participant experience of accessing an adapted programme via videoconference. PARTICIPANTS: Adults with obesity (BMI ≥ 35kg/m2 ), referred to an NHS Dietetics service in Wales, were offered a group videoconference weight management programme as an optional alternative to in-person groups. Thirteen participants (mean age 48.5 ± 20.2 years, 8 female) recruited to two videoconference groups were interviewed. STUDY DESIGN: A Registered Dietitian delivered a behavioural programme using Skype for Business in 10 sessions over 6 months. Participants joined the groups from any Internet-connected device with a webcam. Participant perspectives were audiorecorded in one-to-one, semi-structured interviews. Interviews were transcribed verbatim and thematically analysed using self-determination theory as a theoretical framework. RESULTS: Ten themes were identified, three relating to service engagement and seven relating to behaviour change facilitation. Key themes in engagement included 'reduced burden', described as saving time and travel and 'reduced threat' as participants perceived joining a group from home as less daunting compared to attending in-person. Despite reporting some initial technical difficulties with establishing video and audio connection, participants described beneficial peer support although not physically with other group members. CONCLUSION: Accessing a group weight management programme via videoconference may be the preferred option for some participants, overcoming some of the barriers to access to standard in-person programmes, particularly in rural areas. Participants are able to experience peer support via videoconference. During the COVID-19 pandemic, weight management programmes could utilize videoconference groups to continue to provide support.

Ecological momentary assessment of food perceptions and eating behavior using a novel phone application in adults with or without obesity.

We developed a smart phone application to measure participants' food-reward perceptions and eating behavior in their naturalistic environment. Intensity ratings (0 - not at all to 10 - very strongly) of perceived anticipation of food (wanting) and food enjoyment at endpoint of intake (liking) were recorded as they occurred over a period of 14 days. Moreover, food craving trait, implicit and explicit attitude towards healthy food, and body composition were assessed. 53 participants provided complete data. Participants were classified by percentage of body fat; 33 participants with lower body fat (L-group) and 20 with higher body fat (H-group; ≥25% body fat for males and ≥32% for females). L-group participants reported 6.34 (2.00) food wanting events per day, whereas H-group participants recorded significantly fewer food wanting events (5.07 (1.42)); both groups resisted about the same percentage of wanting events (L-group: 29.2 (15.5)%; H-group 27.3 (12.8)%). Perceived intensity ratings were significantly different within the L-group in the order liking (7.65 (0.81)) > un-resisted wanting (leading to eating) (7.00 (1.01)) > resisted wanting (not leading to eating) (6.02 (1.72)) but not in the H-group. Liking scores (L-group: 7.65 (0.81); H-group: 7.14 (1.04)) were significantly higher in L-group than in H-group after controlling for age. Our results show that individuals with higher percentage of body fat show less food enjoyment after intake and reveal no differentiation in intensity ratings of perceived anticipatory and consummatory food reward. These results are consistent with a hypothesized reward deficiency among individuals with higher percentage of body fat.