eprintid: 10045505 rev_number: 42 eprint_status: archive userid: 608 dir: disk0/10/04/55/05 datestamp: 2018-03-20 16:02:11 lastmod: 2021-11-10 23:23:17 status_changed: 2019-01-25 11:49:14 type: article metadata_visibility: show creators_name: Melendez-Torres, GJ creators_name: Sutcliffe, K creators_name: Burchett, HED creators_name: Rees, R creators_name: Richardson, M creators_name: Thomas, J title: Weight management programmes: Re-analysis of a systematic review to identify pathways to effectiveness ispublished: pub divisions: UCL divisions: B16 divisions: B14 divisions: J81 keywords: components, evidence synthesis, qualitative comparative analysis, systematic review, weight management programme note: Copyright © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. abstract: BACKGROUND: Previous systematic reviews of weight management programmes (WMPs) have not been able to account for heterogeneity of effectiveness within programmes using top-down behavioural change taxonomies. This could be due to overlapping causal pathways to effectiveness (or lack of effectiveness) in these complex interventions. Qualitative comparative analysis (QCA) can help identify these overlapping pathways. METHODS: Using trials of adult WMPs with dietary and physical activity components identified from a previous systematic review, we selected the 10 most and 10 least effective interventions by amount of weight loss at 12 months compared to minimal treatment. Using intervention components suggested by synthesis of studies of programme user views, we labelled interventions as to the presence of these components and, using qualitative comparative analysis, developed pathways of component combinations that created the conditions sufficient for interventions to be most effective and least effective. RESULTS: Informed by the synthesis of views studies, we constructed 3 truth tables relating to quality of the user-provider relationship; perceived high need for guidance from providers; and quality of the relationship between peers in weight management programmes. We found effective interventions were characterized by opportunities to develop supportive relationships with providers or peers, directive provider-led goal setting and components perceived to foster self-regulation. CONCLUSIONS: Although QCA is an inductive method, this innovative approach has enabled the identification of potentially critical aspects of WMPs, such as the nature of relationships within them, which were previously not considered to be as important as more concrete content such as dietary focus. date: 2018-06 date_type: published official_url: http://dx.doi.org/10.1111/hex.12667 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green article_type_text: Journal Article verified: verified_manual elements_id: 1541111 doi: 10.1111/hex.12667 lyricists_name: Rees, Rebecca lyricists_name: Richardson, Michelle lyricists_name: Sutcliffe, Katy lyricists_name: Thomas, James lyricists_id: RWREE34 lyricists_id: MARIC56 lyricists_id: KSUTC11 lyricists_id: JTHOA32 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Health Expectations volume: 21 number: 3 pagerange: 574-584 event_location: England issn: 1369-7625 citation: Melendez-Torres, GJ; Sutcliffe, K; Burchett, HED; Rees, R; Richardson, M; Thomas, J; (2018) Weight management programmes: Re-analysis of a systematic review to identify pathways to effectiveness. Health Expectations , 21 (3) pp. 574-584. 10.1111/hex.12667 <https://doi.org/10.1111/hex.12667>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10045505/20/Rees%20VoR%20Melendez-Torres_et_al-2018-Health_Expectations.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10045505/8/Melendez-Torres_Weight_management_programmes_S1.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10045505/9/Melendez-Torres_Weight_management_programmes_S2.pdf