Edinburgh Napier University

  Background: While stakeholder co-production may reduce the ‘implementation gap’ in design of public health programmes, it can be time consuming and costly. Prototyping offers a potential solution; we tested its value using a 3-month weight-management programme ‘Momenta’, in a deprived area with poor health indices, in Northumberland.
Evaluation Framework: Following pragmatic stakeholder consultation, a mixed methods evaluation framework was developed. Three referral groups (BMI ≥ 25 kg/m2 ) were compared: Momenta (M, n = 59), Momenta and fitness membership (MF, n = 58), fitness membership (F, n = 65). Effectiveness was examined at 3 and 12 months. Implementation and prototyping was evaluated through interviews with referring professionals (n = 5), programme participant focus groups (n = 13), and researcher reflection.
Results: Uptake and 12-week adherence respectively, were higher for
M (84.7%, 45.8%) and MF (93.1%, 60.3%) versus F (75.4%, 24.6%). 12-week weight loss [median, (IQR)] was M -2.9 (-5.0 to -2.0) and MF -2.9
(-5.1 to -1.6) p < 0.001, compared to F 0.0 (-3.2 to 1.0) p = 0.379. BMI and waist circumference showed similar trends. 12-month follow-up data suggested persistence of weight loss for MF. 3-month change was positive for mental wellbeing, depression and anxiety in M and MF, remaining at 12 months (p < 0.05). Prototyping did not detrimentally impact on participants’ reported experiences. Refinements included broadening inclusion criteria, with implementation gaps apparent around referral process and practitioner knowledge.
Conclusions: Momenta was effective for weight loss, particularly with
fitness facility access. Prototyping aided implementation and we recommend this providing: a strong theoretical and empirical underpinning of the intervention, and co-production methods shape iterative refinement of implementation.