Training Healthcare Professionals to Deliver a Group-Based Intervention for People Living With Severe Obesity: Lessons From the PROGROUP Feasibility Trial.

introductionGroup-based programmes are increasingly adopted to support people living with obesity, as they have the potential to reduce staff time and costs and enhance motivation and capability for behaviour change. Group-based programmes could also provide members with opportunities to form meaningful social connections. As such, training should equip healthcare professionals to deliver group interventions successfully and be accessible and feasible for them to complete. This study presents how mixed-methods process evaluation data from the feasibility randomised controlled trial of PROGROUP (a group-based weight management intervention for people living with severe obesity) informed optimisation of the PROGROUP training programme.

methodsFive healthcare professionals (facilitators) from three specialist weight management services across the United Kingdom participated in a 4-day remote training programme in preparation for facilitating PROGROUP. Four patient cohorts were subsequently delivered across these services. Training content was informed by psychological theory and included communication and group facilitation skills, as well as physical activity and dietary education, delivered by an expert research and practitioner team. Following intervention delivery, facilitators were interviewed about their experiences of training and delivery. Additional data collection sources included fidelity (to form and content) checklists, audio and video recordings of intervention delivery, and field note summaries from in-person observations and debrief calls. Interview data was analysed thematically.

resultsFidelity findings showed that intervention content was largely delivered as intended across all cohorts (average across cohorts = 68%), with facilitators showing confidence in delivering the educational components of the intervention. However, variability was observed across cohorts, indicating differences in facilitators' ability to deliver flexibly and in line with intervention delivery principles. Facilitators also reported challenges in attending all training days in full and expressed a preference for more self-directed learning. In response, to improve accessibility and delivery fidelity, training was adapted to include self-directed learning and a greater focus on developing the necessary skills and knowledge to facilitate according to intervention delivery principles.

conclusionThis study outlines a process for optimising training for healthcare professionals, with learnings applicable to other group-based healthcare settings. Findings highlight the need for healthcare professionals to develop skills aligned with delivering such interventions with fidelity, to maximise potential effectiveness. A flexible, self-directed training format can enhance feasibility and acceptability, balancing healthcare professionals' needs with intervention requirements, and offers a valuable and novel training resource for those delivering group-based care.