Abstract
Background
Interventions to support health and wellbeing often attract advantaged, time-rich, organised people, potentially exacerbating health inequalities and failing to support those less advantaged. Our aim was to co-design and feasibility test a novel community-based incentive system to promote healthy weight and wellbeing in disadvantaged communities.
Methods
Intervention co-designed with two disadvantaged communities in Scotland. Single-arm, 12-week feasibility study. Inclusion criteria: aged ≥18 years living within a 20 min walking distance from ELLY activities. Exclusion criteria: not resident during the intervention. Participants were recruited via pop-up cafés outside schools, shops, existing clubs and activities. ELLY intervention components: free soup twice weekly (café/delivery/pickup); loyalty card stamped for engagement in activities (to encourage preparatory behaviours towards healthy weight and wellbeing) exchanged for £25 shopping card for regular activity attendance over 12 weeks; goal-setting, information resources, self-monitoring of weight and wellbeing. Outcome measures: acceptability and feasibility of recruitment, retention, and intervention components assessed by self-report questionnaire (0, 3 months) and interviews (3 months). Further interviews post-intervention assessed behaviour change (6 months). Outcomes for a future trial prioritised by communities: healthy weight (BMI), mental wellbeing (WEMWBS), health-related quality-of-life (EQ-5D-5L) and connectedness (Social Connectedness Scale). Sample size: minimum 30 participants per community based on an estimated event rate of 5% for unforeseen problems. Written consent required. Study approved by GCU(HLS/NCH/22/036).
Findings
Sample characteristics: n=75; 63/75 (84%) female, baseline BMI mean 31·9 (SD 7·3), 48/75 (64%) from disadvantaged areas (SIMD quintiles 1–2). Recruitment completed in 3 months; retention (65/75 [87%]) at 3 months; acceptability of intervention (soup 38/65 [59%], loyalty card and assets 51/65 [79%]); redeemable stamped loyalty cards (55/75 [73%]). Outcomes collected (65/75 [87%] completion rate) within-person change (mean [95% CI]): BMI –0·15 (0·31); EQ-5D-5L 0·02 (0·04); WEMWBS 0·8 (2·39); Social Connectedness Scale 0·8 (3·72).
Interpretation
ELLY is acceptable, feasible and shows promise for improving healthy weight and wellbeing in disadvantaged communities. A full trial is warranted to determine effectiveness and cost-effectiveness, with consideration of scalability.
Funding
Chief Scientist Office (HIPS 21/32), INEOS Charities & Community fund provided funding for soup.
Contributors
JC was principal investigator and project manager on this study, and wrote this abstract. SC provided insight on behaviour change techniques and advised on goal setting components, RA supported community engagement work. SF was the project research assistant. PH provided oversight and expertise to all aspects of the study. MvdP provide advice on incentive design and cost effectiveness measures. GM provided expertise on statistical aspects of the project. All authors have seen and approved the final version of the Abstract for publication.
Declaration of interests
We declare no competing interests.
Acknowledgments
We are grateful for our community partners for their extensive input to and support of the study.
Interventions to support health and wellbeing often attract advantaged, time-rich, organised people, potentially exacerbating health inequalities and failing to support those less advantaged. Our aim was to co-design and feasibility test a novel community-based incentive system to promote healthy weight and wellbeing in disadvantaged communities.
Methods
Intervention co-designed with two disadvantaged communities in Scotland. Single-arm, 12-week feasibility study. Inclusion criteria: aged ≥18 years living within a 20 min walking distance from ELLY activities. Exclusion criteria: not resident during the intervention. Participants were recruited via pop-up cafés outside schools, shops, existing clubs and activities. ELLY intervention components: free soup twice weekly (café/delivery/pickup); loyalty card stamped for engagement in activities (to encourage preparatory behaviours towards healthy weight and wellbeing) exchanged for £25 shopping card for regular activity attendance over 12 weeks; goal-setting, information resources, self-monitoring of weight and wellbeing. Outcome measures: acceptability and feasibility of recruitment, retention, and intervention components assessed by self-report questionnaire (0, 3 months) and interviews (3 months). Further interviews post-intervention assessed behaviour change (6 months). Outcomes for a future trial prioritised by communities: healthy weight (BMI), mental wellbeing (WEMWBS), health-related quality-of-life (EQ-5D-5L) and connectedness (Social Connectedness Scale). Sample size: minimum 30 participants per community based on an estimated event rate of 5% for unforeseen problems. Written consent required. Study approved by GCU(HLS/NCH/22/036).
Findings
Sample characteristics: n=75; 63/75 (84%) female, baseline BMI mean 31·9 (SD 7·3), 48/75 (64%) from disadvantaged areas (SIMD quintiles 1–2). Recruitment completed in 3 months; retention (65/75 [87%]) at 3 months; acceptability of intervention (soup 38/65 [59%], loyalty card and assets 51/65 [79%]); redeemable stamped loyalty cards (55/75 [73%]). Outcomes collected (65/75 [87%] completion rate) within-person change (mean [95% CI]): BMI –0·15 (0·31); EQ-5D-5L 0·02 (0·04); WEMWBS 0·8 (2·39); Social Connectedness Scale 0·8 (3·72).
Interpretation
ELLY is acceptable, feasible and shows promise for improving healthy weight and wellbeing in disadvantaged communities. A full trial is warranted to determine effectiveness and cost-effectiveness, with consideration of scalability.
Funding
Chief Scientist Office (HIPS 21/32), INEOS Charities & Community fund provided funding for soup.
Contributors
JC was principal investigator and project manager on this study, and wrote this abstract. SC provided insight on behaviour change techniques and advised on goal setting components, RA supported community engagement work. SF was the project research assistant. PH provided oversight and expertise to all aspects of the study. MvdP provide advice on incentive design and cost effectiveness measures. GM provided expertise on statistical aspects of the project. All authors have seen and approved the final version of the Abstract for publication.
Declaration of interests
We declare no competing interests.
Acknowledgments
We are grateful for our community partners for their extensive input to and support of the study.
| Original language | English |
|---|---|
| Pages (from-to) | 7 |
| Number of pages | 1 |
| Journal | The Lancet |
| Volume | 404 |
| Issue number | S7 |
| DOIs | |
| Publication status | Published - 1 Nov 2024 |