Prevention programme analysis report published

Recommendations to boost uptake onto the Healthier You: NHS Diabetes Prevention Programme (NDPP) have been unveiled by Public Health England.

A literature review and behavioural analysis entitled ‘Uptake and Retention in group-based weight-management services’ has been released in a bid to identify what drives people to initially take up programmes and then continue to engage and what  specific components of the programme recruitment works and what does not.

Staffordshire University was commissioned to review the published qualitative and quantitative literature on group-based weight management, and collate information on the main commercial programmes.

The NDPP is a national programme that aims to identify those at high risk of type 2 diabetes and refer them onto a behaviour change programme. It started in 2016 with a first wave covering 27 areas of England, with plans to roll-out country-wide by 2020.

The review suggested there was a wide range of programme uptake, from 1 to 99 per cent, which the authors said was “likely a consequence of differences in reporting”.

In over a third of programmes, uptake could not be determined due to insufficient information and varied recruitment methods were used, but, overall, there were no clear patterns linking recruitment methods with level of uptake.

Word of mouth was only used in programmes with high uptake, and the most common method of recruitment for programmes with low uptake was through TV or the media. Uptake for commercial programmes was generally high, especially when participants were given a choice, rather than being allocated a specific treatment.

Recommendations to improve uptake included:

•  More comprehensive reporting of recruitment methods to enable BCT classification.
• Recognising the value of word of mouth, and incorporate (where possible) into recruitment strategies.
• Allowing people choice over type of programme.

Retention across programmes was variable, ranging from 35 per cent to 96 per cent, the authors said.

Higher retention was associated with a higher number of behaviour change technique (BCTs) (average of 7.9 per high retention programme), indicating that a range of techniques is preferable.

The BCTs that were used in the largest proportion of high retention programmes (≥80%) were instructions on how to perform a behaviour (for example, specific aspects of exercise or dietary programmes), having advice/support from a credible source, self-monitoring of behaviour (typically diet and exercise) rather than the outcomes of the behaviour (ie weight), and goal setting for those behaviours.

High retention studies were also more likely to use feedback on behaviour, including biofeedback (for example, heart-rate or blood pressure monitoring), and problem- solving.

Studies with lower retention had less problem-solving and social support (unspecified and emotional). A number of other BCTs were evident in high retention studies only (for example, prompts/cues to elicit specific behaviour, reviewing behavioural goals).