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Publication - Professor Julian Hamilton-Shield

    A mixed methodology study exploring how lifestyle weight management programmes for children are commissioned and evaluated in England


    Jago, R, Mears, R, Sharp, DJ, Kipping, RR & Shield, JPH, 2019, ‘A mixed methodology study exploring how lifestyle weight management programmes for children are commissioned and evaluated in England’. BMJ Open.


    Objectives: To assess how lifestyle weight management programmes for children aged 4-16 years in England are commissioned and evaluated at the local level.
    Design: This was a mixed methods study comprising an online survey and semi-structured telephone interviews.
    Setting: An online survey was sent to all Local Authorities (LAs) in England regarding lifestyle weight management services commissioned for children aged 4-16 years. Online survey data were collected between February and May 2016 and based on services commissioned between April 2014 and March 2015. Semi-structured telephone interviews with LA staff across England were conducted between April and June 2016.
    Participants: Commissioners or service providers working within the Public Health Department of LAs.
    Main outcome measures: The online survey collected information on the evidence-base, costs, reach, service usage and evaluation of child lifestyle weight management services. The telephone interviews explored the nature of child weight management contracts commissioned by LAs, the type of outcome data collected and whether these data were shared with other LAs or organisations, the challenges faced by these services and the perceived ‘markers of success’ for a programme.
    Results: The online survey showed that none of the participating LAs were aware of any peer-reviewed evidence supporting the effectiveness of their specific commissioned service. Despite this, the telephone interviews revealed that there was no national formal sharing of data to enable oversight of the effectiveness of commissioned services across LAs in England to help inform future commissioning decisions. Challenges with long-term data collection, service engagement, funding and the pressure to reduce the prevalence of obesity were frequently mentioned.
    Conclusions: Robust independent, cost-effectiveness analyses of obesity strategies are needed to determine the appropriate allocation of funding to lifestyle weight management treatment services, population-level preventative approaches or development of whole-system approaches by an LA.
    Strengths and limitations of this study
    • There has been no previous independent, peer-reviewed research study assessing how lifestyle weight management programmes in childhood are being commissioned and evaluated across Local Authorities (LAs) in England.
    • The response rate for the online survey was lower than desired however there was good geographical representation across England.
    • The current study focused on LAs in England so generalisation of results to the rest of the UK and wider is unclear.
    • The change in weight status and cost data provided by LAs precluded meaningful statistical analyses so it is impossible to comment on the cost-effectiveness of, or between, commissioned services.
    • There were no freedom of information requests submitted to LAs who did not complete the online survey and it is possible further data could have been obtained through this route.

    Full details in the University publications repository