People with severe obesity in the UK can wait years for a specialist weight management appointment, and the pandemic made those waits even longer. This study takes an existing in-person group programme called PROGROUP—already tested for patient acceptability—and adapts it for remote delivery via video calls, then tests whether that actually works in two large NHS clinics. The problem is stark: demand for specialist services is rising, but in-person capacity is fixed. Remote group sessions could slash travel time and costs for patients, many of whom face significant barriers to attending clinics. The research will also measure whether those travel savings are distributed equally across different patient groups, or if remote delivery risks widening existing inequalities. If successful, PROGROUP-online would give the NHS a scalable, evidence-based alternative to face-to-face care. The programme is designed to be flexible enough to later incorporate new obesity medications. Because the team already has established links with national obesity organisations, a proven remote version could roll out quickly—potentially reshaping how the NHS delivers behavioural support to thousands of people with severe obesity.
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Background Access to specialist weight management services for people with severe obesity is a huge challenge. Waiting lists are long and have lengthened since the Covid pandemic, at the same time the number of patients being referred has increased as other treatment options have become available. As a result, many services are investigating how to evolve to support their patients. A significant proportion of Specialist Weight Management Services have considered virtual delivery of behaviour change programmes where in-person delivery of care is less practical, however evidence-based options are limited. PROGROUP is an evidence-based group behavioural change programme specifically designed for people living with severe obesity. Patient acceptability and service delivery of the in-person version have been assessed through a national feasibility trial. The flexibility of in-person and remote delivery could enable this to become the standard approach across the NHS, and one that can be further adapted to include pharmacotherapy as necessary. Aims and objectives This study designs and tests a new remote version of the "PROGROUP" facilitated group-based behavioural intervention for people with severe obesity. The overall aim is to establish a remote version of PROGROUP as a treatment option in a programme with nationwide reach. Research questions In the setting of Specialist Weight Management Services, the study examines: Patient preferences for a co-designed PROGROUP-online Training and facilitator competencies for successful online delivery of care The feasibility of delivering the PROGROUP group-based intervention remotely and with fidelity How patients and healthcare professionals experience PROGROUP-online The cost of PROGROUP-online compared to usual care Potential travel savings to patients How equally travel savings are distributed. Development work plan PROGROUP (in-person) will be adapted for remote delivery, through a co-design process with the PROGROUP Patient Advisory Group and external Patient and Public Involvement (PPI). The existing facilitator training programme will be updated accordingly, and a guide will be developed to support patients. Working with our established NHS partners, the real-world feasibility of setting up and delivering remote group-based intervention will be tested at two large well-established Specialist Weight Management Services in a single-arm feasibility study. Outcome measures will include collecting data on intervention uptake, attendance and completion, a process evaluation, health economic assessment, and qualitative interviews with participant subsets to explore the treatment delivery experience for both patients and facilitators. Timelines Months 0-8: Intervention development/adaptation, site recruitment, ethics and R&D permissions, facilitator training. 9-19: Patient recruitment, training; virtual intervention and collection of outcome measures. 20-24: Data analysis and dissemination, including a stakeholder workshop, with findings and feedback informing intervention optimisation. Anticipated dissemination and impact A successfully developed and tested version of PROGROUP-online would become available as we complete our main research programme and would add considerable value for patients. This alternative option could be disseminated swiftly through our established stakeholder pathways (Association for the Study of Obesity, British Dietetic Association). In conjunction with face-to-face delivery, remote delivery has the potential to make PROGROUP a more scalable model of care that addresses the current NHS capacity and equity of patient access.
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