Understanding the role of Healthy Weight Coaches in the weight management system

Background: Supporting people with overweight or obesity to lose weight can prevent avoidable illness.

Evidence shows that discussions about weight in primary care can provide effective support, but primary care professionals feel ill-equipped, and do this rarely. However, primary care professionals can now undertake additional training to become a healthy weight coach (HWC).

HWCs aim to support patients to make positive changes to promote a healthier weight, through providing dedicated advice, signposting, and referral to weight management services.

We do not know how this new role has been implemented, how this works from both the system and patient perspective, or how HWCs can best communicate with patients. This is what we aim to find out.

Aim: To understand the role of HWCs in the weight management system, including implementation; patients and practitioners experiences; and the components of effective consultations about weight.

Objectives: Understand programme implementation in different practices and how this leads to practitioner decisions and patients outcomes Map the fit of the HWC role within the weight management pathway and how it is embedded in local systems Identify the components of conversation that are effective at supporting patients to reach their goal Understand patients experiences of consulting with the HWC Triangulate learning to improve training for HWCs and disseminate results Methods We will understand programme implementation, and healthcare professionals experiences, through qualitative interviews (N=~25) and an online practice survey (N=~100).

We will visually map the HWC pathway, and the barriers and facilitators influencing its implementation, by working with key staff and stakeholders (including from the Department of Health and Social Care- DHSC).

To understand patients experiences of consulting with HWCs, we will conduct qualitative interviews (N=~35) and follow-up telephone surveys to assess actions taken.

To identify the components of conversations that are effective at supporting patients to reach their goals, we will analyse conversations between patients and HWCs (N=~100), and link conversation analysis with the follow-up surveys assessing motivation after the consultation, and actions taken 15 weeks later.

With stakeholders, advisors, and PPI we will prioritise the most important results.

Design Science will lead co-design workshops, translating results into accessible written, and visual guidance and online training.

We will firmly embed a focus on health inequalities throughout, prioritising diverse samples, and including underrepresented groups.

PPI Nine people with experience of obesity from diverse backgrounds helped design this project, and seventeen contributed to the lay summary.

A diverse group of nine patients and carers, chaired by lay co-applicant Clara Martins de Barros, will work with us to inform our focus, inputting on analysis, prioritising results, and co-developing: sampling strategies, resources, and dissemination materials and pathways. Dissemination Accessible training and guidance materials will be available online and shared with HWCs.

We will co-develop a dissemination plan with the DHSC, and our advisory and PPI panels, which will focus on reaching practices with and without a HWC. We will present to DHSC, at conferences, and publish in peer-reviewed journals. We will summarise results for lay-audiences in blogs, infographics, and brief video explainers .